Đề thi mẫu USMLE Step 1 (Tiếng Anh)

Bs. Lê Đình Sáng

Kỳ thi Cấp phép Y tế Hoa Kỳ (USMLE) Bước 1 là một bài kiểm tra tiêu chuẩn dành cho sinh viên y khoa và sinh viên tốt nghiệp muốn hành nghề y tại Hoa Kỳ. Nó đánh giá sự hiểu biết và khả năng áp dụng các khái niệm khoa học nền tảng của người kiểm tra, cũng như thể hiện tư duy phản biện và kỹ năng giải quyết vấn đề, trong bối cảnh cung cấp dịch vụ chăm sóc bệnh nhân an toàn và hiệu quả.

Cấu trúc của một đề thi USMLE Bước 1 như sau:

• Đây là một kỳ thi dựa trên máy tính
• Nó bao gồm khoảng 280 câu hỏi trắc nghiệm
• Bài kiểm tra được chia thành bảy Block 60 phút, với 40 câu hỏi trong mỗi Block
• Tổng thời gian làm bài là khoảng 8 giờ, với thời gian nghỉ giữa các Blocks
• Nội dung của kỳ thi bao gồm các môn khoa học y tế cơ bản, bao gồm giải phẫu, sinh lý học, hóa sinh, dược lý, vi sinh và bệnh lý học
• Đề thi được thiết kế để đánh giá khả năng áp dụng kiến thức của người kiểm tra vào các tình huống lâm sàng thực tế.

Bài thi USMLE Bước 1 là một thành phần quan trọng của quy trình cấp phép cho các chuyên gia y tế ở Hoa Kỳ và điểm số cao trong kỳ thi USMLE Bước 1 có thể nâng cao đáng kể cơ hội được chấp nhận vào chương trình nội trú của sinh viên y khoa.

Sau đây là một số câu hỏi mẫu tham khảo cho từng Blocks trong một đề thi USMLE Step 1.

Block 1: Anatomy

1. Describe the structure and function of the four chambers of the heart.
2. What is the anatomical location and function of the hypothalamus?
3. Explain the process of respiration, including the role of the diaphragm and intercostal muscles.

Block 2: Physiology

1. Discuss the regulation of blood glucose levels by insulin and glucagon.
2. What is the role of the renin-angiotensin-aldosterone system in regulating blood pressure?
3. Explain the mechanisms of muscle contraction and relaxation.

Block 3: Microbiology

1. Describe the structure and replication cycle of the herpes simplex virus.
2. What is the mechanism of action of penicillin and how does it differ from that of other beta-lactam antibiotics?
3. Explain the process of bacterial conjugation and the transfer of genetic material.

Block 4: Pathology

1. Discuss the histological features and causes of osteoarthritis.
2. What is the pathogenesis of systemic lupus erythematosus and how does it lead to the development of clinical manifestations?
3. Explain the process of wound healing and the role of cytokines and growth factors in this process.

Block 5: Pharmacology

1. Discuss the mechanisms of action and therapeutic uses of aspirin.
2. What is the mechanism of action of beta blockers and how do they lower blood pressure?
3. Explain the process of drug metabolism and the role of cytochrome P450 enzymes in this process.

Các câu hỏi trong một đề thi USMLE Step 1 còn bao gồm các câu hỏi trắc nghiệm nhiều lựa chọn. Ví dụ như dưới đây:

Block 1: Anatomy

1. What is the function of the sinoatrial (SA) node in the heart? A. To regulate blood flow B. To initiate and regulate the heart’s electrical impulses C. To produce and secrete hormones D. To filter waste products from the blood
2. Which of the following structures is NOT part of the hypothalamus? A. Suprachiasmatic nucleus B. Posterior pituitary gland C. Anterior pituitary gland D. Mammillary bodies
3. What is the function of the diaphragm in the process of respiration? A. To regulate oxygen and carbon dioxide levels in the blood B. To move air into and out of the lungs C. To produce mucus in the respiratory system D. To produce hormones involved in respiratory control

Block 2: Physiology

1. Which hormone is primarily responsible for decreasing blood glucose levels? A. Insulin B. Glucagon C. Cortisol D. Adrenaline
2. What is the primary effect of the renin-angiotensin-aldosterone system on blood pressure? A. It decreases blood pressure B. It increases blood pressure C. It has no effect on blood pressure D. It alternately decreases and increases blood pressure
3. What is the role of actin and myosin in muscle contraction? A. Actin and myosin are enzymes involved in breaking down glucose for energy B. Actin and myosin are hormones involved in regulating muscle contraction C. Actin and myosin are proteins involved in sliding past each other to generate force and cause muscle contraction D. Actin and myosin are neurotransmitters involved in transmitting signals to muscle fibers

Block 3: Microbiology

1. What is the type of viral replication that occurs with the herpes simplex virus? A. Lytic replication B. Lysogenic replication C. Budding D. Pinocytosis
2. How does penicillin differ from other beta-lactam antibiotics in its mechanism of action? A. Penicillin is a broad-spectrum antibiotic while other beta-lactams are narrow-spectrum B. Penicillin has a different target on bacterial cells C. Penicillin is bacteriostatic while other beta-lactams are bactericidal D. Penicillin is more toxic to humans than other beta-lactams
3. What is the purpose of bacterial conjugation? A. To exchange genetic material between bacteria B. To produce spores of bacteria for dispersal C. To eliminate waste from bacteria D. To produce energy for the bacteria

Block 4: Pathology

1. What is the primary cause of osteoarthritis? A. Infection B. Inflammation C. Degeneration of cartilage D. Overuse of the joint
2. What is the main source of systemic inflammation in systemic lupus erythematosus? A. Bacterial infection B. The immune system attacking healthy tissues C. A virus D. Exposure to environmental toxins
3. What is the role of cytokines in the process of wound healing? A. Cytokines stimulate cell growth and division B. Cytokines promote inflammation and scar formation C. Cytokines inhibit inflammation and promote tissue repair

Block 5: Pharmacology

1. What is the mechanism of action of aspirin (acetylsalicylic acid)? A. It decreases production of prostaglandins B. It inhibits the reuptake of serotonin C. It blocks the action of acetylcholine D. It stimulates the production of insulin
2. What is the main side effect of beta blockers such as propranolol? A. Bronchoconstriction B. Decreased heart rate C. Increased heart rate D. Increased blood pressure
3. What is the mechanism of action of the antiepileptic drug valproic acid? A. It increases the availability of gamma-aminobutyric acid (GABA) B. It decreases the availability of glutamate C. It increases the availability of dopamine D. It decreases the availability of acetylcholine
4. What is the main difference between ACE inhibitors and ARBs (angiotensin receptor blockers) in the treatment of hypertension? A. ACE inhibitors block the conversion of angiotensin I to angiotensin II, while ARBs block the action of angiotensin II at the receptor level. B. ACE inhibitors increase the production of angiotensin II, while ARBs decrease the production of angiotensin II. C. ACE inhibitors have more serious side effects than ARBs. D. ARBs are more effective in lowering blood pressure than ACE inhibitors.
5. What is the mechanism of action of the statin class of drugs used to treat hyperlipidemia? A. They increase the excretion of cholesterol in the bile B. They inhibit the production of cholesterol in the liver C. They bind to and remove cholesterol from circulating in the blood D. They stimulate the uptake of low-density lipoproteins (LDL) by peripheral tissues