USMLE-Rx Step 1 Practice Q's

USMLE-Rx Step 1 Qmax Challenge #4133

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USMLE-Rx Step 1 Qmax Challenge #4133A 58-year-old woman presents with a 6-month history of redness, pain, itching, and a burning sensation in her left breast, particularly around the nipple and areola. Her medical history is significant for hypertension, asthma, and untreated fibroadenoma diagnosed at age 22 years. Results of a biopsy specimen from the patient’s left nipple are shown in the image.

Which of the following is the most likely diagnosis?

A. Fibroadenoma
B. Intraductal papilloma
C. Mastitis
D. Paget disease
E. Phyllodes tumor

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USMLE-Rx Step 1 Qmax Challenge #4130

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USMLE-Rx Step 1 Qmax Challenge #4130A 75-year-old man presents with a few weeks of fever and chills. He has hypertension and takes medicines daily to lower his blood pressure and cholesterol, although he cannot remember their names. He is otherwise healthy, although his wife comments that he underwent a dental procedure a few weeks ago. Patient admits that he was supposed to take antibiotics, but was unable to complete course of antibiotics. On physical exam, you find painful, red, raised lesions on his fingers, like that shown in the image.

Which of these is most likely causing this man’s condition?

A. Haemophilus influenzae
B. Staphylococcus aureus
C. Staphylococcus epidermidis
D. Streptococcus pyogenes
E. Viridans streptococci

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USMLE-Rx Step 1 Qmax Challenge #4122

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USMLE-Rx Step 1 Qmax Challenge #4122A 23-year-old man presents to the emergency department complaining of an unsteady heart beat. A prolonged QT interval is noted. The patient loses consciousness 30 minutes later, and a repeat ECG is done, which is shown in the image.

Drugs used to treat which of the following protozoal infections are associated with this cardiac problem?

A. Giardia lamblia
B. Plasmodium falciparum
C. Pneumocystis jirovecii
D. Trichomonas vaginalis
E. Trypanosoma cruzi

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USMLE-Rx Step 1 Qmax Challenge #4101

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USMLE-Rx Step 1 Qmax Challenge #4101A 19-year-old college student presents for evaluation of persistently enlarged nontender supraclavicular lymph nodes. She says she is otherwise healthy and provides no significant medical history. She is experiencing night sweats and has had a 4.5-kg (10-lb) weight loss over the past 3 months. Three supraclavicular lymph nodes are palpable above her right shoulder. No other lymphadenopathy is noted. On X-ray of the chest, mediastinal lymphadenopathy is noted. Results of a lymph node biopsy are shown in the image.

Which of the following is the most likely diagnosis?

A. Burkitt lymphoma
B. Follicular lymphoma
C. Hodgkin lymphoma, lymphocyte-depleted type
D. Hodgkin lymphoma, nodular-sclerosing type
E. T-lymphocyte lymphoblastic lymphoma

———————–

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USMLE-Rx Step 1 Qmax Challenge #4094

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USMLE-Rx Step 1 Qmax Challenge #4094A 55-year-old woman has received treatment for years to manage a chronic, progressive disease. Since her mid-40s the patient has had difficulty initiating movements. She has a shuffling gait, an expressionless face, and tremor in her hands and fingers at rest. Over the years she has tried many medications but with little relief of her symptoms, and instead has experienced severe adverse effects. She is referred for possible ablation surgery. The neurosurgeon explains the different pathways involved in initiation and inhibition of movement, the foundation of her disease. The neurosurgeon explains that by nullifying or accentuating some of the pathways, some of her symptoms may be alleviated.

The introduction of an ablative lesion into which structure labeled in the image would be expected to improve this patient’s bradykinesia?

A. A
B. B
C. C
D. D
E. E

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USMLE-Rx Step 1 Qmax Challenge #4091

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USMLE-Rx Step 1 Qmax Challenge #4091A 70-year-old man complains of a long history of pain in his ankles, toes, and fingers. He has experienced intermittent acute attacks of exquisite pain every few months, followed by completely asymptomatic periods. In recent years, he has had near-constant discomfort at baseline, and now has permanent “swelling” in many of the joints of his fingers and toes. Joint fluid is aspirated, and the fluid is examined under polarized light (shown in the image). Treatment is initiated, and the patient’s uric acid levels gradually fall.

What is the mechanism of action of the best treatment?

A. Binds tubulin
B. Blocks formation of prostaglandins and thromboxane from arachidonic acid
C. Inhibits release of phospholipase A2
D. Inhibits xanthine oxidase
E. Selective, competitive angiotensin II receptor inhibition

———————–

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USMLE-Rx Step 1 Qmax Challenge #4065

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USMLE-Rx Step 1 Qmax Challenge #4065The image depicts steps in an immunologic activation pathway.

This pathway is most important for which activity of the immune system?

A. Antibody production
B. Antigen presentation and destruction of intracellular pathogens
C. Defense against parasites by eosinophils
D. Immediate allergic hypersensitivity reaction
E. Neutrophil chemotaxis

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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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