NBME CBSE LATEST 2026 COMPREHENSIVE EXAMS
QUESTIONS AND SOLUTIONS GUARANTEE A+
✔✔H pylori duodenal PUD tx - ✔✔*(use 2): *Amoxicillin / clarithromycin /
metronidazole / tetracycline
+
*PPI* (omeprazole)
✔✔MOA of Bismuth, Sucralfate, Misoprostol - ✔✔Bind ulcer base
*PGE-i*
tx: traveler's diarrhea
✔✔"-tidine" - ✔✔H2 antagonist
decrease H from parietal
✔✔H2 antagonist - ✔✔"-tidine"
decrease H from parietal
✔✔Cimetidine AE - ✔✔p450 inhibitor
increase *AST/ALT/Creatinine*
gynecomastia
(H2 antagonist = "tidine")
✔✔"prazole" - ✔✔PPI
inhibit *H/K ATPase* in parietal cell
✔✔PPI - ✔✔*"prazole"*
inhibit H/K ATPase in parietal cell
✔✔PPI AE - ✔✔C dif
Nephritis
decrease: Mg, Ca, B12, Fe, Vit C
✔✔Metoclopramide - ✔✔*D2-R agonist *
*inhibit ACh*
MOTILITY
tx: GERD, Gastroparesis
✔✔Loperamide - ✔✔Mu agonist
without CNS penetration
*SLOW motility*
✔✔Enteric bacteria produce what vitamins - ✔✔Vit K and Folate
,✔✔Watershed areas in GI - ✔✔Rectosigmoid + Splenic flexure
✔✔Fat malabsorption stain with - ✔✔Sudan III
✔✔What is absorbed at brush border - ✔✔D-xylose and lactose
✔✔Duodenal atresia is associated with - ✔✔Down Syndrome
✔✔Duodenal atresia - ✔✔failure of recanalization
Double bubble
(tri21)
✔✔Jejunum/Ileum atresia - ✔✔Vascular occlusion
Apple peel
✔✔Jejunum/Ileum atresia example - ✔✔Gastrocschesis
✔✔Colonic Atresia example - ✔✔Hirschsprung
✔✔Colonic Atresia - ✔✔submucosal of RECTUM
= *Meissner plexus* absent
✔✔Abetalipoproteinemia - ✔✔foamy cytoplasm at villi tips
NO *APO-B*
- No VLDL or Chylomicron
✔✔Mesenteric Ischemia - ✔✔*SMA* (A fib embolus)
--> Extreme pain
= Food aversion
✔✔Lactose intolerance - ✔✔low stool pH
high Breath H
high Stool osmolality
✔✔Celiac - genes - ✔✔Gliadin *HS IV *
HLA-DQ2/8
*Anti-tTG (IgA)*
Antiendomysial
✔✔Celiac malabsorption complication - ✔✔Malabsorption of *vit D* in duodenum
decreased Ca/PO4
*high PTH*
--> Osteomalacia/rickets
,✔✔Celiac association - ✔✔Dermatitis Herpetiformis
✔✔Dermatitis herpetiformis - ✔✔*IgA* in dermal papilla
(Celiac)
✔✔Crohns - ✔✔ASCA
Fistula; Transmural thickening
Non-caseating granuloma
Bile acid malabsorption (*TERMINAL ILEUM)
✔✔Crohns complications - ✔✔Ileum resection causes
B12 deficiecny
✔✔Crohn tx - ✔✔*Corticosteroids*
*Sulfasalazine* (*act by bacteria)
✔✔Ulcerative Colitis - ✔✔pANCA
pseudopolyps
*crypt abscess*
friable ulcers
CONTINUOUS FROM RECTUM
✔✔Ulcerative Colitis tx - ✔✔Mesalamine (NSAID)
+ resection
✔✔Colon Cancer most commonly where - ✔✔Rectosigmoid >>> Ascending >
Descending
✔✔Familial adenomatous polyposis - ✔✔*2 hit chromo instability*
APC (adenoma)
KRAS (size)
p53 (carcinoma
✔✔KRAS - ✔✔oncogene
*resistant to anti-EGFR*
--> constitutive active *RAS*
(which normally requires GTP)
✔✔RAS normally requires what to be activated - ✔✔GTP
✔✔Colitis becomes carcinoma how - ✔✔multifocal poorly differentiated
tumors
, early p53/late APC
✔✔HNPCC/Lynch - ✔✔*microsatellite instability*
MSH2/MLH1 = mismatch repair
HEREDITARY
colorectal, endometrial, ovarian
✔✔LN drainage proximal to dentate - ✔✔(UPPER RECTUM)
Inferior Mesenteric
Internal Iliac
✔✔LN drainage Distal to dentate - ✔✔(ANUS)
Inguinal
✔✔Hemorrhoids - internal - ✔✔above dentate
PAINLESS
*superior rectal*
--> inferior mesenteric v --> *PORTAL*
✔✔Hemorrhoid - External - ✔✔below dentate
PAINFUL
Inferior rectal --> *internal pudendal*
= IVC
✔✔Indirect hernia is common in - ✔✔child
✔✔Indirect hernia is a - ✔✔fluctuant hydrocele due to patent processus vaginalis
✔✔Indirect hernia is located - ✔✔through inguinal ring into scrotum
*LATERAL to epigastrics*
✔✔Direct hernia is due to - ✔✔weakened transversalis fascia
✔✔Direct hernia is located - ✔✔Hesselbach triangle
*MEDIAL* to epigastrics
✔✔Femoral hernia is common in - ✔✔female
✔✔What becomes the main pancreatic duct - ✔✔Ventral pancreatic bud
✔✔Annular pancreas is caused from - ✔✔abnormal ventral pancreatic bud MIGRATION
Encircles duodenum
QUESTIONS AND SOLUTIONS GUARANTEE A+
✔✔H pylori duodenal PUD tx - ✔✔*(use 2): *Amoxicillin / clarithromycin /
metronidazole / tetracycline
+
*PPI* (omeprazole)
✔✔MOA of Bismuth, Sucralfate, Misoprostol - ✔✔Bind ulcer base
*PGE-i*
tx: traveler's diarrhea
✔✔"-tidine" - ✔✔H2 antagonist
decrease H from parietal
✔✔H2 antagonist - ✔✔"-tidine"
decrease H from parietal
✔✔Cimetidine AE - ✔✔p450 inhibitor
increase *AST/ALT/Creatinine*
gynecomastia
(H2 antagonist = "tidine")
✔✔"prazole" - ✔✔PPI
inhibit *H/K ATPase* in parietal cell
✔✔PPI - ✔✔*"prazole"*
inhibit H/K ATPase in parietal cell
✔✔PPI AE - ✔✔C dif
Nephritis
decrease: Mg, Ca, B12, Fe, Vit C
✔✔Metoclopramide - ✔✔*D2-R agonist *
*inhibit ACh*
MOTILITY
tx: GERD, Gastroparesis
✔✔Loperamide - ✔✔Mu agonist
without CNS penetration
*SLOW motility*
✔✔Enteric bacteria produce what vitamins - ✔✔Vit K and Folate
,✔✔Watershed areas in GI - ✔✔Rectosigmoid + Splenic flexure
✔✔Fat malabsorption stain with - ✔✔Sudan III
✔✔What is absorbed at brush border - ✔✔D-xylose and lactose
✔✔Duodenal atresia is associated with - ✔✔Down Syndrome
✔✔Duodenal atresia - ✔✔failure of recanalization
Double bubble
(tri21)
✔✔Jejunum/Ileum atresia - ✔✔Vascular occlusion
Apple peel
✔✔Jejunum/Ileum atresia example - ✔✔Gastrocschesis
✔✔Colonic Atresia example - ✔✔Hirschsprung
✔✔Colonic Atresia - ✔✔submucosal of RECTUM
= *Meissner plexus* absent
✔✔Abetalipoproteinemia - ✔✔foamy cytoplasm at villi tips
NO *APO-B*
- No VLDL or Chylomicron
✔✔Mesenteric Ischemia - ✔✔*SMA* (A fib embolus)
--> Extreme pain
= Food aversion
✔✔Lactose intolerance - ✔✔low stool pH
high Breath H
high Stool osmolality
✔✔Celiac - genes - ✔✔Gliadin *HS IV *
HLA-DQ2/8
*Anti-tTG (IgA)*
Antiendomysial
✔✔Celiac malabsorption complication - ✔✔Malabsorption of *vit D* in duodenum
decreased Ca/PO4
*high PTH*
--> Osteomalacia/rickets
,✔✔Celiac association - ✔✔Dermatitis Herpetiformis
✔✔Dermatitis herpetiformis - ✔✔*IgA* in dermal papilla
(Celiac)
✔✔Crohns - ✔✔ASCA
Fistula; Transmural thickening
Non-caseating granuloma
Bile acid malabsorption (*TERMINAL ILEUM)
✔✔Crohns complications - ✔✔Ileum resection causes
B12 deficiecny
✔✔Crohn tx - ✔✔*Corticosteroids*
*Sulfasalazine* (*act by bacteria)
✔✔Ulcerative Colitis - ✔✔pANCA
pseudopolyps
*crypt abscess*
friable ulcers
CONTINUOUS FROM RECTUM
✔✔Ulcerative Colitis tx - ✔✔Mesalamine (NSAID)
+ resection
✔✔Colon Cancer most commonly where - ✔✔Rectosigmoid >>> Ascending >
Descending
✔✔Familial adenomatous polyposis - ✔✔*2 hit chromo instability*
APC (adenoma)
KRAS (size)
p53 (carcinoma
✔✔KRAS - ✔✔oncogene
*resistant to anti-EGFR*
--> constitutive active *RAS*
(which normally requires GTP)
✔✔RAS normally requires what to be activated - ✔✔GTP
✔✔Colitis becomes carcinoma how - ✔✔multifocal poorly differentiated
tumors
, early p53/late APC
✔✔HNPCC/Lynch - ✔✔*microsatellite instability*
MSH2/MLH1 = mismatch repair
HEREDITARY
colorectal, endometrial, ovarian
✔✔LN drainage proximal to dentate - ✔✔(UPPER RECTUM)
Inferior Mesenteric
Internal Iliac
✔✔LN drainage Distal to dentate - ✔✔(ANUS)
Inguinal
✔✔Hemorrhoids - internal - ✔✔above dentate
PAINLESS
*superior rectal*
--> inferior mesenteric v --> *PORTAL*
✔✔Hemorrhoid - External - ✔✔below dentate
PAINFUL
Inferior rectal --> *internal pudendal*
= IVC
✔✔Indirect hernia is common in - ✔✔child
✔✔Indirect hernia is a - ✔✔fluctuant hydrocele due to patent processus vaginalis
✔✔Indirect hernia is located - ✔✔through inguinal ring into scrotum
*LATERAL to epigastrics*
✔✔Direct hernia is due to - ✔✔weakened transversalis fascia
✔✔Direct hernia is located - ✔✔Hesselbach triangle
*MEDIAL* to epigastrics
✔✔Femoral hernia is common in - ✔✔female
✔✔What becomes the main pancreatic duct - ✔✔Ventral pancreatic bud
✔✔Annular pancreas is caused from - ✔✔abnormal ventral pancreatic bud MIGRATION
Encircles duodenum
