USMLE Step 1 Behavioral Health and Nervous System Practice Questions
10–14% of Step 1 · 41 practice questions with a note on every option
280 questions in 14 timed 30-minute blocks, with your score in behavioral health and nervous system and every other content area.
Free behavioral health and nervous system drillA 31-year-old nurse is admitted to the hospital for evaluation of recurrent episodes of sweating, tremor, and confusion. During an observed episode, her serum glucose is 34 mg/dL, serum insulin concentration is markedly elevated, C-peptide concentration is undetectable, and a screen for sulfonylureas is negative. CT of the abdomen shows no masses. She does not have diabetes mellitus, is not seeking disability payments or time off work, and says she is frustrated that physicians cannot find the cause. Her records show four previous hospitalizations for similar episodes at other facilities. Which of the following is the most likely diagnosis?
Behavioral Health & Nervous Systems/Special Senses on Step 1
Behavioral Health & Nervous Systems/Special Senses is 10–14% of Step 1. It pairs neuroscience, where you localize a lesion from the exam findings, with psychiatry, where you match symptoms to a disorder and a drug to its mechanism and adverse effects.
- Share of Step 1
- 10–14% of the exam, per the USMLE content outline
- On our mock exam
- 34 of 280 questions, with your score for this system in the result
- Our drill
- 10 questions from 41 behavioral health and nervous system questions, untimed, a note on every option; one free attempt, unlimited with a pass
What Step 1 behavioral health and nervous system questions test
- Neuroanatomy: localizing lesions in the cortex, brainstem, spinal cord and cranial nerves
- Stroke syndromes by artery, seizures and antiseizure drugs, headache, and CNS tumors
- Neurodegeneration and demyelination: Alzheimer, Parkinson and Huntington diseases, ALS and multiple sclerosis
- CNS infection: meningitis by age and CSF profile, encephalitis and prion disease
- Psychiatric disorders and psychopharmacology: antidepressants, antipsychotics, mood stabilizers, anxiolytics and their toxicities
- The eye and ear, sleep physiology, and substance intoxication and withdrawal
Sit all 280 questions in timed blocks
280 questions in 14 timed 30-minute blocks, with your score in behavioral health and nervous system and every other content area.
Free behavioral health and nervous system drillHow to study it
- Work every neurology vignette in two steps: where is the lesion, then what is the cause.
- Learn each psychiatric drug class by mechanism, main use and one dangerous adverse effect.
- Use the CSF profile table (cells, protein, glucose) for meningitis questions.
Common questions
Is psychiatry on Step 1 or Step 2 CK?
Both. Step 1 tests the science: neurotransmitters, drug mechanisms and adverse effects, and the diagnostic features of disorders. Step 2 CK tests clinical management.
How should I study neuroanatomy for Step 1?
By lesion. Learn the classic findings of each brainstem and spinal cord lesion and each stroke territory, then practice vignettes that make you localize before you diagnose.
280 questions in 14 timed 30-minute blocks, with your score in behavioral health and nervous system and every other content area.
Free behavioral health and nervous system drillThe other Step 1 systems
Sources
- USMLE: Step 1 (blocks, items, testing day, break time)
- USMLE: Step 2 CK (blocks, items, testing day, break time)
- USMLE: Test delivery software updates for Step 2 CK and Step 1 (May 2026)
- USMLE: Step 1 content outline and specifications
- USMLE: Step 2 CK content outline and specifications
- USMLE: Examination results and scoring (minimum passing scores)
- USMLE Bulletin: Scoring and score reporting (about 60% correct to pass; result timing)
- USMLE Bulletin: Eligibility (attempt limits)
- USMLE: Apply for exams (2026 and 2027 fees, FSMB registration, region fees)
- USMLE: Performance data (pass rates)
- Intealth ECFMG: Fees overview (ECFMG Certification)
Original practice questions written to the USMLE content outlines and current standard references. USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and NBME. Independent practice, not affiliated with or endorsed by the FSMB, NBME or Intealth (ECFMG). Follow current guidelines in clinical practice.