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NBME 25 EXAM ACTUAL QUESTIONS AND ANSWERS GUARANTEED PASS 2025

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1 Exam Section 1: Item 1 of 50 National Board of Medical Examiners Comprehensive Basic Science Self-Assessment 1. A75-year-old man has decreased exercise tolerance and occasional syncopal episodes related to exertion. Left-heart catheterization discloses this pressure tracing (Ao -aorta; LV -le...

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  • March 5, 2025
  • 101
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • nbme 25 exam
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  • NBME
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NBME 25 EXAM ACTUAL QUESTIONS AND
ANSWERS GUARANTEED PASS 2025
1
Exam Section 1: Item 1 of 50
National Board of Medical Examiners
Comprehensive Basic Science Self-Assessment
1. A75-year-old man has decreased exercise tolerance and occasional syncopal
episodes related to exertion. Left-heart catheterization discloses this pressure tracing
(Ao -aorta; LV -left ventricle; LA -
left atrium). The most frequently encountered mechanism underlying this disorder is
which of the following?
ЕCG
A) Amyloid deposition
150-
B) Calcification
C) Cystic medial necrosis
D) Pericardial effusion
100-
O E) Septal hypertrophy
Ao
50-
LV
LA
Time
Time-
Correct Answer: B.
The pressure tracing demonstrates a large pressure gradient between the left ventricle
and aorta during systole, which is consistent with the diagnosis of aortic stenosis. In the
setting of aortic stenosis, the left ventricle must generate higher pressures in order to
overcome the opening resistance of the stenotic valve. This increased -Correct Answer


2
Exam Section 1: Item 2 of 50
National Board of Medical Examiners
Comprehensive Basic Science Self-Assessment
2. New reagents are being designed to treat graft-versus-host disease in HLA-unrelated
bone marrow transplant recipients. Reagents should be designed that selectively
deplete which of the following donor cells?
A) B lymphocytes
O B) Dendritic cells
C) Macrophages
D) Neutrophils


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E) T lymphocytes
Correct Answer: E.
T lymphocytes, which are responsible for the immune attack against the recipient,
should be the target of agents used to treat graft-versus-host disease (GVHD) in HLA-
unrelated bone marrow transplant recipients. Prior to grafting of allogeneic stem cells in
a bone
marrow transplant, recipient native marrow must be completely ablated. It is then
replaced with donor marrow, which recolonizes the marrow cavity. Successful
transplantation results in reconstitution of the immune system with the donor's i -Correct
Answer ✔

3
Exam Section 1: Item 3 of 50
National Board of Medical Examiners
Comprehensive Basic Science Self-Assessment
3. A9-year-old boy has had alopecia and hypocalcemia since birth. His serum 1,25-
dihydroxycholecalciferol concentration is within the reference range, serum 24,25-
dihydroxycholecalciferol is undetectable. Serum parathyroid hormone concentration is
above
the upper limit of the laboratory assay and needs to be reassayed at a dilution. The
results are pending. Which of the following is the most likely cause of his condition?
O A) Loss-of-function mutation in the calcium-sensing receptor
B) Multiple endocrine neoplasia type I
C) Mutations inactivating the vitamin D 24-hydroxylase gene
D) Mutations inactivating the vitamin D receptor
Correct Answer: D.
Vitamin D plays a role in serum calcium and phosphate homeostasis by promoting the
intestinal absorption of calcium and phosphate. Parathyroid hormone (PTH) also h -
Correct Answer ✔

4
Exam Section 1: Item 4 of 50
National Board of Medical Examiners®
Comprehensive Basic Science Self-Assessment
4. Assuming the positive predictive value of a test is 50% and the negative predictive
value is 75%, which of the following tables are consistent with these values?
Disease
Disease
Present
Absent
Present
Absent
A
B
Positive
50


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50
750
250
Test
Negative
250
750
50
50
Positive
250
750
50
50
Test
Negative
50
50
750
250
E Cannot be determined from data given
A)
B)
C)
D)
E)
Correct Answer: A.
Positive predictive value (PPV) and negative predictive value (NPV) are statistical
measurements that define the proportion of positive test results that are true positives
(positive tests in patients who have the condition) and true negatives (negative tests in
patients without the condition). PPV is thus defined as (true positives [TP]) / (TP + false
positives [FP]) and measures the probability of a patient having the dise -Correct
Answer ✔

5
Exam Section 1: Item 5 of 50
National Board of Medical Examiners
Comprehensive Basic Science Self-Assessment
5. A 43-year-old woman comes to the physician because of vague discomfort, nausea,
easy bruising, and weight loss. Her prothrombin time is increased. The most likely
cause of the increased prothrombin time is damage to which of the following cells?
A) Endothelial cells
B) Fibroblasts
C) Нерatocytes
D) Macrophages
E) Skeletal muscle cells


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F) T lymphocytes
Correct Answer: C.
Hepatocyte injury accounts for this patient's symptoms and coagulation abnormality.
Hepatocytes filter and detoxify portal venous blood, metabolize medications, synthesize
coagulation factors (including fibrinogen, prothrombin, factors V, VII, IX, X, XI, XII,
proteins
C and S), complement, apoproteins, triglycerides, cholesterol, bile acids, and albumin,
and play critical roles in biochemical metabolism (eg, gluconeogenesis). Many manifest
-Correct Answer ✔

6
Exam Section 1: Item 6 of 50
National Board of Medical Examiners
Comprehensive Basic Science Self-Assessment
6. A 63-year-old man has had this gradually enlarging lesion on his right forearm for the
past 3 years. Which of the following is the most likely diagnosis?
A) Actinic keratosis
B) Blue nevus
C) Compound nevus
D) Dermatofibroma
E) Halo nevus
F) Hemangioma
G) Malignant melanoma
H) Pyogenic granuloma
I) Seborrheic keratosis
1 cm
J) Squamous cell carcinoma
Correct Answer: G.
Malignant melanoma is likely to be present when a lesion demonstrates asymmetry,
irregular appearing borders, variable coloration, a diameter greater than 6 mm, and
rapid evolution in characteristics. Malignant melanoma can rapidly invade and
metastasize,
which carries a poor prognosis when diagnosed late. Subtypes include superficial
spreading, nodular, lentigo maligna, and acral lentiginous. Any lesion with features
suggestive of malignan -Correct Answer ✔

7
Exam Section 1: Item 7 of 50
National Board of Medical Examiners
Comprehensive Basic Science Self-Assessment
7. A 66-year-old man has a surgical excision of a brain mass; a photomicrograph of
excised tissue is shown. He has smoked 1 pack of cigarettes daily for the past 50 years.
His blood pressure is 130/90 mm Hg.
Laboratory studies show polycythemia, hypercalcemia, and microscopic hematuria.
Immunostaining of the tissue is positive for epithelial membrane antigen and negative
for carcinoembryonic antigen. Which of


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