United States Medical Licensing Examination (USMLE) – Sample

The parents of a 7-year-old boy divorce. The boy lives with the mother and sees his father every-other weekend. During these visits, the boy is sullen and angry with the father, but when it is time to return home, he clings to the father and cries in a desperate manner while saying “I’m sorry! I want you and mom to live together again.” Which of the following is the most helpful statement that the father can make to the son?

A 25-year-old man presents with a chief complaint of persistent, high-pitched ringing noises in his ears. Questioning reveals that he has also been losing his balance lately. CT of the head demonstrates bilateral tumors involving the vestibulocochlear nerve. Which of the following chromosomes contains the tumor suppressor gene most likely to be involved in this case?

Researchers are assessing the specificity of a screening procedure for breast cancer in a population of 3000 women whose mothers had the disease. The presence or absence of a malignant condition is established by conventional mammography, which is assumed to be definitive for the purposes of comparison. The following data are collected: Positive Negative Total Cancer 90 10 100 No cancer 360 2540 2900 Total 450 2550 3000 What is the specificity of the test?

A new antifungal medication is being tested in Phase I clinical trials. Examination of the pharmacokinetic properties of the drug reveals that the half-life of the drug is 6 hours. If a continuous intravenous infusion of this drug were started on a research subject, how long would it take to reach 75% of steady state?

A doctor at outpatient clinic is determining the appropriate sequence to arrange patients in the afternoon. Which of the following calls should have the highest priority for medical intervention?

The patient has angiography that shows a 90% obstruction in a major branch of the left anterior descending artery (LAD). The other arteries appear less than 30% obstructed. A drug-eluting stent is placed in the severely obstructed vessel after balloon angioplasty and the patient then reports he is pain free at rest and with exercise. The resting electrocardiogram is now normal and an isotopic stress test fails to show evidence of myocardial ischemia. The patient may be discharged on all the following drugs EXCEPT:

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?

A 37-year-old woman who was diagnosed with AIDS 3 years earlier is unable to work, is physically debilitated, and requests her physician to provide her with medications with which to take her own life. The most common emotional disorder that results in such requests by patients is

A premature infant develops progressive difficulty breathing over the first few days of life. Deficient surfactant synthesis by which of the following cell types may be contributing to the infant’s respiratory problems?

A 24-year-old woman with a history of allergic rhinitis is involved in an automobile accident and sustains a splenic laceration. She undergoes abdominal surgery and is then transfused with four units of blood of the appropriate ABO and Rh type. As the transfusion progresses, she becomes rapidly hypotensive and develops airway edema, consistent with anaphylaxis. Which of the following pre-existing conditions best accounts for these symptoms?