Step 1 Practice Q’s
USMLERx Step 1 QBank Question #2000
Aug 30th
A 45-year-old man who is of Scandinavian descent presents to the physician with hematuria, left-sided flank pain, and a palpable mass in his left flank. He undergoes a kidney biopsy and is diagnosed with renal cell carcinoma. Radiographic findings suggest metastatic disease to his lung. He is initiated on a chemotherapy regimen that includes an interleukin-2 (IL-2). Which of the following is the mechanism of action of interleukin-2 (IL-2)?
A. Blocks the ATP-binding site in the bcr-abl tyrosine kinase domain
B. Causes a decreased blood supply to the tumor
C. Promotes class switching to IgE and IgG
D. Stimulates bone marrow stem cell differentiation
E. Activates lymphoid cells
Q&A Monday – USMLERx Step 1 Question #1005
Jul 19th
A 56-year-old obese man comes to the emergency department because of crushing chest pain that has been present for 3 hours. The pain radiates to his left arm and neck. He also complains of nausea. On physical examination, the patient is found to be sweating and his blood pressure is 164/122 mm Hg. Laboratory analysis reveals that his cardiac enzyme levels are elevated. His ECG is abnormal with ST-segment depression. Which of the following is the pathology underlying the correct diagnosis?
A. Coronary artery vasospasm caused by cigarettes and cocaine
B. Complete occlusion of the coronary arteries by a mural thrombus
C. Increased cardiac demand with coronary arteries that are greater than 75% occluded
D. Ischemic necrosis of 30% of the ventricular wall
E. Ischemic necrosis of 70% of the venricular wall
Q&A Monday – USMLERx Step 1 Question #4778
Jul 12th
A 67-year-old man presents to the emergency department because of acute chest pain that began more than 6 hours ago. ECG shows elevated ST-segments in three consecutive leads. If a biopsy of the affected tissue were taken at this point, bands would be visible under the microscope. What is the best explanation for the presence of these bands?
A. Collagen deposits of fibrosis
B. Elevated intracellular calcium level
C. Inability to form cross-bridges between myosin and actin
D. Macrophage-mediated resorption
Q&A Monday – USMLERx Step 1 Question #2351
Jul 5th
A 25-year-old man comes to the physician with constipation, polyuria, polydipsia, hyporeflexia, and lethargy. Laboratory studies confirm an abnormality in calcium handling. Which of the following drugs would most likely alleviate these symptoms?
A. Acetazolamide
B. Furosemide
C. Hydrochlorothiazide
D. Mannitol
E. Parathyroid hormone
Q&A Monday – USMLERx Step 1 Question #1482
Jun 28th
A 42-year-old man presented to his primary care physician several months ago with complaints of fatigue, loss of appetite, difficulty concentrating, decreased sleep, and feelings of worthlessness. He has been receiving pharmacologic treatment for these symptoms and has now begun to develop symptoms of urinary retention, blurred vision, constipation, and aggravation of his glaucoma. Which of the following drugs is this patient most likely taking?
A. Bupropion
B. Fluoxetine
C. Nortriptyline
D. Phenelzine
E. Trazodone
Q&A Monday – USMLERx Step 1 Question #5049
Jun 21st
An infant is born prematurely at 34 weeks’ gestation. At birth he exhibits a grimace and has a pink trunk with blue extremities, a pulse of 85/min, some muscle tone, and a respiratory rate of 25/min. What is the infant’s Apgar score?
A. 5
B. 6
C. 7
D. 8
E. 9


