LATEST 2025-2026 COMPLETE EXAM (usmle step
1)MEDICAL EXAMINATION.ALREADY GRADED A+
Where does the needle enter during a lumbar puncture?-
ANSWER-Subarachnoid space
What is the reason for the lumbar puncture?-ANSWER-Extract
CSF or inject anesthetic to epidural space
Where is the needle usually inserted during a lumbar
puncture?-ANSWER-Between L3/L4 or L4/L5. (Level of
horizontal line through upper points of iliac crests)
Where does the dural sac extend to?-ANSWER-Level of S2
1|Page
,Where does the spinal chord normally end?-ANSWER-L1 to L2
In what regions does herniations of discs usually occur?-
ANSWER-In two different spinal regions: Either lumbar (L4/L5
or L5/S1) or cervical region (C5/C6 or C6/C7). Note: This only
applies to individuals younger than age 50.
What are the clinical symptoms of herniated disc?-ANSWER-
History of back pain that may radiate down to the lower limb.
Pain begins after patient lifts something heavy.
Which nerve root is compressed during herniated lumbar
discs?-ANSWER-One number below: Herniation of L4/L5 will
compress L5 root. The same applies for the cervical region.
What are the symptoms of herniation of lumbar discs?-
ANSWER-Lower limb reflexes are decreased on the affected
side.
What reflex will be decreased if hernation of disc L2/L3 or
L3/L4?-ANSWER-Patellar tendon reflex
2|Page
,What reflex will be decreased if hernation of disc L5/S1?-
ANSWER-Achilles tendon reflex
What is Kyphosis?-ANSWER-Abnormal curvature of the spine,
exaggeration of the thoracic curvature that may occur in
elderly persons as a result of osteoporosis or disk
degeneration. Explain how it looks.
What is Osteoporosis?-ANSWER-Multiple compression
fracture of vertebral bodies.
What is Lordosis?-ANSWER-Exaggeration of lumbar curvature,
can be temporary. Explain how it looks.
Why does Lordosis occur?-ANSWER-Pregnancy,
spondylolisthesis or potbelly
What is spondylolisthesis?-ANSWER-Displacement of one
vertibrae over another.
What is scoliosis?-ANSWER-A complex lateral deviation or
torsion. Explain how it looks.
3|Page
, Why does scoliosis occur?-ANSWER-Poliomyelitis, a leg–length
discrepancy or a hip disease.
What structures are affected if you have a fracture of the
surgical neck of humerus?-ANSWER-Axillary nerve and
posterior humeral circumflex artery.
What structures are affected if you have a fracture at the
midshaft of the humerus?-ANSWER-Radial nerve and profunda
brachii artery. Note: It can also affect the origin of brachialis.
What structures can be affected if you have a fracture of the
supracondylar region?-ANSWER-Brachial artery and median
nerve
What structure is injured when you have a fracture at the
medial epicondyle?-ANSWER-Ulnar nerve
What is the most common fracture of the forearm after age
50?-ANSWER-Transverse fracture within the distal 2 cm of the
radius.
4|Page