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Test Prep USMLE

United States Medical Licensing Examination

Verified practice questions with detailed answers, clear explanations, and community discussion.

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Question 1 of 622

A 35-year-old male comes to the physician due to watery diarrhea of two weeks' duration. He also has a low-grade fever, fatigue and weight loss of 5kg (11 lbs) over the past month. Laboratory findings include a CD

T cell count 70 cells/mmֲ³. The most likely diagnosis is

+

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Correct answer: C

Cryptosporidium spp are protozoa commonly associated with chronic watery diarrhea in HIV/AIDS patients with CD4 cell counts less than < 100 cells/mmֲ³. It
+
causes milder diarrhea in immunocompetent hosts and can be treated with nitazoxanide and prevented by filtering the city water supplies. The diagnosis can be made by acid fast staining of a stool specimen which reveals the presence of acid-fast oocysts.

Question 2 of 622

A 24-year-old AIDS patient develops chronic abdominal pain, low-grade fever, diarrhea, and malabsorption. Oocysts are demonstrated in the stool. Which of the following organisms is MOST likely to be the cause of the patient's diarrhea?

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Correct answer: D

All the organisms listed are protozoa. There are two intestinal protozoa specifically associated with AIDS that can cause transient diarrhea in immunocompetent individuals but can cause debilitating, and potentially life-threatening, chronic diarrhea in AIDS patients. These organisms are Isospora belli, treated with trimethoprim sulfamethoxazole or other folate antagonists) and Cryptosporidium parvum (no treatment currently available). Diphyllobothrium latum is the fish tapeworm and occasionally causes diarrhea. Entamoeba histolytica and Giardia lamblia are both causes of diarrhea, but they are not specifically associated with
AIDS. Microsporidia are a protozoan cause of diarrhea but produce spores rather than oocysts.

Question 3 of 622

While lying supine in bed eating, a child aspirates a peanut. Which of the following bronchopulmonary segments would this foreign object most likely enter?

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Correct answer: E

Because the right main bronchus is wider and more vertical than the left, foreign objects are more likely to be aspirated into the right main bronchus. The superior segmental bronchus of the lower lobar bronchus is the only segmental bronchus that exits from the posterior wall of the lobar bronchi. Therefore, if a patient is supine at the time of aspiration, the object is most likely to enter the superior segmental bronchus of the lower lobe. None of the segmental bronchi of the left lung are likely to receive the object because the object is less likely to enter the left main bronchus. The apical segment of the right upper lobe is not likely to receive the foreign object because of the sharp angle that the upper lobar bronchus makes with the right main bronchus, and the sharp angle that the apical segmental bronchus makes with the lobar bronchus. The medial segmental bronchus of the right middle lobe arises from the anterior wall of the right middle lobar bronchus.
Therefore, when the patient is supine, the effect of gravity will tend to prevent the object from entering this segmental bronchus.

Question 4 of 622

A 2-year-old child with uncomplicated coarctation of the aorta appears to be in good health. Growth and development are normal. The constriction is located just distal to the subclavian arteries. Which of the following is decreased in this patient?

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Correct answer: D

In fully compensated aortic coarctation, blood flow is normal in the lower and upper body despite an increased arterial pressure (about 50% higher) in the upper body compared with the pressure in the lower body. Because resistance = pressure/blood flow, it is clear that resistance must be lower in the lower portions of the body. The mechanism of this decrease in resistance below the constriction (and increased resistance above the constriction) is autoregulation of blood flow.
The small arteries and arterioles dilate (or constrict) in accordance with the metabolic needs of the tissues, ensuring that each tissue receive an adequate amount of blood flow. Thus, the increase in blood pressure in the upper body leads to constriction of the arterioles, which increases vascular resistance, and the lower pressure below the coarctation leads to dilation of the arterioles, which decreases vascular resistance.

Question 5 of 622

An adult patient presents with persistent headaches. A CT scan of the head demonstrates a 2-cm spherical mass at the junction of the white and gray matter of the lateral aspect of the cerebral hemisphere. Which of the following would most likely produce this lesion?

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Correct answer: E

Seventy percent of adult brain tumors occur above the tentorium (70% of childhood tumors occur below the tentorium). Statistically, metastases > astrocytomas
(including glioblastoma) > meningioma > pituitary tumor. Location at the junction of cortical gray and white matter is also typical for metastatic disease, as is the round shape. Astrocytomas typically arise in the white matter and have an irregular shape. Ependymomas are uncommon and arise from the ependymal lining of the ventricles. Glioblastoma multiforme is an aggressive form of astrocytoma that can cause a ג€butterfly lesion,ג€ crossing between the cerebral hemispheres.
Meningiomas can cause spherical lesions and are usually located on the surface of the brain.

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Honestly, I had already gone through the official documentation quite thoroughly, but still didn't feel fully confident going in. This helped things finally click for me. I realized I knew the material, but just hadn't connected all the pieces yet.
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I don't usually leave reviews, but this one felt worth sharing. The questions were quite close to what actually appeared on the exam, more than I expected. I spent about a week going through the material before my test, and it helped me feel more prepared.
Remi Nuyts
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Archie Hopkins
United States
I had a smooth experience from start to finish. Access was available right away, no technical issues, which made it easy to get started. The content felt relevant and aligned well with what I was looking for.
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United States
Does what it says it does. Content felt solid, nothing confusing to navigate and I didn't run into any weird issues. I been putting off scheduling the exam for a while and going through this gave me enough confidence to finally book it and pass.
Neil Savage
United States
A very quick response was received via email when a link issue occurred. The study materials provided were high quality and extremely helpful. I was able to complete the test successfully. Many thanks for the excellent support.

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