Over the years, the AMA has run dozens of example questions from Kaplan Medical. If you’re preparing for the United States Medical Licensing Examination® (USMLE®) Step 1 exam, you might want to know which questions are most often missed by test-prep takers.

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As students reach the final phases of their Step 1 prep, we’ve compiled a list of the top five most-read Step 1 stumpers. You can check out all posts in this series.

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  1. Which test confirms suspected relapse?

    1. A 56-year-old man with a history of alcohol-use disorder comes to the physician because of depression. He says that he has been sober for a month and is enrolled in a 12-step program, but he is unable to go back to work. The physician strongly suspects that the man relapsed and was fired from his job.
  2. Girl has ravenous appetite, weight gain

    1. A 4-year-old girl is brought to the physician by her mother. The mother is concerned about the child's ravenous appetite and rapid weight gain. Her mother says that at birth, the child had a poor sucking reflex and fed poorly. As a baby, she was floppy and did not meet motor development milestones. Her older brother and sister are both normal. The patient’s karyotype shows no abnormalities, but Southern blotting shows a microdeletion in one of her chromosomes.
  3. Replacing which medication will improve symptoms?

    1. A 60-year-old man comes to the physician because of a constant cough that keeps him awake at night. He denies sputum production, fever or chills. He has a history of type 2 diabetes mellitus, hypertension, hypercholesterolemia, asthma and heart failure. He is currently taking albuterol, theophylline, atorvastatin, metoprolol, enalapril, hydralazine and digoxin.
    2. Related Coverage

      Kaplan USMLE Step 1 prep: 4 stumpers about middle-aged adults
  4. Newborn has large mass over lumbar region

    1. A male newborn born at 37 weeks' gestation has a large mass over the lumbar region. Examination of the mass shows cerebrospinal fluid-filled meningeal tissue that has herniated through a vertebral defect. The newborn is able to move all extremities and responds normally to external stimuli.  
  5. Which substance will confirm diagnosis?

    1. A 55-year-old man is admitted to the hospital because of hematemesis. Measurement fasting serum gastrin levels show them to be 8-fold higher compared with a normal individual and an upper gastrointestinal endoscopy shows multiple ulcers in the duodenum. A multiple endocrine neoplasia type 1 is suspected.

For more prep questions on USMLE Steps 1, 2 and 3, view other posts in this series.

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