USMLE-Rx Step 1 Practice Q's

USMLE-Rx Step 1 Qmax Challenge #3878

10

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USMLE-Rx Step 1 Qmax Challenge #3878A 75-year-old homeless alcoholic man presents to the emergency department complaining of shortness of breath, high fever, shaking chills, and a productive cough. His temperature is 39.6°C (103.2°F), pulse is 110/min, respiratory rate is 27/min, and blood pressure is 130/85 mm Hg. X-ray of the chest shows a diffuse infiltrate. Gram staining of his sputum culture resembles that shown in the image.

Which of the following antibiotics would be appropriate for this patient’s illness?

A. Amphotericin B
B. Aztreonam
C. Clavulanic acid
D. Isoniazid
E. Vancomycin

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USMLE-Rx Step 1 Qmax Challenge #3866

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USMLE-Rx Step 1 Qmax Challenge #3866A 17-year-old girl presents with 4 months of fatigue, night sweats, constant low-grade fever, and a 9.1-kg (20-lb) unintentional weight loss. A large mass is palpable in the left upper quadrant, 8 cm below the costal margin. It is suspected that an infiltrative process led to organomegaly, and the organ is scheduled to be surgically removed. Results of a lymph node biopsy are shown in the image.

What preventative treatment should be considered prior to surgery in this patient?

A. Intravenous vancomycin daily
B. Oral acyclovir daily
C. Oral metronidazole daily
D. Vaccination for influenza A and B
E. Vaccinations against pneumococcus and Haemophilus influenzae

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USMLE-Rx Step 1 Qmax Challenge #3865

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USMLE-Rx Step 1 Qmax Challenge #3865A 9-year-old boy with massive swelling of his right mandible is seen during a medical relief mission. He has lost a significant amount of weight over the past 2 months. In addition he has night sweats requiring a change in his bedclothes. He has no cough, murmur, or change in bowel habits. A biopsy of the spleen is taken, and results are shown in the image.

What translocation is likely present in the malignant cells shown in the image?

A. t(8;14)
B. t(9;22)
C. t(11;14)
D. t(14;18)
E. t(15;17)

———————–

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USMLE-Rx Step 1 Qmax Challenge #3862

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USMLE-Rx Step 1 Qmax Challenge #3862A 67-year-old former landscaper is referred to the dermatologist for a lesion on his right forearm. The lesion is a flesh-colored pearly papule approximately 1.5 cm in diameter with a central telangiectasia. A biopsy is taken, and the results are shown in the image.

Which of the following is the most likely diagnosis?

A. Actinic keratosis
B. Basal cell carcinoma
C. Dermatitis herpetiformis
D. Melanoma
E. Seborrheic keratosis
F. Squamous cell carcinoma

———————–

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USMLE-Rx Step 1 Qmax Challenge #3856

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USMLE-Rx Step 1 Qmax Challenge #3856An 86-year-old man presents to his physician with 4 months of increasing fatigue, a 6.8-kg (15-lb) unintentional weight loss, and an uncomfortable sense of fullness in the left upper quadrant. A complete blood cell count shows:

WBC count: 14,000/mm³
Hemoglobin: 9 g/dL
Hematocrit: 30%
Platelet count: 470,000/mm³

Several attempts at bone marrow aspiration were unsuccessful, A peripheral blood smear is shown in the image.

Which of the following processes is associated with the cells indicated on the peripheral smear?

A. Aplastic anemia
B. Asplenia
C. Extramedullary hematopoiesis
D. Hemoglobin clumping
E. Intravascular hemolysis

———————–

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USMLE-Rx Step 1 Qmax Challenge #3813

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USMLE-Rx Step 1 Qmax Challenge #3813The image is from a 51-year-old man at autopsy. Prior to his death he suffered from an illness characterized by increasing shortness of breath, lower extremity edema, and a loud holosystolic heart murmur. In childhood he suffered from several bouts of an illness with polyarthritis, rash, chorea, and fever.

Which of the following is the most common histologic finding in heart tissue following death from this illness?

A. Caseous granuloma
B. Degenerative calcification
C. Fibroblast infiltrate and collagen deposition
D. Lymphocytic infiltrate
E. Myxoid degeneration
F. Non-caseating granuloma with multi-nucleated giant cells

———————–

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USMLE-Rx Step 1 Qmax Challenge #3777

9

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USMLE-Rx Step 1 Qmax Challenge #3777A 26-year-old man presents with left eye pain and intermittent double vision. When at rest, his left eye is deviated downward and laterally, as pictured in the image. Upgaze and adduction are limited in the affected eye; however, abduction appears intact. Also, the left lid droops, and the left pupil is dilated and unresponsive to light as shown in the image.

Which of the following cranial nerves is most likely to have been injured?

A. Abducens nerve
B. Oculomotor nerve
C. Optic nerve
D. Trigeminal nerve
E. Trochlear nerve

———————–

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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