{"id":721,"date":"2023-02-15T02:15:00","date_gmt":"2023-02-15T02:15:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=721"},"modified":"2025-10-01T11:40:35","modified_gmt":"2025-10-01T19:40:35","slug":"usmle-step-1-question-of-the-day-chancroid","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-chancroid","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Chancroid"},"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-chancroid\/#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><\/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-chancroid\/#D_Haemophilus_ducreyi\" >D. Haemophilus ducreyi<\/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-chancroid\/#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-chancroid\/#A_Herpes_simplex_virus-2\" >A. Herpes simplex virus-2<\/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-chancroid\/#B_Klebsiella_granulomatis\" >B. Klebsiella granulomatis&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-chancroid\/#C_Treponema_pallidum\" >C. Treponema pallidum&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-chancroid\/#E_Chlamydia_trachomatis\" >E. &nbsp;Chlamydia trachomatis&nbsp;<\/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-chancroid\/#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-chancroid\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-chancroid\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/37.webp?w=1024\" alt=\"Current image: USMLE\u00ae Step 1 Question of the Day: Chancroid\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong>This week, we&#8217;re sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics! Today&#8217;s case involves a 28-year-old man who was diagnosed with with fever, generalized muscle aches, and inguinal ulcers. Can you figure it out? Let&#8217;s take a look!<\/strong><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 28-year-old man comes to a primary care clinic with fever, generalized muscle aches, and inguinal ulcers. Three months ago, he was diagnosed with acute urethritis and treated with a course of oral antibiotics. He is sexually active and began a monogamous relationship with a new partner three months ago. They use condoms inconsistently. Temperature is 37.0\u00b0C (98.6\u00b0F), pulse is 90\/min, respirations are 20\/min, and blood pressure is 120\/75 mmHg. The abdomen is soft and nontender. External genital examination reveals multiple purulent, tender ulcers on the penile shaft. Tender inguinal lymphadenopathy is noted along with overlying ulcerative lesions. Histological analysis of one of these ulcers reveals an organism organized in parallel strands. Which of the following is the most likely organism responsible for this patient\u2019s symptoms?&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Herpes simplex virus-2<\/strong><strong>B. &nbsp;Klebsiella granulomatis<br><br>C. Treponema pallidum<br><br>D. Haemophilus ducreyi<br><br>E. Chlamydia trachomatis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Scroll down to find the 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<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Haemophilus_ducreyi\"><\/span>D. Haemophilus ducreyi<span class=\"ez-toc-section-end\"><\/span><\/h2>\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<p class=\"wp-block-paragraph\">The incorrect answers to today&#8217;s USMLE\u00ae Step 1 Question are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Herpes_simplex_virus-2\"><\/span>A. Herpes simplex virus-2<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>The clinical presentation of genital herpes includes multiple, shallow, tender vesicular genital ulcers. Histology of vesicular fluid typically shows multinucleated cells with intracytoplasmic inclusion bodies. This patient\u2019s presentation is more consistent with chancroid, which is caused by&nbsp;<em>Haemophilus ducreyi.<\/em><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_Klebsiella_granulomatis\"><\/span>B. Klebsiella granulomatis&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Donovanosis is caused by Klebsiella granulomatis, a gram-negative rod-shaped bacterium. Clinically, infection with this organism results in the presence of painless, ulcerative genital lesions without associated lymphadenopathy. This patient has painful genital lesions with lymphadenopathy, which is more consistent with chancroid, caused by&nbsp;<em>Haemophilus ducreyi<\/em>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Treponema_pallidum\"><\/span>C. Treponema pallidum&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>The classic clinical presentation of primary syphilis is a single, painless, indurated genital ulcer. This patient has multiple painful genital ulcers with lymphadenopathy, which is more consistent with chancroid, caused by&nbsp;<em>Haemophilus ducreyi.<\/em><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_Chlamydia_trachomatis\"><\/span>E. &nbsp;Chlamydia trachomatis&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>Serotypes L1-L3 of Chlamydia trachomatis are responsible for developing lymphogranuloma venereum. This clinical entity presents with multiple, painless genital ulcers with painful lymphadenopathy. Histologically, this disease is characterized by the presence of epithelial cells with intracytoplasmic inclusion bodies. This patient has multiple painful genital ulcers with lymphadenopathy, which is more consistent with chancroid, caused by&nbsp;<em>Haemophilus ducreyi.<\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-everything-you-need-to-know-banner.png?w=700\" alt=\"Osmosis ad\" class=\"wp-image-615\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-everything-you-need-to-know-banner.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-everything-you-need-to-know-banner.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/figure>\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<p class=\"wp-block-paragraph\">This patient presents with&nbsp;<strong>multiple painful genital ulcers and tender lymphadenopathy.<\/strong>&nbsp;Microscopic analysis indicates the presence of organisms organized in parallel strands (or a \u201cschool of fish\u201d appearance). This description and clinical features are characteristic of&nbsp;<em><strong>Haemophilus ducreyi<\/strong><\/em>, the causative agent of the sexually transmitted infection&nbsp;<strong>chancroid<\/strong>.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Haemophilus ducreyi<\/em>&nbsp;is a gram-negative rod transmitted through sexual contact, and clinical manifestations of the infection include&nbsp;<strong>multiple painful genital ulcers<\/strong>&nbsp;with a gray exudate and&nbsp;<strong>tender regional inguinal lymphadenopathy<\/strong>. One way to remember these clinical findings is that patients \u201cdo cry\u201d when infected with H. ducreyi. Most lesions involve the penile shaft, prepuce, and glans penis in individuals with male genitalia. In individuals with female genitalia, the areas involved include the labia majora and minora, vaginal introitus, and the perianal regions. Diagnostic evaluation via gram stain will reveal&nbsp;<strong>gram-negative rods organized in parallel strands.&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Genital ulcers in sexually active individuals raise concern for infection from several organisms, which requires prompt identification and treatment. Recalling the nature of the ulcer (painful vs. painless, multiple vs. single) and features of lymphadenopathy can assist in diagnosis, as outlined in the table below.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"848\" height=\"424\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_9f73ff.png\" alt=\"A table with genital ulcers information\" class=\"wp-image-723\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_9f73ff.png 848w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_9f73ff.png?resize=300,150 300w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_9f73ff.png?resize=768,384 768w\" sizes=\"auto, (max-width: 848px) 100vw, 848px\" \/><\/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>Chancroid<\/strong>&nbsp;is a sexually transmitted infection caused by the gram-negative rod&nbsp;<em>Haemophilus ducreyi<\/em>&nbsp;which causes multiple painful genital ulcers and tender inguinal lymphadenopathy. Under gram stain analysis, the organism appears as gram-negative rods in parallel strands or a \u201cschool of fish\u201d appearance.&nbsp;<\/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<p class=\"wp-block-paragraph\">Lewis DA.&nbsp;<em>Epidemiology, clinical features, diagnosis and treatment of Haemophilus ducreyi &#8211; a disappearing pathogen? Expert Rev Anti Infect Ther.&nbsp;<\/em>2014 Jun;12(6):687-96. doi: 10.1586\/14787210.2014.892414. Epub 2014 Mar 6. PMID: 24597521.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">DiCarlo RP, Martin DH.&nbsp;<em>The clinical diagnosis of genital ulcer disease in men. Clin Infect Dis.<\/em>&nbsp;1997 Aug;25(2):292-8. doi: 10.1086\/514548. PMID: 9332527.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Lewis DA.\u00a0<em>Diagnostic tests for chancroid. Sex Transm Infect.<\/em>\u00a02000 Apr;76(2):137-41. doi: 10.1136\/sti.76.2.137. PMID: 10858718; PMCID: PMC1758295.<em><strong>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 <\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\/md\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-02T195148.146.png?w=700\" alt=\"Osmosis ad\" class=\"wp-image-701\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-02T195148.146.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-02T195148.146.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><figcaption class=\"wp-element-caption\"><em><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.\u00a0<\/sub><\/em><\/em><\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong>Want more USMLE\u00ae Step 1 practice questions? Try Osmosis today! Access your\u00a0<em><strong><a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a><\/strong><\/em>\u00a0and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Today&#8217;s USMLE Step 1 case explores what&#8217;s causing a chancroid with multiple painful genital ulcers in a 28 year old male patient visiting his primary care doctor.<\/p>\n","protected":false},"author":202,"featured_media":722,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[27,20,16,1369,44],"tags":[1021,1025,1022,1018,1020,1019,1023,1024,479,664],"class_list":["post-721","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-do","category-step-1-questions","category-step-1","tag-chancroid","tag-differential-diagnosis","tag-genital-ulcer-disease","tag-genital-ulcers","tag-gram-negative-rods","tag-haemophilus-ducreyi","tag-inguinal-lymphadenopathy","tag-sexually-transmitted-infections","tag-stis","tag-usmle-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - 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What's next in patient management?","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 2 CK Question of the Day:\u00a0Cutaneous findings","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/05\/Step-2-question-of-the-day-Cutaneous_Findings.jpg","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/05\/Step-2-question-of-the-day-Cutaneous_Findings.jpg 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/05\/Step-2-question-of-the-day-Cutaneous_Findings.jpg 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/05\/Step-2-question-of-the-day-Cutaneous_Findings.jpg 2x"},"classes":[]},{"id":6016,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-coronary-angiography","url_meta":{"origin":721,"position":3},"title":"USMLE\u00ae Step 1 Question of the Day:\u00a0Coronary angiography","author":"Marina Horiates Kerekes, MD &amp; Team","date":"May 21, 2025","format":false,"excerpt":"Delve into today's USMLE\u00ae Step 1 question on a post-MI patient with chest pain and uncover the common adverse effects of antiplatelet therapy.","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 Step 1 Question of the Day Coronary angiography","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/05\/coronary_angiography.png 2x"},"classes":[]},{"id":2866,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-spasms-and-syncope","url_meta":{"origin":721,"position":4},"title":"USMLE\u00ae Step 1 Question of the Day: Spasms and Syncope","author":"Marina Horiates Kerekes, MD &amp; Team","date":"February 24, 2021","format":false,"excerpt":"For today\u2019s USMLE\u00ae Step 1-style question, we examine the case of a woman who is brought into the ER by her partner after experiencing a sudden episode of jerky movements and loss of consciousness.\u00a0 A 23-year-old woman is brought to the emergency department by her partner due to an episode\u2026","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":"","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-question-of-the-day-spasms-and-syncope.webp","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-question-of-the-day-spasms-and-syncope.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-question-of-the-day-spasms-and-syncope.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-question-of-the-day-spasms-and-syncope.webp 2x"},"classes":[]},{"id":3336,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-bilateral-pitting-ankle-edema","url_meta":{"origin":721,"position":5},"title":"USMLE\u00ae Step 1 Question of the Day: Bilateral Pitting Ankle Edema","author":"Marina Horiates Kerekes, MD &amp; Team","date":"March 31, 2021","format":false,"excerpt":"Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today's case involves a 38-year-old woman with pain in the center of her chest. The pain is slightly better when she sits up straight. Physical examination shows conjunctival pallor and bilateral pitting ankle\u2026","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: Bilateral Pitting Ankle Edema","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-18T112652.031.webp","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-18T112652.031.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-18T112652.031.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-18T112652.031.webp 2x"},"classes":[]}],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/721","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\/202"}],"replies":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/comments?post=721"}],"version-history":[{"count":3,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/721\/revisions"}],"predecessor-version":[{"id":6532,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/721\/revisions\/6532"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/media\/722"}],"wp:attachment":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/media?parent=721"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/categories?post=721"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/tags?post=721"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}