USMLE STEP 1 Questions and Answers with Complete Solutions 2024

USMLE STEP 1 Questions and Answers with Complete Solutions 2024 Heterophile ab NEGATIVE Mono-like syndromes - ANS*CMV HHV-6 HIV Toxoplasmosis Wernicke's Aphasia - ANS-word salad: well-articulated, nonsensical speech paired with lack of lang comprehension -aud association cortex: post part of sup temporal gyrus - supplied by MCA Congenital Deficiency of Propionyl CoA Carboxylase - ANS-prevents conversion of propionyl CoA to methylmalonyl CoA -propionyl CoA derived from= val, ile, met, thr, odd # FA, cholesterol side chains -Propionic Acidemia: poor feeding, vomiting, hypotonia, lethargy, dehydration, anion gap acidosis Down Synd Comorbidities - ANSNeuro: MR, early onset Alzheimer's Cardio: complete AV septal defect, VSD, ASD GI: duodenal atresia, hirschprung disease Endo: hypothyroid, DM1, obesity Heme: ALL (> 5 yo) and AML (<5 yo) Rheumatology: atlantoaxial stability MCC of Hypoglycemia in EtOH-ics - ANSThiamine def= suppression of GNG (pyruvate DH) and TCA cyle (alpha-KG DH) MCC of Hypoglycemia in advanced renal insuff - ANSimpaired clearance of insulin Avoid Nitrates in Hypertrophic Cardiomyopathy bc... - ANSNitrates decrease preload, which will increase the LV outflow tract... BUT since the ventricle is abnormally shaped, there is an outflow obstruction Mets through BM - ANSClonal proliferation of cells can invade/ metastasize* 1. malignant cells to lose their cell-to-cell adhesion molecules (cadherins) 2. cell receptors to attach to laminin (a glyc