USMLE Step 1 · 61 free questions
Free USMLE Step 1 practice questions
61 Step 1 questions, free to answer with full explanations and no account: questions from 18 organ systems, plus every past Daily Challenge.
Step 1 asks why: the mechanism behind a finding, the cause of a disease, how a drug works. Every question here is a full clinical vignette with one best answer.
Free questions are part of the 1,090-question Step 1 bank, in the same format.
By organ system
Free Step 1 questions
Pick a system, or work down the list. Each question opens on its own page.
General Principles of Foundational Science · 5
- Fat-soluble vitaminsA 19-year-old man with cystic fibrosis and pancreatic insufficiency reports that he has difficulty seeing when entering a dark room, although his vision is normal in daylight.AQ-1055
- PorphyriasA 24-year-old woman is evaluated for recurrent episodes of severe, diffuse abdominal pain and constipation.AQ-1057
- Trinucleotide repeat disorders Daily #3A 7-year-old boy is evaluated for developmental delay and difficulty with social interaction.8 Oct 2026
- Tumor suppressor genes Daily #19A 5-year-old child with no family history of eye tumors is found to have multiple retinal tumors in both eyes.24 Oct 2026
- Trinucleotide repeat disorders Daily #29A 7-year-old boy is evaluated for delayed speech, learning difficulties, and limited eye contact.3 Nov 2026
Immune System · 4
- Hereditary angioedema Daily #1A 19-year-old woman is evaluated for progressive lip and tongue swelling with severe abdominal pain several hours after a dental procedure.6 Oct 2026
- Immunodeficiency disordersA 19-year-old woman comes to the clinic because of several months of intermittent diarrhea and bloating.AQ-1139
- Hypersensitivity reactionsA 19-year-old woman develops repeated sneezing and copious watery nasal discharge within minutes of entering a room where a cat is present.AQ-1154
- Transplant immunology Daily #33A 34-year-old man with acute myeloid leukemia undergoes allogeneic hematopoietic cell transplantation from an HLA-matched sibling.7 Nov 2026
Blood & Lymphoreticular System · 4
- Hemolytic anemiasA 34-year-old woman presents with 2 weeks of fatigue and yellowing of her eyes.AQ-1054
- Inherited thrombophiliasA 27-year-old man is hospitalized with a proximal deep venous thrombosis.AQ-1082
- Antiphospholipid syndrome Daily #17A 32-year-old woman is evaluated after an unexplained proximal deep venous thrombosis and two prior pregnancies ending in fetal death after 10 weeks’ gestation.22 Oct 2026
- Hemophagocytic lymphohistiocytosis Daily #23A 19-year-old man is evaluated after 12 days of persistent fever, fatigue, and worsening sore throat.28 Oct 2026
Behavioral Health · 2
Nervous System & Special Senses · 4
- Viral encephalitisA 13-year-old boy is brought to the physician because of worsening school performance and personality changes over the past 8 months.AQ-1056
- Disorders of the earAn 18-month-old boy is brought to the clinic because of fever and right ear pain for 2 days.AQ-1107
- Viral encephalitis Daily #24A 29-year-old woman is brought to the emergency department after 2 days of fever and headache, followed by abrupt confusion, irritability, and difficulty naming familiar objects.29 Oct 2026
- Seizures and epilepsy Daily #34A 46-year-old hospitalist has twice been observed to stop speaking abruptly during patient care, stare, and make repetitive chewing movements for about 1 minute.8 Nov 2026
Skin & Subcutaneous Tissue · 2
Musculoskeletal System · 5
- Muscular dystrophiesA 7-year-old boy with progressive proximal muscle weakness and calf pseudohypertrophy is diagnosed with Duchenne muscular dystrophy.AQ-1091
- Sjogren syndromeA 52-year-old woman reports 8 months of dry mouth and a gritty sensation in both eyes.AQ-1099
- Bone lesions Daily #8A 24-year-old man is evaluated for a painful mass in his right thigh.13 Oct 2026
- Osteogenesis imperfecta Daily #5A 9-year-old boy is evaluated after sustaining several fractures from falls while walking or playing.10 Oct 2026
- Bone tumors Daily #14A 17-year-old boy has 8 months of progressively worsening focal lower back pain and a mild painful scoliosis.19 Oct 2026
Cardiovascular System · 3
- CardiomyopathiesA 46-year-old woman with lymphoma is receiving doxorubicin.AQ-1060
- Complications of myocardial infarctionA 64-year-old man is hospitalized 4 days after an inferior myocardial infarction.AQ-1072
- Dyslipidemias Daily #22A 9-year-old boy is evaluated after a second episode of acute pancreatitis.27 Oct 2026
Respiratory System · 2
Gastrointestinal System · 4
- Esophageal disordersA 21-year-old man with asthma and seasonal allergies has had intermittent difficulty swallowing solid food for 8 months.AQ-1069
- Portal hypertensionA 52-year-old man with recurrent episodes of pancreatitis is evaluated after an episode of hematemesis.AQ-1073
- Functional gastrointestinal disorders Daily #7A 29-year-old woman has 10 months of bothersome fullness after meals and early satiety, often after eating only a small amount.12 Oct 2026
- Ischemic bowel disease Daily #35A 72-year-old woman develops cramping abdominal pain and then passes a small amount of blood-streaked stool several hours after an operation complicated by prolonged…9 Nov 2026
Renal & Urinary System · 2
Pregnancy, Childbirth, & the Puerperium · 2
Female and Transgender Reproductive System & Breast · 7
- Urinary incontinenceA 32-year-old woman reports intermittent urine leakage since the vaginal delivery of her second child 5 months ago.AQ-1110
- Ovarian neoplasmsA 35-year-old woman discusses contraception with her physician.AQ-1152
- Menopause Daily #11A 47-year-old woman brings her menstrual calendar to an appointment after receiving different interpretations of her reproductive stage from two laboratory reports.16 Oct 2026
- Amenorrhea Daily #20A 32-year-old woman presents with 10 months of absent menstrual bleeding.25 Oct 2026
- Female sexual dysfunction Daily #4A 34-year-old woman reports reduced genital engorgement during sexual activity despite preserved sexual desire and genital sensation.9 Oct 2026
- Abnormal uterine bleeding Daily #26A 34-year-old woman is evaluated for 8 months of unpredictable uterine bleeding, with intervals ranging from 3 to 10 weeks.31 Oct 2026
- Endometriosis Daily #12A 31-year-old woman is evaluated for 2 years of progressively worsening pelvic pain that intensifies during menstruation and pain with deep sexual intercourse.17 Oct 2026
Male and Transgender Reproductive System · 2
Endocrine System · 3
- Congenital adrenal hyperplasiaA 2-week-old infant is evaluated for atypical external genitalia noted at birth.AQ-1090
- HyperprolactinemiaA 26-year-old woman with schizophrenia has had regular menstrual periods until starting risperidone 4 months ago.AQ-1155
- Adrenal insufficiency Daily #30A 46-year-old woman is brought to the emergency department after 2 days of vomiting and profound weakness.4 Nov 2026
Multisystem Processes & Disorders · 3
- Respiratory alkalosisA 21-year-old woman develops rapid, deep breathing while waiting to give a presentation.AQ-1065
- Blast injuryA 24-year-old man is brought to the emergency department after an explosion in an enclosed workshop.AQ-1083
- Zoonotic infections Daily #2A 27-year-old man is evaluated for 6 days of fever, headache, and worsening muscle pain.7 Oct 2026
Biostatistics, Epidemiology/Population Health, & Interpretation of the Medical Literature · 2
- Statistical vs clinical significanceA randomized trial assigns 800 adults with type 2 diabetes mellitus to a structured dietary intervention or usual dietary advice.AQ-1125
- Measures of riskInvestigators follow 600 hospitalized adults who have no active Clostridioides difficile infection at enrollment.AQ-1127
Go deeper
Practice Step 1 by subject
- Step 1 cardiology questions7–11% of the exam on the official outline
- Step 1 neurology questions10–14% of the exam on the official outline
- Step 1 gastrointestinal questions6–10% of the exam on the official outline
- Step 1 renal questions11–15% of the exam on the official outline
- Step 1 biostatistics questions4–6% of the exam on the official outline
- The full Step 1 question bank1,090 questions, tutor and timed modes, ARGO
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Free Step 1 questions, explained.
Looking for the official samples? USMLE Step 1 sample test questions.
01How many free Step 1 questions are there?
61, from 18 organ systems, including 25 past Daily Challenges. Each has the full explanation of every answer choice. The full Step 1 bank has 1,090.
02Do I need an account to answer them?
No. Choose an answer, check it, and read the explanation on the page. A free account adds stats, the Daily Challenge leaderboard and free Library chapters.
03Are these real Step 1 questions?
No. They're original questions written to the NBME Item-Writing Guide and approved by a clinician. The USMLE program publishes its own official Step 1 sample questions.
04What do I get with Full access?
All 1,090 Step 1 questions plus the Step 2 CK bank, tutor and timed blocks, the full Library and ARGO, for $48 once. See the Step 1 question bank.
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Full access unlocks every Step 1 question, plus the Step 2 CK bank, for $48 once.
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Social Sciences: Communication, Ethics & Patient Safety · 5