NBME CBSE REAL EXAM QUESTIONS AND VERIFIED
ANSWERS LATEST 2025/2026 COMPLETE EXAM
1)MEDICAL EXAMINATION
70yo M dies in a motor vehicle collision. Was undergoing
evaluation for occult blood in the stool. Photo of transverse
colon shown. Dx?..ANSWER.. Tubular adenoma or villous polyp.
GI blood loss suggests a risk for malignancy
38yo M truck driver with 1-week hx of watery, itchy eyes and a
runny nose. Physical shows inflamed nasal mucosa. No
congestion in lower lung. Pharmacotherapy?..ANSWER..
Loratadine--> less sedating antihistamine
16yo girl with 3-day hx of fever, nonproductive cough, and
fatigue. T 38.3, P 88/min, BP 102-70. PE shows pale
conjunctivae. CXR shows bilateral interstitial infiltrates. Blood
spontaenously agglutinates while awaiting transport to the
laboratory. Antibody isotypes causing agglutination?..ANSWER..
IgM (mono and mycoplasma)
24yo M with small tender blisters on his penis 3 days after
unprotected sex. Photograph shown. Causal agent?..ANSWER..
HSV-2
1|Page
,42yo F with 3-year hx of an intermittent facial rash, including
the forehead, eyelids, nose, and cheeks. Rash seems to be
getting worse since she moved from New York to Florida last
year. Spicy foods precipitate a flushing reaction that seems to
exacerbate the rash. PE shows erythema over the nose and
cheeks, with scattered telangiectasias and a few papules.
Dx?..ANSWER.. Rosacea
53yo M returned from Africa, has fever, headache, and
abdominal discomfort. Received appropriate vaccinations prior
to the trip. T 39.4C. A wright-stained peripheral smear shown
(ring forms in RBCs). Dx?..ANSWER.. Malaria
68yo F with T2DM and hypertension that has been poorly
controlled despite hydrochlorothiazide treatment. BP 150/96,
Labs show serum glucose concentration of 130 and proteinuria.
In addition to current Rx, which is most appropriate
pharmacotherapy?..ANSWER.. ACE I (Lisinopril)
66yo M with stage IV colon cancer with 3-day hx of severe
diarrhea after receiving chemotherapy with flourouracil,
leucovorin, and irinotecan. Prescribed opioid antidiarrheal
agent with no CNS effects. Which med?..ANSWER.. Loperamide
2|Page
,35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had
profuse, watery diarrhea for 8 hours despite a lack of oral
intake. Recently returned from a medical relief trip to a remove
village in Honduras. T 36.7 C, P 122/min, BP 90/50. PE shows
dry skin and decreased capillary refill. Stool for occult blood is
negative; stool is gray and turbid. Gram stain shows gram-
negative, comma-shaped bacteria; no erythrocytes of
leukocytes. MOA of toxin?..ANSWER.. V. Cholerae--> activates
AC
59yo F with gradual onset of lack of muscle control in her left
arm and leg. Sx 1 mo ago after dx with metastatic breast
cancer. PE shows ataxia of left upper and lower extremities.
Muscle strength, DTR, sensation, proprioception normal.
Metastatic tumor in which location?..ANSWER.. Cerebellum
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE
shows petechial rash, microcephaly, and hepatosplenomegaly.
Serologic test for CMV: IgG + in mother, + in newborn; IGM - in
mother, + in newborn. Explanation?..ANSWER.. Congenital CMV
infection
Female newborn is delivered at 38 weeks' gestation. Apgar 8
and 8 at 1/5 min. PE shows a bulging, fluod0filled mass
approximately 5 cm in diameter in the midline over the
3|Page
, lumbosacral region. No spontaneous movements of the lower
extremities. Abnormality most likely occurred because of
abnormal development during which periods of postconception
(in days)?..ANSWER.. 15-40; neutral tube closes at about 4
weeks
64yo M in ED 3 hours after SOB with exertion and extreme
fatigue. Has ischemic heart disease. P 125/min, BP 105/60. ECG
shows atrial fibrillation. Intravenous ibutilide is administered.
Ten minutes later, ECG shows normal sinus rhythm. Risk for
which drug effect in the next 6 hours?..ANSWER.. Torsades de
pointes
65yo F with 20-year hx of osteoarthritis of the hands now has
pain radiating down the distal anterior thigh, knee, medial leg,
and food. Bony outgrowth of vertebrae compressing one of the
spinal nerves is suspected. Nerve root in which intervertebral
foramina is effected?..ANSWER.. L3 to L4
38yo M with 3-year hx of T2DM. Taking an oral
antihyperglycemic agent, he has tried diet and exercise. BMI 32.
PE normal. Hb A1c is 10%. Physician recommends initiation of
insulin injections. Responds, "I know that insulin would help
control my blood sugar. But a lot of people in my family have
4|Page
ANSWERS LATEST 2025/2026 COMPLETE EXAM
1)MEDICAL EXAMINATION
70yo M dies in a motor vehicle collision. Was undergoing
evaluation for occult blood in the stool. Photo of transverse
colon shown. Dx?..ANSWER.. Tubular adenoma or villous polyp.
GI blood loss suggests a risk for malignancy
38yo M truck driver with 1-week hx of watery, itchy eyes and a
runny nose. Physical shows inflamed nasal mucosa. No
congestion in lower lung. Pharmacotherapy?..ANSWER..
Loratadine--> less sedating antihistamine
16yo girl with 3-day hx of fever, nonproductive cough, and
fatigue. T 38.3, P 88/min, BP 102-70. PE shows pale
conjunctivae. CXR shows bilateral interstitial infiltrates. Blood
spontaenously agglutinates while awaiting transport to the
laboratory. Antibody isotypes causing agglutination?..ANSWER..
IgM (mono and mycoplasma)
24yo M with small tender blisters on his penis 3 days after
unprotected sex. Photograph shown. Causal agent?..ANSWER..
HSV-2
1|Page
,42yo F with 3-year hx of an intermittent facial rash, including
the forehead, eyelids, nose, and cheeks. Rash seems to be
getting worse since she moved from New York to Florida last
year. Spicy foods precipitate a flushing reaction that seems to
exacerbate the rash. PE shows erythema over the nose and
cheeks, with scattered telangiectasias and a few papules.
Dx?..ANSWER.. Rosacea
53yo M returned from Africa, has fever, headache, and
abdominal discomfort. Received appropriate vaccinations prior
to the trip. T 39.4C. A wright-stained peripheral smear shown
(ring forms in RBCs). Dx?..ANSWER.. Malaria
68yo F with T2DM and hypertension that has been poorly
controlled despite hydrochlorothiazide treatment. BP 150/96,
Labs show serum glucose concentration of 130 and proteinuria.
In addition to current Rx, which is most appropriate
pharmacotherapy?..ANSWER.. ACE I (Lisinopril)
66yo M with stage IV colon cancer with 3-day hx of severe
diarrhea after receiving chemotherapy with flourouracil,
leucovorin, and irinotecan. Prescribed opioid antidiarrheal
agent with no CNS effects. Which med?..ANSWER.. Loperamide
2|Page
,35yo M in ED with 2-hour hx of sever fatigue and dizziness. Had
profuse, watery diarrhea for 8 hours despite a lack of oral
intake. Recently returned from a medical relief trip to a remove
village in Honduras. T 36.7 C, P 122/min, BP 90/50. PE shows
dry skin and decreased capillary refill. Stool for occult blood is
negative; stool is gray and turbid. Gram stain shows gram-
negative, comma-shaped bacteria; no erythrocytes of
leukocytes. MOA of toxin?..ANSWER.. V. Cholerae--> activates
AC
59yo F with gradual onset of lack of muscle control in her left
arm and leg. Sx 1 mo ago after dx with metastatic breast
cancer. PE shows ataxia of left upper and lower extremities.
Muscle strength, DTR, sensation, proprioception normal.
Metastatic tumor in which location?..ANSWER.. Cerebellum
Newborn delivered at 38 weeks' gestation weighs 1800 g. PE
shows petechial rash, microcephaly, and hepatosplenomegaly.
Serologic test for CMV: IgG + in mother, + in newborn; IGM - in
mother, + in newborn. Explanation?..ANSWER.. Congenital CMV
infection
Female newborn is delivered at 38 weeks' gestation. Apgar 8
and 8 at 1/5 min. PE shows a bulging, fluod0filled mass
approximately 5 cm in diameter in the midline over the
3|Page
, lumbosacral region. No spontaneous movements of the lower
extremities. Abnormality most likely occurred because of
abnormal development during which periods of postconception
(in days)?..ANSWER.. 15-40; neutral tube closes at about 4
weeks
64yo M in ED 3 hours after SOB with exertion and extreme
fatigue. Has ischemic heart disease. P 125/min, BP 105/60. ECG
shows atrial fibrillation. Intravenous ibutilide is administered.
Ten minutes later, ECG shows normal sinus rhythm. Risk for
which drug effect in the next 6 hours?..ANSWER.. Torsades de
pointes
65yo F with 20-year hx of osteoarthritis of the hands now has
pain radiating down the distal anterior thigh, knee, medial leg,
and food. Bony outgrowth of vertebrae compressing one of the
spinal nerves is suspected. Nerve root in which intervertebral
foramina is effected?..ANSWER.. L3 to L4
38yo M with 3-year hx of T2DM. Taking an oral
antihyperglycemic agent, he has tried diet and exercise. BMI 32.
PE normal. Hb A1c is 10%. Physician recommends initiation of
insulin injections. Responds, "I know that insulin would help
control my blood sugar. But a lot of people in my family have
4|Page
