USMLE Step 1 Qs (7)
Questions from various sources for practicing
- 1.Benign prostatic hypertrophy results in obstruction of the urinary tract. This specific condition is associated with enlargement of which of the following?
- A.
Entire prostate gland
- B.
Lateral lobes
- C.
Median lobe
- D.
Posterior lobes
- 2.In the male, which of the following is the homologue of the vaginal artery?
- A.
Obturator artery
- B.
Internal pudendal artery
- C.
Middle rectal artery
- D.
Umbilical artery
- E.
Inferior vesical artery
- 3.
The patient is a 45-year-old male with a history of colonic diverticulosis. He complains of fever with pain and swelling in the rectal area. You are concerned that the colonic diverticulum may have become infected (diverticulitis) and ruptured into the space indicated by the * in this CT scan. Which of the following is correct regarding the indicated space?- A.
It is called the paracolic gutter
- B.
The space is largely filled with muscle
- C.
The space is located superior to the pelvic diaphragm
- D.
Pus from the abscessed diverticuli in that space can extend anteriorly to the perineal body, inferior to the urogenital diaphragm
- E.
Pus from the abscessed diverticuli in that space can extend superiorly anterior to the sacrum
- 4.Which of the following arteries may occasionally arise as a branch of the external iliac artery or inferior epigastric artery instead of as a branch of the internal iliac artery?
- A.
Internal pudendal artery
- B.
Obturator artery
- C.
Superior gluteal artery
- D.
Umbilical artery
- E.
Uterine artery
- 5.Which of the following contains the ovarian neurovascular bundle
- A.
Broad ligament
- B.
Mesosalpinx
- C.
Mesovarium
- D.
Suspensory ligament
- E.
Transverse cervical ligament
- 6.Which of the following empties into the penile urethra?
- A.
Ampulla of the vas deferens
- B.
Bulbourethral gland
- C.
Ejaculatory duct
- D.
Prostate gland
- E.
Seminal vesicle
- 7.
. The diagram below represents a frontal section through the bladder and prostate gland. Which lettered structure that forms the external urethral sphincter?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
- 8.Innervation to the rotator cuff muscle that medially rotates the arm is provided by which of the following nerves?
- A.
Axillary nerve
- B.
Suprascapular nerve
- C.
Thoracodorsal nerve
- D.
Upper and lower subscapular nerves
- 9.A patient presents in her fifth pregnancy with a history of numbness and tingling in her right thumb and index finger during each of her previous four pregnancies. Currently, the same symptoms are constant, although generally worse in the early morning. Symptoms could be somewhat relieved by vigorous shaking of the wrist. Neurologic examination revealed atrophy and weakness of the abductor pollicis brevis, the opponens pollicis, and the first two lumbrical muscles. Sensation was decreased over the lateral palm and the volar aspect of the first three digits. Numbness and tingling were markedly increased over the first three digits and the lateral palm when the wrist was held in flexion for 30 s. The symptoms suggest damage to which of the following structures?
- A.
The radial artery
- B.
The median nerve
- C.
The ulnar nerve
- D.
Proper digital nerves
- E.
The radial nerve
- 10.In the upper extremity, each major nerve passes between two heads of a muscle. The median nerve passes between which of the following?
- A.
Long and medial heads of the triceps brachii muscle
- B.
Medial and posterior division of the coracobrachialis muscle
- C.
Ulnar and humeral heads of the flexor carpi ulnaris muscle
- D.
Ulnar and humeral heads of the pronator teres muscle
- 11.Which of the following types of femoral fracture is most likely to result in avascular necrosis of the femoral head in adults?
- A.
Acetabular
- B.
Cervical
- C.
Intertrochanteric (between the trochanters)
- D.
Subtrochanteric
- E.
Midfemoral shaft
- 12.Paresthesia, hyperesthesia, or even painful sensation in the anterolateral region of the thigh may occur in obese persons. It results from an abdominal panniculus adiposus that bulges over the inguinal ligament and compresses which of the following underlying nerves?
- A.
Femoral branch of the genitofemoral nerve
- B.
Femoral nerve
- C.
Iliohypogastric nerve
- D.
Ilioinguinal nerve
- E.
Lateral femoral cutaneous nerve
- 13.A 27-year-old man was admitted for neurologic evaluation of a gunshot wound received five days previously. A 9-mm bullet had passed through both the medial and lateral heads of the gastrocnemius muscle. The exit wound on the lateral head of the muscle was somewhat deeper than the entrance wound in the medial head. The bullet had not struck bone or significant arteries although significant tissue damage, suppuration, and swelling were found around the exit wound. Neurologic examination revealed losses of dorsiflexion and eversion of the left foot. The patient could not feel pinprick or touch on the dorsum of the left foot or anterolateral surface of the left leg. Which of the following nerves was most likely involved in the injury?
- A.
Sciatic nerve
- B.
Femoral nerve
- C.
Sural nerve
- D.
Common peroneal nerve
- E.
Tibial nerve
- 14.The odontoid process (dens) is correctly described by which of the following statements?
- A.
It articulates with the occipital portion of the skull
- B.
It is separated from the atlas by an intervertebral disk
- C.
It projects from the inferior surface of the atlas
- D.
It represents the vertebral body of the first cervical vertebra
- 15.A 38-year-old man is seen in the emergency room complaining of severe chest pain. He tends to sit leaning forward. On physical examination he is noted to be tachypneic (breathing rapidly); he has a rapid pulse rate, and on auscultation of the chest, his valve sounds appear distant. A radiograph shows a globular heart shadow. All evidence indicates pericarditis with pericardial effusion. Pericardiocentesis (to drain the exudate) via the costoxiphoid approach passes through which of the following structures?
- A.
The interchondral portion of an internal oblique muscle
- B.
The left costodiaphragmatic recess
- C.
The rectus sheath and rectus abdominis muscle
- D.
The visceral pericardium
- E.
The left costomediastinal recess
- 16.A 38-year-old man is seen in the emergency room complaining of severe chest pain. He tends to sit leaning forward. On physical examination he is noted to be tachypneic (breathing rapidly); he has a rapid pulse rate, and on auscultation of the chest, his valve sounds appear distant. A radiograph shows a globular heart shadow. All evidence indicates pericarditis with pericardial effusion. Which of the following vessels is at high risk during the parasternal approach?
- A.
Anterior interventricular artery
- B.
Left internal thoracic artery
- C.
Right coronary artery
- D.
Right marginal artery
- E.
Nodal artery
- 17.A 52-year-old man is brought to the emergency room after being found in the park, where apparently he had lain overnight after a fall. He complains of severe pain in the left arm. Physical examination suggests a broken humerus that is confirmed radiologically. The patient can extend the forearm at the elbow, but supination appears to be somewhat weak; the hand grasp is very weak compared with the uninjured arm. Neurologic examination reveals an inability to extend the wrist (wristdrop). Because these findings point to apparent nerve damage, the patient is scheduled for a surgical reduction of the fracture. The observation that extension at the elbow appears normal but supination of the forearm appears weak warrants localization of the nerve lesion to which of the following?
- A.
Posterior cord of the brachial plexus in the axilla
- B.
Posterior divisions of the brachial plexus
- C.
Radial nerve at the distal third of the humerus
- D.
Radial nerve in the midforearm
- E.
Radial nerve in the vicinity of the head of the radius
- 18.A 52-year-old man is brought to the emergency room after being found in the park, where apparently he had lain overnight after a fall. He complains of severe pain in the left arm. Physical examination suggests a broken humerus that is confirmed radiologically. The patient can extend the forearm at the elbow, but supination appears to be somewhat weak; the hand grasp is very weak compared with the uninjured arm. Neurologic examination reveals an inability to extend the wrist (wristdrop). Because these findings point to apparent nerve damage, the patient is scheduled for a surgical reduction of the fracture. On examination of muscle function at the metacarpophalangeal (MP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints, the findings expected in the presence of radial nerve palsy would include which of the following?
- A.
Inability to abduct the digits at the MP joint
- B.
Inability to adduct the digits at the MP joint
- C.
Inability to extend the MP joint only
- D.
Inability to extend the MP, PIP, and DIP joints
- E.
Inability to extend the PIP and DIP joints
- 19.After a night of fraternity parties, a 20-year-old college sophomore came to the ER the following morning complaining that she could not raise her wrist. There was no history of trauma. On examination, the patient could not extend her fingers or wrist but could flex them. She could also both flex and extend her elbow normally. There were no other motor deficits. The symptoms suggest damage to which of the following nerves?
- A.
Median nerve
- B.
Ulnar nerve
- C.
Radial nerve
- D.
Axillary nerve
- E.
Musculocutaneous nerve
- 20.After a night of fraternity parties, a 20-year-old college sophomore came to the ER the following morning complaining that she could not raise her wrist. There was no history of trauma. On examination, the patient could not extend her fingers or wrist but could flex them. She could also both flex and extend her elbow normally. There were no other motor deficits. Which of the following muscles is spared by the type of injury described above?
- A.
Extensor digitorum communis
- B.
Extensor carpi radialis
- C.
Extensor pollicis longus
- D.
Triceps
- E.
Anconeus
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