USMLE STEP 1
The Score95 USMLE Step 1 question bank contains a little over 2,000+ practice questions with thousands of images, audio, and video! Yes, you heard right, VIDEO! We have identified and produced the most likely videos you will encounter on the USMLE. For this reason alone, this Qbank is a must buy.
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A 54-year-old woman with headaches for the past week has a lumbar puncture performed. The cerebrospinal fluid (CSF) opening pressure is 220 mm H2O, the CSF protein 60 mg/dl, and the CSF glucose 75 mg/dl (serum glucose 105 mg/dl). A CT scan is obtained and can be seen in the image. Biopsy of the mass reveals gliosis and fibrosis with necrosis, neutrophils, and lymphocytes. These findings most strongly suggest a diagnosis of:
A. Glioblastoma multiforme
B. Herpes simplex type II encephalitis
C. Vascular malformation
D. Subacute infarction
E. Cerebral abscess
The adult kidney develops from the metanephros which has two sources: the ureteric bud and the metanephric mesoderm. If a problem in the development of the ureteric bud occurred, which of the following structures in the adult kidney would be directly affected?
A. Collecting duct
B. Connecting tubule
C. Distal convoluted tubule
D. Loop of Henle
E. Proximal convoluted tubule
A patient is admitted to the hospital with shortness of breath and found to have a pleural effusion on chest X-ray. Thoracentesis is performed and the fluid is sent for laboratory testing. Results of the fluid analysis are: pleural protein 8.0, serum protein 6.5, pleural LDH 500, serum LDH 100. Based on these findings, which of the following is the most likely etiology of the pleural effusion?
B. Congestive heart failure (CHF)
D. Nephrotic syndrome
E. Pulmonary embolism
A 19-year-old female college student presents to the student health center complaining of a sore throat and headache. She reports that she had been feeling tired and worn-down for the past few weeks, but attributed it to her busy schedule at school. She denies feeling sad or depressed and denies weight loss. On physical exam, she has enlarged posterior chain cervical lymph nodes. What histology is likely to be seen when the physician looks at her peripheral blood smear?
A. All stages of granulocyte maturation
B. All stages of granulocyte maturation
C. Knobs on RBC membranes and intrerythrocyte organisms
D. Microcytic, hypochromic red blood cells
A researcher develops a new test to detect lung cancer at an earlier stage. The test picks up the lung cancer in 85% of patients with lung cancer diagnosed by the gold standard and is negative in 90% of patients without lung cancer. The prevalence of lung cancer in the population of 1000 being studied is 3%. What is the sensitivity of the test?
A 40-year-old man has had a productive cough with yellowish sputum for several days. A complete blood count shows that he has a total WBC count of 15,700/microliter with differential count of 73 segs, 10 bands, 12 lymphs, and 5 monos. He has a fever of 38.9 C. A chest radiograph reveals a nodule in the left upper lobe that has a central cavity with an air-fluid level. Which of the following findings is most likely to be present in his sputum specimen:
A. 1+ acid fast bacilli
B. Viral inclusions
C. Atypical squamous cells
D. Hemosiderin-laden macrophages
E. 4+ gram positive cocci
Five days after a mitral valve replacement, a 63-year-old woman becomes hypotensive, tachycardic, and febrile. She is rushed to the CCU where an emergent transesophogeal echocardiogram shows multiple vegetations on the new mitral valve. Blood cultures are taken, the patient is started on vancomycin and gentamycin. The initial Gram stain is seen in the image. What additional bacterial characteristics are likely to be found?
A. Catalase negative with no hemolysis
B. Catalase negative with partial hemolysis/positive quellung test
C. Catalase negative with partial hemolysis and no capsule
D. Catalase positive, coagulase negative
E. Catalase positive, coagulase positive
A 40-year-old female presents to her physician for worsening joint pain. She has had joint pain for many years in both wrists, MCP joints, and PIP joints. Her DIPs are spared. Her pain is always worse in the morning and improves as the day goes on. Lately she realizes both knees also hurt her and she is more tired than usual. Examination reveals her painful joints to be mildly warm and her PIPs are flexed, while her DIPs are extended. Laboratory testing reveals high titers of rheumatoid factor (RF), an elevated ESR and C-reactive protein, and a normocytic normochromatic anemia. Examination of the synovial fluid at the involved joints would most likely reveal which of the following?
A. Clear fluid; 125 WBC/mm3; 20% PMNs
B. Clear-yellow fluid; 1,800 WBC/mm3; 20% PMNs
C. Cloudy-yellow fluid; 6,000 WBC/mm3; 60% PMNs
D. Turbid, purulent fluid; 50,000 WBC/mm3; 80% PMNs
E. Reddish fluid; 1,500 WBC/mm3; 20% PMNs
A 34-year-old nulligravid woman comes to clinic complaining of difficulty getting pregnant for the past 15 months. The woman reports that her menses have always been irregular. The woman has a BMI of 31 and hirsutism on physical exam. What is the most likely cause of infertility in this patient?
B. Antiphospholipid syndrome
D. Submucosal uterine leiomyomas
E. Unexplained infertility
A 25-year-old male patient complains of increased thirst and increased frequency of urination. He denies any trauma or recent surgery. At baseline his urine specific gravity is 1.001 and his serum osmolality is 350. He is admitted to the hospital for observation and water restriction. After 6 hours, his urine specific gravity is 1.003 and his serum osmolality is 365. He is given intranasal desmopressin (DDAVP) and water is restricted for 6 hours. Afterward his urine specific gravity is 1.004 and his serum osmolality is 400. What medication most likely caused these symptoms?