USMLE Step1 STEP1 Exam Questions in PDF

Free USMLE STEP1 Dumps Questions (page: 31)

below figure shows a lead II electrocardiogram from a normal 30-year-old female at rest. If a beta- adrenergic agonist such as isoproterenol is administered intravenously to this woman, what will be her resulting heart rate in beats per minute?

  1. 40
  2. 55
  3. 65
  4. 70
  5. 90

Answer(s): E

Explanation:

From inspection of the figure, the R-R interval (time between heart beats) at rest is 0.83 seconds; 60 seconds/minute divided by 0.83 yields a resting heart rate of 72 beats/minute. Since activation of receptors in the sinoatrial node will result in increased heart rate, the only alternative larger than 72 beats/ minute is E., 90 beats/minute.



With increasing age, it is quite common for adults to have very low sensitivity for highpitch sounds. Which of the following physiologic responses occur as the pitch of a sound is increased at constant sound pressure?

  1. a greater number of hair cells become activated
  2. the amplitude of maximal basilar membrane displacement increases
  3. the frequency of action potentials in auditory nerve fibers increases
  4. the location of maximal basilar membrane displacement moves toward the cochlear base
  5. units in the auditory nerve become responsive to a wider range of sound frequencies

Answer(s): D

Explanation:

The primary change in the cochlea due to an increase in the frequency of a sound wave is a change in the position of maximal displacement of the basilar membrane. A low-pitched sound produces the greatest displacement toward the apex of the cochlea, which results in activation of hair cells at that location. As pitch increases, the position of greatest displacement moves closer to the base of the cochlea. Increases in the number of hair cells that are activated (choice A), increased amplitude of basilar membrane displacement (choice B), increases in the frequency of discharge of units in the auditory nerve fibers (choice C), and an increase in range of frequencies to which such units respond (choice E), are all more likely to be observed in response to increases in the intensity of the sound stimulus (sound pressure) rather than to increases in pitch.



A 20-year-old woman admits herself to the emergency room with a yellow discoloration of the whites of her eyes. She says that she does not drink and that she has not experienced any changes in her stool. Her liver enzyme profile and direct serum bilirubin levels are normal, while total bilirubin is elevated.
What is the most likely cause for her jaundice?

  1. defect in hepatocytes
  2. defect in Kupffer cells
  3. gallstones
  4. hemolysis
  5. tumor obstructing bile duct

Answer(s): D

Explanation:

Rupture of large numbers of red blood cells can result in jaundice in the absence of any liver disease. The capacity of the liver to clear released heme metabolites such as bilirubin is temporarily exceeded. Since the liver will not perform its normal function to conjugate bilirubin before excretion in bile and urine, unconjugated bilirubin backs up in serum. This is the reason for the increase in total bilirubin, while conjugated bilirubin, also called direct bilirubin, is not affected. Direct bilirubin would be elevated with most defects of liver cells (choice A) and with obstruction of bile flow by gallstones (choice C) or by a tumor (choice E). All these would most likely also affect bile formation and consequently absorption of dietary fat and fat-soluble vitamins, with the consequence of developing oily, fatty stool. Kupffer cells (choice B) are macrophages within the liver and don't play a role in the production of bilirubin.



A 54-year-old insulin-dependent diabetic notes that her insulin requirements have gone up dramatically in the past year (from 50 U to nearly 200 U of recombinant human insulin) and her blood glucose is still poorly controlled. A possible explanation for the worsening of her diabetes includes which of the following?

  1. a high titer of anti-insulin antibodies
  2. an improved diet
  3. an improved exercise program
  4. progression of macrovascular disease
  5. weight loss

Answer(s): A

Explanation:

The patient clearly has an increase in her state of insulin resistance. Given the magnitude of her increased insulin requirements, she most likely developed a high titer of antiinsulin antibodies that are preventing the injected insulin from lowering blood glucose effectively. Agood choice of lifestyle, including an improved diet (choice B), an improved exercise program (choice C), or weight loss (choice E) each are shown to beneficially affect her insulin requirements. Progression of macrovascular disease (choice D) is largely irrelevant to her insulin requirements, except to the extent that it might decrease her ability to exercise.



A 55-year-old male diabetic has an accommodative power of the lens of 10 dioptres. His near point is located 5 cm (2 in), his far point 10 cm (3.9 in) in front of the eye. Which of the following statements are correct?

  1. his corrective lenses are convex
  2. his corrective lenses have a positive dioptric value
  3. the patient has hyperopia
  4. the patient is capable of driving a car without corrective glasses
  5. the patient is functionally blind

Answer(s): E

Explanation:

Functionally blind means that a person has a visual impairment, that does not qualify as "legally blind" but results in substantial impediment. With a near point of 5 cm and a far point of 10 cm, the man has a severe case of myopia, not hyperopia as stated in choice C. The total convergence power of the relaxed eye with normal vision is approximately 60 dioptres, and the cornea accounts for more than two-thirds of that (40 dioptres). The accommodative power of the lens is about 20 dioptres in the very young, about 10 dioptres at age 25, and would be around 1 dioptre at the patient's age, if he had normal vision. For young adults with normal vision, the near point is about 10 cm from the eye; the far point is at infinity. The corrective lenses for the myopic eye are concave, not convex (choice A). Concave lenses compensate for the excessive positive dioptres of the myopic eye. These lenses are thin in the middle and wide at the edges and have negative dioptric values, not positive ones (choice B). The patient definitely won't be able to drive a car or perform other activities that require fast accommodation without corrective glasses (choice D).



Share your comments for USMLE STEP1 exam with other users:

A
abuti
7/21/2023 6:10:00 PM

are they truely latest

C
Curtis Nakawaki
7/5/2023 8:46:00 PM

questions appear contemporary.

V
Vv
12/2/2023 6:31:00 AM

good to prepare in this site

P
praveenkumar
11/20/2023 11:57:00 AM

very helpful to crack first attempt

A
asad Raza
5/15/2023 5:38:00 AM

please upload this exam

R
Reeta
7/17/2023 5:22:00 PM

please upload the c_activate22 dump questions with answer

W
Wong
12/20/2023 11:34:00 AM

q10 - the answer should be a. if its c, the criteria will meet if either the prospect is not part of the suppression lists or if the job title contains vice president

D
david
12/12/2023 12:38:00 PM

this was on the exam as of 1211/2023

T
Tink
7/24/2023 9:23:00 AM

great for prep

J
Jaro
12/18/2023 3:12:00 PM

i think in question 7 the first answer should be power bi portal (not power bi)

9
9eagles
4/7/2023 10:04:00 AM

on question 10 and so far 2 wrong answers as evident in the included reference link.

T
Tai
8/28/2023 5:28:00 AM

wonderful material

V
VoiceofMidnight
12/29/2023 4:48:00 PM

i passed!! ...but barely! got 728, but needed 720 to pass. the exam hit me with labs right out of the gate! then it went to multiple choice. protip: study the labs!

A
A K
8/3/2023 11:56:00 AM

correct answer for question 92 is c -aws shield

N
Nitin Mindhe
11/27/2023 6:12:00 AM

great !! it is really good

B
BailleyOne
11/22/2023 1:45:00 AM

explanations for the answers are to the point.

P
patel
10/25/2023 8:17:00 AM

how can rea next

M
MortonG
10/19/2023 6:32:00 PM

question: 128 d is the wrong answer...should be c

J
Jayant
11/2/2023 3:15:00 AM

thanks for az 700 dumps

B
Bipul Mishra
12/14/2023 7:12:00 AM

thank you for this tableau dumps . it will helpfull for tableau certification

H
hello
10/31/2023 12:07:00 PM

good content

M
Matheus
9/3/2023 2:14:00 PM

just testing if the comments are real

Y
yenvti2@gmail.com
8/12/2023 7:56:00 PM

very helpful for exam preparation

M
Miguel
10/5/2023 12:16:00 PM

question 11: https://help.salesforce.com/s/articleview?id=sf.admin_lead_to_patient_setup_overview.htm&type=5

N
Noushin
11/28/2023 4:52:00 PM

i think the answer to question 42 is b not c

S
susan sandivore
8/28/2023 1:00:00 AM

thanks for the dump

A
Aderonke
10/31/2023 12:51:00 AM

fantastic assessments

P
Priscila
7/22/2022 9:59:00 AM

i find the xengine test engine simulator to be more fun than reading from pdf.

S
suresh
12/16/2023 10:54:00 PM

nice document

W
Wali
6/4/2023 10:07:00 PM

thank you for making the questions and answers intractive and selectable.

N
Nawaz
7/18/2023 1:10:00 AM

answers are correct?

D
das
6/23/2023 7:57:00 AM

can i belive this dump

S
Sanjay
10/15/2023 1:34:00 PM

great site to practice for sitecore exam

J
jaya
12/17/2023 8:36:00 AM

good for students

AI Tutor 👋 I’m here to help!