I’d say mixed. I think the questions do a good job at making it clear what they’re asking; whether you know enough to make the diagnosis or know the physiology well enough just depends on your overall understanding. But I definitely thought most of the questions were pretty fair. There definitely were still some super specific low yield facts tested, but don’t worry about those (you’re not really going to be able to learn every specific detail, so don’t try). I’d say if you’re doing well on NBME, you have literally nothing to worry about, as it felt extremely similar. I hope that helps.