USMLE-Rx Step 1 Practice Q's

USMLE-Rx Step 1 Qmax Challenge #3613

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USMLE-Rx Step 1 Qmax Challenge #3613A 57-year-old man presents to his internist because of abnormal bleeding following a routine dental cleaning. Over the past several months he has experienced symptoms of headache, dizziness, fatigue, decreased vision, and occasional epistaxis. He has also begun noticing “lumps” on his armpits and groin region. The spleen tip is palpable on physical examination. Laboratory tests show a hemoglobin level of 11 g/dL, blood urea nitrogen of 25 mg/dL, calcium of 9.1, and total protein of 15 g/dL. Immunofixation shows high levels of IgM. Results of bone marrow biopsy are shown in the image.

Which of the following is the most likely explanation for the patient’s symptoms?

A. Heavy-chain disease
B. Monoclonal gammopathy of undetermined significance
C. Multiple myeloma
D. Primary amyloidosis
E. Waldenström’s macroglobulinemia

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USMLE-Rx Step 1 Qmax Challenge #3590

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USMLE-Rx Step 1 Qmax Challenge #3590An exceptionally tall 35-year-old man with long fingers and a history of poor vision presents to the emergency department complaining of severe chest pain radiating to the middle of his back. The physicians believe that he is having a heart attack and treat him accordingly. Sadly, he dies during the resuscitation attempt, and it was later discovered that he had a different fatal complication as a result of a chronic illness. A microscope slide of his aorta is shown in the image.

What microscopic pathology is responsible for the complication that led to his death?

A. Atherosclerosis
B. Calcified aortic valve
C. Cystic medial necrosis
D. Mitral valve prolapse
E. Syphilitic aortitis

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USMLE-Rx Step 1 Qmax Challenge #3574

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USMLE-Rx Step 1 Qmax Challenge #3574A 68-year-old man suffers a stroke of his left posterior inferior cerebellar artery. One of the cell types damaged by the stroke is shown in the image.

What is the neurotransmitter used by this neuron subtype?

A. ?-Aminobutyric acid
B. Acetylcholine
C. Dopamine
D. Glutamate
E. Glycine
F. Norepinephrine

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USMLE-Rx Step 1 Qmax Challenge #3567

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USMLE-Rx Step 1 Qmax Challenge #3567A 37-year-old man complains of an unsteady gait when he walks. He has a history of drug abuse, alcohol abuse, and numerous sex partners. A myelin stain of the spinal cord is shown in the image.

Which of the following organisms is responsible for this spinal cord lesion?

A. Herpes simplex virus
B. HIV
C. Mycobacterium tuberculosis
D. Poliovirus
E. Treponema pallidum

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USMLE-Rx Step 1 Qmax Challenge #3563

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USMLE-Rx Step 1 Qmax Challenge #3563A 32-year-old man presents with a painful ulcerated skin lesion (see image). A thorough history reveals weight loss as well as 4 years of intermittent diarrhea that is often bloody.

Other than a wound dressing, most appropriate therapy to address the underlying cause of this patient’s skin lesion?

A. Ampicillin
B. Bacitracin
C. Glipizide
D. Oral corticosteroids
E. Tetracycline

———————–

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USMLE-Rx Step 1 Qmax Challenge #3561

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USMLE-Rx Step 1 Qmax Challenge #3561A 27-year-old pregnant woman from Guatemala dies suddenly while lifting a heavy object in her home. She has no cardiac history, but her mother tells the coroner that her daughter developed a murmur 3 or 4 years ago. A histologic specimen of her heart at autopsy is shown in the image.

What is the most likely cause of this pathology and the patient’s death?

A. Atherosclerosis
B. Bicuspid aorta
C. Hypertrophic obstructive cardiomyopathy
D. Infectious endocarditis
E. Rheumatic heart disease

———————–

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USMLE-Rx Step 1 Qmax Challenge #3527

5

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USMLE-Rx Step 1 Qmax Challenge #3527A pregnant woman presents to her obstetrician for her first scheduled prenatal examination. Her uterus is larger than it should be for the gestational age of 10 weeks, as calculated on the basis of her last menstrual period. Her ?-human chorionic gonadotropin level is elevated to >100,000 mU/mL. A transvaginal ultrasound of the uterus is performed and is shown in the image.

What are the most common karyotype and the most usual chromosomal origin in this case?

A. 46,XO; both maternal and paternal derivations
B. 46,XX; all maternally derived
C. 46,XX; all paternally derived
D. 69,XXX; extra maternal set
E. 69,XXY; extra paternal set

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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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