Step 1 – Sample Questions

Example Item

A 32-year-old woman with type 1 diabetes mellitus has had progressive renal failure over the past 2 years. She has not yet started dialysis. Examination shows no abnormalities. Her hemoglobin concentration is 9 g/dL, hematocrit is 28%, and mean corpuscular volume is 94 m3. A blood smear shows normochromic, normocytic cells. Which of the following is the most likely cause?

  1. Acute blood loss
  2. Chronic lymphocytic leukemia
  3. Erythrocyte enzyme deficiency
  4. Erythropoietin deficiency
  5. Immunohemolysis
  6. Microangiopathic hemolysis
  7. Polycythemia vera
  8. Sickle cell disease
  9. Sideroblastic anemia
  10. β-Thalassemia trait

(Answer: 4)

Fonte: http://usmle.org/step-1/