USMLE Step 1 · 1,090 questions
USMLE Step 1 question bank
Argonaut's Step 1 bank has 1,090 exam-style questions across 19 organ systems, with every answer choice explained and every question approved by a clinician. Practice in tutor or timed mode, in 20-question blocks that match the 2026 exam. Full access is $48 once and covers Step 2 CK too.
No account needed for the free questions.
At a glance
The Step 1 bank in numbers
Counts come straight from the live bank and update as questions are added.
- Questions
- 1,090
- Organ systems
- 19
- Topics
- 404
- Format
- Single best answer
- Explanations
- Every answer choice
- Review
- Clinician-approved
- Modes
- Tutor and timed
- Timed pace
- 90 s per question
- Default block
- 20 questions · 30 min
- Free to try
- 61 questions, no account
- Price
- $48 once, both exams
- Expires
- Never
Who it's for
- Students in their dedicated period who want exam-style reps on every system.
- Students who have finished a bigger bank and want fresh questions written to the same item-writing rules.
- International medical graduates who need a complete Step 1 bank without paying hundreds of dollars.
Coverage
Built for what Step 1 tests
Step 1 is pass/fail, but it still checks that you can apply basic science to a patient. Most questions ask why: the mechanism behind a finding, the cause of a disease, or how a drug works and what it does wrong.
Pathology (45–55% of items) and physiology (30–40%) dominate the official content outline, and two thirds of questions test applied foundational science. Argonaut's Step 1 questions are written to that balance, as full clinical vignettes with one best answer.
| System | Share | Questions |
|---|---|---|
| General Principles | 38 | |
| Human Development | 10 | |
| Immune | 42 | |
| Hematology | 59 | |
| Behavioral Health | 34 | |
| Nervous & Special Senses | 104 | |
| Dermatology | 48 | |
| Musculoskeletal | 52 | |
| Cardiovascular | 95 | |
| Respiratory | 66 | |
| Gastrointestinal | 91 | |
| Renal & Urinary | 44 | |
| Pregnancy & Childbirth | 43 | |
| Female Reproductive & Breast | 75 | |
| Male Reproductive | 24 | |
| Endocrine | 54 | |
| Multisystem | 59 | |
| Biostatistics & Epidemiology | 70 | |
| Social Sciences & Ethics | 82 |
By discipline: Pathology 343 · Physiology 271 · Biostatistics & Epidemiology 67 · Ethics & Communication 57 · Behavioral Sciences 51 · Gross Anatomy & Embryology 48 · Pharmacology 39 · Microbiology 34. Questions can count toward more than one discipline on the real exam; here each has one primary discipline.
Content shares from the official USMLE Step 1 content outline, checked 11 October 2026.
Try one now
A real Step 1 question, explained
This is one of the 61 free Step 1 questions, exactly as it appears in the bank: cardiovascular, cardiomyopathies.
A 46-year-old woman with lymphoma is receiving doxorubicin. She feels well and has no shortness of breath, chest pain, or exercise intolerance. Her oncologist schedules an echocardiogram before treatment and plans to repeat it during therapy. She asks why her heart needs to be checked when she has no symptoms.
Which of the following is the most accurate explanation?
Show the answer and explanation
Answer: D. Doxorubicin can injure heart muscle as the total dose accumulates, gradually reducing its pumping function. An echocardiogram can detect this change before symptoms develop.
Doxorubicin is an anthracycline with dose-dependent cardiotoxic potential: as cumulative exposure rises, oxidative stress and injury to cardiac myocytes can impair left ventricular contraction. This dysfunction can develop without symptoms and may appear after treatment, so checking ventricular function before and during therapy can identify a change earlier than waiting for clinical heart failure. The monitoring is precautionary; it does not mean that this patient already has heart damage.
Why each answer choice is right or wrong
- A
A normal level of activity without breathlessness shows that doxorubicin has not injured the heart, so imaging can wait until symptoms appear.. Absence of symptoms does not exclude early or developing ventricular dysfunction. In this patient, waiting for breathlessness could delay recognition of a decline in cardiac function.
- B
Doxorubicin narrows the coronary arteries, causing brief episodes of reduced blood flow that an echocardiogram can identify between episodes.. This incorrectly attributes the main concern to episodic coronary ischemia. The relevant toxicity is direct injury to cardiac myocytes with possible loss of ventricular function, not primarily coronary vasospasm.
- C
Doxorubicin temporarily changes blood volume and vascular resistance, so the echocardiogram checks for a short-lived change in cardiac loading rather than muscle injury.. This describes a transient hemodynamic effect rather than the drug’s important cardiac toxicity. The concern is that myocardial injury can reduce contractile function, which is why ventricular function is monitored.
- D
Doxorubicin can injure heart muscle as the total dose accumulates, gradually reducing its pumping function. An echocardiogram can detect this change before symptoms develop. (correct). Cumulative doxorubicin exposure can cause clinically silent myocardial injury and reduced left ventricular function, supporting surveillance before symptoms develop.
- E
Doxorubicin affects the heart only during an infusion reaction, so an echocardiogram is useful only if symptoms occur during treatment.. Infusion-related reactions are a separate potential complication, but they do not account for the risk of cumulative myocardial injury. This patient’s lack of symptoms during treatment does not remove the rationale for surveillance.
Educational objective
Explain that cumulative doxorubicin exposure can injure cardiac myocytes and reduce left ventricular function. Cardiac imaging can detect ventricular dysfunction before symptoms appear.
Study the concept: Cardiomyopathies (free Library chapter)
How practice works
Test-day conditions, or learn as you go
Tutor mode
See the answer and the full explanation after each question. Best for learning a system for the first time.
Timed mode
90 seconds per question, explanations after the block. Default blocks are 20 questions in 30 minutes, like the real exam.
Real exam tools
Highlighter, strike-out, lab values, calculator, notes and marking, on a screen laid out like test day.
Your own blocks
Filter by exam, system, discipline and topic, or by unused, incorrect and marked questions. Up to 40 per block.
The Step 1 format
What the 2026 Step 1 looks like
Since 14 May 2026, Step 1 uses new test software with shorter blocks. Content and scoring did not change.
- Questions
- 280
- Blocks
- 14
- Questions per block
- 20
- Minutes per block
- 30
- Exam day
- 8 hours
- Before
- seven 60-minute blocks of 40 questions
How Argonaut matches it: timed mode runs at 90 seconds a question and defaults to 20-question blocks, so one Argonaut block is one exam block. Within a block you can move between questions and change answers; explanations appear when the block ends.
Read the full 2026 format guideSource: USMLE test delivery software update, checked 11 October 2026.
ARGO
Practice that follows your weak spots
Optional, included in Full access, and easy to ignore if you prefer to build your own blocks.
- 01
Measure
ARGO logs 16 data points on every answer: right or wrong, time, confidence, changed answers, the distractor that pulled you in, and how long since you last saw the topic.
- 02
Rank
It works out which Step 1 topics cost you the most points, separating gaps from misconceptions, second-guessing and forgetting.
- 03
Fix
Each ARGO session mixes new questions on your weakest topics, drills on concepts you confuse, and spaced retests of questions you missed.
Quality
Who writes the questions
Each question is written to the NBME Item-Writing Guide. A clinician reviews the facts, the keyed answer and every explanation, and approves it before it goes live.
- One best answer, a full clinical vignette, and no negatively worded or trick lead-ins.
- Answer choices of the same kind and length, so test-taking tricks don't work.
- Duplicates of an existing question are caught before import.
- Students can flag any question from the explanation, and every report is read.
Free and paid
What's free, and what $48 adds
Free
- 61 Step 1 questions with full explanations, no account
- The Daily Challenge, every day
- Free Library chapters
- Basic stats with a free account
Full access, $48 once
- All 1,090 Step 1 questions, plus the Step 2 CK bank
- The full high-yield Library
- ARGO sessions and full analytics
- Nuggets, flashcards and a notebook
One payment, no renewal and no expiry date: "lifetime" means for as long as Argonaut runs the service, as our terms define it. Full refund within 14 days if you've answered fewer than 200 questions (refund policy). The optional question-writing add-on is $4.99 a month.
By subject
Practice Step 1 by subject
Each subject page lists the topics the bank covers, with free questions to try.
- Step 1 cardiology questionsOfficial outline: Cardiovascular System, 7–11% of the exam
- Step 1 neurology questionsOfficial outline: Behavioral Health & Nervous Systems/Special Senses, 10–14% of the exam
- Step 1 gastrointestinal questionsOfficial outline: Gastrointestinal System, 6–10% of the exam
- Step 1 renal questionsOfficial outline: Respiratory & Renal/Urinary Systems, 11–15% of the exam
- Step 1 biostatistics questionsOfficial outline: Biostatistics & Epidemiology/Population Health, 4–6% of the exam
- All free Step 1 questions61 questions with full explanations, no account neededFree
Step 1 questions, answered.
01How many questions are in Argonaut's Step 1 question bank?
1,090 as of 12 November 2026, across 19 organ systems and 404 topics. We count only published bank questions; practice questions ARGO writes for one student aren't included.
02Does Argonaut match the new 2026 Step 1 format?
Yes. Since 14 May 2026, Step 1 has 14 blocks of 20 questions, 30 minutes each. Argonaut's timed mode gives 90 seconds per question and starts at 20-question blocks, so a block takes the same 30 minutes. You can also build longer custom blocks of up to 40 questions. See the 2026 exam format.
03Step 1 is pass/fail. Do I still need a question bank?
You still have to clear the pass mark, and questions are how most students learn to apply basic science under time pressure. A bank also shows you which systems are weak before test day, and ARGO does that ranking for you.
04Can I try the Step 1 bank before paying?
Yes. 61 Step 1 questions are free to answer without an account, with full explanations: free Step 1 questions. A free account adds the Daily Challenge leaderboard, free Library chapters and basic stats.
05Does one purchase cover Step 2 CK too?
Yes. $48 once unlocks the Step 1 and Step 2 CK banks, the full Library and ARGO, with no expiry date. See pricing.
06Who writes the questions?
Each question is written to the NBME Item-Writing Guide and reviewed and approved by a clinician before it goes live. Read our editorial policy.
07Can I use Argonaut alongside UWorld or AMBOSS?
Yes. Plenty of students add a second bank for fresh questions once they've worked through their first, and Argonaut is priced so that's affordable. How Argonaut compares with UWorld.
Start your Step 1 prep today.
Answer the free Step 1 questions now. When you're ready, $48 once unlocks every question for Step 1 and Step 2 CK.
$48 · once · Step 1 + Step 2 CK