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HIGH-YIELD NBME
PICTURES
By ROCKS2018

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TABLE OF CONTENTS

NBME 1 ............................................................................................................................................. 4

NBME 2 ............................................................................................................................................. 8

NBME 3 ........................................................................................................................................... 12

NBME 4 ........................................................................................................................................... 18

NBME 5 ........................................................................................................................................... 24

NBME 6 ........................................................................................................................................... 30

NBME 7 ........................................................................................................................................... 35

NBME 11.......................................................................................................................................... 40

NBME 12.......................................................................................................................................... 44

NBME 13.......................................................................................................................................... 49

NBME 15.......................................................................................................................................... 53

NBME 16.......................................................................................................................................... 56

NBME 17.......................................................................................................................................... 58

NBME 18.......................................................................................................................................... 61

NBME 19.......................................................................................................................................... 64

NBME 20.......................................................................................................................................... 67

NBME 21.......................................................................................................................................... 70

NBME 22.......................................................................................................................................... 73

NBME 23.......................................................................................................................................... 77

NBME 24.......................................................................................................................................... 81

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NBME 1

Toxoplasma gondii

Cleft lip and palate

(Multifactorial inheritance)

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Candida (Vignette mentions

vaginal discharge)

Esophageal varices

Abnormality X will cause ataxic

limb movements. Something to
do with cerebellar vessels,
probably related to
telangiectasias or the Osler-
Weber-Rendu syndrome

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Infantile hemangioma

Actinic keratosis. Prevent by

sunscreen

Neurofibromatosis (NF-1)

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Angiofibroma. Case of
Tuberous Sclerosis

Gap Junction

Aplastic Anemia

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NBME 2

Asbestosis

Pulmonary infarct

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HPV Wart (Thickened stratum

corneum and epidermis and
vacuolated squamous cells)

CMV

Renal Infarct

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Dementia -> Alzheimer’s dz

Horseshoe kidney. Associated

with NORMAL renal function
(Asymptomatic)

PSGN

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Opening into parotid

duct gland

Pneumocystis Jirovecii

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NBME 3

Q was testing pernicious

anemia

Infectious mononucleosis

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Nerve injured in X ->

Dorsiflexion of the foot
impaired

Girl with chronic renal

insufficiency -> what is
the cause of that
insufficiency from the
picture ->
Vesicoureteral reflux.
(Tbh I hate this pic !!!)

Psoriasis = hyperplasia
of epidermis

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Enterobius Vermicularis
pinworm. This is from
cellophane tape test from
perirectal region. You
treat by mebendazole

Cystic fibrosis ->> bronchiectasis

Cryptococcus neoformans

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Lenticulostriate artery
hemorrhage

Medial meniscus

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Multiple Myeloma

Neisseria gonorrhoeae

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3rd degree AV
Block

Intraluminal mass in
transverse colon -> most
likely adenocarcinoma.
Vignette helps, because it
can also look like adenoma

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NBME 4

Macular degeneration

Trichophyton rubrum ->>

tinea pedis ->> treat by
miconazole

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Solid cystic mass in right

kidney ->> RCC

CMV

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Disease that will

affect the primary
function of this tissue
in the pic ->> lobar
pneumonia

Renal insufficiency
and this structure on
urinalysis ->> PSGN

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Right ureteral obstruction

Bloodborne metastasis
to liver

Burkitt’s Lymphoma

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Subdural Hematoma

Staghorn calculus

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Thymus in 3-yr-old. Can

be seen in Wilms tumor

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NBME 5

Osteomyelitis in right
thumb (arrow) -> Affect
Flexor Pollicis Longus
tendon

Axillary nerve injured in this picture

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Pinealoma

HHV-8 in HIV (lesion

biopsy from forehead
lesion)

Cutaneous Sarcoidosis
manifestation. Vignette
gives you hilar
lymphadenopathy

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Granulomatous
inflammation

Gap junctions

Lab that will show

earliest response
after treatment
for this ->
reticulocyte count

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The legendary photo

of Coxsackie virus
infection (HFMD).

Pottery Syndrome

Crohn’s dz

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Atrial flutter

Pseudomonas aeruginosa
(Culture at autopsy of this
bronchiectasis)

Pulmonary infarct

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Emphysema

Monochorionic
monoamniotic

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NBME 6

Mass resected from

head of pancreas ->>
the patient has
gastrinoma

And here is the

legendary NBME
picture, which everyone
loves

Ureteral obstruction
(autopsy of 69-yr-old)

Nodular glomerulosclerosis
(Diabetic)

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From esophagus ->>

adenocarcinoma

Crohn’s dz

Caused by
systemic HTN

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Coagulative necrosis

Malaria

Problem with collagen

synthesis (man with
bleeding gums, loose
teeth, bruises on legs).
Vit C deficiency

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Invasion of submucosa
and muscular layer by
malignant neoplasm in
colon

Epidural hematoma.
This pic sucks, but
vignette helps

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Molluscum Bodies

Papilledema

Radial nerve at greatest risk

of injury here

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NBME 7

Primordial germ cell

migration defect. This is the
legendary pic of
sacrococcygeal teratoma

Parvovirus B19. This is from

BM smear.

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Left Pneumothorax

Neonatal respiratory
distress syndrome

Membranous nephropathy
(Spike and dome)

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Ossification of MCL

Molluscum Contagiosum

This mass will be

causing hearing loss.

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Patient at risk of
choriocarcinoma.
Complete Hydatidiform
mole

Acute Pyelonephritis

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Strep Pneumonia

Diabetic Glomerulosclerosis

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NBME 11

Urothelial cancer

Oral Thrush -> Candida

Kernicterus from
unconjugated
hyperbilirubinemia

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External
Hemorrhoids.
Vignette tells
patient feels pain

Coccidioides immitis

Subdural hematoma

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Liver cirrhosis

Lyme disease and

leptospirosis
(Spirochete infections)

Spleen is damaged from

gun shot

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Which valve is
replaced here ->
Tricuspid

Chancre -> Syphilis

Defect in fibrillar
collagen synthesis

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NBME 12

Neisseria Meningitidis/gonorrhea

Uterine Leiomyoma

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Malrotation

RCC

Cutaneous larva migrans

-> Ancylostoma sp,
Necator americanus
(hookworms)

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Cryptococcus

SLE

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Lesion in vocal
cords ->
Squamous cell
carcinoma

Chronic Graft rejection

Perforated viscus -> causing

pneumoperitoneum

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1-week history of fever -

> So you guys already
know -> Kawasaki
disease or
mucocutaneous lymph
node syndrome

Chest tube inserted

through serratus
anterior

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NBME 13

Scleroderma/CREST

Vascular malformation
(AVMs)

Malformation of
paramesonephric ducts -
> Unicornuate uterus

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Listeria. Vignette about

pregnant woman

Multiple myeloma

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Subarachnoid hemorrhage

Paraganglioma -> In
bifurcation of carotid
arteries

Pneumocystis Jirovecii

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Dermatitis Herpetiformis

Sickle cell dz

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NBME 15

Contact Dermatitis

Multiple myeloma

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Action of pancreatic
enzymes on adipose
tissue

Ectopic pregnancy

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The legendary external

hemorrhoid picture (with
thrombosis)

Same exact picture as in

NBME 3, but different
vignette. Now this is
hydronephrosis. Can’t
they even afford to have
better pictures !!!

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NBME 16

Schistosoma mansoni

Candida (budding)

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Peutz-Jeghers Syndrome

Klinefelter’s
syndrome (testicular
atrophy) -> you can’t
visualize any
spermatogonia

Cryptococcus

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NBME 17

Epidural Hematoma

These ferruginous bodies react

with alveolar macrophages

Congenital diaphragmatic
hernia = incomplete formation
of pleuroperitoneal
membrane

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Actinic Keratosis

Here comes the legendary

picture again !!! But what
could it be this time
around??

Congenital Ureteral
obstruction. Phew !! Not
that different from the last
one (NBME 4)

HSV-2

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Inferior alveolar
nerve. Look at that
fracture !!!

Myxoma in left
atrium, NOT
MITRAL VALVE !!!

Strangulation

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NBME 18

This is gout. Believe it or

not !!! Because of that
crystal in the middle there

Oh no !! What now??

Now the answer is diffuse

cortical necrosis lol. Vignette
goes with tubular atrophy
because of posterior urethral
valves

Amyloid infiltration in
heart

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Ancylostoma/Necator.
Vignette helps by saying
patient is barefoot.
Expect to see microcytic
anemia

Kaposi Sarcoma

Parkinson’s Dz

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You get Axillary

nerve damage

Osler-Weber-
Rendu Syndrome

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NBME 19

Granuloma

Legendary H. pylori Peptic

ulcer disease

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Herpes

Gout

Familial Adenomatous
Polyposis

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Cholesterol Emboli

Osteogenesis Imperfecta

Those eyes sure look blue !!!

Problem with scar formation, NOT

GRANULATION TISSUE
DEPOSITION (REMEMBER IT’S A
COLLAGE 1 PROBLEM)

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NBME 20

Mass of meningeal
origin

Tumor in Rectus
Femoris muscle

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AGAIN ????

Ok what is it now??

Ok I guess now it is
urothelial cancer. Thank
you, biopsy, I love you
so much.

Schistosoma mansoni

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Infantile hemangioma

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NBME 21

Chondrosarcoma

Diverticulitis

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Squamous cell carcinoma of

the lung

Giardia Lamblia

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PCOS

Actinic Keratosis

Trichotillomania

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NBME 22

Avascular Necrosis

Cleft lip/palate -> Failure of fusion

of maxillary and medial nasal
prominences

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ADPKD

Jejunal intussusception

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EXCUSE ME???

CAN YOU STOP??

Anyway, answer this time around is interstitial

inflammation

Vesicouteric Reflux (VR) can lead to Reflux

Nephropathy, which is characterized by chronic
tubulointerstitial inflammation

Transmitted by Reduviid
bug. This is Trypanosoma
cruzi

Pott’s fracture, from

forced eversion

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Scabies

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NBME 23

Bed bugs serve

as carriers of
MRSA. WOW !!!

Metastasis to the liver

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Staghorn calculi

Renal angiogram showing

fibromuscular dysplasia

Capillary Hemangioma

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Painless transilluminating
mass -> Ganglion cyst ->
resolves on its own

Entrapment of inferior
rectus muscle

This is Malaria. Believe it or

not, it will put you at greatest
risk of hypoglycemia. Malaria
can impair hepatic
gluconeogenesis and can also
consume glucose for its own
metabolic demands. This is
one of the hardest NBME Qs in
history btw. Truly legendary
don’t you guys think??

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The cystic structure

is a yolk sac

Seminoma is the most

common testicular tumor. It's
a germ cell tumor. Commonly
see "fried egg cells".

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NBME 24

Monosodium urate
crystals

Granulation tissue

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Niacin deficiency

Aphthous ulcers

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Abdominal Aortic
Aneurysm (Crescent
sign)

Cryptococcus

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Lunate
dislocation

Strongyloides infection

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