100+ Free USMLE® Step 1
Anatomy Questions

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USMLE Step 1 Qbank

100+ Free USMLE® Step 1
Anatomy Questions

Sneak preview 9 free anatomy sample questions below or create a free account now to get access to the free version of Lecturio’s Qbank—including 2.150+ USMLE® Step 1 questions.


9 Free USMLE Step 1 Anatomy Sample Questions

A 31-year-old woman presents to the clinic with shortness of breath, palpitations, and fatigue. She has had these symptoms over the last several weeks. She had been tolerating these symptoms until last night when she could not fall asleep due to palpitations. She has a past medical history of infective endocarditis from 6 months ago successfully treated with antibiotics. She does not smoke or drink alcohol. Her blood pressure is 138/89 mm Hg and pulse is 76/min and regular. Cardiac exam reveals a soft S1, S3 gallop, a hyperdynamic apex beat, and a pansystolic murmur that radiates to the axilla on auscultation. Echocardiography reveals incompetency of one of the valves. Which of the following sites is the best position to auscultate this defect?
  1. Right lower end of the body of the sternum
  2. 4th intercostal space at the midclavicular line on left side
  3. Medial end of the 2nd intercostal space on right side
  4. 5th intercostal space at the midclavicular line on left side
  5. Medial end of the 2nd intercostal space on left side

An 85-year-old woman otherwise healthy presents with left-sided weakness. Her symptoms started 4 hours ago while she was on the phone with her niece. The patient recalls dropping the phone and not being able to pick it up with her left hand. No significant past medical history. No current medications. Physical examination reveals decreased sensation on the left side, worse in the left face and left upper extremity. There is significant weakness of the left upper extremity and weakness and drooping of the lower half of the left face. Ophthalmic examination reveals conjugate eye deviation to the right. A noncontrast CT of the head is unremarkable. The patient is started on aspirin. A repeat contrast CT of the head a few days later reveals an ischemic stroke involving the lateral convexity of right cerebral hemisphere. Which of the following additional findings would most likely be seen in this patient?
  1. Amaurosis fugax
  2. Profound lower limb weakness
  3. Horner’s syndrome
  4. Homonymous hemianopsia
  5. Prosopagnosia

A 28-year-old man presents to his physician with a complaint of a 4-week history of headaches that is affecting his academic performance. Over-the-counter medications do not seem to help. He also mentions that he has to raise his head each time to look at the board when taking notes. His blood pressure is 125/75 mm Hg, pulse 86/min, respiratory rate 13/min, temperature 36.8°C (98.2°F). Ophthalmic examination shows an upward gaze palsy, convergence-retraction nystagmus, and papilledema. CT scan of the head reveals a 1.5 x 1.2 cm heterogeneous mass in the epithalamus with dilated lateral and 3rd ventricles. What other finding is most likely to be associated with this patient’s condition?
  1. Medial strabismus
  2. Sensorineural hearing loss
  3. Pseudo-Argyll Robertson pupils
  4. Eyes down and out
  5. Conducting hearing loss

A 54-year-old patient is brought to the emergency department by ambulance with palpitations, lightheadedness, and generalized weakness. He was enjoying the long weekend with his friends at a prolonged destination bachelor’s party over the last several days. They all drank a great deal of alcohol. He can’t quite recall how much he had to drink but he did not blackout. Past medical history includes hypertension. He takes enalapril daily. His blood pressure is 110/75 mm Hg, pulse 140/min, respiratory rate 14/min, temperature 37.0°C (98.6°F). The patient appears ill and has an irregular pulse. An electrocardiogram is performed (see in the picture). The physician explains to the patient that he has an abnormal heartbeat and he needs to be started on anticoagulation therapy to avoid an ischemic stroke from a thrombus that may be forming in his heart. In which of the following locations is a thrombus most likely to be formed?
  1. Middle cerebral artery
  2. Left main coronary artery
  3. Right coronary artery
  4. Posterior descending artery
  5. Left atrial appendage
Anatomy USMLE Step 1 Sample Question

Image: Resting electrocardiogram showing fast atrial fibrillation. By Peake ST, Mehta PA, Dubrey SW – J Med Case Rep (2007), License: CC BY 2.0

A 55-year-old man visits the clinic with his wife. He has had difficulty swallowing solid foods for the past 2 months. His wife adds that his voice is getting hoarse but they thought it was due to his recent flu. His medical history is significant for type 2 diabetes mellitus for which he is on metformin. He suffered from many childhood diseases due to lack of medical care and poverty. His blood pressure is 125/87 mm Hg, pulse 95/min, respiratory rate 14/min, and temperature 37.1°C (98.7°F). On examination, an opening snap is heard over the cardiac apex. An echocardiogram shows an enlarged cardiac chamber pressing into his esophagus. Changes in which of the following structures is most likely responsible for this patient’s symptoms?
  1. Left ventricle
  2. Left atrium
  3. Right atrium
  4. Right ventricle
  5. Patent ductus arteriosus

A 12-year-old boy is brought to the emergency department late at night by his worried mother. She says he has not been feeling well since this morning after breakfast. He skipped both lunch and dinner. He complains of abdominal pain as he points towards his lower abdomen but says that the pain initially started at the center of his belly. His mother adds that he vomited once on the way to the hospital. His past medical history is noncontributory and his vaccinations are up to date. His temperature is 38.1°C (100.6°F), pulse is 98/min, respirations are 20/min, and blood pressure is 110/75 mm Hg. Physical examination reveals right lower quadrant tenderness. The patient is prepared for laparoscopic abdominal surgery. Which of the following structures is most likely to aid the surgeons in finding the source of this patient’s pain and fever?
  1. Teniae coli
  2. McBurney’s point
  3. Transumbilical plane
  4. Linea Semilunaris
  5. Arcuate line

A 40-year old man presents to the clinic with vague upper abdominal pain that has been worsening for the last several days. He says that he often gets similar pain but less severe and that it worsens with meals. The pain sometimes radiates to his back. He recently lost 15 kg (33.6 lb) of weight secondary to his lack of appetite since his last visit 2 months ago. He admits to drinking alcohol almost every night since the age of 17. His temperature is 37.0° C (98.6°F), respirations are 15/min, pulse is 67/min, and blood pressure is 122/98 mm Hg. Physical examination reveals moderate epigastric tenderness. An abdominal CT scan reveals calcifications as shown by the white arrows. Which of the following organs is affected in this patient?
  1. Pancreas
  2. Jejunum
  3. Duodenum
  4. Large intestine
  5. Gall bladder
Anatomy USMLE Step 1 Sample Question

Image by Sommer CA, Wilcox CM – F1000Res (2014), License: CC BY 3.0

A 55-year-old woman is brought to the emergency department due to sudden onset retrosternal chest pain. An ECG shows ST-segment elevation. A diagnosis of myocardial infarction is made and later confirmed by elevated levels of troponin I. The patient is sent to the cardiac catheter laboratory where she undergoes percutaneous catheterization. She has 2 occluded vessels in the heart and undergoes a percutaneous coronary intervention to place 2 stents in her coronary arteries. Blood flow is successfully restored in the affected arteries. The patient complains of flank pain on post-procedure evaluation a few hours later. A significant drop in hematocrit is observed, as well as a drop in her blood pressure to 90/60 mm Hg. Physical examination reveals extensive ecchymoses in the flanks and loin as seen in the provided image. Which of the following conditions is this patient most likely experiencing?
  1. Complication from femoral artery access
  2. Fat embolism
  3. Patent ductus arteriosus
  4. Adrenal hemorrhage
  5. Ventricular septal defect
Anatomy USMLE Step 1 Sample Question

Image: By Herbert L. Fred, MD and Hendrik A. van Dijk, License: CC BY 2.0

A 67-year-old man presents to the office complaining of abdominal pain. He was started on a trial of proton pump inhibitors 5 weeks ago but the pain has not improved. He describes the pain as dull, cramping, and worse during meals. Medical history is unremarkable. Physical examination is normal except for tenderness in the epigastric region. Endoscopy reveals an eroding gastric ulcer in the proximal part of the greater curvature of the stomach overlying a large pulsing artery. Which of the following arteries is most likely visible?
  1. Common hepatic artery
  2. Left gastric artery
  3. Right gastro-omental artery
  4. Left gastro-omental artery
  5. Superior pancreaticoduodenal artery
  6. Cystic artery
  7. Gastroduodenal artery

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