Illinois Physician Licensing Examination (USMLE) Practice Questions And Correct Answers (Verified Answers) Plus Rationales 2026 Q&A Instant Download Pdf

Illinois Physician Licensing Examination
(USMLE) Practice Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf


Question 1
A 65-year-old man presents with progressive shortness of breath and lower
extremity edema. Echocardiography shows a reduced ejection fraction of
30%. Which of the following medications has been shown to improve
survival in systolic heart failure?

A. Furosemide
B. Digoxin
C. Lisinopril
D. Metoprolol

,Rationale: ACE inhibitors such as lisinopril reduce afterload, decrease
mortality, and slow disease progression in systolic heart failure. Diuretics
relieve symptoms but do not improve survival. Digoxin improves symptoms
but not survival. Beta-blockers may improve survival but are started carefully
in stable patients.



Question 2
A 25-year-old woman presents with fatigue and pallor. Laboratory
evaluation shows hemoglobin 8 g/dL, MCV 70 fL, and ferritin 8 ng/mL.
Which is the most likely diagnosis?

A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Sickle cell anemia
D. Thalassemia

Rationale: Microcytic anemia (low MCV) with low ferritin indicates iron
deficiency anemia. Vitamin B12 deficiency presents with macrocytosis. Sickle
cell anemia shows normocytic anemia with sickled cells. Thalassemia
typically shows microcytosis but normal or high ferritin.



Question 3
A patient with chronic hypertension presents with severe headache and

,blurred vision. Fundoscopic exam shows flame-shaped hemorrhages and
papilledema. Which is the most likely diagnosis?

A. Hypertensive emergency
B. Hypertensive urgency
C. Acute angle-closure glaucoma
D. Temporal arteritis

Rationale: Hypertensive emergency is defined by markedly elevated blood
pressure with evidence of end-organ damage, including papilledema.
Hypertensive urgency is high BP without end-organ damage. Acute angle-
closure glaucoma causes eye pain and halos. Temporal arteritis presents
with jaw claudication and vision loss.



Question 4
Which of the following is the primary mechanism of action of warfarin?

A. Direct thrombin inhibition
B. Platelet aggregation inhibition
C. Vitamin K epoxide reductase inhibition
D. Factor Xa direct inhibition

Rationale: Warfarin inhibits vitamin K epoxide reductase, decreasing
synthesis of vitamin K–dependent clotting factors II, VII, IX, and X. Direct
thrombin inhibitors include dabigatran, and factor Xa inhibitors include
rivaroxaban.

, Question 5 y




A 7-year-old child presents with a fever, cough, and a red rash that started
y y y y y y y y y y y y y




y on the face and spread to the trunk. Koplik spots are present. What is the
y y y y y y y y y y y y y y




y most likely causative agent?
y y y




A. Varicella-zoster virus y




B. Measles virus (rubeola) y y




C. Rubella virus y




D. Parvovirus B19 y




Rationale: Measles presents with fever, cough, coryza, conjunctivitis, Koplik
y y y y y y y y




y spots, and a descending rash. Rubella is milder, varicella causes vesicular
y y y y y y y y y y




lesions, and parvovirus B19 causes “slapped cheek” rash.
y y y y y y y




Question 6 y




A 30-year-old man presents with sudden severe chest pain radiating to the
y y y y y y y y y y y




y back. He has a history of Marfan syndrome. Chest X-ray shows a widened
y y y y y y y y y y y y




y mediastinum. What is the most likely diagnosis? y y y y y y




A. Aortic dissection y




B. Myocardial infarction y




C. Pulmonary embolism y




D. Pericarditis