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USMLE (United States Medical Licensing Examination): Step 1: Basic sciences assessment Practice Exam 23

Practice exam for USMLE (United States Medical Licensing Examination): Step 1: Basic sciences assessment.

Active sessionUSMLE Step 1 practice testUSMLE Step 1 practice examUSMLE Step 1 practice questionsUSMLE Step 1 basic sciencesUSMLE Step 1 foundational sciences+5
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Question 1 of 1100%
Time remaining120:00
Attempts allowedUnlimited
Difficulty mixE • M • H
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Question 1

HARD

A 66-year-old man presents with fatigue and back pain. Laboratory studies show hemoglobin 9.1 g/dL, creatinine 2.0 mg/dL, and calcium 11.8 mg/dL. Serum protein electrophoresis shows an M-spike. X-ray of the spine shows multiple lytic lesions. Bone marrow biopsy shows sheets of plasma cells. Which of the following additional findings is most likely in this patient?

Multiple myeloma causes monoclonal light chain production (Bence Jones proteins) that can precipitate in renal tubules, leading to renal dysfunction. Auer rods suggest AML; JAK2 mutation suggests polycythemia vera; serum viscosity is typically increased in monoclonal gammopathies.

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