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NBME CBSE EXAM NEWEST 2025 ACTUAL EXAM
TEST BANK| COMPLETE REAL EXAM QUE STIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+| NBME CBSE
EXAM PREP 2025 (BRAND NEW!!)
28yo M in ED 30 minutes after SOB. 3-year hx of cocaine abuse. T 38.1,
P 100/min, BP 150/45. PE: diminished pulses in left upper extremity.
Crackles heard over all lung fields. 2/6 diastolic murmur at left sternal border. CXr shows a widened aortic arch. Dx? - ANSWER - Dissecting aneurysm
1-week-old girl. screening showed a possible defect in fatty acid oxidation. PE normal. Next step? - ANSWER - Measurement of serum acylcarnitine concentrations
79yoM 30 minutes after LOC for 30 seconds. Alert, but dizzy. No urinary or fecal incontinence. Pulse 40/min, BP 92/56. PE shows no tongue biting. Lungs clear, Variable intensity S1. Oriented X3. ECG shows a third-degree atrioventricular block. Next step? - ANSWER - Insertion of transvenous pacemaker
55yo M with chronic bronchitis in ED after being unresponsive. Found bottles of albuterol, ampicillin, codeine, and theophylline bedside. T 37.2 C, p 112/min, respirations are 6/min, BP 95/60. Acute Rx should include? - ANSWER - naloxone
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pg. 2 50yo man has persistent cough for 2 months. He has had a 5 kg (11 lb) weight loss. He is a farmer and on itraconazole 4 weeks for
histoplasmosis from chicken coops. Medications: hydrochlorothiazide,
enalapril, atenolol, omeprazole, and metoclopramide for hypertension and gastroesophageal reflux. Thin. Physical exam otherwise normal.Itraconazole interacts with which drug and account for lack of effect of itraconazole? - ANSWER - omeprazole
20yo man with 6-hour difficulty breathing and vomiting. 10-year history of type 1 diabetes on insulin. Pulse 90, respirations 30 and deep, bp
90/60. Physical shows dehydration. Labs: Na+ 130, K+ 6.5, HCO3 5,
glucose 500, pH 7.2, pCO2 25 mm Hg. Which compound stimulated hormone-sensitive lipase in adipocytes causing accumulation of metabolites causing acidosis? - ANSWER - epinephrine
75yo man 2-year history of decreased force of urinary stream, urinate several times throughout night. BUN 55, Cr 5.0. Ultrasound shows bilateral hydronephrosis and dilated ureter. Mechanism of renal failure?
- ANSWER - Increased hydrostatic pressure in Bowman space
4yo boy two bacterial urinary tract infections past year. Physical exam normal. Radiologic studies show dilation of left ureter and renal pelvis,
minimal left-sided renal function. Left nephrectomy done. Photo: dilated
renal pelvis and ureter. Which is cause of renal disease? - ANSWER - congenital urethral obstruction
45yo man poorly controlled type 2 diabetes 1-month low-grade fever.Getting hemodialysis for end-stage renal disease. T 37 C (98.6 F), pulse 72, bp 144/92. Physical subclavian catheter below right clavicle. Lungs 2 / 4
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pg. 3 clear. Cardiac exam no murmurs. Blood cultures grow nonhemolytic, catalase-negative, gram-positive cocci in pairs and chains. Which organism? - ANSWER - Enterococcus faecalis
3yo boy sickle cell disease with fever and pain over left foot 3 weeks.Hematocrit stable. Leukocyte count 15,000 predominance of neutrophils. Which is most likely explanation for findings? - ANSWER - osteomyelitis
10yo girl well-child examination. No menstrual period. 50th percentile height and weight. Physical exam absence of breast bud development and no pubic or axillary hair. It is most appropriate to tell mother that first objective sign of puberty will be which? - ANSWER - Breast bud development
45yo woman follow-up exam after 8 weeks tamoxifen therapy for estrogen and progesterone positive invasive ductal carcinoma of breast.50yo sister also hormone-sensitive breast cancer. Physical exam normal.Serum decreased concentrations of endoxifen, active metabolite of prodrug tamoxifen. Genetic analysis shows homozygous cytochrome P450 2D6*4 alleles. Likelihood patient's sisters has same alleles? -
ANSWER - 25%
60yo man progressive shortness of breath past 3 months. Worked in shipyard. Respirations 25. Bilateral basilar crepitant crackles. Xray chest reticulonodular pulmonary infiltrates consistent with interstitial fibrosis.
Picture: sputum sample of elongate structures (ferruginous body).
Fibrosis initiated by interaction of structures with which cell? - ANSWER - Alveolar macrophages 3 / 4
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pg. 4 30yo woman 20 weeks gestation, uncomplicated pregnancy. Fundal height is greater than expected for gestational age. Ultrasound shows increased amniotic fluid. Which abnormality is cause? - ANSWER - Tracheoesophageal atresia
27yo woman 12-hour history of fever and abdominal pain. History of recurrent urinary tract infections. Temperature is 39 C (102.2 F).Physical exam tenderness of right flank. Abdominal xrays bilateral staghorn renal calculi. Urinalysis pH 8, many RBCs, WBC, bacteria.Calculi composed of? - ANSWER - struvite
48yo nulligravid woman with excessive uterine bleeding for 3 months.Bleeding during menses and at irregular intervals. Menses were regular
before. BMI 27. Pelvic exam: adnexae are nonpalpable. Endometrial
curettage shows abundant tissue. Which is cause of symptoms? - ANSWER - Endometrial hyperplasia
10yrs after total gastrectomy, 60yo man difficulty walking. Diffuse spasticity in arms and legs, impaired proprioception in his feet, increased muscle stretch reflexes in arms and knees, absence of muscle stretch reflexes in ankles, bilateral extensor plantar responses. Which vitamin is deficient? - ANSWER - B12 (cobalamin)
80yo man type 2 diabetes 2-month history severe constipation. Laxatives haven't relieved symptoms. Abdominal exam shows distention.Colonoscopy shows no abnormalities. Patient has dysfunction of which nerve? - ANSWER - Pelvic splanchnic
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