USMLE Step 1- Quiz 1

A 65-year-old farmer presents to the clinic for evaluation of a long time lesion on his forehead. During an examination for life insurance, the nurse noticed it and advised him to go to the clinic for evaluation. The lesion is 1.5 in diameter, tan and nodular with an adherent greasy scale. Microscopically, it shows atypical keratinocytes invading the dermis and presence of intercellular bridges between the tumor cells.

What is the most likely diagnosis?

A- Basal cell carcinoma

B- Langerhans cell histiocytosis

C- Malignant melanoma

D- Mycosis fungoides

E- Squamous cell carcinoma

This is a typical presentation of squamous cell carcinoma. Forehead is a common site due to direct exposure to sun. Gross and microscopic findings are typical for squamous cell carcinoma.

The correct answer is E


A 72-year-old man presents to his physician for a follow up after a stroke. The physician pays more attention for the care of this patient, as he reminds the physician of his father who passed away 3 years ago after having a stroke.

This is an example of which one of these mechanisms?

A-Acting out





This is an example of countertransference, which is redirection of the physician’s feeling toward his patient. It is opposite to transference, which is redirection of the patient’s feeling of a significant person to the physician. Other options have different definitions.

The correct answer is E

2 thoughts on “USMLE Step 1- Quiz 1”

  1. E bcz the doctor pays attention towards patient its example of countertransference.

  2. Answers e

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