Sample test questions
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- Bu səhifədəki naviqasiya:
- Answer Form for USMLE Step 1 Sample Test Questions Block 1 (Questions 1-40)
- Answer Key for USMLE Step 1 Sample Test Questions
- Block 2 (Questions 41-80)
- Block 3 (Questions 81-117)
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110.
A 16-year-old boy comes to the physician because of a rash on his left inner thigh that first appeared 2 days after he returned from a hunting trip with friends in Minnesota. A photograph of the rash is shown. Without treatment, this patient is at increased risk for which of the following?
(A) Carditis (B) Glomerulonephritis (C) Hepatitis (D) Pancreatitis (E) Thrombocytopenia
After being severely beaten and sustaining a gunshot wound to the abdomen, a 42-year-old woman undergoes resection of a perforated small bowel. During the operation, plastic reconstruction of facial fractures, and open reduction and internal fixation of the left femur are also done. Thirty-six hours postoperatively, she is awake but not completely alert. She is receiving intravenous morphine via a patient-controlled pump. She says that she needs the morphine to treat her pain, but she is worried that she is becoming addicted. She has no history of substance use disorder. She drinks one to two glasses of wine weekly. Which of the following initial actions by the physician is most appropriate?
(A) Reassure the patient that her chance of becoming addicted to narcotics is minuscule (B) Maintain the morphine, but periodically administer intravenous naloxone (C) Switch the patient to oral acetaminophen as soon as she can take medication orally (D) Switch the patient to intramuscular lorazepam (E) Switch the patient to intravenous phenobarbital
A 51-year-old man comes to the office because of a 6-month history of a lump on his tongue that is interfering with his speech and eating; he also has had a 6.8-kg (15-lb) weight loss during this period. He has smoked 1 pack of cigarettes daily and has consumed six 12-oz bottles of beer on weekend nights during the past 30 years. His vital signs are within normal limits. Physical examination shows a 1.5-cm mass on the apex of the tongue. Further evaluation of the mass confirms squamous cell carcinoma. It is most appropriate to evaluate which of the following lymph nodes first for evidence of metastasis in this patient?
(A) Inferior deep cervical (B) Parotid (C) Retropharyngeal (D) Submental (E) Superior deep cervical
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113.
A 31-year-old woman comes to the physician because of a 2-week history of malaise, nausea, vomiting, and decreased appetite. She is a known user of intravenous heroin. She appears chronically ill. She is 165 cm (5 ft 5 in) tall and weighs 47 kg (103 lb); BMI is 17 kg/m 2 . Her temperature is 36.7°C (98.1°F), pulse is 90/min, respirations are 18/min, and blood pressure is 114/68 mm Hg. Physical examination shows scleral icterus and a liver span of 16 cm. The spleen is not palpable. Serum studies show:
Total bilirubin 3.2 mg/dL AST
774 U/L ALT
820 U/L HIV antibody negative Hepatitis B surface antigen negative Hepatitis B surface antibody positive Anti-hepatitis B core antibody positive Hepatitis B DNA negative Anti-hepatitis C virus positive Hepatitis C RNA positive
Which of the following is the most likely outcome of this patient's infection? (A) Complete resolution of infection (B) Latent infection with intermittent viremia (C) Lifelong persistent infection (D) Patient death from acute infection
114.
A 57-year-old man receives radiation therapy for a squamous cell carcinoma of the lung. Despite therapy, the tumor progressively increases in size, and he dies 6 months later. His tumor cells contain a point mutation in the p53 gene (TP53), leading to an inactive gene product. Based on this finding, the progressive tumor growth despite irradiation therapy is most likely to be related to a defect in cell cycle arrest in which of the following phases of the cell cycle?
(A) G 0
(B) G 1
(C) G 2
(D) M (E) S
115.
A 55-year-old man comes to the physician for a routine physical examination. He is currently taking no medications. His pulse is 80/min, and blood pressure is 165/95 mm Hg. Physical examination shows no other abnormalities. The presence of which of the following mechanisms is most likely to increase this patient's blood pressure further?
(A) Decreased cardiac output (B) Decreased pulse (C) Decreased stroke volume (D) Increased peripheral vascular resistance (E) Increased pulmonary artery pressure
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116.
A 53-year-old man comes to the physician because of a 6-month history of intermittent blood in his stool. He has had no pain with defecation. Physical examination shows a 1-cm, visible anal mass located below the dentate line. A biopsy of the mass is scheduled. If the mass if found to be malignant, it is most appropriate to evaluate which of the following lymph nodes for possible metastasis?
(A) Internal iliac (B) Popliteal (C) Sacral (D) Superficial inguinal (E) Superior rectal
A 59-year-old man is brought to the emergency department because of a 4-day history of nausea, vomiting, and diarrhea. He also has been confused and agitated during this period. He has a history of mild hypertension. His current medication is a diuretic. His temperature is 37°C (98.6°F), pulse is 108/min, respirations are 26/min, and blood pressure is 70/47 mm Hg. Physical examination shows delayed capillary refill of the lips and nail beds and cool extremities. His oxyhemoglobin saturation in a central vein is 60% (N=70–75). These findings are most consistent with which of the following types of shock?
(B) Distributive (C) Hypovolemic (D) Obstructive (E) Septic
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Answer Form for USMLE Step 1 Sample Test Questions
Block 1 (Questions 1-40)
1.
___ 11.
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2. ___
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3. ___ 13.
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7. ___ 17.
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9. ___ 19.
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10. ___
20. ___ 30. ___ 40. ___
Block 2 (Questions 41-80)
41. ___
51. ___
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42.
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43. ___ 53.
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44. ___ 54.
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45. ___ 55.
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46. ___ 56.
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47. ___ 57.
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48. ___ 58.
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49. ___ 59.
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50. ___ 60.
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Block 3 (Questions 81-117)
81. ___
91. ___
101. ___
111. ___
82. ___ 92.
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103. ___
113. ___
84. ___ 94.
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86. ___ 96.
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88. ___ 98.
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90. ___ 100.
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Answer Key for USMLE Step 1 Sample Test Questions
Block 1 (Questions 1-40)
1. D 2. A
3. D 4. A
5. E 6. C
7. C 8. B
9. C 10. F
11. D 12. E
13. C 14. D
15. C 16. A
17. D 18. B
19. B 20. B
21. B 22. E
23. A 24. A
25. A 26. B
27. C 28. C
29. B 30. C
31. A 32. E
33. E 34. E
35. D 36. D
37. C 38. C
39. A 40. B
41. C 42. E 43. D
44. A 45. B
46. A 47. C
48. B 49. D
50. D 51. C
52. G 53. C
54. B 55. D
56. E 57. E
58. D 59. E
60. A 61. A
62. A 63. C
64. C 65. B
66. A 67. B
68. E 69. D
70. A 71. B
72. C 73. A
74. A 75. A
76. A 77. D
78. B 79. E
80. E
82. E 83. E
84. E 85. E
86. A 87. B
88. B 89. C
90. E
91. C 92. C
93. B 94. A
95. F 96. D
97. D 98. E
99. B 100. B
101. B 102. C 103. D
104. C 105. B
106. E 107. E
108. B 109. B
110. A
111. A 112. D
113. C 114. B
115. D 116. D
117. C Document Outline
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