9 USMLE Step 1 Mixed Review Questions with Answers (Set 4)

These 9 quick USMLE review questions test the high-yield facts that show up again and again on the exam: pregnancy testing, factor V Leiden, chest pain, aortic aneurysm, endocarditis signs, thrombolysis, secondary dyslipidemia, Mullerian-inhibitory factor and spermatogenesis. Each question includes the correct answer.

Written by Dr. Ray Makar, MD, author of the Repeated USMLE Questions eBook series.

Prefer video? Watch daily USMLE case questions on MedFocus by Dr. Ray on YouTube.

How to use this page: read the question, pick your answer, then tap Show Answer and Explanation.

Questions

Question 1. A 19-year-old woman presents with nausea and vomiting. Her last menstrual period was 6 weeks ago. Which of the following is the best next step in management?

A- Beta-hCG
B- Complete blood count
C- Serum electrolytes
D- Urinalysis

A- Beta-hCG- In any woman of reproductive age with nausea, vomiting, and a missed or late period, the first step is to check for pregnancy. A beta-hCG test confirms or excludes pregnancy before pursuing other evaluations.
The correct answer is A

 

Question 2. Which of the following is the most common inherited cause of hypercoagulability?

A- Congenital antithrombin III deficiency
B- Factor V Leiden mutation
C- Protein C deficiency
D- Prothrombin gene mutation

B- Factor V Leiden mutation
The correct answer is B

 

Question 3. Which of the following is the most common cause of chronic chest pain?

A- Cardiac
B- Gastrointestinal
C- Musculoskeletal
D- Malignant

C- Musculoskeletal
The correct answer is C

 

Question 4. What is the most common cause of abdominal aortic aneurysm?

A- Atherosclerosis
B- Complication of coronary artery disease
C- Post-inflammatory
D- Post-operative

A- Atherosclerosis
The correct answer is A

 

Question 5. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads?

A- Janeway lesions
B- Osler nodes
C- Roth’s spots
D- Splinter hemorrhages

B- Osler nodes
The correct answer is B

 

Question 6. A patient comes to a rural hospital one hour after he experienced excruciating chest pain. After workup, you diagnose his case as a myocardial infarction. The nearest hospital is 2 hours away. What is the best next step??

A- Administer thrombolytic now
B- Consult a cardiologist
C- Transfer to the nearest hospital

A- Administer thrombolytic now- In a confirmed myocardial infarction where PCI cannot be performed within 120 minutes, the best immediate treatment is thrombolytic therapy.Since the nearest hospital is 2 hours away and time-to-reperfusion is critical, giving thrombolytics immediately offers the greatest survival benefit.
The correct answer is A

 

Question 7. Which of the following is the common cause of secondary dyslipidemia?

A- Apo C-II deficiency
B- Diabetes mellitus
C- Familial combined hyperlipidemia
D- Familial hypercholesterolemia

B- Diabetes mellitus
The correct answer is B

 

Question 8. Mullerian-inhibitory factor plays a major role in the development of the male reproductive system. Which type of cells secrete it?

A- Leydig cells
B- Sertoli cells

B- Sertoli cells- Sertoli cells in the testes secrete Müllerian-inhibitory factor (MIF), also called anti-Müllerian hormone, which causes regression of the Müllerian ducts during male fetal development. Leydig cells produce testosterone but do not secrete MIF.
The correct answer is B

 

Question 9. Primitive spermatogenic germ cells are located in which one of the following sites?

A- Interstitium of the testes
B- Seminal vesicles
C- Seminiferous tubules
D- Vas deferens

C- Seminiferous tubules
The correct answer is C

 

High-yield points from this set

  • Check beta-hCG in any woman of reproductive age with nausea and a late period.
  • Factor V Leiden is the most common inherited thrombophilia.
  • Osler nodes are tender; Janeway lesions are painless.
  • Thrombolyse a STEMI if PCI cannot be done within 120 minutes.

Keep practicing

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