Demyelinating Diseases USMLE Step 1 Practice Questions
65 board-style USMLE Step 1 questions in Neurology. Each question shows the correct answer; create a free account for the full explanation and adaptive practice.
- USMLE Step 1 · medium1. A 34-year-old woman presents with acute vision loss in her left eye and pain with eye movements. MRI shows inflammation of the optic nerve. She has no other neurologic symptoms…
- USMLE Step 1 · easy2. A 31-year-old woman with multiple sclerosis presents with electric shock-like pain radiating down her spine triggered by neck flexion. Vital signs: BP 118/76, HR 82, RR 16, Temp…
- USMLE Step 1 · hard3. A 29-year-old woman with multiple sclerosis on natalizumab therapy presents with acute severe headache, fever (38.9°C), and confusion. Vital signs show BP 118/76, HR 102, RR 18,…
- USMLE Step 1 · hard4. A 52-year-old man presents with a 6-month history of progressive cognitive decline and personality changes. He reports gait disturbance and frequent falls. Vital signs: BP 138/8…
- USMLE Step 1 · hard5. A 40-year-old woman presents with acute onset vertical diplopia, ataxia, and dysarthria. Vital signs: BP 128/82, HR 88, RR 16, Temp 37.2°C, SpO2 98%. Examination reveals vertica…
- USMLE Step 1 · medium6. A 45-year-old man with known multiple sclerosis presents with acute onset of bilateral leg weakness, urinary retention, and loss of perianal sensation. Vital signs show BP 128/8…
- USMLE Step 1 · medium7. A 34-year-old woman presents with acute vision loss in the right eye and pain with rightward gaze. Vitals: BP 118/76, HR 82, RR 16, Temp 37.2°C, SpO2 98%. Fundoscopic exam is no…
- USMLE Step 1 · hard8. A 37-year-old woman undergoes MRI for suspected MS and is found to have multiple brain T2 lesions, but only 1 lesion shows gadolinium enhancement. Spine MRI is normal. She repor…
- USMLE Step 1 · hard9. A 26-year-old female with known multiple sclerosis on interferon-beta therapy presents with progressive cognitive decline, visual disturbances, and ataxia over 4 weeks. Vital si…
- USMLE Step 1 · medium10. A 19-year-old previously healthy male presents 2 weeks after an upper respiratory viral illness with acute confusion and generalized seizure. Vital signs: BP 118/76, HR 102, RR…
- USMLE Step 1 · medium11. A 45-year-old woman with multiple sclerosis presents with acute severe vertigo, horizontal nystagmus, and intention tremor. Vital signs show BP 128/82, HR 88, RR 16, Temp 37.2°C…
- USMLE Step 1 · medium12. A 28-year-old man presents with acute paraplegia developing over 24 hours. Vital signs: BP 128/82, HR 92, RR 16, Temp 37.2°C, SpO2 98% on room air. Examination reveals sensory l…
- USMLE Step 1 · medium13. A 34-year-old woman presents with acute monocular vision loss and pain with eye movements. Vital signs: BP 118/76, HR 88, RR 16, Temp 37.2°C, SpO2 98%. Examination reveals a rel…
- USMLE Step 1 · easy14. A 31-year-old man with no past medical history presents with progressive painful paresthesias in both feet and hands over 4 weeks following a diarrheal illness 2 weeks ago. Vita…
- USMLE Step 1 · medium15. A 45-year-old woman presents with progressive ascending paresthesias and weakness in both legs and hands over 6 weeks. Vital signs: BP 138/82, HR 94, RR 18, temp 37.2°C, SpO2 98…
- USMLE Step 1 · medium16. A 28-year-old man presents with acute transverse myelitis causing total paraplegia and sensory level at T6. Vital signs show BP 128/82, HR 88, RR 16, temp 37.2°C, SpO2 98%. Days…
- USMLE Step 1 · medium17. A 34-year-old woman presents with acute monocular vision loss and eye pain on upgaze. MRI shows optic nerve inflammation. Three months later, she develops bilateral leg weakness…
- USMLE Step 1 · medium18. A 44-year-old man with established MS presents with worsening spasticity, hyperreflexia, and a positive Babinski sign bilaterally. He reports progressive difficulty walking over…
- USMLE Step 1 · medium19. A 27-year-old woman with no prior neurologic history presents with acute onset of diplopia and facial numbness. Vital signs show BP 118/76, HR 88, RR 16, temperature 37.2°C, SpO…
- USMLE Step 1 · hard20. A 38-year-old man presents with a 6-month history of progressive tremor, dysarthria, and cognitive decline. Vital signs: BP 128/82, HR 88, RR 16, Temp 37.2°C, SpO2 98% on room a…
- USMLE Step 1 · hard21. A 31-year-old woman with multiple sclerosis on natalizumab for 18 months presents with progressive cognitive decline, right-sided weakness, and visual field defect. Vital signs:…
- USMLE Step 1 · hard22. A 52-year-old woman with no prior neurologic history develops asymmetric vision loss, vertigo, and sensory loss in the lower extremities. Laboratory testing shows elevated infla…
- USMLE Step 1 · medium23. A 45-year-old man with a 10-year history of relapsing-remitting MS presents with progressive leg weakness, spasticity, and bladder dysfunction over 3 years without distinct rela…
- USMLE Step 1 · medium24. A 28-year-old man presents with acute bilateral leg weakness and sensory loss below the T8 dermatome following a viral illness two weeks prior. Vital signs: BP 128/82, HR 92, RR…