NBME 30 questions and answers 2026\2027
A+ Grade
difference b/w Kwashiorkor & Marasmus
- correct answer - kwashiorkor (edematous malnutrition): marasmus PLUS EDEMA
- marasmus (WASTING SYNDROME): skin lesions, fatty liver, acute protein-energy malnutrition with
decreased arm circumference, weight per length or BMI
deformation
- correct answer disruption in organ morphogenesis occurring AFTER embryonic period; extrinsic force
limits normal organ development
vascular changes in chronic HTN
- correct answer - hyaline arteriolosclerosis: protein deposition in vessel walls
- hyperplastic arteriosclerosis (arteriolitis): concentric thickening of vessel wall w/ laminar appearance
caused by proliferation of smooth muscle cells
- commonly affects renal arterioles
Nodular glomerulosclerosis
- correct answer assoc w/ diabetic nephropathy & amyloidosis
supraoptic nucleus
- correct answer responsible for ADH secretion from pituitary & urine concentration
anterior hypothalamic nucleus
- correct answer thermoregulation (cooling)
,arcuate hypothalamic nucleus
- correct answer appetite stimulation
dorsomedial hypothalamic nucleus
- correct answer regulation of feeding & circadian rhythm
lateral hypothalamic nucleus
- correct answer promotes appetite (GHRELIN)
posterior hypothalamic nucleus
- correct answer thermoregulating (heating)
ventromedial hypothalamic nucleus
- correct answer satiety (LEPTIN)
osteopetrosis
- correct answer excessive mineralization of bone & failure of osteoclastic resorption
- mutation in macrophage colony stimulating factor
achondroplasia
- correct answer human dwarfism
- AD mutation in fibroblast growth factor receptor 3 (FGFR3) gene
porphyria cutanea tarda
- correct answer severe cutaneous photosensitivity with blistering & hyperpigmentation after exposure
to sunlight
- decreased activity of uroporphyringoen decarboxylase enzyme in the production of HEME
,CD8+ T lymphocytes
- correct answer responsible for CLEARING a virus
- class I MHC receptors present a virus to CD8+ T cell on an APC
- CD8+ T cell has a specific TCR for the virus; responds by secreting inflammatory mediators (to attract
other cells) perforin/granzyme or interacting with Fas/FasL to trigger apoptosis
Class II MHC
- correct answer are on the surface of antigen-presenting cells (APCs), including B cells
- trigger CD4+ T cells, which recruit CD8+ cytotoxic T cells
PKU
- correct answer deficiency of phenylalanine hydroxylase
- supplementation of TYROSINE is required for synthesis of catecholamines (norepinephrine,
epinephrine & dopamine)
leuprolide
- correct answer GnRH agonist used for the treatment of prostate cancer
- decreased LH & testosterone release
production of progesterone during pregnancy
- correct answer - first 7-10 weeks: CORPUS LUTEUM (stimulating by hCG from placenta)
>10 weeks: placenta
Chronic granulomatous disease
- correct answer X-linked mutation affecting NADPH oxidase causing dysfunctioning neutrophils and
oxidative burst
, - recurrent infections with catalase (+) organisms: S. aureus, Aspergillus & Nocardia
MPO deficiency
- correct answer Recurrent candida infections
Wiskott-Aldrich syndrome
- correct answer mutation in WAS gene; abnormal cytoskeleton of B & T cells
- Eczema, recurrent respiratory infections, thrombocytopenia
Chediak-Higashi syndrome
- correct answer Mutation in LYST (lysosomal trafficking gene regulator) which causes accumulation of
large cytoplasmic granules that cannot fuse with lysosomes
- increase of bacterial, viral, and fungal infections
- Albinism, photophobia, silver hair
Coccidioidomycosis
- correct answer fungal infection endemic to Southwest US & California
- respiratory illness, fever, fatigue, cough, arthralgia
Lambert-Eaton Myasthenic Syndrome (LEMS)
- correct answer Auto-Immune; antibodies formed against voltage gated Ca2+ channels at NMJ;
IMPAIRED PRESYNAPTIC ACH RELEASE
- Sx: skeletal muscle weakness in limbs (improves w/ activity)
- paraneoplastic syndrome assoc w/ small cell lung carcinoma
A+ Grade
difference b/w Kwashiorkor & Marasmus
- correct answer - kwashiorkor (edematous malnutrition): marasmus PLUS EDEMA
- marasmus (WASTING SYNDROME): skin lesions, fatty liver, acute protein-energy malnutrition with
decreased arm circumference, weight per length or BMI
deformation
- correct answer disruption in organ morphogenesis occurring AFTER embryonic period; extrinsic force
limits normal organ development
vascular changes in chronic HTN
- correct answer - hyaline arteriolosclerosis: protein deposition in vessel walls
- hyperplastic arteriosclerosis (arteriolitis): concentric thickening of vessel wall w/ laminar appearance
caused by proliferation of smooth muscle cells
- commonly affects renal arterioles
Nodular glomerulosclerosis
- correct answer assoc w/ diabetic nephropathy & amyloidosis
supraoptic nucleus
- correct answer responsible for ADH secretion from pituitary & urine concentration
anterior hypothalamic nucleus
- correct answer thermoregulation (cooling)
,arcuate hypothalamic nucleus
- correct answer appetite stimulation
dorsomedial hypothalamic nucleus
- correct answer regulation of feeding & circadian rhythm
lateral hypothalamic nucleus
- correct answer promotes appetite (GHRELIN)
posterior hypothalamic nucleus
- correct answer thermoregulating (heating)
ventromedial hypothalamic nucleus
- correct answer satiety (LEPTIN)
osteopetrosis
- correct answer excessive mineralization of bone & failure of osteoclastic resorption
- mutation in macrophage colony stimulating factor
achondroplasia
- correct answer human dwarfism
- AD mutation in fibroblast growth factor receptor 3 (FGFR3) gene
porphyria cutanea tarda
- correct answer severe cutaneous photosensitivity with blistering & hyperpigmentation after exposure
to sunlight
- decreased activity of uroporphyringoen decarboxylase enzyme in the production of HEME
,CD8+ T lymphocytes
- correct answer responsible for CLEARING a virus
- class I MHC receptors present a virus to CD8+ T cell on an APC
- CD8+ T cell has a specific TCR for the virus; responds by secreting inflammatory mediators (to attract
other cells) perforin/granzyme or interacting with Fas/FasL to trigger apoptosis
Class II MHC
- correct answer are on the surface of antigen-presenting cells (APCs), including B cells
- trigger CD4+ T cells, which recruit CD8+ cytotoxic T cells
PKU
- correct answer deficiency of phenylalanine hydroxylase
- supplementation of TYROSINE is required for synthesis of catecholamines (norepinephrine,
epinephrine & dopamine)
leuprolide
- correct answer GnRH agonist used for the treatment of prostate cancer
- decreased LH & testosterone release
production of progesterone during pregnancy
- correct answer - first 7-10 weeks: CORPUS LUTEUM (stimulating by hCG from placenta)
>10 weeks: placenta
Chronic granulomatous disease
- correct answer X-linked mutation affecting NADPH oxidase causing dysfunctioning neutrophils and
oxidative burst
, - recurrent infections with catalase (+) organisms: S. aureus, Aspergillus & Nocardia
MPO deficiency
- correct answer Recurrent candida infections
Wiskott-Aldrich syndrome
- correct answer mutation in WAS gene; abnormal cytoskeleton of B & T cells
- Eczema, recurrent respiratory infections, thrombocytopenia
Chediak-Higashi syndrome
- correct answer Mutation in LYST (lysosomal trafficking gene regulator) which causes accumulation of
large cytoplasmic granules that cannot fuse with lysosomes
- increase of bacterial, viral, and fungal infections
- Albinism, photophobia, silver hair
Coccidioidomycosis
- correct answer fungal infection endemic to Southwest US & California
- respiratory illness, fever, fatigue, cough, arthralgia
Lambert-Eaton Myasthenic Syndrome (LEMS)
- correct answer Auto-Immune; antibodies formed against voltage gated Ca2+ channels at NMJ;
IMPAIRED PRESYNAPTIC ACH RELEASE
- Sx: skeletal muscle weakness in limbs (improves w/ activity)
- paraneoplastic syndrome assoc w/ small cell lung carcinoma
