{"id":11044,"date":"2026-09-30T00:25:35","date_gmt":"2026-09-30T08:25:35","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=11044"},"modified":"2026-08-13T16:10:21","modified_gmt":"2026-08-14T00:10:21","slug":"usmle-step-1-question-of-the-day-sickle-cell-trait","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-sickle-cell-trait","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day:\u00a0Sickle cell trait"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_86 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-sickle-cell-trait\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today\u2019s USMLE\u00ae Step 1 Question is\u2026<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-sickle-cell-trait\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-sickle-cell-trait\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-sickle-cell-trait\/#Major_Takeaway\" >Major Takeaway&nbsp;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-sickle-cell-trait\/#Want_to_learn_more_about_this_topic\" >Want to learn more about this topic?<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-sickle-cell-trait\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>Today\u2019s USMLE\u00ae Step 1 question of the day features a couple seeking genetic counseling regarding the likelihood of their child being born with sickle cell disease. What&#8217;s the answer to their question? Let\u2019s find out!<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A couple trying to conceive visits their physician for <strong>genetic counseling<\/strong>. The parents both have <strong>sickle cell trait<\/strong> and they are worried about the risk of their baby having <strong>sickle cell disease<\/strong>. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Assuming the population is in Hardy-Weinberg equilibrium, which of the following is the <em>most likely probability<\/em> that their child will have the disease?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. 0%<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. 25%<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. 33%<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. 50%<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. 100%<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Scroll down for the correct answer!<\/em><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Learn with Osmosis\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/iDxHtjjCMbU?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today\u2019s USMLE\u00ae Step 1 Question is\u2026<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. 25%\u00a0<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Correct:<\/strong> See Main Explanation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. 0%<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> It would be zero percent if it was an X-linked recessive disease and only the father had the mutant allele. Sickle cell disease is an autosomal recessive disease.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. 33%<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> The chance of this couple having a child with sickle cell disease would be 25% since it is an autosomal recessive condition.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. 50%<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">**Incorrect: **It would be 50% if it was an autosomal dominant disease and only one of the parents had the mutant allele. Sickle cell disease is an autosomal recessive disease.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. 100%<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> It would be 100% if the disease would exhibit a mitochondrial inheritance pattern and the mother had the mutant allele. Sickle cell disease is an autosomal recessive disease.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image alignleft size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"542\" height=\"457\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/09\/image_86799e.png\" alt=\"Osmosis.org style illustration of a Punnett square showing two carrier parents (Rr \u00d7 Rr), with a 25% healthy, 50% carrier, and 25% disease inheritance pattern.\" class=\"wp-image-11047\" style=\"width:338px;height:auto\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/09\/image_86799e.png 542w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/09\/image_86799e.png?resize=300,253 300w\" sizes=\"auto, (max-width: 542px) 100vw, 542px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">There are&nbsp;different types&nbsp;of&nbsp;<strong>modes of inheritance<\/strong>&nbsp;of diseases that are described by the&nbsp;<strong>Hardy-Weinberg equation<\/strong>. If a genetic disease mutation affects a&nbsp;<strong>recessive allele<\/strong>&nbsp;and it takes two mutant copies to cause a disease, it is called a&nbsp;<strong>recessive inheritance pattern<\/strong>.&nbsp;<strong>Autosomal recessive diseases<\/strong>&nbsp;(e.g., sickle cell disease, cystic fibrosis, etc.) only occur when a person has two recessive alleles (rr).&nbsp;<strong>Heterozygotes&nbsp;<\/strong>with only one mutant allele (Rr)&nbsp;are considered to be&nbsp;<strong>carriers&nbsp;<\/strong>of the disease, even though they&nbsp;don\u2019t&nbsp;have the disease phenotype.&nbsp;This&nbsp;punnett&nbsp;square can be explained as follows:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The\u00a0two parents are\u00a0<strong>carriers\u00a0<\/strong>for sickle cell disease &#8211; they are both\u00a0<strong>heterozygous Rr<\/strong>.\u00a0\u00a0<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>They make gametes that have the\u00a0<strong>normal R allele<\/strong>, or the\u00a0<strong>recessive mutant r allele<\/strong>.\u00a0<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>So, their children have a 25% chance of ending up being\u00a0<strong>homozygous dominant (RR)<\/strong>, which means they\u00a0don\u2019t\u00a0have sickle cell disease,\u00a0and also\u00a0are not carriers, so they are healthy.\u00a0<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>They also have a 25% chance of ending up being\u00a0<strong>homozygous recessive (rr)<\/strong>, which means they do have sickle cell disease.\u00a0<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Finally, they have a 50% chance of ending up being\u00a0<strong>heterozygous carriers (Rr)<\/strong>, just like their parents.\u00a0<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">If a genetic disease mutation affects a\u00a0<strong>recessive allele<\/strong>\u00a0and it takes two mutant copies to cause a disease, it is called a\u00a0<strong>recessive inheritance pattern<\/strong>.\u00a0<strong>Autosomal recessive diseases<\/strong>\u00a0(e.g., sickle cell disease, cystic fibrosis, etc.) only occur when a person has two recessive alleles (rr).\u00a0<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Want_to_learn_more_about_this_topic\"><\/span>Want to learn more about this topic?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Watch this Osmosis video:<\/strong> <a href=\"https:\/\/www.osmosis.org\/learn\/Hardy-Weinberg_equilibrium\">Hardy-Weinberg equilibrium<\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Gulani\u00a0A, Weiler T. <strong>Genetics, Autosomal Recessive.<\/strong> [Updated 2021 May 8]. In:\u00a0StatPearls\u00a0[Internet]. Treasure Island (FL):\u00a0StatPearls\u00a0Publishing; 2021 Jan-. Available from:\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK546620\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK546620\/<\/a><\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><a href=\"http:\/\/osmosis.org\/plans\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2020\/09\/Blog_Display_Ads_MD1_2023.png?w=700\" alt=\"\" class=\"wp-image-5904\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2020\/09\/Blog_Display_Ads_MD1_2023.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2020\/09\/Blog_Display_Ads_MD1_2023.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Want more practice questions? Get your&nbsp;<a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a>&nbsp;and discover why millions of clinicians and caregivers love learning by Osmosis.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Two prospective parents with the same inherited trait want to understand their child&#8217;s genetic risk. Can you calculate the probability using key principles of Mendelian inheritance?<\/p>\n","protected":false},"author":208,"featured_media":11048,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,16,1366,1369,44],"tags":[3381,2967,3108,3380,3384,1297,3382,3385,84,3378,3386,462,3383,3379,664],"class_list":["post-11044","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-do","category-questions","category-step-1-questions","category-step-1","tag-autosomal-recessive","tag-board-exam-prep","tag-clinical-vignette","tag-genetic-counseling","tag-genetic-risk","tag-genetics","tag-hardy-weinberg-equilibrium","tag-inheritance-patterns","tag-medical-education","tag-medical-genetics","tag-mendelian-genetics","tag-osmosis","tag-punnett-square","tag-sickle-cell-trait","tag-usmle-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - 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Which fetal condition is most likely associated with these results?","rel":"","context":"In &quot;Allopathic Medicine (MD)&quot;","block_context":{"text":"Allopathic Medicine (MD)","link":"https:\/\/www.osmosis.org\/blog\/category\/medicine"},"img":{"alt_text":"USMLE\u00ae Step 1 Question of the Day: Quadruple test","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/07\/usmle-quadruple-test.webp","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/07\/usmle-quadruple-test.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/07\/usmle-quadruple-test.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/07\/usmle-quadruple-test.webp 2x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/07\/usmle-quadruple-test.webp 3x"},"classes":[]}],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/09\/Step-1-Question-of-the-Day-sickle-cell-trait.jpg","_links":{"self":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/11044","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/users\/208"}],"replies":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/comments?post=11044"}],"version-history":[{"count":2,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/11044\/revisions"}],"predecessor-version":[{"id":11049,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/11044\/revisions\/11049"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/media\/11048"}],"wp:attachment":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/media?parent=11044"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/categories?post=11044"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/tags?post=11044"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}