USMLE-Rx Step 1 Practice Q's

USMLE-Rx Step 1 Qmax Challenge #3403

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USMLE-Rx Step 1 Qmax Challenge #3403A 63-year-old woman presents to the emergency department complaining of a productive cough with green sputum. She smoked 1.5 packs of cigarettes per day for the past 30 years and had several hospitalizations in the past 15 years for lung infections. She reports some friends in her nursing home have been sick recently with “some sort of lung infection.” Further work-up is indicated and CT of the chest is ordered (see image).

What pathology is most likely present in this patient?

A. Bronchiectasis
B. Lung cancer
C. Pneumonia
D. Pulmonary embolism
E. Tuberculosis

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USMLE-Rx Step 1 Qmax Challenge #3401

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USMLE-Rx Step 1 Qmax Challenge #3401A 67-year-old nurse dies and an autopsy is performed to determine the cause of death. She was the victim of a needle stick injury about 40 years ago. Prior to her death, she appeared jaundiced and had abdominal ascites. Her husband states that she abstained from alcohol but smoked 1 pack of cigarettes a day for 25 years, quitting 10 years ago. The woman’s liver at autopsy is shown in the image.

Based on the pathology seen in the image, which of the following laboratory findings would be expected?

A. ?-Fetoprotein level of 64 ng/mL
B. ?-Human chorionic gonadotropin level of 10,000 mIU/mL
C. Aspartate aminotransferase and alanine aminotransferase levels of 590 and 967 U/L, respectively
D. International Normalized Ratio of 1.0
E. Total protein level of 14 g/dL
F. WBC count of 25 × 10³/?L

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USMLE-Rx Step 1 Qmax Challenge #3394

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USMLE-Rx Step 1 Qmax Challenge #3394A family requests an autopsy after the death of their 70-year-old father. He was a nonsmoker, never drank alcohol, and until his retirement 5 years ago, had never missed a day of work at the shipyards. A Prussian blue stain of lung tissue is shown in the image.

What additional pathology may be uncovered during the autopsy?

A. Black scars in the lungs, as well as progressive massive fibrosis
B. Hemorrhagic pleural effusions
C. Irregular black patches of the lung on gross inspection
D. Keratin pearls and intercellular bridges
E. Noncaseating epitheliod granulomas

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USMLE-Rx Step 1 Qmax Challenge #3390

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USMLE-Rx Step 1 Qmax Challenge #3390A 27-year-old woman presents to her primary care physician complaining of feeling “under the weather” for the past 2 weeks. Her history is remarkable only for previously diagnosed mitral valve prolapse. On examination, her temperature is 37.8°C (100°F). The patient has erythematous palms and painful, small lesions on her finger pads. The results of an ophthalmologic examination are shown in the image.

What is the most likely pathogen causing this woman’s symptoms?

A. Group B streptococcus
B. Haemophilus influenzae
C. Staphylococcus aureus
D. Streptococcus pyogenes
E. Streptococcus viridans

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USMLE-Rx Step 1 Qmax Challenge #3379

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USMLE-Rx Step 1 Qmax Challenge #3379An 89-year-old woman is brought to the clinic after suffering from a number of recent minor falls and episodes of confusion. MRI of the brain reveals a mass localized to a convexity of the left hemisphere. The patient declines treatment and dies a few months later. An autopsy slide obtained from the patient’s brain lesion is shown in the image.

From which type of cell does the tumor seen here typically arise?

A. Arachnoid cells
B. Astrocytes
C. Melanocytes
D. Neurons
E. Oligodendrocytes

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USMLE-Rx Step 1 Qmax Challenge #3358

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USMLE-Rx Step 1 Qmax Challenge #3358A medical student is asked to perform a cardiovascular examination on a patient. After 10 minutes of auscultation with no success, the medical student gives up and asks his resident for help. The resident puts up the patient’s anteroposterior chest radiograph (see image) and begins to explain the molecular etiology of this patient’s condition.

What is one complication that this patient is at increased risk of developing as a result of his condition?

A. Bronchiectasis
B. Heart failure
C. Mitral regurgitation
D. Pneumothorax
E. Small bowel obstruction

———————–

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USMLE-Rx Step 1 Qmax Challenge #3345

10

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USMLE-Rx Step 1 Qmax Challenge #3345A 46-year-old woman comes to her primary care physician after visiting her optometrist. While being fitted for new glasses, the patient was found to have persistent constriction of her left pupil. After a thorough history and physical examination, x-ray of the chest was ordered, and results are shown in the image.

Disruption of which of the following explains this woman’s symptoms?

A. Cranial nerve II on the left
B. Cranial nerve III on the right
C. First-order sympathetic neuron
D. Second-order (preganglionic) sympathetic neuron
E. Third-order (postganglionic) sympathetic neuron

———————–

Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

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