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2025 NBME Final Exam And Practice Exam with 1000 accurate questions and verified answers covering clinical knowledge, diagnostic reasoning, pathology, pharmacology, and medical decision-making.
An 18-year-old woman develops sepsis after an abortion. Within 24 hours she becomes dyspneic, oliguric, and develops petechiae, ecchymoses, and bleeding from venipuncture sites.Which of the following is the laboratory finding most consistent with this disease process? - ANSWER-Decreased plasma fibrinogen concentration
A 27-year-old primigravid woman at 34 weeks' gestation is admitted to the hospital because of nausea and vomiting, and abdominal pain for 12 hours. Her pregnancy has been otherwise unremarkable. Prior laboratory studies, including a complete blood count and serologic tests for HIV and hepatitis, have shown no abnormalities. Her blood pressure now is 164/102 mm Hg. Abdominal examination shows right upper quadrant
tenderness. Laboratory studies show: Hemoglobin 7.4 g/dL;
Hematocrit 24%; Platelet count 72,000; Serum Creatinine 1.2 mg/dL; Total bilirubin 2.3 mg/dL; AST 112 U/L; ALT 116 U/L. 1 / 4
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Examination of a peripheral blood smear is most likely to show a predominance of which of the following in this patient? - ANSWER-Schistocytes
A 44-year-old man with a 1-year history of angina pectoris comes to the emergency department because of increasingly severe chest pain during the past 2 days. He has had five previous similar episodes, which required treatment with increasing doses of nitroglycerin to resolve. His temperature is 37°C (98.6°F), pulse is 105/min , respirations are 16/min, and blood pressure is 150/90 mm Hg. Cardiac examination shows an S4. An ECG shows ST-segment depression in the precordial leads. In addition to aspirin, heparin, and nitroglycerin, he is given a dose of a monoclonal antibody against the platelet lib/Illa receptor. This antibody will most likely prevent binding of which of the following substances to platelets? - ANSWER- Fibrinogen
"A 4-year-old boy is brought to the emergency department because of a 1-hour history of headache, nausea and vomiting, and dizziness. Physical examination shows severe lethargy. His venous blood is bright red; carboxyhemoglobin saturation is 30°/c, (reference range < 5°/c,). Which of the following steps in the electron transport pathway is primarily affected in this patient? - ANSWER- 2 / 4
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Reduced A B substrate ., NAO+ ., - ANSWER-
Flavin C D E - ANSWER-
-• coa-• Cyt b • Cyt c-• Cyt aa3 • 0mononucleotide 2 -
ANSWER-
- A)" - ANSWER-(cyta + a3)
A 25-year-old woman undergoes a radical mastectomy with removal of the axillary lymph nodes on the left side. After the operation, she develops painful edema of the left upper extremity. Which of the following therapies is most likely to decrease the swelling in this patient? - ANSWER-Compression sleeve
A 60-year-old man comes to the physician because of weakness and lightheadedness for 3 months. His diet consists of a healthy balance of fruits, vegetables, whole grains, and lean chicken and fish. He has a 10-year history of chronic autoimmune (Hashimoto) thyroiditis treated with thyroxine. Physical examination shows pallor. Serum studies show increased 3 / 4
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concentrations of methylmalonic acid and total homocysteine. A peripheral blood smear shows megaloblastic anemia. Which of the following is the most likely cause of the findings in this patient? - ANSWER-Failure of intrinsic factor production
A 22-year-old woman comes to the physician for a follow-up examination. One year ago, she was diagnosed with a pulmonary embolism. Two years ago, she delivered a female stillborn at 23 weeks gestation. Physical examination today shows no abnormalities. Laboratory studies show a platelet count of 250,000/mm3, a prothrombin time within the reference range, and an increased partial thromboplastin time. The findings in this patient are most consistent with which of the following conditions? - ANSWER-Antiphospholipid antibody syndrome
A 12-year-old African American girl is brought to the emergency department by her mother because of a 6-hour history of fever and severe rib pain. She has had numerous episodes in the past.Her paternal aunt and uncle have had similar symptoms since youth (autosomal recessive). Her temperature is 39°C (102.2°F).The lungs are clear to auscultation. Abdominal examination shows tenderness to palpation. A peripheral blood smear is shown in the photomicrograph. Which of the following is the most likely underlying cause (molecular/genetic cause) of this
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