USMLE Step 1 Musculoskeletal and Skin Practice Questions
8–12% of Step 1 · 33 practice questions with a note on every option
280 questions in 14 timed 30-minute blocks, with your score in musculoskeletal and skin and every other content area.
Free musculoskeletal and skin drillA 24-year-old woman comes to the physician because of joint pain, fatigue, and swelling of her legs for 2 months. Examination shows an erythematous rash over the cheeks and nasal bridge that spares the nasolabial folds, painless ulcers on the hard palate, tenderness of several small joints of the hands, and pitting edema of the ankles. Urinalysis shows 3+ protein and red blood cell casts. Serum C3 and C4 concentrations are low, and anti-double-stranded DNA antibodies are positive. A kidney biopsy shows thickened capillary loops with subendothelial deposits. Which of the following is the primary mechanism of this patient's kidney injury?
Musculoskeletal, Skin & Subcutaneous Tissue on Step 1
Musculoskeletal, Skin & Subcutaneous Tissue is 8–12% of Step 1. Questions mix gross anatomy (which nerve is injured by this fracture) with pathology and pharmacology of joints, bone, muscle and skin.
- Share of Step 1
- 8–12% of the exam, per the USMLE content outline
- On our mock exam
- 27 of 280 questions, with your score for this system in the result
- Our drill
- 10 questions from 33 musculoskeletal and skin questions, untimed, a note on every option; one free attempt, unlimited with a pass
What Step 1 musculoskeletal and skin questions test
- Upper and lower limb anatomy: brachial plexus and peripheral nerve injuries, and the muscles each nerve supplies
- Bone disease: osteoporosis, osteomalacia, Paget disease and bone tumors
- Arthritis: osteoarthritis, rheumatoid arthritis, gout and pseudogout, and seronegative spondyloarthritis
- Autoimmune disease: lupus, scleroderma, Sjögren syndrome, dermatomyositis and their antibodies
- Skin: blistering disease, psoriasis, skin cancer, and the layers and cells of the skin
- Drugs: NSAIDs, gout drugs, DMARDs and biologics
Sit all 280 questions in timed blocks
280 questions in 14 timed 30-minute blocks, with your score in musculoskeletal and skin and every other content area.
Free musculoskeletal and skin drillHow to study it
- Learn nerve injuries by the fracture or injury that causes them and the deficit they leave.
- Make an autoantibody table: disease, antibody, and one clinical clue.
- Learn gout drugs by where they act: synthesis, excretion or inflammation.
Common questions
How much anatomy is on Step 1?
Gross anatomy and embryology together are listed at 10–20% of Step 1, spread across systems. Limb anatomy and nerve injuries cluster in this category.
Are dermatology images tested?
The real exam uses images. Our questions describe skin findings in words, so learn the descriptive terms for each lesion.
280 questions in 14 timed 30-minute blocks, with your score in musculoskeletal and skin and every other content area.
Free musculoskeletal and skin 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.