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 · medium25. A 58-year-old man presents to the emergency department with severe chest pain following repeated forceful vomiting after heavy alcohol intake. Vital signs show temperature 38.5°…
- USMLE Step 1 · medium26. A 72-year-old man with a 3-year history of omeprazole use presents with halitosis, regurgitation of undigested food, and chronic nonproductive cough. His wife reports a gurgling…
- USMLE Step 1 · medium27. A 41-year-old woman presents with several months of progressive dysphagia to both solids and liquids. She also reports regurgitation of undigested food and a 4-kg weight loss. P…
- USMLE Step 1 · easy28. A 52-year-old man presents with 8 years of burning substernal chest pain that worsens after large meals and when lying flat. He has chronic nocturnal cough and occasional sour t…
- USMLE Step 1 · hard29. A 44-year-old woman with chronic constipation has self-medicated with daily over-the-counter stimulant laxatives for 5 years. She presents with abdominal cramping and loose stoo…
- USMLE Step 1 · medium30. A 39-year-old obese woman started orlistat 3 weeks ago for weight loss. She now presents with oily spotting, increased flatulence, and abdominal discomfort. Vital signs are BP 1…
- USMLE Step 1 · hard31. A 55-year-old woman receiving cisplatin-based chemotherapy for ovarian cancer presents with nausea. She is started on a medication blocking substance P signaling at neurokinin-1…
- USMLE Step 1 · medium32. A 47-year-old woman receiving highly emetogenic chemotherapy presents with nausea. She is prescribed an antiemetic medication that blocks serotonin 5-HT3 receptors in the chemor…
- USMLE Step 1 · medium33. A 33-year-old woman with poorly controlled diabetes mellitus presents with epigastric discomfort, early satiety, and nausea. Vital signs: BP 118/76 mmHg, HR 88/min, RR 16/min, t…
- USMLE Step 1 · easy34. A 29-year-old woman with irritable bowel syndrome presents with noninfectious diarrhea and abdominal cramping. Vital signs: BP 118/76, HR 88, RR 16, Temp 37.2°C, SpO2 98%. She r…
- USMLE Step 1 · medium35. A 54-year-old man with alcoholic cirrhosis and portal hypertension presents with hematemesis and melena. Vital signs show BP 90/55, HR 118, RR 20, SpO2 98% on room air. Endoscop…
- USMLE Step 1 · medium36. A 61-year-old woman with severe osteoarthritis requires chronic NSAID therapy. She previously developed a gastric ulcer while taking naproxen and now presents with epigastric pa…
- USMLE Step 1 · easy37. A 4-week-old firstborn boy presents with projectile nonbilious vomiting after feeds for 3 days. Vital signs show HR 152/min, RR 28/min, BP 78/52 mmHg, and temperature 37.2°C. Ph…
- USMLE Step 1 · hard38. A 47-year-old man with a 3-month history of epigastric discomfort and nausea presents with progressive weight loss and bilateral lower extremity edema. Vital signs show BP 128/8…
- USMLE Step 1 · medium39. A 62-year-old woman with a 15-year history of gastroesophageal reflux disease treated with omeprazole 40 mg daily presents with a 6-month history of progressive fatigue, paresth…
- USMLE Step 1 · medium40. A 49-year-old man with a 3-month history of epigastric burning pain that temporarily improves after meals presents with BP 128/82, HR 92, RR 16, temp 37.2°C. He denies NSAID use…
- USMLE Step 1 · medium41. A 58-year-old obese man with a 10-year history of GERD presents with worsening dysphagia and 8-kg unintended weight loss over 3 months. He takes omeprazole daily but remains sym…
- USMLE Step 1 · medium42. A 64-year-old male with 40 pack-year smoking history and daily alcohol use presents with progressive dysphagia and 8-kg weight loss over 3 months. Vital signs: BP 128/82, HR 92,…
- USMLE Step 1 · medium43. A 14-year-old boy with asthma and atopic eczema presents with progressive solid food dysphagia and two episodes of food impaction requiring endoscopic removal. Vital signs: BP 1…
- USMLE Step 1 · medium44. A 39-year-old man with untreated HIV (CD4 count 45 cells/μL) presents with odynophagia and retrosternal chest pain for 2 weeks. He denies antacid use. Vital signs show BP 118/76…
- USMLE Step 1 · hard45. A 44-year-old man with a history of GERD not on medication develops sudden severe chest pain radiating to the back after repeated violent retching and vomiting. Vital signs show…
- USMLE Step 1 · medium46. A 45-year-old man presents with progressive dysphagia to solids and liquids, nocturnal regurgitation, and 8-kg weight loss over 3 months. He denies heartburn. Vital signs: BP 12…
- USMLE Step 1 · easy47. A 48-year-old man with a 10-year history of heartburn presents with epigastric pain (8/10) worsening postprandially and when supine. Vitals: BP 128/82, HR 88, RR 16, Temp 37.2°C…
- USMLE Step 1 · medium48. A 62-year-old man with a 3-year history of GERD managed with omeprazole presents with progressive dysphagia to solids, regurgitation of undigested food, and halitosis. Vital sig…