USMLE-Rx Step 1 Practice Q's

USMLE-Rx Step 1 Qmax Challenge #3442

8

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USMLE-Rx Step 1 Qmax Challenge #3442A 34-year-old man is brought to the emergency department after being involved in a high-speed collision with an oncoming car. He has multiple fractures and contusions. Results of fundoscopy are shown in the image. The patient is stabilized and transferred to the intensive care unit. Two days later, there is evidence of gastrointestinal hemorrhage.

What is the most likely mechanism of the gastrointestinal bleeding?

A. Chronic irritation of the gastroesophageal junction by caustic acid secretions
B. Dilated submucosal veins in the esophagus due to portal hypertension
C. Increased vagal stimulation secondary to elevated intracranial pressure
D. Inhibited gastric secretion of mucus secondary to bacterial infection in the stomach
E. Overuse of oral analgesics leading to superficial gastric erosions

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USMLE-Rx Step 1 Qmax Challenge #3421

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USMLE-Rx Step 1 Qmax Challenge #3421A 54-year-old woman complains about a persistent cough she has had for the past 3 months. The cough has been bothering her a lot and making her anxious. She thinks the anxiety is why she has lost some weight recently. She also blames the anxiety whenever she wakes up in the middle of the night and finds herself drenched in sweat. Further history reveals she has rheumatoid arthritis (RA), but her joint pains and swellings are well controlled by medications her rheumatologist has prescribed her. Following a physical examination, the physician orders an x-ray of the chest (see image). Based on the results, the physician immediately prescribes an antibiotic regimen and asks her to discontinue one of the drugs used to treat her RA.

Which of the following drugs increased her risk of developing the disease shown on the radiograph?

A. Etanercept
B. Methotrexate
C. Nonsteroidal anti-inflamatory drugs
D. Risedronate
E. Sulfasalazine

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USMLE-Rx Step 1 Qmax Challenge #3417

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USMLE-Rx Step 1 Qmax Challenge #3417A 58-year-old man presents to his physician with fatigue and cough. He has a history of chronic myelogenous leukemia and has been in remission for 3 years. His WBC count is 50,000/mm³, and immature cells are noted on peripheral blood smear. In the office he spikes a fever of 39.4°C (103°F). Lung tissue is obtained for biopsy and silver stained (results are shown in the image). Based on the results, appropriate antimicrobial therapy is initiated. In a few hours the patient develops blurred vision, and later the patient’s QTc interval is noted to be elongated on ECG.

What is the most likely antimicrobial agent this patient was prescribed?

A. Voriconazole
B. Amphotericin B
C. Caspofungin
D. Griseofulvin
E. Terbinafine

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USMLE-Rx Step 1 Qmax Challenge #3408

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USMLE-Rx Step 1 Qmax Challenge #3408A patient undergoing lung transplantation because of pulmonary fibrosis had his pressure-volume curves monitored throughout the operation. The following events took place in the operating room: (1) his right lung was resected, (2) the new right lung was transplanted, and (3) positive end-expiratory pressure (PEEP) was added to prevent pulmonary edema.

Which pressure-volume loop most likely represents the patient’s pulmonary function when the patient was being ventilated on one lung prior to the new lung being transplanted?

A. Loop A
B. Loop B
C. Loop C
D. Loop D

———————–

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USMLE-Rx Step 1 Qmax Challenge #3406

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USMLE-Rx Step 1 Qmax Challenge #3406A 48-year-old woman presents to her physician with a 2-month history of dull left upper quadrant pain and chronic fatigue. Laboratory evaluation reveals the patient is anemic, and further tests indicate she has a malignancy. Her peripheral blood smear is shown in the image. The patient’s condition is highly susceptible to a single drug treatment regimen that results in the inhibition of a critical oncogene.

The drug in question interacts most strongly with which of the following signaling pathways?

A. G protein-coupled receptor signaling
B. NF-?B signaling pathway.
C. Steroid receptor signaling
D. TGF-? receptor signaling pathway
E. Tyrosine receptor kinase signaling

———————–

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USMLE-Rx Step 1 Qmax Challenge #3403

16

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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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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.

USMLE-Rx Step 1 Qmax Challenge #3408

0

Check out today’s Step 1 Qmax Question Challenge.

Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

USMLE-Rx Step 1 Qmax Challenge #3408A patient undergoing lung transplantation because of pulmonary fibrosis had his pressure-volume curves monitored throughout the operation. The following events took place in the operating room: (1) his right lung was resected, (2) the new right lung was transplanted, and (3) positive end-expiratory pressure (PEEP) was added to prevent pulmonary edema.

Which pressure-volume loop most likely represents the patient’s pulmonary function when the patient was being ventilated on one lung prior to the new lung being transplanted?

A. Loop A
B. Loop B
C. Loop C
D. Loop D

———————–

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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