Usmle Step 1 High Yield Pharmacology Practice Exam

Test yourself under real exam conditions: 50 timed questions, 60 on the clock, pass mark 70%%. Instant score with a full review of everything you got wrong. Free — no account needed.

📝 50 questions · ⏱ 60 minutes · 🎯 Pass mark 70% · 🆓 Free, no signup

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Exam details

✓50 questions drawn from 161 cards
✓Countdown timer — auto-submits when time runs out
✓Pass mark 70% (real certification threshold)
✓Full review of wrong answers at the end
✓No signup required — save your score with a free account

Sample Questions

5 shown

Mechanism of acetaminophen toxicity?

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Hepatic CYP2E1 oxidizes APAP → toxic NAPQI metabolite. Glutathione normally detoxifies; in overdose glutathione is depleted → centrilobular hepatic necrosis.

Antidote for acetaminophen overdose?

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N-acetylcysteine — replenishes glutathione.

Aspirin mechanism?

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Irreversible COX-1 / COX-2 inhibitor → ↓ thromboxane A₂ in platelets (antithrombotic) + ↓ prostaglandins (analgesic, antipyretic, anti-inflammatory).

Aspirin overdose acid-base picture?

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Mixed: respiratory alkalosis (early — direct medullary stimulation) + anion-gap metabolic acidosis (later — uncoupled oxidative phosphorylation).

ACE inhibitor side effects?

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Cough (↑ bradykinin), angioedema, hyperkalemia, creatinine bump, teratogenic.

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