Repeated USMLE Questions Step 1- 376

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Q- An old woman is having difficulty in holding or keeping her head up. She also mentions that she experiences fatigue in her hands shortly after washing dishes. Physical examination reveals neck flexion weakness as well as proximal weakness in the arms. Which of the following is the initial diagnosis for her condition?

A- Meningitis

B- Myasthenia gravis

C- Peripheral neuropathy

D- Spinal cord compression

B- Myasthenia gravis- It is one of the most common autoimmune diseases that affect the neuromuscular junction. It is typically characterized by painless, fatigable muscle weakness. It has a bimodal age of onset, meaning it will either affect at a young age or elderly.



Q- A 30-year-old pregnant woman visits her obstetrician’s clinic at 10 weeks gestation. The patient has a history of type 1 diabetes and is worried that her condition may cause some complications in her pregnancy. From the list below, advise your patient that all of the following are a potential risk of type 1 diabetes in pregnancy EXCEPT which one?

A- Fetal malformations

B- Having to undergo a cesarean section

C- Preterm labor

D- Spontaneous abortions in the first trimester

B- Having to undergo a cesarean section- Diabetes is known to cause complications in pregnancies. Type 1 diabetes puts a pregnant woman at risk for preterm labor, preeclampsia, spontaneous abortions, and even fetal malformations due to fetal growth restrictions. There is, however, no reason to believe that if she has type 1 diabetes, she will have to undergo a cesarean section. A normal delivery is also possible, but the obstetrician will be the best person to recommend which type of birth plan is best suited for her and the baby.



Q- Which one of the following medications inhibits HMG-CoA reductase?

A- Aspirin

B- Digoxin

C- Simvastatin

D- Tacrolimus

C- Simvastatin



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8 thoughts on “Repeated USMLE Questions Step 1- 376”

  1. Thank you Dear Dr. I promise you, I will do my best to write more questions and cases. Have a good luck and bright future in your medical journey.

  2. Welcome back Dr Ray , i missed you and your wonderful medical questions and discussions! Thank you so much for your inspiring efforts you have made on clinical cases which I
    love surprisingly .! Don’t hold on sharing the cases please, no matter how you’re busy!!!

  3. Thank you. I hope they help you in your medical journey

  5. Hi Dr Claudio, this is a tricky question. The choice gives the impression that CS is mandatory in all cases of diabetic mothers but this is not true. It is optional and the decision should be made at the time of delivery according to the proportional size of the baby. It is a great comment. Thank you.

  6. Hey Dr. Ray, Thank you for these amazing questions! I’m really enjoying to do them.
    I have one doubt about the “type 1 diabetes woman pregnant” question.
    I know that the gestational diabetes can cause macrossomia, which can be an indication of cesarian section. Can macrossomia happen to the Type I diabetes mom’ babies too? If it’s true, so the answer should not be the letter B anymore.

  7. Thank you so much Dr. I am glad you like them.

  8. Good questions

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