USMLE Histology Questions
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Free USMLE Step 1 Histology Questions

An 82-year-old woman presents to the emergency department status post fall. Imaging reveals diffuse trauma to the left humerus from midshaft to the olecranon process with shearing of the periosteum to the shame region. The orthopedic doctor suggests a follow-up in 2 weeks. In that time, the patient develops worsening pain and presents to the office. She is found to have diffuse bone necrosis in the area involved with no symptoms to the distal arm structures. What structure must have been damaged to cause this diffuse bone necrosis?

  1. Haversian canal
  2. Brachial artery
  3. Volkmann’s canal
  4. Ulnar nerve
  5. Epiphyseal plate
A patient has been exposed to an antigen. This antigen encounters a CD4+ helper T cell which phagocytosed the antigen, processes it, and presents it on MHC class II. This T cell encounters a B cell in the lymph node. The mature B cell proliferates and begins to differentiate antibodies to target this antigen. Where does this B cell proliferation occur?
  1. 1
  2. 2
  3. 3
  4. 4
  5. 5
Histology USMLE Step 1 Practice Question

Image: by Gleiberg, License: CC BY-SA 2.0 DE

A 3-year-old male was diagnosed with an Alpha-gal allergy, also known as Mammalian Meat Allergy (MMA). This allergy is mediated by a reaction to the carbohydrate galactose-alpha-1,3-galactose. An experimental treatment has been developed to halt the N-linked oligosaccharide addition that occurs in the synthesis of this compound. What microscopic structure is targeted by this experimental drug?
  1. Golgi apparatus
  2. Rough endoplasmic reticulum
  3. Sodium-potassium pump
  4. Proteasome
  5. Tumor suppressor p53
A 42-year-old woman presents to the office complaining of loss of sensation to her left arm and hand. Rapid evaluation is done due to risk of stroke. No other focal neurologic deficits exist except for loss of touch sensation in a C6 dermatomal pattern. Further evaluation reveals that the patient was recently sick with an upper respiratory infection. Biopsy is performed and shows the cell bodies of the sensory nerves are destroyed. What is the pathologic structure?
  1. Meissner's corpuscles
  2. Dorsal root ganglion
  3. Ventral root ganglion
  4. Dorsal column
  5. Lateral corticospinal tract

A 36-year-old man undergoes ileocecal resection for a gunshot injury. Resected ileocecal segment is sent for histological evaluation. One of the slides derived from the specimen is shown in the picture below. Which of the following statements regarding the structure marked with the red circle is correct?

  1. This structure can be only found in the colon.
  2. This structure can become a site of entry of certain microorganisms including S. typhi.
  3. Infants have the largest amount of these structures within their intestinal wall.
  4. This structure only appears in case of bacterial infection.
  5. These structures mostly contain M-cells.
Histology USMLE Step 1 Practice Question

Image: By Plainpaper, License: CC BY-SA 3.0

A 58-year-old male patient with a history of alcoholism is hospitalized due to a sudden onset of nausea and hematemesis. On admission, his vitals are as follows: blood pressure 110/70 mm Hg, heart rate 88/min, respiratory rate 16/min, and temperature 37.8℃ (100.0℉). Examination shows jaundiced mucosa, palmar erythema, widespread spider angiomata, ascites, and visible distended superficial epigastric veins. Abdominal ultrasound examination demonstrates a portal vein obstruction caused by liver cirrhosis. What is the first site of fibrous tissue deposition expected in the liver?
  1. Portal field
  2. Lumen of sinusoids
  3. Perisinusoidal space
  4. Interlobular connective tissue
  5. Lumen of bile ducts
A histologist examines an appendix specimen brought to the laboratory from the pediatric operating room. The slide is shown in the image. Which statement about the structures marked with yellow circles is correct?
  1. In children, appendicitis can frequently arise from certain changes in these structures
  2. The only part of the digestive system in which this structure can be found is the appendix
  3. Neutrophils are the major component of these structures
  4. These structures are not normally present within appendix
  5. These structures belong to the primary lymphatic system
Histology USMLE Step 1 Practice Question

Image: By Jatheesh Mohan, License: CC BY-SA 3.0, modified by Lecturio

A 32-year-old woman presents to her primary care office for evaluation of blurred vision and problems walking that have been happening on and off for the past 3 months. The patient states that she often feels “pins and needles” in her legs that cause her problems when she’s walking. The patient is afebrile and all vital signs are stable. An autoimmune disorder is suspected. What would the expected histology findings be?
  1. Decreased cerebrospinal fluid due to destruction of cells
  2. Destruction of blood-brain barrier
  3. Failure of cells that myelinate individual axons
  4. Damaged myelin sheath and myelin-producing cells
  5. Absence of interneurons
A 47-year-old man comes to the clinic with complaints of daily substernal chest pain for the past ‘year or so’, additionally, he reports that he often suffers from hoarseness and a cough in the mornings. His wife has also reported he has developed a ‘bad breath’. His medical history is positive for diabetes mellitus, to which he takes metformin. His physical examination is unremarkable. ECG is normal. An esophagogastroduodenoscopy is performed, the lower third of the esophagus looks erythemic, and a biopsy of the gastroesophageal junction is taken. He is given sublingual nitroglycerin and notes that his chest discomfort is worsened. A normal finding of the biopsied material would contain which of the following?
  1. Villi and microvilli
  2. Brunner glands
  3. Simple columnar epithelium
  4. Peyer patches
  5. Stratified squamous epithelium
A 28-year-old man presents with episodic abdominal pain, bloody diarrhea up to 7 times per day, and pain on defecation. Colonoscopy shows continuous erythema, superficial ulcers, and pseudopolyps in the rectum and sigmoid colon. Biopsy is performed and sent for histological evaluation. One of the slides is shown in the picture. The area of this slide marked with the yellow circle features which of the following pathological changes characteristic of the suspected disease?
  1. Goblet cell hyperplasia
  2. Paneth cells metaplasia
  3. Crypt abscess
  4. Enterocyte dysplasia
  5. Granuloma
Histology USMLE Step 1 Practice Question

Image: By KGH, License: CC BY-SA 3.0, edited by Lecturio

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