ANATOMY NBME ACTUAL PAPER 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◉ 82 year old man comes to the physician for evaluation of chest
pain. He lives with his daughters family. He has numerous welts and
abrasions and appears to be malnourished. He says his diet is fine.
Which of the following is the most appropriate next step in patient
care?
A. confront his family about the abuse
B. enroll the family in family counseling
C. notify social services of potential abuse
D. place him in a nursing home
E. refer him to a residential community. Answer: C. notify social
services of potential abuse
◉ 67 year old woman has the sudden onset of dyspnea and chest
pain and dies within minutes. Stage IV ovarian cancer was diagnosed
1 year ago, and she has been bedridden for 2 months. Which of the
following is most likely to be found on autopsy?
A. Acute myocardial infarction
B. Deep venous thrombosis
C. Dissecting aortic aneurysm
D. Renal papillary necrosis
,E. Rupttured berry aneurysm. Answer: B. Deep venous thrombosis
◉ 45 year old man has a 6-month history of burning pain that begins
in the epigastric area and ascends into the chest. Episodes occur
most frequently after large meals and at night. Endoscopic
examination shows moderately severe inflammation in the distal
3cm of the esophagus. Which of the following is the most likely
cause of this condition?
A. Diffuse spasm of the esophageal musculature
B. Failure of the lower sphincter to relax after a swallow
C. Helicobacter pylori infection
D. Hypersection of gastric acid
E. Inappropriate relaxation of the lower esophageal sphincter.
Answer: E. Inappropriate relaxation of the lower esophageal
sphincter
◉ 45- year old woman has an acute coronary occlusion. Within
seconds, the ischemic region shows mitochondrial swelling and
depletion of glycogen granules. Which of the following metabolic
events is most likely cause of these cellular changes?
A. Accumulation of free fatty acids
B. ATP depletion
C. Degradation of membrane phospholipid
D. Efflux of K+
,E. Influx of Na+. Answer: C. Degradation of membrane phospholipid
◉ 65-year old man dies of bronchopneumonia. He has a 6-year
history of progressive loss of facial expression, tremors, rigidity, and
slowing of voluntary movement. At autopsy, loss of pigmented cells
is noted in the substantial nigra. Which of the following additional
abnormalities is most likely to be present?
A. Eosinophilic inclusions in neurons of the substantial nigra
B. Loss of neurons in the caudate nuclei
C. Microglial nodules and multinucleated giant cells in the white
matter
D. Neurofibrillary tangles in the cortical neurons
E. Viral inclusions in the oligodendrocytes. Answer: A. Eosinophilic
inclusions in neurons of the substantial nigra
◉ 50 year old man has a 10-year history of poorly controlled
hypertension. Vital signs are:
Pulse 96/min
Respirations 16/min
Bp of left arm 226/120 mmHg
Bp of right arm 218/118mmHg
, With the patient in the left lateral decubitus position, a late diastolic
sound is heard best with the bell at the apex. Which of the following
is the most likely explanation for this auscultatory finding?
A. Aortic insufficiency
B. Aortic stenosis
C. Mitral insufficiency
D. Mitral stenosis
E. Opening snap
F. Pulmonic insufficiency
G. Pulmonic stenosis
H.S3
I.S4
J. Tricuspid insufficiency. Answer: I.S4
◉ in gout, hyperuricemia resulting from overproduction of urate is
most likely to result from a lack of feedback inhibition by ADP or
GDP at which enzyme?
A. Adenosine deaminase
B. Dihydrofolate reductase
C. Glucose 6-phosphate dehydrogenase
D. Nucleotide phosphorylase
E. Phosphoribosylprophosphate synthetase. Answer: E.
Phosphoribosylprophosphate synthetase
QUESTIONS WITH SOLUTIONS GRADED A+
◉ 82 year old man comes to the physician for evaluation of chest
pain. He lives with his daughters family. He has numerous welts and
abrasions and appears to be malnourished. He says his diet is fine.
Which of the following is the most appropriate next step in patient
care?
A. confront his family about the abuse
B. enroll the family in family counseling
C. notify social services of potential abuse
D. place him in a nursing home
E. refer him to a residential community. Answer: C. notify social
services of potential abuse
◉ 67 year old woman has the sudden onset of dyspnea and chest
pain and dies within minutes. Stage IV ovarian cancer was diagnosed
1 year ago, and she has been bedridden for 2 months. Which of the
following is most likely to be found on autopsy?
A. Acute myocardial infarction
B. Deep venous thrombosis
C. Dissecting aortic aneurysm
D. Renal papillary necrosis
,E. Rupttured berry aneurysm. Answer: B. Deep venous thrombosis
◉ 45 year old man has a 6-month history of burning pain that begins
in the epigastric area and ascends into the chest. Episodes occur
most frequently after large meals and at night. Endoscopic
examination shows moderately severe inflammation in the distal
3cm of the esophagus. Which of the following is the most likely
cause of this condition?
A. Diffuse spasm of the esophageal musculature
B. Failure of the lower sphincter to relax after a swallow
C. Helicobacter pylori infection
D. Hypersection of gastric acid
E. Inappropriate relaxation of the lower esophageal sphincter.
Answer: E. Inappropriate relaxation of the lower esophageal
sphincter
◉ 45- year old woman has an acute coronary occlusion. Within
seconds, the ischemic region shows mitochondrial swelling and
depletion of glycogen granules. Which of the following metabolic
events is most likely cause of these cellular changes?
A. Accumulation of free fatty acids
B. ATP depletion
C. Degradation of membrane phospholipid
D. Efflux of K+
,E. Influx of Na+. Answer: C. Degradation of membrane phospholipid
◉ 65-year old man dies of bronchopneumonia. He has a 6-year
history of progressive loss of facial expression, tremors, rigidity, and
slowing of voluntary movement. At autopsy, loss of pigmented cells
is noted in the substantial nigra. Which of the following additional
abnormalities is most likely to be present?
A. Eosinophilic inclusions in neurons of the substantial nigra
B. Loss of neurons in the caudate nuclei
C. Microglial nodules and multinucleated giant cells in the white
matter
D. Neurofibrillary tangles in the cortical neurons
E. Viral inclusions in the oligodendrocytes. Answer: A. Eosinophilic
inclusions in neurons of the substantial nigra
◉ 50 year old man has a 10-year history of poorly controlled
hypertension. Vital signs are:
Pulse 96/min
Respirations 16/min
Bp of left arm 226/120 mmHg
Bp of right arm 218/118mmHg
, With the patient in the left lateral decubitus position, a late diastolic
sound is heard best with the bell at the apex. Which of the following
is the most likely explanation for this auscultatory finding?
A. Aortic insufficiency
B. Aortic stenosis
C. Mitral insufficiency
D. Mitral stenosis
E. Opening snap
F. Pulmonic insufficiency
G. Pulmonic stenosis
H.S3
I.S4
J. Tricuspid insufficiency. Answer: I.S4
◉ in gout, hyperuricemia resulting from overproduction of urate is
most likely to result from a lack of feedback inhibition by ADP or
GDP at which enzyme?
A. Adenosine deaminase
B. Dihydrofolate reductase
C. Glucose 6-phosphate dehydrogenase
D. Nucleotide phosphorylase
E. Phosphoribosylprophosphate synthetase. Answer: E.
Phosphoribosylprophosphate synthetase
