{"id":3479,"date":"2023-12-06T20:08:00","date_gmt":"2023-12-06T20:08:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=3479"},"modified":"2025-10-01T11:39:34","modified_gmt":"2025-10-01T19:39:34","slug":"usmle-step-1-question-of-the-day-maternal-infection","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Maternal infection"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 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-maternal-infection\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection\/#A_Spirochete_bacteria\" >A.&nbsp;Spirochete bacteria<\/a><\/li><\/ul><\/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-maternal-infection\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection\/#B_Obligate_intracellular_protozoan\" >B. Obligate intracellular protozoan<\/a><\/li><li class='ez-toc-page-1 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-maternal-infection\/#C_Enveloped_double-stranded_DNA_virus\" >C. &nbsp;Enveloped, double-stranded DNA virus&nbsp;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection\/#D_Enveloped_single-stranded_RNA_virus\" >D. Enveloped, single-stranded RNA virus&nbsp;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection\/#E_Gram-positive_cocci_in_chains\" >E. Gram-positive cocci in chains<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection\/#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-9\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case focuses on a 28-month-old with unusual clinical features. Can you identify the most likely cause behind the disseminated rash, hepatosplenomegaly, and distinctive facial and skeletal abnormalities?Test your diagnostic skills with this USMLE Step 1 question.<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 28-month-old boy is brought to the pediatrician for a routine evaluation. The patient was born via vaginal delivery at 38-weeks of gestational age. The patient\u2019s mother received minimal antenatal care. During the third trimester of pregnancy, the mother had developed a disseminated maculopapular rash involving the palms and soles and arthralgias. The patient\u2019s weight is at the 25th percentile, and head circumference is at the 50th percentile. Vitals are within normal limits. Abdominal examination reveals hepatosplenomegaly. A depressed nasal bridge, notched incisors, and bowing of the tibia are also observed. Cardiovascular examination is unremarkable. Which of the following is the most likely cause of this patient\u2019s condition?&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Spirochete bacteria<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Obligate intracellular protozoan<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Enveloped, double-stranded DNA virus<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Enveloped, single-stranded RNA virus<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Gram-positive cocci in chains<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Scroll down for the correct answer!<\/p>\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&#8217;s USMLE\u00ae Step 1 Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Spirochete_bacteria\"><\/span>A.&nbsp;<strong>Spirochete bacteria<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the Main Explanation, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/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<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_Obligate_intracellular_protozoan\"><\/span>B. Obligate intracellular protozoan<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Congenital toxoplasmosis is caused by the protozoan Toxoplasma gondii. The condition can lead to chorioretinitis, hydrocephalus, microcephaly, and intracranial calcifications. In contrast, the facial features and bone abnormalities seen in this patient are not typically associated with congenital toxoplasmosis.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Enveloped_double-stranded_DNA_virus\"><\/span>C. &nbsp;Enveloped, double-stranded DNA virus&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Cytomegalovirus (CMV) is an enveloped, double-stranded DNA virus. Congenital CMV infection can lead to hepatosplenomegaly, microcephaly, periventricular calcifications, and hearing loss. The characteristic facial features in this patient are not present in individuals with congenital CMV infection.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Enveloped_single-stranded_RNA_virus\"><\/span>D. Enveloped, single-stranded RNA virus&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Maternal infection with rubella can present with a self-limited maculopapular rash and arthralgias. However, congenital rubella is characterized by cataracts, sensorineural hearing loss, and congenital heart defects. The absence of these findings in this patient makes the diagnosis of congenital rubella syndrome unlikely.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_Gram-positive_cocci_in_chains\"><\/span>E. Gram-positive cocci in chains<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Neonates infected with group B streptococcus (GBS), which appears microscopically as chains of Gram-positive cocci, can present with sepsis, meningitis, and encephalitis. Fetuses can acquire GBS via exposure to vaginal bacteria during the childbirth process. However, GBS infection would not account for this patient&#8217;s facial and tibial deformities.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span><strong>Main Explanation<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This infant has a depressed nasal bridge, notching of the incisors, bowing of the tibia, and hepatosplenomegaly. These findings are consistent with the clinical manifestations of&nbsp;<strong>congenital syphilis<\/strong>. Furthermore, the mother has a history of a maculopapular rash and arthralgias, indicating a&nbsp;<strong>maternal infection<\/strong>&nbsp;with secondary syphilis.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Syphilis is a&nbsp;<strong>sexually transmitted disease<\/strong>&nbsp;caused by the spirochete&nbsp;<em><strong>Treponema pallidum<\/strong><\/em>. During pregnancy, maternal syphilis infection produces symptoms similar to those in a non-pregnant adult. Symptoms may include a&nbsp;<strong>painless papule<\/strong>&nbsp;(primary syphilis), maculopapular rash, pharyngitis,&nbsp;<strong>mucocutaneous lesions&nbsp;<\/strong>(secondary syphilis), as well as&nbsp;<strong>cardiovascular and neurological involvement<\/strong>&nbsp;(tertiary syphilis).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Syphilis can be vertically transmitted via the placenta, resulting in congenital syphilis. Most neonates are asymptomatic at birth but can subsequently develop manifestations of congenital syphilis. Early symptoms (&lt;2 years of age) include&nbsp;<strong>generalized lymphadenopathy<\/strong>,&nbsp;<strong>fever<\/strong>, and a&nbsp;<strong>maculopapular rash<\/strong>&nbsp;affecting the palms and soles. Later symptoms of congenital syphilis include dental deformities (<strong>Hutchinson teeth<\/strong>),&nbsp;<strong>skeletal abnormalities<\/strong>&nbsp;(anterior bowing of the tibia),&nbsp;<strong>hepatosplenomegaly<\/strong>, saddle nose deformity, and sensorineural hearing loss. Fortunately, congenital syphilis can be prevented via early screening, identification of maternal infection, and treatment with&nbsp;<strong>penicillin<\/strong>. &nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"838\" height=\"706\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_c837ac.png\" alt=\"table of congenital torch infections\" class=\"wp-image-3481\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_c837ac.png 838w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_c837ac.png?resize=300,253 300w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_c837ac.png?resize=768,647 768w\" sizes=\"auto, (max-width: 838px) 100vw, 838px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" height=\"1024\" width=\"1024\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2023\/12\/Clinical_Pearl-Congenital_TORCH_infections_u_20240515.png?w=1024\" alt=\"\" class=\"wp-image-4294\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2023\/12\/Clinical_Pearl-Congenital_TORCH_infections_u_20240515.png 1080w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2023\/12\/Clinical_Pearl-Congenital_TORCH_infections_u_20240515.png?resize=150,150 150w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2023\/12\/Clinical_Pearl-Congenital_TORCH_infections_u_20240515.png?resize=300,300 300w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2023\/12\/Clinical_Pearl-Congenital_TORCH_infections_u_20240515.png?resize=768,768 768w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2023\/12\/Clinical_Pearl-Congenital_TORCH_infections_u_20240515.png?resize=1024,1024 1024w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Congenital syphilis<\/strong>&nbsp;is caused by transplacental transmission of the spirochete&nbsp;<em><strong>Treponema pallidum<\/strong><\/em>. Clinical manifestations of congenital syphilis include&nbsp;<strong>rash<\/strong>,&nbsp;<strong>skeletal and dental abnormalities<\/strong>, and&nbsp;<strong>sensorineural hearing loss<\/strong>. The condition can be prevented via early screening, maternal infection identification, and penicillin treatment.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>References<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Rathbun, K.C. (1983) Congenital syphilis. Sexually Transmitted Diseases. 10(2), 102-107. Doi: 10.1097\/00007435-198304000-00009.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ricci, J.M., Fojaco, R.M., O&#8217;Sullivan, M.J. (1989) Congenital syphilis: The University of Miami\/Jackson Memorial Medical Center experience, 1986-1988. Obstetrics and Gynecology. 74(5), 687-693. PMID: 2812644.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Woods, C.R. (2005) Syphilis in children: Congenital and acquired. Seminars in Pediatric Infectious Diseases. 16(4), 245-257. Doi: 10.1053\/j.spid.2005.06.005.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;________________________<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong>Want more USMLE\u00ae Step 1 practice questions? Try Osmosis by Elsevier today! Access your&nbsp;<em><strong><a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a><\/strong><\/em>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/www.osmosis.org\/ultimate-guide\/usmle-step-1\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_c61dbd.png\" alt=\"Osmosis sign up ad\" class=\"wp-image-3482\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_c61dbd.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_c61dbd.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em><sub>The United States Medical Licensing Examination (USMLE\u00ae) is a joint program of the Federation of State Medical Boards (FSMB\u00ae) and National Board of Medical Examiners (NBME\u00ae). Osmosis is not affiliated with NBME nor FSMB.&nbsp;<\/sub><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case focuses on a 28-month-old with unusual clinical features. Can you identify the most likely cause behind the disseminated rash, hepatosplenomegaly, and distinctive facial and skeletal abnormalities?Test your diagnostic skills with this USMLE Step 1 question. [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":3480,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[27,20,1366,1369,44],"tags":[],"class_list":["post-3479","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-questions","category-step-1-questions","category-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day: Maternal infection - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day: Maternal infection - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case focuses on a 28-month-old with unusual clinical features. Can you identify the most likely cause behind the disseminated rash, hepatosplenomegaly, and distinctive facial and skeletal abnormalities?Test your diagnostic skills with this USMLE Step 1 question. [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection\" \/>\n<meta property=\"og:site_name\" content=\"Osmosis Blog\" \/>\n<meta property=\"article:published_time\" content=\"2023-12-06T20:08:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-10-01T19:39:34+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-18T140947.846.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1080\" \/>\n\t<meta property=\"og:image:height\" content=\"1080\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Marina Horiates Kerekes, MD &amp; Team\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":[\"Article\",\"BlogPosting\"],\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-maternal-infection\"},\"author\":{\"name\":\"Marina Horiates Kerekes, MD &amp; 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What's the diagnosis?","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:\u00a0Breast cancer exam","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/05\/Step-1-question-of-the-day-Breast_Cancer_Exam.png","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/05\/Step-1-question-of-the-day-Breast_Cancer_Exam.png 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/05\/Step-1-question-of-the-day-Breast_Cancer_Exam.png 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/05\/Step-1-question-of-the-day-Breast_Cancer_Exam.png 2x"},"classes":[]},{"id":5566,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-left-sided-weakness","url_meta":{"origin":3479,"position":5},"title":"USMLE\u00ae Step 1 Question of the Day:\u00a0Left-sided weakness","author":"Marina Horiates Kerekes, MD &amp; Team","date":"March 20, 2025","format":false,"excerpt":"Ace the USMLE\u00ae Step 1 exam by studying with us! Let's explore a clinical case involving a 66-year-old woman with left-sided weakness. Learn to identify the most common origin of thrombus in patients experiencing ischemic strokes, particularly in the context of atrial fibrillation. 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