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NBME 30
NBME 30 EXAM QUESTIONS & ANSWERS |
GRADE A|100% CORRECT (VERIFIED
SOLUTIONS) (2025/2026 UPDATE)
Chediak-Higashi syndrome - ANS ✓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 - ANS ✓fungal infection endemic to Southwest US & California
- respiratory illness, fever, fatigue, cough, arthralgia
Lambert-Eaton Myasthenic Syndrome (LEMS) - ANS ✓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
round ligament - ANS ✓binds uterus to labia majora
- commonly leads to pain during pregnancy
mesothelioma - ANS ✓pleural effusion & scalloped pleural density; thick, firm, white pleural
tumor
- interstitial fibrosis
- ASBESTOSIS: working in a shipyard, roofing & plumbing
biggest risk factor for complications w/ use of OCPs - ANS ✓tobacco smoking in patients
>35 years
- contraindications: history of DVT, PE, stroke, MI, HTN, migraine w/ aura, cirrhosis &
current breast cancer
NBME 30
, 2
NBME 30
Pores of Kohn - ANS ✓small openings in the alveolar walls that allow gases, fluid,
macrophages & BACTERIA to travel between the alveoli
Osgood-Schlatter disease - ANS ✓inflammation or irritation of the tibia at its point of
attachment with the PATELLAR TENDON
- common in YOUNG ATHLETES
- focal pain & tenderness w/ application of tension to tibial tubercle
increased risk of liver injury from acetaminophen + alcohol - ANS ✓alcohol leads to
induction of P450 enzymes that convert acetaminophen to NAPQI
- NAPQI can cause hepatotoxicity
childhood perception of death - ANS ✓- <3 years: no understanding of death
- age 3-5: death is temporary & reversible
- >5 years: all living things die (irreversible & inevitable)
Weber syndrome (lower midbrain stroke) - ANS ✓stroke of paramedic branches of PCA
- ipsilateral CN III palsy (diplopia, ptosis, primary gaze palsy, pupillary constriction defects)
- contralateral hemiparesis with UMN pattern dysfunction
gerstmann syndrome - ANS ✓stroke of angular gyrus
- agraphia, acalculia, finger agnosia & left sided disorientation
Horner syndrome - ANS ✓lesion of upper spinal cord interrupting sympathetic supply to
ipsilateral face
- ptosis, mitosis, anhidrosis
Waardenburg Syndrome - ANS ✓autosomal dominant disorder of abnormal neural crest
development → abnormal melanoblasts
- white forelock, PATCHY depigmentation iridic heterochromia & deafness
- eyes may be laterally displaced
failure of internalization of melanin granules by keratinocytes - ANS ✓NONPATCHY
albinism, no hearing loss (vs. Waardenburg)
NBME 30
, 3
NBME 30
maintenance of constant GFR in the setting of renal artery constriction - ANS ✓increased
EFFERENT arteriole resistance → activation of RAAS
rapid plasma reagent (RPR) false positive - ANS ✓SLE → antiphospholipid antibodies will
yield false (+)
RPR/VDRL are used to detect antibodies against syphilis
cold agglutinins - ANS ✓Mycoplasma pneumoniae, EBV
- marker of HEMOLYSIS
heterophiles antibodies - ANS ✓Infectious mononucleosis (EBV)
p24 antigen - ANS ✓HIV1/2
glucose-independent insulinotrophic peptide (GIP) - ANS ✓secreted by K cells in the
duodenum & jejunum
- decrease gastric acid production & stimulate insulin release from pancreas
- secreted in response to glucose/fatty acids to lower blood sugar
ureteral constriction - ANS ✓hydronephrosis
- vesicoureteral junction, crossing point over COMMON ILIAC ARTERY or ureteropelvic
junction
^ renal calculi tend to lodge at these 3 locations
most common artery to obstruct the ureter - ANS ✓COMMON ILIAC
21-hydroxylase deficiency - ANS ✓excessive androgens, low aldosterone & cortisol
- female: hypoaldosteronism & virilization during infancy (develops male characteristics)
- male: precocious puberty in childhood
5a-reductase deficiency - ANS ✓Inability to convert testosterone into DHT
- Male internal genitalia, ambiguous external genitalia until puberty
Androgen Insensitivity Syndrome (AIS) - ANS ✓- XY fetus → blind vagina
- internal testes/ambiguous genitalia, increased LH, testosterone & estrogen
NBME 30
NBME 30
NBME 30 EXAM QUESTIONS & ANSWERS |
GRADE A|100% CORRECT (VERIFIED
SOLUTIONS) (2025/2026 UPDATE)
Chediak-Higashi syndrome - ANS ✓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 - ANS ✓fungal infection endemic to Southwest US & California
- respiratory illness, fever, fatigue, cough, arthralgia
Lambert-Eaton Myasthenic Syndrome (LEMS) - ANS ✓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
round ligament - ANS ✓binds uterus to labia majora
- commonly leads to pain during pregnancy
mesothelioma - ANS ✓pleural effusion & scalloped pleural density; thick, firm, white pleural
tumor
- interstitial fibrosis
- ASBESTOSIS: working in a shipyard, roofing & plumbing
biggest risk factor for complications w/ use of OCPs - ANS ✓tobacco smoking in patients
>35 years
- contraindications: history of DVT, PE, stroke, MI, HTN, migraine w/ aura, cirrhosis &
current breast cancer
NBME 30
, 2
NBME 30
Pores of Kohn - ANS ✓small openings in the alveolar walls that allow gases, fluid,
macrophages & BACTERIA to travel between the alveoli
Osgood-Schlatter disease - ANS ✓inflammation or irritation of the tibia at its point of
attachment with the PATELLAR TENDON
- common in YOUNG ATHLETES
- focal pain & tenderness w/ application of tension to tibial tubercle
increased risk of liver injury from acetaminophen + alcohol - ANS ✓alcohol leads to
induction of P450 enzymes that convert acetaminophen to NAPQI
- NAPQI can cause hepatotoxicity
childhood perception of death - ANS ✓- <3 years: no understanding of death
- age 3-5: death is temporary & reversible
- >5 years: all living things die (irreversible & inevitable)
Weber syndrome (lower midbrain stroke) - ANS ✓stroke of paramedic branches of PCA
- ipsilateral CN III palsy (diplopia, ptosis, primary gaze palsy, pupillary constriction defects)
- contralateral hemiparesis with UMN pattern dysfunction
gerstmann syndrome - ANS ✓stroke of angular gyrus
- agraphia, acalculia, finger agnosia & left sided disorientation
Horner syndrome - ANS ✓lesion of upper spinal cord interrupting sympathetic supply to
ipsilateral face
- ptosis, mitosis, anhidrosis
Waardenburg Syndrome - ANS ✓autosomal dominant disorder of abnormal neural crest
development → abnormal melanoblasts
- white forelock, PATCHY depigmentation iridic heterochromia & deafness
- eyes may be laterally displaced
failure of internalization of melanin granules by keratinocytes - ANS ✓NONPATCHY
albinism, no hearing loss (vs. Waardenburg)
NBME 30
, 3
NBME 30
maintenance of constant GFR in the setting of renal artery constriction - ANS ✓increased
EFFERENT arteriole resistance → activation of RAAS
rapid plasma reagent (RPR) false positive - ANS ✓SLE → antiphospholipid antibodies will
yield false (+)
RPR/VDRL are used to detect antibodies against syphilis
cold agglutinins - ANS ✓Mycoplasma pneumoniae, EBV
- marker of HEMOLYSIS
heterophiles antibodies - ANS ✓Infectious mononucleosis (EBV)
p24 antigen - ANS ✓HIV1/2
glucose-independent insulinotrophic peptide (GIP) - ANS ✓secreted by K cells in the
duodenum & jejunum
- decrease gastric acid production & stimulate insulin release from pancreas
- secreted in response to glucose/fatty acids to lower blood sugar
ureteral constriction - ANS ✓hydronephrosis
- vesicoureteral junction, crossing point over COMMON ILIAC ARTERY or ureteropelvic
junction
^ renal calculi tend to lodge at these 3 locations
most common artery to obstruct the ureter - ANS ✓COMMON ILIAC
21-hydroxylase deficiency - ANS ✓excessive androgens, low aldosterone & cortisol
- female: hypoaldosteronism & virilization during infancy (develops male characteristics)
- male: precocious puberty in childhood
5a-reductase deficiency - ANS ✓Inability to convert testosterone into DHT
- Male internal genitalia, ambiguous external genitalia until puberty
Androgen Insensitivity Syndrome (AIS) - ANS ✓- XY fetus → blind vagina
- internal testes/ambiguous genitalia, increased LH, testosterone & estrogen
NBME 30
