United States Medical Licensing Examination (USMLE) Step 1 Practice Questions

Hundreds of practice questions mapped to all organ systems and foundational science disciplines on the USMLE Step 1. Questions include worked explanations with full solution steps.

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Sample Questions

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Question 1 of 3

A 14-year-old boy is significantly shorter than his peers and has not begun puberty. His father was a "late bloomer." Exam shows Tanner stage 1 with bone age of 11.5 years. Growth velocity is 5 cm/year. TSH, IGF-1, and CBC are normal. Which of the following is the most likely diagnosis?

A Growth hormone deficiency
B Constitutional delay of growth and puberty
C Primary hypogonadism
D Hypothyroidism
E Turner syndrome
Question 2 of 3

A 14-month-old boy is not walking yet. He sat without support at 6 months, crawled at 10 months, stands holding furniture, uses a pincer grasp, and waves bye-bye. No dysmorphic features. Growth is at the 50th percentile. The most likely explanation is:

A Global developmental delay
B Normal variation in motor milestone attainment
C Cerebral palsy
D Autism spectrum disorder
E Spinal muscular atrophy
Question 3 of 3

A 15-month-old boy's diet consists primarily of cow's milk (4–5 cups daily) and crackers. He has pale conjunctivae. Labs: Hb 8.2 g/dL, MCV 68 fL, serum iron 25 μg/dL, TIBC 450 μg/dL, ferritin 8 ng/mL. The most likely explanation is:

A Beta-thalassemia minor
B Dietary iron deficiency
C Lead poisoning
D Autoimmune hemolytic anemia
E G6PD deficiency

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