USMLE Step 1 Pharmacology Questions
1. A 70-year-old man presents to a medical clinic reporting blood in his urine and lower
abdominal pain for the past few days. He is also concerned about urinary frequency and
urgency. He states that he recently completed a cycle of chemotherapy for non-Hodgkin
lymphoma. Which medication in the chemotherapy regimen most likely caused his
symptoms?
A. Cytarabine
B. Methotrexate
C. Rituximab
D. Cyclophosphamide
E. Prednisone
2. A 22-year-old man presents with abdominal cramps and diarrhea over the last few weeks.
He notes that several of his bowel movements have a small amount of blood. Past
medical history is significant for an intermittent cough that has been persistent since
returning from Mexico last month. The patient takes no current medications. On physical
examination, there is diffuse tenderness to palpation. Which of the following medications
is indicated for this patient’s condition?
A. Mebendazole
B. Ivermectin
C. Albendazole
, D. Pyrantel
E. Praziquantel
3. A 25-year-old G1P0 woman at an estimated gestational age of 9 weeks presents for her
first prenatal visit following a positive home pregnancy test. She says she missed 2
periods but assumed it was due to stress at work. She has decided to continue with the
pregnancy. Her past medical history is significant for migraine headaches, seizures, and
asthma. She takes multiple medications for her condition. Physical examination is
unremarkable. An ultrasound confirms a 9-week-old intrauterine pregnancy. Which of
these following medications poses the greatest risk to the fetus?
A. Acetaminophen
B. Sumatriptan
C. Valproic acid
D. Albuterol
E. Budesonide
4. A 35-year-old man who works in a shipyard presents with a sharp pain in his left big toe
for the past 5 hours. He says he had similar pain a few weeks ago after an evening of
heavy drinking with his friends. He denies any recent history of trauma or fever. There is
no significant past medical history and he takes no medications. Family history is
significant for a mother who has type 2 diabetes mellitus and a father who has
hypertension. He reports regular drinking and the occasional binge on weekends, but
denies any smoking history or recreational drug use. The vital signs include: pulse
, 86/min, respiratory rate 14/min, and blood pressure 130/80 mm Hg. On physical
examination, the patient is slightly overweight and in obvious distress. The 1st
metatarsophalangeal joint of the left foot is erythematous, severely tender to touch, and
swollen. No obvious deformity is seen. Arthrocentesis of the 1st left metatarsophalangeal
joint reveals sodium urate crystals. Which of the following would be the most appropriate
next step in management?
A. Probenecid
B. Morphine
C. Aspirin
D. Allopurinol
E. Naproxen
5. A 30-year-old woman came to her OBGYN for an infertility consultation. The patient
reports having intercourse with her husband at least 3 times per week with increasing
frequency during the periods. The lab reports of her husband revealed an adequate sperm
count. After the work-up was complete, her OBGYN prescribed a medication similar to
GnRH to be administered in a pulsatile manner. Which drug is prescribed to the patient?
A. Danazol
B. Leuprolide
C. Anastrazole
D. Clomiphene
E. Mestranol
1. A 70-year-old man presents to a medical clinic reporting blood in his urine and lower
abdominal pain for the past few days. He is also concerned about urinary frequency and
urgency. He states that he recently completed a cycle of chemotherapy for non-Hodgkin
lymphoma. Which medication in the chemotherapy regimen most likely caused his
symptoms?
A. Cytarabine
B. Methotrexate
C. Rituximab
D. Cyclophosphamide
E. Prednisone
2. A 22-year-old man presents with abdominal cramps and diarrhea over the last few weeks.
He notes that several of his bowel movements have a small amount of blood. Past
medical history is significant for an intermittent cough that has been persistent since
returning from Mexico last month. The patient takes no current medications. On physical
examination, there is diffuse tenderness to palpation. Which of the following medications
is indicated for this patient’s condition?
A. Mebendazole
B. Ivermectin
C. Albendazole
, D. Pyrantel
E. Praziquantel
3. A 25-year-old G1P0 woman at an estimated gestational age of 9 weeks presents for her
first prenatal visit following a positive home pregnancy test. She says she missed 2
periods but assumed it was due to stress at work. She has decided to continue with the
pregnancy. Her past medical history is significant for migraine headaches, seizures, and
asthma. She takes multiple medications for her condition. Physical examination is
unremarkable. An ultrasound confirms a 9-week-old intrauterine pregnancy. Which of
these following medications poses the greatest risk to the fetus?
A. Acetaminophen
B. Sumatriptan
C. Valproic acid
D. Albuterol
E. Budesonide
4. A 35-year-old man who works in a shipyard presents with a sharp pain in his left big toe
for the past 5 hours. He says he had similar pain a few weeks ago after an evening of
heavy drinking with his friends. He denies any recent history of trauma or fever. There is
no significant past medical history and he takes no medications. Family history is
significant for a mother who has type 2 diabetes mellitus and a father who has
hypertension. He reports regular drinking and the occasional binge on weekends, but
denies any smoking history or recreational drug use. The vital signs include: pulse
, 86/min, respiratory rate 14/min, and blood pressure 130/80 mm Hg. On physical
examination, the patient is slightly overweight and in obvious distress. The 1st
metatarsophalangeal joint of the left foot is erythematous, severely tender to touch, and
swollen. No obvious deformity is seen. Arthrocentesis of the 1st left metatarsophalangeal
joint reveals sodium urate crystals. Which of the following would be the most appropriate
next step in management?
A. Probenecid
B. Morphine
C. Aspirin
D. Allopurinol
E. Naproxen
5. A 30-year-old woman came to her OBGYN for an infertility consultation. The patient
reports having intercourse with her husband at least 3 times per week with increasing
frequency during the periods. The lab reports of her husband revealed an adequate sperm
count. After the work-up was complete, her OBGYN prescribed a medication similar to
GnRH to be administered in a pulsatile manner. Which drug is prescribed to the patient?
A. Danazol
B. Leuprolide
C. Anastrazole
D. Clomiphene
E. Mestranol
