USMLE Step 1 Gastrointestinal Practice Questions
6–10% of Step 1 · 27 practice questions with a note on every option
280 questions in 14 timed 30-minute blocks, with your score in gastrointestinal and every other content area.
Free gastrointestinal drillA 67-year-old man who has smoked for 45 years comes to the physician because of painless jaundice, generalized itching, dark urine, and a 9-kg (20-lb) weight loss over 3 months. Twice in the past 2 months he developed tender, red, cord-like swellings along veins of his arms and legs that resolved and then recurred at new sites. Examination shows a nontender, palpable gallbladder. CT shows a mass in the head of the pancreas with dilation of the common bile duct and pancreatic duct. Which of the following genetic alterations is most likely present in the tumor?
Gastrointestinal System on Step 1
The Gastrointestinal System is 6–10% of Step 1. Questions cover anatomy and embryology of the gut, GI hormones, and diseases from the esophagus to the colon, the liver, the gallbladder and the pancreas.
- Share of Step 1
- 6–10% of the exam, per the USMLE content outline
- On our mock exam
- 22 of 280 questions, with your score for this system in the result
- Our drill
- 10 questions from 27 gastrointestinal questions, untimed, a note on every option; one free attempt, unlimited with a pass
What Step 1 gastrointestinal questions test
- Embryology and anatomy: gut rotation, the blood supply of the gut and hernias
- GI hormones and digestion: gastrin, secretin, CCK and absorption of nutrients
- Esophageal, gastric and small bowel disease, malabsorption and celiac disease
- Inflammatory bowel disease, polyps and colorectal cancer genetics
- Liver disease: hepatitis serology, cirrhosis, bilirubin metabolism and hereditary liver disease
- Biliary and pancreatic disease, and drugs for acid, motility and inflammatory bowel disease
Sit all 280 questions in timed blocks
280 questions in 14 timed 30-minute blocks, with your score in gastrointestinal and every other content area.
Free gastrointestinal drillHow to study it
- Learn hepatitis B serology as a table of markers by stage.
- Trace bilirubin metabolism once and place each jaundice syndrome on it.
- Contrast Crohn disease and ulcerative colitis by location, depth and complications.
Common questions
Is GI a big part of Step 1?
The content outline puts the Gastrointestinal System at 6–10% of Step 1. Our 280-question mock includes 22 GI questions.
What GI pharmacology is tested?
Proton pump inhibitors, H2 blockers, antiemetics by receptor, laxatives and antidiarrheals, and the drugs used for inflammatory bowel disease, with their mechanisms and adverse effects.
280 questions in 14 timed 30-minute blocks, with your score in gastrointestinal and every other content area.
Free gastrointestinal 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.