GERD and Peptic Ulcer Disease USMLE Step 1 Practice Questions
53 board-style USMLE Step 1 questions in Gastroenterology. Each question shows the correct answer; create a free account for the full explanation and adaptive practice.
- USMLE Step 1 · easy1. A 45-year-old man presents with a 3-month history of retrosternal burning pain that awakens him at night and worsens 30–60 minutes after eating spicy foods or large meals. He de…
- USMLE Step 1 · medium2. A 56-year-old man with a 15-year history of chronic heartburn presents to the gastroenterology clinic for evaluation of persistent retrosternal discomfort not fully controlled b…
- USMLE Step 1 · hard3. A 64-year-old man with newly diagnosed stage IIIB non-small cell lung cancer is admitted for chemotherapy. Two weeks into treatment, he develops acute epigastric pain and passes…
- USMLE Step 1 · easy4. A 28-year-old male with a 3-year history of chronic lower back pain presents to the emergency department with sudden-onset severe epigastric pain that began 2 hours ago while he…
- USMLE Step 1 · medium5. A 42-year-old man presents to your clinic with a 6-month history of progressive epigastric pain and chronic diarrhea refractory to treatment with omeprazole 20 mg daily. He comp…
- USMLE Step 1 · medium6. A 45-year-old man presents with a 6-year history of weekly heartburn and regurgitation despite omeprazole 20 mg daily for the past 8 months. He reports nocturnal cough and occas…
- USMLE Step 1 · medium7. A 35-year-old woman with rheumatoid arthritis presents with acute epigastric pain, nausea, and hematemesis. She began taking ibuprofen 800 mg three times daily 3 weeks ago for j…
- USMLE Step 1 · medium8. A 52-year-old man presents with a 3-month history of burning epigastric pain that worsens 2-3 hours after meals and improves with antacids. He denies dysphagia or weight loss. E…
- USMLE Step 1 · hard9. A 48-year-old man on chronic omeprazole therapy for GERD presents with fatigue and paresthesias. Vital signs show BP 128/76 mmHg, HR 82 bpm, RR 16, temp 37°C, SpO2 98%. Laborato…
- USMLE Step 1 · medium10. A 32-year-old man presents to the clinic with a 3-month history of epigastric pain and chronic diarrhea, along with an 8-pound weight loss. He denies NSAID use, alcohol abuse, o…
- USMLE Step 1 · hard11. A 55-year-old man with a 10-year history of GERD presents with sudden-onset severe epigastric pain, forceful vomiting, and subcutaneous emphysema of the neck. Vital signs show B…
- USMLE Step 1 · medium12. A 52-year-old woman on chronic ibuprofen for rheumatoid arthritis presents with acute epigastric pain and hematemesis. Vital signs show BP 105/68, HR 102, RR 18, temperature 37.…
- USMLE Step 1 · medium13. A 45-year-old man presents with progressive dysphagia to solids over the past 3 months. He has had chronic heartburn and regurgitation for 12 years, managed with omeprazole 20 m…
- USMLE Step 1 · medium14. A 65-year-old man with a 10-pack-year smoking history and chronic NSAID use for osteoarthritis presents to the emergency department with a 6-hour history of epigastric pain foll…
- USMLE Step 1 · hard15. A 28-year-old man presents with a 1-year history of epigastric pain and acid regurgitation unresponsive to omeprazole 40 mg twice daily for 6 months. He denies NSAID use or H. p…
- USMLE Step 1 · hard16. A 52-year-old man with a 10-year history of gastroesophageal reflux disease presents with worsening epigastric pain and diarrhea over the past 2 months, despite adequate proton…
- USMLE Step 1 · medium17. A 27-year-old man presents with recurrent bloody diarrhea and urgency. Vital signs show BP 128/82 mmHg, HR 92 bpm, RR 18, temp 37.2°C, SpO2 98%. Colonoscopy reveals continuous i…
- USMLE Step 1 · hard18. A 45-year-old man presents with recurrent peptic ulcers and chronic diarrhea unresponsive to omeprazole 40 mg daily for 3 months. Vital signs show BP 128/82, HR 92, RR 16, temp…
- USMLE Step 1 · medium19. A 6-hour-old newborn with maternal polyhydramnios presents with coughing, cyanosis, and choking during first feeding attempt. Vital signs show HR 160/min, RR 52/min, SpO2 88% on…
- USMLE Step 1 · easy20. A 4-week-old boy presents with progressive nonbilious projectile vomiting after feeds for 3 days. He appears hungry immediately after vomiting. Vital signs show HR 145/min, RR 3…
- USMLE Step 1 · medium21. A 64-year-old woman presents with epigastric pain worsening postprandially, early satiety, and 3-kg weight loss over two months. She takes ibuprofen daily for osteoarthritis. Vi…
- USMLE Step 1 · medium22. A 38-year-old man presents with burning epigastric pain that improves shortly after meals but recurs a few hours later. He has no weight loss. Upper endoscopy shows an ulcer in…
- USMLE Step 1 · medium23. A 54-year-old man with 20-year history of alcohol use disorder presents with massive hematemesis. Vital signs show BP 92/58, HR 118, RR 22, temp 37.2°C. Laboratory studies revea…
- USMLE Step 1 · easy24. A 29-year-old woman presents with hematemesis following repeated forceful vomiting during acute viral gastroenteritis. Vital signs: BP 118/76 mmHg, HR 92 bpm, RR 18/min, temp 37…