USMLE Step 1
Study online at https://quizlet.com/_bvjtix
NBME CBSE REAL EXAM Test Bank. 200 QUESTIONS
With ANSWERS LATEST (Usmle Step 1)MEDICAL
EXAMINATION
1. Serum LDL-cholesterol concentrations are measured in blood samples
collected from 25 healthy volunteers. The data follow a normal distribution. The
mean and standard deviation for this group are 130 mg/dL and 25 mg/dL,
respectively. The standard error of the mean is 5.0. With a 95% confidence level,
the true mean for the population from which this sample was drawn falls within
which of the following ranges (in mg/dL)?: 120-140
2. A 48-year-old man dies suddenly of a cardiac arrhythmia. Six weeks ago, he
was resuscitated from a cardiac arrest caused by coronary artery disease and
developed oliguric renal failure. Five weeks ago (1 week after being resuscitated),
his serum urea nitrogen (BUN) concentration was 40 mg/dL, his serum creatinine
concentration was 3.5 mg/dL, and his urine contained granular casts. Four weeks
ago, his oliguria resolved, and his BUN and serum creatinine concentrations
returned to normal. Examination of his kidneys at autopsy is most likely to show
which of the following?: Normal Kidney
3. In a sample of 100 individuals, the mean leukocyte count is 7500/mm3 , with a
standard deviation of 1000/mm3 . If the leukocyte counts in this population follow a
normal (gaussian) distribution, approximately 50% of individuals will have which
of the following total leukocyte counts?: <7500/mm^3
4. A 55-year-old woman comes to the clinic because of a 2-month history of
increasingly severe vaginal pain and itching during sexual intercourse. She avoids
intercourse with her husband because of the symptoms. She has been in a
monogamous relationship with her husband for the past 25 years. She has type 2
diabetes mellitus. Her vital signs are within normal limits. Pelvic examination shows
edematous and erythematous vaginal mucosa with white discharge. A
photomicrograph of a vaginal smear is shown. Which of the following is the most
likely causal infectious agent?: Candida albicans
5. A 39-year-old man comes to the physician because of a 6-month history of
progressive shortness of breath. He has had a cough productive of white sputum for
2 years. He smoked 1 pack of cigarettes daily for 16 years but quit 10 years ago. He
is in mild respiratory distress with pursed lips and a barrel chest; he is using the
accessory muscles of respiration. Breath sounds are distant and crackles are present
in the lower lung fields bilaterally. Pulmonary function tests show a decreased
FEV1:FVC ratio, increased residual volume, and decreased diffusion capacity. An
x-ray of the chest shows hyperinflation and hypertranslucency of the lower lobes of
both lungs. Which of the following is the most likely diagnosis?: Emphysema
1/8
, USMLE Step 1
Study online at https://quizlet.com/_bvjtix
6. A previously healthy 33-year-old woman is brought to the emergency
department by the Secret Service for stalking the president of the USA for 2
months. She claims to be married to the president's twin brother and states that the
president just had his twin kidnapped to avoid competition. She speaks rapidly and
is difficult to interrupt. Her associations are often loose. She says, "I haven't slept
for days, but I won't even try to sleep until my husband is rescued. God has been
instructing me to take over the White House. I can't wait to be reunited with my
husband. I hear his voice telling me what to do." When asked about drug use, she
says she uses only natural substances. She refuses to permit blood or urine tests,
saying, "I don't have time to wait for the results." Which of the following is the most
likely diagnosis?: Bipolar disorder, manic, with psychotic features
7. During an experiment, a mouse is vaccinated with live attenuated bacteria at
two different times. The results following immunization are shown in the graph. The
subject's serum total antibody concentration (Y-axis) was measured at various time
points (X-axis). The response to the first immunization is indicated by Peak A, while
that of the second immunization with the same bacterial antigen is indicated by
Peak B. The phase of the immune response represented by the asterisk is most likely
the direct result of which of the following?: Apoptosis of activated lymphocytes
8. A 53-year-old man comes to the physician because of a dry scaly rash on his
body for the past year. He has had a 15- kg (33-lb) weight loss during the past year.
He is 178 cm (5 ft 10 in) tall and now weighs 54 kg (120 lb); BMI is 17 kg/m2 . His
stools have a large volume and float. Which of the following nutrient deficiencies is
most likely?: Vitamin A
9. In screening for prostate cancer, the current serum prostate-specific antigen
concentration at which biopsy is recommended is 4.1 ng/mL. If the threshold for
recommending a biopsy procedure were lowered to 2.0 ng/mL, which of the
following changes would occur to the positive and negative predictive values of the
test?: G
10. In informing a couple that their newborn has Down syndrome, there is a
specific, relatively limited amount of information that the consulting physician
should give immediately. The rest can be discussed at a later time. Which of the
following best explains the purpose of using this approach to disclosure?: Disclosing
the most important information so that it can be understood as fully as possible
11. A 25-year-old man volunteers to participate in a study of exercise. The solid
curves in the graph show the relationship between right atrial pressure and cardiac
output (cardiac function curves). The dashed lines show the relationship between
cardiac output and right atrial pressure (vascular function curves). Point X is the
pre-exercise equilibrium point. Which of the following labeled areas is the most
likely new cardiac and vascular equilibrium point during exercise in this subject?:
H
2/8
Study online at https://quizlet.com/_bvjtix
NBME CBSE REAL EXAM Test Bank. 200 QUESTIONS
With ANSWERS LATEST (Usmle Step 1)MEDICAL
EXAMINATION
1. Serum LDL-cholesterol concentrations are measured in blood samples
collected from 25 healthy volunteers. The data follow a normal distribution. The
mean and standard deviation for this group are 130 mg/dL and 25 mg/dL,
respectively. The standard error of the mean is 5.0. With a 95% confidence level,
the true mean for the population from which this sample was drawn falls within
which of the following ranges (in mg/dL)?: 120-140
2. A 48-year-old man dies suddenly of a cardiac arrhythmia. Six weeks ago, he
was resuscitated from a cardiac arrest caused by coronary artery disease and
developed oliguric renal failure. Five weeks ago (1 week after being resuscitated),
his serum urea nitrogen (BUN) concentration was 40 mg/dL, his serum creatinine
concentration was 3.5 mg/dL, and his urine contained granular casts. Four weeks
ago, his oliguria resolved, and his BUN and serum creatinine concentrations
returned to normal. Examination of his kidneys at autopsy is most likely to show
which of the following?: Normal Kidney
3. In a sample of 100 individuals, the mean leukocyte count is 7500/mm3 , with a
standard deviation of 1000/mm3 . If the leukocyte counts in this population follow a
normal (gaussian) distribution, approximately 50% of individuals will have which
of the following total leukocyte counts?: <7500/mm^3
4. A 55-year-old woman comes to the clinic because of a 2-month history of
increasingly severe vaginal pain and itching during sexual intercourse. She avoids
intercourse with her husband because of the symptoms. She has been in a
monogamous relationship with her husband for the past 25 years. She has type 2
diabetes mellitus. Her vital signs are within normal limits. Pelvic examination shows
edematous and erythematous vaginal mucosa with white discharge. A
photomicrograph of a vaginal smear is shown. Which of the following is the most
likely causal infectious agent?: Candida albicans
5. A 39-year-old man comes to the physician because of a 6-month history of
progressive shortness of breath. He has had a cough productive of white sputum for
2 years. He smoked 1 pack of cigarettes daily for 16 years but quit 10 years ago. He
is in mild respiratory distress with pursed lips and a barrel chest; he is using the
accessory muscles of respiration. Breath sounds are distant and crackles are present
in the lower lung fields bilaterally. Pulmonary function tests show a decreased
FEV1:FVC ratio, increased residual volume, and decreased diffusion capacity. An
x-ray of the chest shows hyperinflation and hypertranslucency of the lower lobes of
both lungs. Which of the following is the most likely diagnosis?: Emphysema
1/8
, USMLE Step 1
Study online at https://quizlet.com/_bvjtix
6. A previously healthy 33-year-old woman is brought to the emergency
department by the Secret Service for stalking the president of the USA for 2
months. She claims to be married to the president's twin brother and states that the
president just had his twin kidnapped to avoid competition. She speaks rapidly and
is difficult to interrupt. Her associations are often loose. She says, "I haven't slept
for days, but I won't even try to sleep until my husband is rescued. God has been
instructing me to take over the White House. I can't wait to be reunited with my
husband. I hear his voice telling me what to do." When asked about drug use, she
says she uses only natural substances. She refuses to permit blood or urine tests,
saying, "I don't have time to wait for the results." Which of the following is the most
likely diagnosis?: Bipolar disorder, manic, with psychotic features
7. During an experiment, a mouse is vaccinated with live attenuated bacteria at
two different times. The results following immunization are shown in the graph. The
subject's serum total antibody concentration (Y-axis) was measured at various time
points (X-axis). The response to the first immunization is indicated by Peak A, while
that of the second immunization with the same bacterial antigen is indicated by
Peak B. The phase of the immune response represented by the asterisk is most likely
the direct result of which of the following?: Apoptosis of activated lymphocytes
8. A 53-year-old man comes to the physician because of a dry scaly rash on his
body for the past year. He has had a 15- kg (33-lb) weight loss during the past year.
He is 178 cm (5 ft 10 in) tall and now weighs 54 kg (120 lb); BMI is 17 kg/m2 . His
stools have a large volume and float. Which of the following nutrient deficiencies is
most likely?: Vitamin A
9. In screening for prostate cancer, the current serum prostate-specific antigen
concentration at which biopsy is recommended is 4.1 ng/mL. If the threshold for
recommending a biopsy procedure were lowered to 2.0 ng/mL, which of the
following changes would occur to the positive and negative predictive values of the
test?: G
10. In informing a couple that their newborn has Down syndrome, there is a
specific, relatively limited amount of information that the consulting physician
should give immediately. The rest can be discussed at a later time. Which of the
following best explains the purpose of using this approach to disclosure?: Disclosing
the most important information so that it can be understood as fully as possible
11. A 25-year-old man volunteers to participate in a study of exercise. The solid
curves in the graph show the relationship between right atrial pressure and cardiac
output (cardiac function curves). The dashed lines show the relationship between
cardiac output and right atrial pressure (vascular function curves). Point X is the
pre-exercise equilibrium point. Which of the following labeled areas is the most
likely new cardiac and vascular equilibrium point during exercise in this subject?:
H
2/8
