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USMLE Practice Questions With Every Answer Explained

A single question card. Three grey placeholder lines stand in for the question stem, and below them five answer rows each begin with a small circle; the third row is filled bright orange as the selected choice while the other four stay muted.

Answer USMLE practice questions right now: 72 original clinical vignettes in the standard five-option format, with the key and every distractor explained the moment you commit. Nothing is gated, nothing expires, and no email is asked for.

Educational use only — these are not official NBME or USMLE questions.

Question 1 of 72 in this filterCardiologymediumStep 1 & 2 CK

A 62-year-old man is brought to the emergency department 45 minutes after the sudden onset of crushing substernal chest pressure that began while he was shoveling snow. He has vomited twice and feels lightheaded. He has a 30-year history of hypertension and smokes one pack of cigarettes daily. His pulse is 50/min, respirations are 18/min, and blood pressure is 94/58 mm Hg. He is diaphoretic. Jugular venous pressure is elevated, the lungs are clear to auscultation bilaterally, and no murmur is heard. ECG shows 3-mm ST-segment elevation in leads II, III, and aVF, with ST elevation greater in lead III than in lead II and reciprocal ST depression in leads I and aVL. A right-sided ECG shows 1.5-mm ST-segment elevation in lead V4R. Serum troponin I is elevated.

Occlusion of which of the following arteries is most likely responsible for this patient's findings?

Select one answer. Scoring and the full explanation appear immediately.

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What these USMLE practice questions cover

8 disciplines, 9 items each, built around the concepts that generate USMLE practice questions rather than around trivia.

Cardiology

Ischemia localisation, murmurs, arrhythmia and heart failure care.

Pulmonology

Obstructive vs restrictive disease, gas exchange and acute dyspnea.

Renal

Acute kidney injury patterns, electrolytes, acid-base and casts.

Gastrointestinal

Liver failure and its complications, pancreas, gut and biliary tree.

Neurology

Stroke syndromes, CSF interpretation and neuromuscular weakness.

Endocrine

Diabetes emergencies, thyroid, adrenal and calcium disorders.

Infectious Disease

Empiric therapy, endocarditis, tuberculosis and HIV complications.

Pharmacology

Drug mechanisms, characteristic adverse effects and antidotes.

Free USMLE practice questions with no account

No USMLE practice questions are gated here

All 72 USMLE practice questions are open on arrival. No registration wall, no email capture, no trial that dies after ten items.

No paid tier holds the explanations back either, which is what separates these free USMLE practice questions from most of what ranks beside them.

Answers to these USMLE practice questions and your per-subject accuracy are written to local storage and never leave the device.

That trade costs something real: clear your site data and the history of the USMLE practice questions you answered starts again, because no account is holding it.

USMLE step 1 practice questions: shared science

Be precise about what is here, because most sites are not. Most of these USMLE practice questions are written on material serving both exams.

Mechanism, pathophysiology, pharmacology, microbiology and the physiology behind an abnormal value are the USMLE practice questions that work for Step 1.

There are no Step 1-exclusive items here, and nothing in these USMLE practice questions samples a Step 1 blueprint.

Treat these USMLE practice questions as a drill on reasoning rather than as coverage: one line in the stem rules an option out on mechanism.

USMLE step 2 CK practice questions: management

The rest are USMLE practice questions written for Step 2 CK, and they ask a different thing.

Where shared USMLE practice questions stop at the mechanism, these run on to the decision: the next diagnostic step, the drug to start or stop, the patient who can go home.

Each lead-in matches what the keyed answer actually is, so management USMLE practice questions never hide behind a diagnosis question.

Filtering USMLE practice questions, and the random ten

Filter these USMLE practice questions by subject, by easy, medium or hard, or by both at once.

Difficulty is mixed rather than escalating. USMLE practice questions that ramp train you to expect the next item to be harder, which is not how a real block behaves.

The random ten is the closest these USMLE practice questions come to a block. Take it cold, without filters, and score it at the end.

Mixed subjects and mixed difficulty are what make a block hard, and ten unfiltered USMLE practice questions expose pacing and switching costs a filtered run never will.

It is still ten USMLE practice questions, not forty, so read the result as a mood check rather than a measurement.

How to work these USMLE practice questions

USMLE practice questions: read the last line first

Standardised USMLE practice questions are engineered so one answer is defensible and four are not, and the discriminating detail always sits in the stem.

Read the last line of these USMLE practice questions first, so you know what is asked: a diagnosis, a mechanism, a next step, the likeliest organism.

Then read the stem hunting for that one thing, and commit before you look at the options.

Name it from the stem alone and the option list becomes a matching exercise instead of a trap.

Eliminate on positive grounds, never on instinct

Every distractor in well-built USMLE practice questions is plausible for someone. Your job is to find the line in the vignette that kills it.

A murmur that softens with Valsalva argues against dynamic left ventricular outflow obstruction.

A urine sodium under 20 mEq/L argues for a prerenal cause and against acute tubular necrosis.

A normal complement level argues against post-streptococcal glomerulonephritis. Pointing at the disqualifying line is what separates a stable score from a volatile one.

Review beats volume on USMLE practice questions

Reading the explanation for an item you got right by luck beats three more USMLE practice questions, because it converts a guess into a rule.

One habit worth importing from real blocks into these USMLE practice questions: never change an answer unless you can say which line made you change it.

Most reversals on USMLE practice questions are anxiety rather than evidence, and the explanation panel tells you within seconds which of the two it was.

What a percentage on USMLE practice questions means

A percentage on USMLE practice questions is not a three-digit score, and it cannot be converted into one.

Scores come from forms equated against the real examination. Unequated USMLE practice questions have no such calibration, and any site offering that conversion is inventing it.

Use USMLE practice questions to find and close gaps, then sit a scored NBME or UWorld self-assessment when you want an estimate of where you stand, and convert a real practice form.

The accuracy panel is triage, not a grade. Grinding more USMLE practice questions in your worst discipline only keeps confirming the gap you already found.

How these USMLE practice questions were written

Every vignette, option set and explanation is original material written for this site. None of these USMLE practice questions is lifted from anywhere else.

Content is anchored to textbook-level, high-consensus material — infarct localisation, obstructive versus restrictive physiology, stroke syndromes, drug mechanisms and their adverse effects.

An item built on a disputed fact teaches a disputed fact, so contested edge cases stay out of these USMLE practice questions.

Laboratory values inside these USMLE practice questions follow the reference sheet these vignettes assume, so the numbers you reason with match test day.

The limits are worth stating plainly: 72 USMLE practice questions sample no full blueprint, and nothing here is timed the way a real block is.

These USMLE practice questions are not a substitute for a paid question bank either. They are the free set you work before, between, or alongside one.

Prefer a light habit to a long run of USMLE practice questions? One item a day instead, or fit question practice into a schedule.

Frequently asked questions

What this set of USMLE practice questions contains, who wrote it, and what a percentage here is worth.

Are these free USMLE practice questions without signing up?

All 72 USMLE practice questions are open right now — no account, no email address, no trial that expires. Your per-subject accuracy stays in your own browser.

How many USMLE practice questions are here?

72 USMLE practice questions across 8 disciplines, 9 in each, every one a five-option clinical vignette with a worked explanation.

Are these official NBME or USMLE practice questions?

No. Every stem, option set and explanation is original. None of these USMLE practice questions is reproduced from an official examination or a commercial question bank.

Does my percentage on USMLE practice questions predict a score?

No, and no honest set this size could claim otherwise. A three-digit score comes from an equated form; USMLE practice questions like these carry no such calibration.

How should I read my USMLE practice questions accuracy?

As triage. A discipline well below your own average is a content problem; one near your average with scattered misses is usually a test-taking problem, and more USMLE practice questions will not fix it.

Can I filter these USMLE practice questions?

Yes — by any of the 8 subjects, by easy, medium or hard, or by both at once. A random set of ten USMLE practice questions returns a scored summary at the end.

How many USMLE practice questions fit in one session?

That depends on your calendar, not this page. What does not change is the ratio: review time should at least match question time, or the items stop teaching you anything.

Do the lab values in the stems match the exam sheet?

Yes. Reference intervals inside these USMLE practice questions follow the NBME laboratory values sheet, so the numbers you reason with are the ones you will be given.

All 72 USMLE practice questions above are free, explained, and open without an account.

Not affiliated with, endorsed by, or sponsored by the NBME® or USMLE®. Original study items, not official questions, and not medical advice.