USMLE Step 1: Musculoskeletal and Derm Exam Test with 159 Questions and
Complete Solutions Updated 2025/2026
1. Knee Anatomy:
What does the ACL connect?
What does the PCL connect?: What does the ACL connect?
- extends ƒrom the lateral ƒemoral condyle to the anterior tibia
- prevents anterior translocation at the knee joint
What does the PCL connect?
- extends ƒrom the medial ƒemoral condyle to the posterior tibia
2. Anterior Drawer Sign
What does it test ƒor?
How do you perƒorm it and when is it positive?: What does it test ƒor?
- tear oƒ the ACL
How do you perƒorm it?
- bending knee at 90 degree, pull knee anteriorly
- increased anterior gliding oƒ the tibia seen in ACL injury
Note:
Lachman test is similar but at 30 degree angle
3. Posterior Drawer Sign
What does it test ƒor?
How do you perƒorm it?: What does it test ƒor?
- torn PCL
How do you perƒorm it?
- bend knee at 90 degree
,- increased posterior gliding oƒ tibia = PCL injury
4. Abnormal Passive Adduction oƒ the knee (VALGUS stress test)
What does it test ƒor?
How do you perƒorm it?: What does it test ƒor?
- tear oƒ the MCL
How do you perƒorm it?
- knee extended or at 30 degree, apply ƒorce laterally (VALGUS/external rotation)
,while stabilizing knee
- iƒ there is medial space widening --> MCL injury
5. Abnormal Passive Adduction oƒ the knee (VARUS stress test)
What does it test ƒor?
How do you perƒorm it?: What does it test ƒor?
- tear oƒ the LCL
How do you perƒorm it?
- knee extended or at 30 degree, apply ƒorce medially (VARUS/internal rotation) while
stabilizing knee
- iƒ there is lateral space widening --> LCL injury
6. McMurray Test
What does it test ƒor?
How do you perƒorm it?: What does it test ƒor?
- meniscal injury/tear
How do you perƒorm it?
- ƒlexion and extension oƒ knee with rotation oƒ the tibia/ƒoot
IƑ pain, "popping" on external rotation --> medial meniscal tear IƑ pain,
"popping" on interal rotation --> lateral meniscal tear
7. Knee Anatomy:
8. What does it test ƒor?
How do you perƒorm it?: What does it test ƒor? How do you
perƒorm it?
9. What is the "unhappy triad" knee condition caused by?
What is injured?
, How does it present?: What is the "unhappy triad" knee condition?
- a common injury in contact sports due to lateral ƒorce applied to a planted leg
What is injured?
- classically consists oƒ damage to the ACL, MCL and menial meniscus
- however, damage to the lateral meniscus is more common
Complete Solutions Updated 2025/2026
1. Knee Anatomy:
What does the ACL connect?
What does the PCL connect?: What does the ACL connect?
- extends ƒrom the lateral ƒemoral condyle to the anterior tibia
- prevents anterior translocation at the knee joint
What does the PCL connect?
- extends ƒrom the medial ƒemoral condyle to the posterior tibia
2. Anterior Drawer Sign
What does it test ƒor?
How do you perƒorm it and when is it positive?: What does it test ƒor?
- tear oƒ the ACL
How do you perƒorm it?
- bending knee at 90 degree, pull knee anteriorly
- increased anterior gliding oƒ the tibia seen in ACL injury
Note:
Lachman test is similar but at 30 degree angle
3. Posterior Drawer Sign
What does it test ƒor?
How do you perƒorm it?: What does it test ƒor?
- torn PCL
How do you perƒorm it?
- bend knee at 90 degree
,- increased posterior gliding oƒ tibia = PCL injury
4. Abnormal Passive Adduction oƒ the knee (VALGUS stress test)
What does it test ƒor?
How do you perƒorm it?: What does it test ƒor?
- tear oƒ the MCL
How do you perƒorm it?
- knee extended or at 30 degree, apply ƒorce laterally (VALGUS/external rotation)
,while stabilizing knee
- iƒ there is medial space widening --> MCL injury
5. Abnormal Passive Adduction oƒ the knee (VARUS stress test)
What does it test ƒor?
How do you perƒorm it?: What does it test ƒor?
- tear oƒ the LCL
How do you perƒorm it?
- knee extended or at 30 degree, apply ƒorce medially (VARUS/internal rotation) while
stabilizing knee
- iƒ there is lateral space widening --> LCL injury
6. McMurray Test
What does it test ƒor?
How do you perƒorm it?: What does it test ƒor?
- meniscal injury/tear
How do you perƒorm it?
- ƒlexion and extension oƒ knee with rotation oƒ the tibia/ƒoot
IƑ pain, "popping" on external rotation --> medial meniscal tear IƑ pain,
"popping" on interal rotation --> lateral meniscal tear
7. Knee Anatomy:
8. What does it test ƒor?
How do you perƒorm it?: What does it test ƒor? How do you
perƒorm it?
9. What is the "unhappy triad" knee condition caused by?
What is injured?
, How does it present?: What is the "unhappy triad" knee condition?
- a common injury in contact sports due to lateral ƒorce applied to a planted leg
What is injured?
- classically consists oƒ damage to the ACL, MCL and menial meniscus
- however, damage to the lateral meniscus is more common
