NRE October 2026 Prediction Sheet 1

High-Yield Topic List with Recognition Triggers, Discriminators, and Traps

Prepared for: Ahmad Zafar
Date: 2026-06-22
Purpose: Blueprint for Mock 1 and high-yield revision before the October 2026 NRE attempt.

Source Legend

• May2026-confirmed: confirmed in May 2026 recall/intelligence.
• Dec2025-confirmed: confirmed in December 2025 paper.
• Prior-prediction: present in existing NRE 2026 prediction material.
• PMDC-mock: reinforced by PMDC/NRE mock bank.
• Syllabus-core: official PM&DC syllabus core topic.
• NRE50-aligned: matches NRE50 rotation/high-yield logic.

How To Use This Sheet

1. Read the recognition trigger first.
2. Say the answer out loud before reading the discriminator.
3. For every topic, do one “Why not?” sentence against the trap.
4. Convert missed items into error-log records.

Highest Priority List

Rank	Subject	Predicted Topic	Source Strength	Recognition Trigger	Key Discriminator	Main Trap
1	Medicine	Aortic dissection	May2026-confirmed, Dec2025-confirmed, Prior-prediction, Syllabus-core	Sudden tearing chest/back pain + BP difference between arms	CT angiography for diagnosis; Type A surgery, Type B IV beta-blocker	Treating as MI based on chest pain alone
2	Obstetrics	Anti-D immunoglobulin	May2026-confirmed, Prior-prediction, Syllabus-core	Rh-negative mother + Rh-positive baby or sensitising event	Give anti-D within 72 hours	Choosing 24h/48h/96h instead of 72h
3	Medicine	Rheumatoid arthritis	May2026-confirmed, Dec2025-confirmed, QBank-recall, Syllabus-core	Symmetric MCP/PIP pain + morning stiffness >1 hour	Anti-CCP is the best confirming test when asked	Mistaking shoulder pain or age for OA
4	Medicine	Osteoarthritis	Dec2025-confirmed, Prior-prediction, Syllabus-core	Elderly + DIP Heberden nodes + pain worse with use	DIP involvement strongly favors OA	Confusing PIP Bouchard nodes with RA
5	Paediatrics	Post-streptococcal GN	May2026-confirmed, Dec2025-confirmed, Prior-prediction	Cola urine + periorbital edema 1-3 weeks after sore throat	Latent period after infection + low C3	IgA nephropathy, which occurs during URTI
6	Medicine	IgA nephropathy	May2026-confirmed, Prior-prediction, Syllabus-core	Hematuria during or immediately after URTI	Synpharyngitic hematuria, often normal C3	Post-strep GN timing
7	ENT / Paeds	Epiglottitis	May2026-confirmed, Prior-prediction, NRE50-aligned	Toxic child + drooling + tripod + thumb sign	Secure airway first in controlled setting	Examining throat or delaying for imaging
8	ENT	Nasal foreign body	May2026-confirmed, Dec2025-pattern, Syllabus-core	Child + unilateral foul-smelling/blood-stained nasal discharge	Foreign body until proven otherwise	Treating as sinusitis
9	Surgery	Testicular torsion	May2026-confirmed, NRE50-aligned, Syllabus-core	Sudden severe testicular pain + high-riding testis + absent cremasteric reflex	Urgent surgical exploration if Doppler unavailable	Waiting for imaging
10	Surgery	Perforated peptic ulcer	May2026-confirmed, Prior-prediction, Syllabus-core	Sudden severe abdominal pain + board-like rigidity + free air	Exploratory laparotomy / surgical management	PPI or endoscopy as definitive step
11	Surgery	Esophageal carcinoma	May2026-confirmed, Prior-prediction, Syllabus-core	Progressive dysphagia solids first then liquids + weight loss	Mechanical obstruction pattern	Achalasia
12	Surgery	Achalasia	May2026-confirmed, Prior-prediction, Syllabus-core	Dysphagia to liquids and solids + bird-beak	Functional obstruction; manometry/endoscopy depending wording	Cancer when liquids are involved early
13	Medicine / Surgery	Esophageal varices	May2026-confirmed, Prior-prediction, Syllabus-core	Cirrhosis/portal HTN + hematemesis	Endoscopic band ligation; vasoactive bridge may be terlipressin/octreotide	Mallory-Weiss or PPI-only answer
14	Medicine	H. pylori eradication confirmation	Dec2025-confirmed, QBank-recall, Syllabus-core	Treated PUD after triple therapy	Urea breath test for eradication	Serology, endoscopy, barium
15	Medicine	IBS	Dec2025-confirmed, NRE50-aligned, Prior-prediction	Chronic abdominal pain relieved by defecation + normal workup	No red flags; stress worsens	IBD when there is no blood/weight loss
16	Medicine	Chronic bronchitis	Dec2025-confirmed, Prior-prediction, Syllabus-core	Smoker + productive cough for 2 years	Productive cough >=3 months/year for 2 years	Asthma or bronchiectasis
17	Medicine	Pleural effusion vs collapse	Dec2025-confirmed, Prior-prediction, QBank-recall	Dullness with tracheal shift	Effusion pushes trachea away; collapse pulls toward	Pneumothorax if percussion note ignored
18	Medicine	Goodpasture syndrome	Dec2025-confirmed, Prior-prediction, Syllabus-core	Hemoptysis + hematuria/RBC casts	Anti-GBM pulmonary-renal syndrome	GPA/Wegener without ENT/sinus clue
19	Medicine	Cushing syndrome	May2026-confirmed, Dec2025-confirmed, Prior-prediction	Purple striae + proximal weakness + HTN + eosinopenia	Cortisol excess	Addison, hypothyroid, diabetes
20	Medicine	Hypocalcaemia	May2026-confirmed, QBank-recall, Syllabus-core	Tetany + Chvostek/Trousseau	Low calcium	Magnesium or potassium reflex answer
21	Medicine	Hyperparathyroidism	Dec2025-confirmed, Prior-prediction	Bone/renal symptoms or early biochemical clue	Early hypophosphatemia; later hypercalcemia	Choosing PTH/hypercalcemia for earliest abnormality
22	Medicine	Parkinson disease	May2026-confirmed, QBank-recall, Syllabus-core	Resting tremor + rigidity + bradykinesia + shuffling gait	Resting tremor; substantia nigra dopamine loss	Essential tremor/intention tremor
23	Medicine	Myasthenia gravis	May2026-style, QBank-recall, Syllabus-core	Ptosis/diplopia worse at day end, improves with rest	Pyridostigmine for symptomatic treatment	GBS or Lambert-Eaton
24	Medicine	Guillain-Barre syndrome	May2026-style, QBank-recall, Syllabus-core	Ascending weakness after infection + areflexia	Acute inflammatory demyelinating polyneuropathy	Myasthenia or MS
25	Medicine	Amaurosis fugax / TIA	May2026-confirmed, Prior-prediction	Transient monocular blindness	Retinal artery embolic TIA	Treating as completed stroke only
26	Medicine	AML	May2026-confirmed, Prior-prediction, Syllabus-core	Auer rods + MPO positive +/- gum hyperplasia	Auer rods = AML	ALL because of blasts
27	Medicine	CML	May2026-confirmed, Prior-prediction, Syllabus-core	Massive splenomegaly + myeloid left shift	BCR-ABL / Philadelphia chromosome	CLL or myelofibrosis
28	Medicine	Iron deficiency anemia	May2026-style, Prior-prediction, Syllabus-core	Microcytic hypochromic anemia + low ferritin	Low ferritin + high TIBC	Thalassemia trait
29	Medicine	B12 deficiency	QBank-recall, NRE50-aligned, Syllabus-core	Macrocytosis + glossitis + posterior column signs	Pernicious anemia if Schilling/intrinsic factor clue	Folate deficiency
30	Medicine	Gout	May2026-style, QBank-recall, Syllabus-core	Sudden painful red first MTP	Podagra	RA/OA
31	Infectious Disease	CAP organism	May2026/QBank-recall, Prior-prediction	Most common CAP organism	Streptococcus pneumoniae	H. influenzae as second common
32	Infectious Disease	Meningitis investigation	May2026-paper, QBank-recall, Syllabus-core	Fever + neck stiffness/bulging fontanelle	Lumbar puncture if no raised ICP contraindication	Blood CP/culture as confirmation
33	Infectious Disease	ATT adverse effects	May2026-style, Syllabus-core	ATT + joint pains/hyperuricemia	Pyrazinamide	INH or rifampicin
34	Infectious Disease	Measles	May2026-style, Syllabus-core	Fever + cough/coryza/conjunctivitis + Koplik spots	Koplik spots	Rubella/scarlet fever
35	Pharmacology	Warfarin reversal	May2026-recall, Dec2025-style, QBank-recall	Warfarin + high INR +/- bleeding	Oral vitamin K for high INR/no major bleed; PCC/FFP if major bleed	Protamine
36	Pharmacology	Paracetamol overdose	May2026-recall, QBank-recall, Syllabus-core	Child ingests paracetamol	N-acetylcysteine if toxic risk/level	Observation when risk remains unclear
37	Pharmacology	Benzodiazepine antidote	May2026-confirmed, Prior-prediction	Sedation + normal pupils + ataxia	Flumazenil	Naloxone
38	Pharmacology	Phenytoin adverse effects	May2026-confirmed, Prior-prediction	Gingival hyperplasia + hirsutism	Phenytoin signature	Carbamazepine/valproate
39	Pharmacology	Wernicke encephalopathy	May2026-confirmed, QBank-recall	Alcoholic + confusion + ataxia + ophthalmoplegia	Thiamine before glucose	Giving glucose first
40	Pharmacology	ACE inhibitor in diabetic nephropathy	May2026-confirmed, Prior-prediction	DM + HTN + microalbuminuria/proteinuria	ACEi/ARB renal protection	CCB/thiazide as generic HTN answer
41	Surgery	Femoral hernia location	QBank-recall, Syllabus-core	Groin swelling below pubic tubercle	Below and lateral to pubic tubercle	Inguinal hernia locations
42	Surgery	Direct inguinal hernia	QBank-recall, Syllabus-core	Hernia through Hesselbach triangle	Direct inguinal	Indirect hernia
43	Surgery	Thyroglossal duct cyst	May2026-confirmed, Syllabus-core	Midline neck swelling moves with tongue protrusion	Thyroglossal duct cyst	Thyroid nodule/branchial cyst
44	Surgery	Breast carcinoma severity/workup	May2026-confirmed, PMDC-mock, Syllabus-core	Hard irregular lump, skin changes, nodes	Triple assessment; lymph nodes worsen prognosis	Fibroadenoma/reassurance
45	Surgery	Fibroadenoma	May2026-paper, QBank-recall	Young woman + painless mobile breast lump	Reassurance/follow-up if classic small lesion	Mastectomy/cancer management
46	Surgery	Intraductal papilloma	NRE50-aligned, Syllabus-core	Bloody nipple discharge from single duct, no lump	Intraductal papilloma	Breast carcinoma
47	Surgery	Acute appendicitis	QBank-recall, Syllabus-core	Periumbilical pain migrates to RIF + rebound	Appendectomy/definitive surgical management	Antibiotics only
48	Surgery	Tension pneumothorax	NRE50-aligned, Syllabus-core	Hypotension + tracheal deviation + absent breath sounds	Needle decompression before CXR	Waiting for imaging
49	Surgery	Burns escharotomy	NRE50-aligned, Syllabus-core	Circumferential burn + weak pulses + paresthesia	Escharotomy	Fasciotomy or fluids only
50	Surgery	Pelvic fracture shock	May2026/MediCall-overlap but verified concept, Syllabus-core	Pelvic fracture + shock	Internal hemorrhage/blood loss	Fat embolism/head injury
51	Surgery	Gallstone disease / cholangitis	NRE50-aligned, Syllabus-core	RUQ pain + fever + jaundice + CBD stone	Urgent ERCP if septic cholangitis	Cholecystectomy first
52	Surgery	Pancreatic pseudocyst	Dec2025-confirmed, Prior-prediction	Epigastric mass 4-6 weeks after pancreatitis	Pseudocyst without fever	Abscess/cancer
53	Obstetrics	Placenta previa	May2026-confirmed, Prior-prediction	Painless bright red antepartum bleeding + soft uterus	Avoid PV exam until placenta location known; CS if major/late	Abruption
54	Obstetrics	Placental abruption	Syllabus-core, NRE50-aligned	Painful bleeding + tender rigid uterus + fetal distress	Pain and uterine tenderness	Placenta previa
55	Obstetrics	Ectopic pregnancy	Syllabus-core, NRE50-aligned	Amenorrhea + abdominal pain + bleeding + shock	Rule out first in reproductive-age acute abdomen	PID/miscarriage without pregnancy test
56	Obstetrics	Severe pre-eclampsia / HELLP	NRE50-aligned, Syllabus-core	BP >=160/110 + proteinuria + headache/epigastric pain +/- low platelets	MgSO4 for seizure prophylaxis; delivery depending gestation/stability	Simple gestational HTN
57	Obstetrics	Gestational diabetes	Prior-prediction, Syllabus-core	Pregnancy 24-28 weeks / glucosuria	OGTT	Random glucose/urine glucose
58	Obstetrics	Preterm labor steroids/neuroprotection	NRE50-aligned, Syllabus-core	Preterm contractions with cervical dilation	Betamethasone for lung maturity; MgSO4 for neuroprotection if very preterm	Continuing tocolysis as fetal outcome drug
59	Gynaecology	PCOS	QBank-recall, Syllabus-core	Infertility + obesity + hirsutism + irregular cycles	Hyperandrogenism + polycystic ovaries	Endometriosis/hyperprolactinemia
60	Gynaecology	Androgen insensitivity	QBank-recall, Syllabus-core	Primary amenorrhea + blind vagina + absent uterus + 46XY + normal breasts	Testicular feminization/AIS	Mullerian agenesis if karyotype is 46XX
61	Gynaecology	Abnormal uterine bleeding in adolescence	QBank-recall, Syllabus-core	Heavy bleeding since menarche, pregnancy/coag normal	Anovulatory cycles most common	Fibroid/cancer
62	Gynaecology	GTN	May2026-confirmed, Syllabus-core	High beta-hCG + bleeding after pregnancy/molar features	Serial beta-hCG follow-up	Normal miscarriage follow-up
63	Paediatrics	Down syndrome	May2026-confirmed, QBank-recall	Upslanting eyes + single palmar crease	Trisomy 21; VSD/AV canal associations	Patau/Edwards
64	Paediatrics	Erb palsy	May2026-paper, QBank-recall	Newborn after difficult delivery + waiter’s tip	C5-C6 upper trunk	Klumpke palsy
65	Paediatrics	Severe dehydration	May2026-paper, Syllabus-core	Drowsy child with profuse diarrhea/vomiting unable to drink	IV Ringer lactate	ORS when severe
66	Paediatrics	Neonatal CPR ratio	May2026-confirmed	Newborn resuscitation compression:ventilation	3:1	Adult/pediatric ratios
67	Paediatrics	Vitamin K deficiency bleeding	QBank-recall, Syllabus-core	Newborn bleeding, no prophylaxis	Vitamin K deficiency	Hemophilia
68	Paediatrics	Rickets	May2026-paper, QBank-recall	Bowed legs + rachitic rosary + low Ca/phosphate + high ALP	Vitamin D deficiency	Renal failure/excess calcium
69	Paediatrics	Croup	May2026-confirmed, Prior-prediction	Barking cough + steeple sign + non-toxic	Nebulized adrenaline/steroids depending severity	Epiglottitis
70	Paediatrics	Autism	QBank-recall, Syllabus-core	Poor eye contact + hand flapping + delayed speech	Autism spectrum disorder	CP/ADHD
71	Ophthalmology	Acute angle-closure glaucoma	May2026/Ophthalmology-pattern, Syllabus-core	Painful red eye + halos + fixed mid-dilated pupil	Lower IOP urgently; pilocarpine may appear after pressure lowered	Conjunctivitis
72	Ophthalmology	Vernal keratoconjunctivitis	QBank-recall, Syllabus-core	Child + severe itching in summer + cobblestone papillae	Spring catarrh	Bacterial/viral conjunctivitis
73	Ophthalmology	Endophthalmitis	QBank-recall, Syllabus-core	Severe pain/redness/hypopyon 1 day after cataract surgery	Post-op endophthalmitis	Lens reaction
74	Ophthalmology	Amblyopia from strabismus	May2026-style, QBank-recall	Child with long-standing squint + reduced vision, normal structures	Amblyopia	Cataract/glaucoma
75	Applied Anatomy	Common peroneal nerve	May2026-confirmed, Syllabus-core	Fibular neck injury + foot drop	Common peroneal nerve	Sciatic nerve
76	Applied Anatomy	Radial nerve	May2026-confirmed, Syllabus-core	Midshaft humerus fracture + wrist drop	Radial nerve	Axillary nerve
77	Applied Anatomy	Axillary nerve	May2026-confirmed, Syllabus-core	Surgical neck humerus + deltoid weakness + regimental badge numbness	Axillary nerve	Radial nerve
78	Applied Anatomy	Anterior interosseous nerve	NRE50-aligned, Syllabus-core	Supracondylar fracture + cannot make OK sign	AIN branch of median nerve	Ulnar or radial nerve
79	Applied Anatomy	Facial nerve lesion level	QBank-recall, Syllabus-core	Facial palsy + hyperacusis	Lesion proximal to nerve to stapedius	Stylomastoid foramen lesion
80	Applied Anatomy	Brainstem crossed syndrome	May2026-confirmed, Prior-prediction	Ipsilateral cranial nerve palsy + contralateral hemiplegia	Brainstem lesion	Internal capsule/cortex
81	Applied Pathology	Hypersensitivity types	May2026-confirmed, Prior-prediction	Asked to classify TB, PSGN, AIHA, contact dermatitis	I, II, III, IV examples cold	Type III vs IV
82	Applied Pathology	Barrett esophagus	May2026-confirmed, Prior-prediction	Chronic GERD + squamous to columnar change	Metaplasia, premalignant	Dysplasia/hyperplasia
83	Applied Pathology	Acute inflammation mediator	QBank-recall, Syllabus-core	Immediate vascular permeability	Histamine	Prostaglandins/cytokines
84	Applied Pathology	Marjolin ulcer	NRE50-aligned, Syllabus-core	Chronic burn scar ulcer becomes raised non-healing nodule	SCC in scar; wide local excision	Venous/diabetic ulcer
85	Applied Pathology	TTP vs DIC	Prior-prediction, Syllabus-core	MAHA + thrombocytopenia; coag profile asked	TTP normal PT/APTT; DIC prolonged	Treating all MAHA as DIC
86	Physiology	Metabolic alkalosis from vomiting	May2026-confirmed, Prior-prediction	Vomiting + high pH + high HCO3 + low Cl	Metabolic alkalosis	Respiratory alkalosis
87	Physiology	High altitude response	QBank-recall, Syllabus-core	Shift to high altitude	Hyperventilation lowers pCO2	Assuming CO2 rises
88	Physiology	Pancreatic bicarbonate secretion	QBank-recall, Syllabus-core	High flow pancreatic secretion	HCO3-rich ductal secretion	Chloride
89	Physiology	Resting membrane/action potential ions	AppliedPhysiology-prediction, PMDC-mock	Resting potential/depolarization asked	Resting = K; depolarization = Na influx	Mixing phases
90	Physiology	Shock hemodynamics	AppliedPhysiology-prediction, PMDC-mock	Compare anaphylactic/hypovolemic/cardiogenic shock	Anaphylaxis low SVR; cardiogenic low CO	Treating all shock as low CO
91	Community Medicine	Doubling time	May2026-recall, Prior-prediction	Population growth rate given	Rule of 70	Exact arithmetic trap
92	Community Medicine	Study design	QBank-recall, Syllabus-core	Groups receive surgery vs diet/intervention	Randomized controlled trial if assigned intervention	Cohort because groups are followed
93	Community Medicine	Data presentation	QBank-recall, Syllabus-core	Percentages/proportions asked	Pie chart	Bar chart when parts of whole
94	Community Medicine	Median/biostatistics basics	May2026-confirmed, Syllabus-core	Skewed data or middle value	Median	Mean
95	Forensic	Kerosene ingestion	May2026-confirmed, Syllabus-core	Child ingests kerosene	Aspiration pneumonitis/bronchopneumonia	Gastric lavage/toxicity focus
96	Forensic	Rigor mortis timing	NRE50-aligned, Syllabus-core	Rigor distribution after death	Estimate PMI from progression	Treating rigor as instant
97	Forensic	Organophosphate poisoning	Syllabus-core, NRE50-aligned	Salivation, lacrimation, bronchorrhea, miosis	Atropine + pralidoxime	Naloxone/benzodiazepine
98	ENT	Otic barotrauma	QBank-recall, Syllabus-core	Ear pain/fullness after airplane travel + retracted congested TM	Barotrauma	AOM/cholesteatoma
99	ENT	Retropharyngeal abscess	QBank-recall, Syllabus-core	Child + fever + neck stiffness + pharyngeal abscess	Retropharyngeal space	Submandibular/parapharyngeal
100	Dermatology	Psoriasis	May2026-paper, QBank-recall, Syllabus-core	Extensor plaques + silvery scales + nail pitting	Psoriasis	Tinea/eczema

Subject Hot Zones For Mock 1

Medicine and Allied

Prioritize endocrine, renal, rheumatology, neurology, hematology, respiratory, GI, psychiatry, and dermatology. The exam repeatedly rewards one-step discrimination:

• DM/HTN renal protection: ACEi/ARB.
• Cushing vs Addison vs hypothyroidism.
• RA vs OA vs gout.
• PSGN vs IgA nephropathy vs nephrotic syndrome.
• Parkinson vs essential tremor vs cerebellar tremor.
• AML vs ALL vs CML.
• Chronic bronchitis vs asthma/bronchiectasis.
• IBS vs IBD red flags.

Surgery and Allied

Prioritize emergency recognition and “next best step”:

• Tension pneumothorax: decompress before imaging.
• Testicular torsion: explore, do not wait.
• Perforated ulcer: surgical abdomen.
• Cholangitis: urgent ERCP when septic.
• Breast lump: triple assessment, core biopsy when needed.
• Groin hernia anatomy and femoral/inguinal discriminators.
• Burns: escharotomy for circumferential vascular compromise.

OBGYN

Predict classic safety-first vignettes:

• Ectopic pregnancy in reproductive-age abdominal pain.
• Placenta previa vs abruption.
• Severe pre-eclampsia/HELLP.
• Anti-D timing.
• PCOS and amenorrhea algorithms.
• GDM diagnosis by OGTT.

Paediatrics

Punches above its 14-question allocation. Must-not-miss topics:

• Neonatal resuscitation ratio.
• Severe dehydration management.
• Rickets and vitamin deficiencies.
• Down syndrome with cardiac defect.
• Erb palsy.
• Croup vs epiglottitis.
• Autism and developmental pattern recognition.

Applied Basic Sciences

Basic sciences are applied, not abstract. The recurring pattern is “clinical clue -> exact mechanism/anatomy”:

• Nerve injuries from fractures.
• Hypersensitivity types.
• Acid-base from vomiting/DKA/respiratory disease.
• Drug antidotes and adverse effects.
• Study designs and simple biostatistics.
• Forensic poisoning and PMI basics.

Mock-Building Rules From This Sheet

For Mock 1, use this distribution:

Block	Questions
Medicine and Allied	52
Surgery and Allied	48
Obstetrics and Gynaecology	14
Paediatrics	14
Ophthalmology	6
ENT	6
Applied Pathology	11
Applied Anatomy	11
Applied Physiology	10
Clinical Pharmacology	8
Applied Biochemistry	6
Community Medicine	6
Forensic Medicine and Toxicology	4

Each question should carry one of these provenance labels:

• recall-derived
• PMDC-mock-derived
• NRE50-derived
• syllabus-derived
• concept-derived

Avoid direct copying. Preserve the discriminator, rewrite the clinical stem, and force a single best answer.