Metabolism USMLE Step 1 Practice Questions
110 board-style USMLE Step 1 questions in Biochemistry. Each question shows the correct answer; create a free account for the full explanation and adaptive practice.
- USMLE Step 1 · medium49. A 17-year-old male presents with acute left flank pain and gross hematuria. Vital signs show BP 128/82 mmHg, HR 92 bpm, RR 16, temp 37.2°C, SpO2 98%. Urinalysis reveals hexagona…
- USMLE Step 1 · medium50. A 3 year old girl is brought in for sensitivity to sunlight and poor visual acuity. Examination shows very light skin and hair compared with her parents, nystagmus, and decrease…
- USMLE Step 1 · medium51. A 46 year old man presents with chronic back pain and dark staining of his underwear. He reports that his urine turns black if left standing in the toilet. Physical examination…
- USMLE Step 1 · medium52. A 14 year old boy is evaluated after a deep venous thrombosis. He is tall and thin with long extremities. Slit lamp examination shows downward and inward displacement of the len…
- USMLE Step 1 · medium53. A 6-day-old male newborn presents with poor feeding, vomiting, and alternating hypotonia and hypertonia with intermittent opisthotonos. Vital signs reveal HR 148/min, RR 32/min,…
- USMLE Step 1 · hard54. A 2-week-old male presents with poor feeding and hypotonia. Newborn screening revealed markedly elevated serum phenylalanine (28 mg/dL; normal <2). Despite strict low-phenylalan…
- USMLE Step 1 · easy55. A 7-month-old girl with fair skin and microcephaly presents with developmental delay and recurrent vomiting. Parents report a distinctive musty odor to her diapers and note she…
- USMLE Step 1 · medium56. A 6-month-old male presents with recurrent vomiting, irritability, and poor weight gain over 2 months. Vital signs show HR 128/min, RR 26/min, temp 37.2°C, and BP 85/55 mmHg. Ph…
- USMLE Step 1 · hard57. A 2-day-old female newborn presents with vomiting, tachypnea (RR 58/min), and progressive somnolence. Vital signs show HR 168/min, BP 65/40 mmHg, temperature 36.8°C, SpO2 98% on…
- USMLE Step 1 · medium58. A 3 day old male newborn develops progressive lethargy, poor feeding, and tachypnea. He becomes difficult to arouse but has no hepatomegaly. Laboratory studies show markedly ele…
- USMLE Step 1 · medium59. A 7 year old boy is evaluated for chronic jaundice and fatigue. He has scleral icterus and splenomegaly. Laboratory studies show hemoglobin 8.8 g per dL, elevated indirect bilir…
- USMLE Step 1 · hard60. A 2 month old boy has poor feeding, tachypnea, and developmental delay. He has intermittent ataxia and hypotonia. Laboratory studies show elevated serum lactate and pyruvate, bu…
- USMLE Step 1 · easy61. A 19-year-old man presents with severe muscle cramps and early fatigue during sprinting and weightlifting. He reports dark urine after intense exercise. Vital signs at rest are…
- USMLE Step 1 · medium62. A 2-year-old boy presents with growth delay and progressive abdominal fullness. Vital signs show HR 102/min, BP 95/62 mmHg, RR 20/min, temperature 37.2°C. Physical examination r…
- USMLE Step 1 · easy63. A 3-month-old girl presents with poor feeding and weak crying. Vital signs show HR 152, RR 38, BP 78/52, temp 37°C, SpO2 98% on room air. Examination reveals marked hypotonia an…
- USMLE Step 1 · medium64. A 4-month-old boy presents with tremulousness and irritability occurring before feeds. Vital signs show HR 145 bpm, RR 28/min, BP 85/52 mmHg, temperature 37.2°C. Physical examin…
- USMLE Step 1 · medium65. A 3 week old male infant is brought in for poor visual tracking. He was born at term and has been feeding well on formula. Examination reveals bilateral cataracts but no jaundic…
- USMLE Step 1 · easy66. A 5-day-old female newborn develops jaundice, poor feeding, and vomiting after breastfeeding. She becomes lethargic and is admitted to the NICU. Vital signs show temperature 37.…
- USMLE Step 1 · medium67. A 9 month old boy is evaluated for vomiting, diaphoresis, and lethargy that occur shortly after fruit puree is introduced into his diet. His parents report that he was previousl…
- USMLE Step 1 · easy68. A 6 year old boy is brought to the pediatrician after a routine school urine screen shows a positive test for reducing substances. He has no abdominal pain, vomiting, or develop…
- USMLE Step 1 · medium69. A 50-year-old male was admitted into the hospital of a leading research university with a diagnosis of hepatitis and early cirrhosis of the liver. His past medical history is si…
- USMLE Step 1 · medium70. A 3-week-old female infant (46,XX) presents with ambiguous genitalia, poor feeding, and lethargy. Vital signs show BP 78/52 mmHg, HR 148/min, RR 32/min, temp 36.8°C. Laboratory…
- USMLE Step 1 · medium71. A 28-year-old female with a history of progressive hepatosplenomegaly and epistaxis was admitted to the hospital with severe pain in her right thigh of 3 days' duration. A simil…
- USMLE Step 1 · medium72. A 22-year-old female with anorexia nervosa is seen in a specialty clinic that deals with eating disorders. A nutritional nurse estimates the content of the patient's regular die…