Free practice questions
No accountFull explanationsFree USMLE Step 1 practice questions
30 original questions, modeled on the official USMLE Step 1 format. Every question comes with why the answer is right, why the other choices are wrong, a key takeaway and a tip. Practice mode explains each question as you go; Timed mode runs one clock and saves the explanations for the end.
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USMLE Step 1: question 1 of 30
A 17-year-old boy is brought to the emergency department 1 hour after he fainted while sprinting at soccer practice. He regained consciousness within 1 minute. For 3 months, he has had chest tightness during hard exercise. His paternal uncle died suddenly at the age of 29 years while jogging. His pulse is 68/min, and blood pressure is 122/74 mm Hg. Cardiac examination shows a grade 3/6 harsh systolic murmur heard best along the left sternal border at the fourth intercostal space; it does not radiate to the carotid arteries. During the strain phase of a Valsalva maneuver, the murmur becomes louder.
Which of the following hemodynamic changes during the strain best explains the louder murmur?
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USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), which is not affiliated with and does not endorse ProMed United. These are original practice questions written by ProMed United, not official test questions, and a practice score is not a prediction of your result.
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