Acid-Base Disorders USMLE Step 1 Practice Questions
36 board-style USMLE Step 1 questions in Nephrology. Each question shows the correct answer; create a free account for the full explanation and adaptive practice.
- USMLE Step 1 · medium1. A 24-year-old woman presents with severe vomiting for 3 days following gastroenteritis. Vital signs: BP 110/70 mmHg, HR 105 bpm, RR 16, temp 37.2°C, SpO2 98% on room air. Labs s…
- USMLE Step 1 · hard2. A 41-year-old man with Child-Pugh Class C cirrhosis presents to the emergency department with progressive confusion, asterixis, and lethargy over 24 hours. He has been taking fu…
- USMLE Step 1 · hard3. A 38-year-old woman presents to the clinic with a 3-month history of progressive headaches, polyuria, and muscle weakness. Her blood pressure is 162/98 mmHg. Laboratory studies…
- USMLE Step 1 · hard4. A 71-year-old man with stage 4 chronic kidney disease and hypertension presents with fatigue and nausea. Labs show pH 7.32, HCO3- 14 mEq/L, PaCO2 32 mmHg, K+ 6.2 mEq/L, BUN 78 m…
- USMLE Step 1 · medium5. A 19-year-old woman with a history of generalized anxiety disorder presents to the emergency department with acute onset palpitations, dizziness, and tingling around her mouth a…
- USMLE Step 1 · medium6. A 28-year-old woman with a 6-month history of Crohn's disease presents with persistent diarrhea. She reports approximately 4-6 loose stools daily but denies vomiting or recent a…
- USMLE Step 1 · hard7. A 28-year-old woman with systemic lupus erythematosus presents to the clinic with a 3-week history of progressive muscle weakness, polyuria, and polydipsia. She has been on pred…
- USMLE Step 1 · hard8. A 45-year-old man with Child-Pugh class C cirrhosis presents to the emergency department with altered mental status, diffuse muscle weakness, and muscle cramping. He has been ta…
- USMLE Step 1 · medium9. A 7-year-old boy presents to the emergency department with a 5-day history of severe watery diarrhea. His mother reports he has been increasingly lethargic and refusing to drink…
- USMLE Step 1 · medium10. A 35-year-old woman with anxiety disorder presents to the ER following a panic attack with hyperventilation. She reports dizziness, perioral paresthesias, and hand tetany. Vital…
- USMLE Step 1 · medium11. A 24-year-old woman with a 3-day history of severe vomiting from gastroenteritis presents with generalized weakness and muscle cramps. Vital signs: BP 108/62 mmHg, HR 98 bpm, RR…
- USMLE Step 1 · easy12. A 42-year-old woman with poorly controlled type 2 diabetes mellitus presents to the emergency department with a 2-day history of polyuria, polydipsia, and progressive dyspnea. S…
- USMLE Step 1 · hard13. A 48-year-old man with chronic alcoholism presents to the emergency department with acute confusion and slurred speech. Vital signs show BP 128/82 mmHg, HR 102 bpm, RR 18/min, t…
- USMLE Step 1 · medium14. A 70-year-old man with systolic heart failure presents with dyspnea and orthopnea. He receives aggressive loop diuretic therapy and becomes euvolemic within 48 hours. Vitals: BP…
- USMLE Step 1 · medium15. A 39-year-old woman with resistant hypertension (BP 168/102 mmHg) presents with frequent muscle cramps and polyuria. Vital signs show HR 88/min, RR 16/min, temperature 37.2°C. L…
- USMLE Step 1 · medium16. A 45-year-old woman with idiopathic intracranial hypertension is started on acetazolamide. Two weeks later she presents with fatigue and mild paresthesias. Vital signs show BP 1…
- USMLE Step 1 · hard17. A 36-year-old woman presents with chronic watery diarrhea due to inflammatory bowel disease. She has pH 7.30 and serum bicarbonate 16 mEq/L. Her physician wants to distinguish e…
- USMLE Step 1 · hard18. A 64-year-old man with multilobar pneumonia and sepsis presents with hypoxemic respiratory failure requiring intubation. Vital signs: BP 92/58, HR 118, RR 32, Temp 39.2°C, SpO2…
- USMLE Step 1 · easy19. A 20-year-old college student comes to the emergency department because of chest tightness, dizziness, and tingling in both hands that began during an exam. She is visibly anxio…
- USMLE Step 1 · medium20. A 31-year-old man is found unresponsive with pinpoint pupils and shallow respirations next to an empty oxycodone bottle. Vital signs show BP 92/58, HR 52, RR 8, SpO2 88%. Arteri…
- USMLE Step 1 · easy21. A 73-year-old woman is admitted for septic shock due to pyelonephritis. Blood pressure is 78/40 mm Hg despite fluid resuscitation. She is cool and confused. Arterial blood gas s…
- USMLE Step 1 · medium22. A 61-year-old man with advanced chronic kidney disease presents with fatigue and anorexia. Vital signs show BP 158/92 mmHg, HR 88/min, RR 22/min, temperature 37.1°C, and SpO2 98…
- USMLE Step 1 · medium23. A 52-year-old man is brought to the emergency department after being found confused in his garage. He has nausea and flank pain. Laboratory studies show high anion gap metabolic…
- USMLE Step 1 · medium24. A 41-year-old man is brought to the emergency department because of blurry vision and confusion after drinking homemade alcohol. He is tachypneic. Laboratory studies show pH 7.1…