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USMLE (United States Medical Licensing Examination): Step 1: Basic sciences assessment Practice Exam 11

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 1000%
Time remaining120:00
Attempts allowedUnlimited
Difficulty mixE • M • H
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Question 1

MEDIUM

A 2-day-old boy is evaluated for bilious vomiting and abdominal distension since birth. Pregnancy was uncomplicated. Temperature is 37.1°C (98.8°F), blood pressure is 68/40 mm Hg, pulse is 152/min, and respirations are 46/min. The abdomen is mildly distended without hepatosplenomegaly. An abdominal radiograph shows a "double-bubble" sign with minimal distal bowel gas. Which of the following embryologic errors most likely explains this patient's condition?

The double-bubble sign with little distal gas and bilious vomiting in a newborn is most consistent with duodenal atresia/stenosis. This results from failure of recanalization due to abnormal apoptosis during development. Hirschsprung disease (neural crest migration failure) causes distal obstruction with delayed meconium. Malrotation can cause volvulus and ischemia with variable gas patterns. Meckel diverticulum (vitelline duct persistence) typically presents later with painless bleeding.

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