10 USMLE Step 1 Mixed Review Questions with Answers (Set 6)

These 10 quick USMLE review questions test high-yield facts that show up again and again on the exam: SIADH, growth hormone excess, hyperaldosteronism, normal pregnancy, contraception, breech delivery, glycogen storage disease, acne, Paget disease and polycystic kidney disease. 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. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion?

A- Euvolemic hyponatremia with continued Na excretion
B- Hyperosmotic volume contraction
C- Recommended treatment is desmopressin acetate and hydration
D- Serum osmolality is greater than urine osmolality

A- Euvolemic hyponatremia with continued Na excretion- The Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) is characterized by excessive secretion of antidiuretic hormone (ADH), leading to increased water reabsorption in the kidneys. This causes dilutional hyponatremia with a euvolemic state (normal extracellular fluid volume) due to compensatory mechanisms such as increased natriuresis (sodium excretion).
The correct answer is A

 

Question 2. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)?

A- Carpal tunnel syndrome
B- Gastric adenocarcinoma
C- Hypothyroidism
D- Malignant melanoma

A- Carpal tunnel syndrome- edematous synovial tissues compress the median nerve
The correct answer is A

 

Question 3. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity?

A- Addison’s disease
B- Pheochromocytoma
C- Primary hyperaldosteronism
D- Secondary hyperaldosteronism

C- Primary hyperaldosteronism- Secondary hyperaldosteronism is almost the same as primary but renin activity increases.
The correct answer is C

 

Question 4. Which of the following conditions is considered a physiological change for normal pregnancy?

A- Decreased blood volume
B- Decreased body weight
C- Decreased GI tone and motility
D- Decreased respiratory tidal volume

C- Decreased GI tone and motility: It is the only option that decreases, others increase during pregnancy.
The correct answer is C

 

Question 5. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)?

A- Depo-Provera injections
B- Intrauterine contraceptive device (IUD)
C- Combined oral contraceptive
D- Norplant

C- Combined oral contraceptive- Estrogen is thrombogenic and should be avoided in this category.
The correct answer is C

 

Question 6. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery?

A- Lovset maneuver
B- Mauriceau-Smellie-Veit maneuver
C- Pinard maneuver
D- Prague maneuver

A- Lovset maneuver- In a breech delivery, the Lovset maneuver is specifically used to deliver the arms when they are extended above the fetal head. The other maneuvers have different purposes in breech extraction.
The correct answer is A

 

Question 7. Deficiency of which of the following enzymes most likely result in the development of Cori disease?

A- Debranching enzyme (alpha-1,6-glucoside)
B- Glucose-6-phosphatase
C- Lysosomal alpha-1,4 glucosidase
D- Muscle glycogen phosphorylase

A- Debranching enzyme (alpha-1,6-glucoside)- Cori disease (Glycogen Storage Disease type III) is caused by a deficiency of the debranching enzyme, leading to accumulation of abnormal glycogen and hypoglycemia. The other enzyme deficiencies correspond to different glycogen storage diseases.
The correct answer is A

 

Question 8. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)?

A- Acne vulgaris
B- Atopic dermatitis
C- Bullous pemphigoid
D- Pemphigus vulgaris

A- Acne vulgaris- AV is the only option that accompanied with comedones which are follicular papules with black heads.
The correct answer is A

 

Question 9. Paget disease of bone is characterized by which one of the following features?

A- Increase osteoblastic activity only
B- Increase osteoclastic activity only
C- Increase both osteoblastic and osteoclastic activity
D- Decrease osteoclastic activity

C- Increase both osteoblastic and osteoclastic activity- Paget disease of the bone is the only disease that combined both these features together. It is characterized by bone enlargement and arthritis
The correct answer is C

 

Question 10. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis?

A- Niemann-Pick disease
B- Phenylketonuria
C- Pompe disease
D- Recessive polycystic kidney disease

D- Recessive polycystic kidney disease- RPKD begins in utero and is characterized by decreased urine production leading to oligohydramnios which results in pulmonary hypoplasia.
The correct answer is D

 

High-yield points from this set

  • SIADH = euvolemic hyponatremia with concentrated urine.
  • Primary hyperaldosteronism: hypertension, hypokalemia, low renin.
  • Combined oral contraceptives are contraindicated with a history of thrombosis.
  • Paget disease = increased osteoclastic and osteoblastic activity.

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