NBME 9 QUESTIONS AND ANSWERS
2026 VERIFIED
next step? –
biopsy
77 yr old woman with 1 day hx of nausea + vomiting + confusion + has HTN + on
diltiazem + BP 160/70 + ox 84% + JVD borderline high + crackles in lungs + S3 +
edema + signs of kidney injury
Dx and next step? –
fluid overload; hemodialysis
In diabetic patients, foot injuries can be prevented with? –
wearing shoes when standing or walking
In diabetic patients, worsening of foot injuries can be prevented with? –
daily foot checks
37 yr old woman with no hx of abnormal pap smears + current visit shows pap smear
with atypical glandular cells
potential dx and next step? –
endometrial malignancy; colposcopy with endocervical curettage
37 yr old woman with no hx of abnormal pap smears + current visit shows pap smear
with atypical glandular cells
After colposcopy with endocervical curettage, what can be considered as a next step? –
hysteroscopy
1
,T/F: Neonate that improved with PPV can be taken off of PPV immediately after –
true
If there is suspected FSGS, what is the next step? –
renal biopsy
If there is suspected FSGS, what is the next step after confirming it with renal biopsy? –
prednisone therapy
1st line tx for Merniere's disease –
antihistamines (e.g. Meclizine)
2nd line tx for refractory Merniere's disease –
methylprednisolone
T/F: Initial step to controlling allergic rhinitis can include use of pillow and mattress
covers –
true
COPD exacerbations can be treated with? –
supplemental oxygen, SABA, steroids, antibiotics, and nebulizers
COPD daily management should include? –
LABA, tiotropioum, steroids
T/F: Oral steroids are the main daily treatment for chronic COPD patients. –
false
T/F: LABA are the main daily treatment for chronic COPD patients. –
true
What chemical can cause osmotic diarrhea, bloating, and abdominal discomfort when
used in excessive quantities? –
sorbitol
T/F: Aspartame is commonly associated with diarrhea –
false
Most umbilical hernias regress by years of age –
3
Most umbilical hernias that are > cm in children >3 years of age are most likely to
continue enlarging. –
1.5
T/F: CT scan is better for nephrolithiasis than x-ray –
2
, true
Majority of renal calculi are radioopaque and can be visualized with
- CT
Struvite and cystine calculi are renal calculi –
radiolucent
US can be useful for detecting renal calculi –
radiolucent
24 yr old woman who has fever + diffuse tenderness on bimanual + tender uterus + 28
hours post vaginal delivery
Kid with bed wetting problems + constipation
tx? –
administration of an osmotic laxative
Multiple myeloma is marked by proliferation of B cells –
monoclonal
In patients with bipolar disorder that are suffering from acute depression + stopped
taking meds, what do you give them? –
bipolar medication like lithium, lamotrigine, quetiapine, and lurasidone
SSRIs in bipolar patients can be bad because? –
it can precipitate mania or convert depression to mania
Patient with afib with a history of TIA or stroke
Tx? –
warfarin
Patient without afib with history of TIA or stroke
Tx? –
aspirin
T/F: Aspirin and clopidogrel are anticoagulants –
false
1st line therapy for mild to moderate acne vulgaris
Tx? –
topical retinoids
Patient with juvenile idiopathic arthritis may present with what extraarticular
3
2026 VERIFIED
next step? –
biopsy
77 yr old woman with 1 day hx of nausea + vomiting + confusion + has HTN + on
diltiazem + BP 160/70 + ox 84% + JVD borderline high + crackles in lungs + S3 +
edema + signs of kidney injury
Dx and next step? –
fluid overload; hemodialysis
In diabetic patients, foot injuries can be prevented with? –
wearing shoes when standing or walking
In diabetic patients, worsening of foot injuries can be prevented with? –
daily foot checks
37 yr old woman with no hx of abnormal pap smears + current visit shows pap smear
with atypical glandular cells
potential dx and next step? –
endometrial malignancy; colposcopy with endocervical curettage
37 yr old woman with no hx of abnormal pap smears + current visit shows pap smear
with atypical glandular cells
After colposcopy with endocervical curettage, what can be considered as a next step? –
hysteroscopy
1
,T/F: Neonate that improved with PPV can be taken off of PPV immediately after –
true
If there is suspected FSGS, what is the next step? –
renal biopsy
If there is suspected FSGS, what is the next step after confirming it with renal biopsy? –
prednisone therapy
1st line tx for Merniere's disease –
antihistamines (e.g. Meclizine)
2nd line tx for refractory Merniere's disease –
methylprednisolone
T/F: Initial step to controlling allergic rhinitis can include use of pillow and mattress
covers –
true
COPD exacerbations can be treated with? –
supplemental oxygen, SABA, steroids, antibiotics, and nebulizers
COPD daily management should include? –
LABA, tiotropioum, steroids
T/F: Oral steroids are the main daily treatment for chronic COPD patients. –
false
T/F: LABA are the main daily treatment for chronic COPD patients. –
true
What chemical can cause osmotic diarrhea, bloating, and abdominal discomfort when
used in excessive quantities? –
sorbitol
T/F: Aspartame is commonly associated with diarrhea –
false
Most umbilical hernias regress by years of age –
3
Most umbilical hernias that are > cm in children >3 years of age are most likely to
continue enlarging. –
1.5
T/F: CT scan is better for nephrolithiasis than x-ray –
2
, true
Majority of renal calculi are radioopaque and can be visualized with
- CT
Struvite and cystine calculi are renal calculi –
radiolucent
US can be useful for detecting renal calculi –
radiolucent
24 yr old woman who has fever + diffuse tenderness on bimanual + tender uterus + 28
hours post vaginal delivery
Kid with bed wetting problems + constipation
tx? –
administration of an osmotic laxative
Multiple myeloma is marked by proliferation of B cells –
monoclonal
In patients with bipolar disorder that are suffering from acute depression + stopped
taking meds, what do you give them? –
bipolar medication like lithium, lamotrigine, quetiapine, and lurasidone
SSRIs in bipolar patients can be bad because? –
it can precipitate mania or convert depression to mania
Patient with afib with a history of TIA or stroke
Tx? –
warfarin
Patient without afib with history of TIA or stroke
Tx? –
aspirin
T/F: Aspirin and clopidogrel are anticoagulants –
false
1st line therapy for mild to moderate acne vulgaris
Tx? –
topical retinoids
Patient with juvenile idiopathic arthritis may present with what extraarticular
3
