United States Medical Licensing
Examination (USMLE) Practice Exam
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A 23-year-old woman presents with fatigue and pallor. Labs show
hemoglobin 9 g/dL, MCV 70 fL, ferritin 8 ng/mL. The most likely diagnosis is:
A. Anemia of chronic disease
B. Iron deficiency anemia
C. Thalassemia minor
D. Sideroblastic anemia
Rationale: Iron deficiency anemia presents with microcytic, hypochromic
anemia and low ferritin due to depleted iron stores.
,2. A patient with chronic kidney disease has anemia. The anemia is most
likely due to deficiency of:
A. Vitamin B12
B. Erythropoietin
C. Folic acid
D. Iron
Rationale: Decreased erythropoietin production by diseased kidneys leads
to reduced red cell production.
3. A 60-year-old smoker presents with hematuria. Cystoscopy shows a
papillary mass in the bladder. The most likely diagnosis is:
A. Renal cell carcinoma
B. Transitional cell carcinoma
C. Squamous cell carcinoma
D. Adenocarcinoma
Rationale: Transitional cell carcinoma is the most common bladder cancer,
strongly associated with smoking.
4. A 5-year-old presents with a barking cough and inspiratory stridor. The
likely cause is:
A. Epiglottitis
B. Croup (laryngotracheobronchitis)
,C. Asthma
D. Bronchiolitis
Rationale: Croup, caused by parainfluenza virus, causes subglottic
inflammation leading to barking cough and stridor.
5. A patient develops chest pain after forceful vomiting. Chest X-ray shows
mediastinal air. Diagnosis?
A. Tension pneumothorax
B. Boerhaave syndrome
C. Mallory-Weiss tear
D. Pericarditis
Rationale: Boerhaave syndrome is esophageal rupture due to vomiting
with air in the mediastinum.
6. A 70-year-old man with long-standing hypertension develops left
ventricular hypertrophy. This represents which type of adaptation?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Rationale: Cardiac muscle fibers increase in size, not number, in response
to increased workload.
, 7. A 45-year-old man presents with episodic hypertension, palpitations, and
headache. Labs show elevated metanephrines. Diagnosis?
A. Carcinoid tumor
B. Pheochromocytoma
C. Insulinoma
D. Zollinger–Ellison syndrome
Rationale: Pheochromocytoma is a catecholamine-secreting tumor of
chromaffin cells causing episodic hypertension.
8. A newborn has meconium ileus. Which condition should be suspected?
A. Hirschsprung disease
B. Cystic fibrosis
C. Duodenal atresia
D. Pyloric stenosis
Rationale: Meconium ileus is classic for cystic fibrosis due to thick
secretions obstructing the intestine.
9. A patient with rheumatoid arthritis develops splenomegaly and
neutropenia. Diagnosis?
A. Felty syndrome
B. Still disease
Examination (USMLE) Practice Exam
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A 23-year-old woman presents with fatigue and pallor. Labs show
hemoglobin 9 g/dL, MCV 70 fL, ferritin 8 ng/mL. The most likely diagnosis is:
A. Anemia of chronic disease
B. Iron deficiency anemia
C. Thalassemia minor
D. Sideroblastic anemia
Rationale: Iron deficiency anemia presents with microcytic, hypochromic
anemia and low ferritin due to depleted iron stores.
,2. A patient with chronic kidney disease has anemia. The anemia is most
likely due to deficiency of:
A. Vitamin B12
B. Erythropoietin
C. Folic acid
D. Iron
Rationale: Decreased erythropoietin production by diseased kidneys leads
to reduced red cell production.
3. A 60-year-old smoker presents with hematuria. Cystoscopy shows a
papillary mass in the bladder. The most likely diagnosis is:
A. Renal cell carcinoma
B. Transitional cell carcinoma
C. Squamous cell carcinoma
D. Adenocarcinoma
Rationale: Transitional cell carcinoma is the most common bladder cancer,
strongly associated with smoking.
4. A 5-year-old presents with a barking cough and inspiratory stridor. The
likely cause is:
A. Epiglottitis
B. Croup (laryngotracheobronchitis)
,C. Asthma
D. Bronchiolitis
Rationale: Croup, caused by parainfluenza virus, causes subglottic
inflammation leading to barking cough and stridor.
5. A patient develops chest pain after forceful vomiting. Chest X-ray shows
mediastinal air. Diagnosis?
A. Tension pneumothorax
B. Boerhaave syndrome
C. Mallory-Weiss tear
D. Pericarditis
Rationale: Boerhaave syndrome is esophageal rupture due to vomiting
with air in the mediastinum.
6. A 70-year-old man with long-standing hypertension develops left
ventricular hypertrophy. This represents which type of adaptation?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Rationale: Cardiac muscle fibers increase in size, not number, in response
to increased workload.
, 7. A 45-year-old man presents with episodic hypertension, palpitations, and
headache. Labs show elevated metanephrines. Diagnosis?
A. Carcinoid tumor
B. Pheochromocytoma
C. Insulinoma
D. Zollinger–Ellison syndrome
Rationale: Pheochromocytoma is a catecholamine-secreting tumor of
chromaffin cells causing episodic hypertension.
8. A newborn has meconium ileus. Which condition should be suspected?
A. Hirschsprung disease
B. Cystic fibrosis
C. Duodenal atresia
D. Pyloric stenosis
Rationale: Meconium ileus is classic for cystic fibrosis due to thick
secretions obstructing the intestine.
9. A patient with rheumatoid arthritis develops splenomegaly and
neutropenia. Diagnosis?
A. Felty syndrome
B. Still disease
