{"id":785,"date":"2021-03-24T13:09:00","date_gmt":"2021-03-24T13:09:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=785"},"modified":"2026-02-19T17:39:08","modified_gmt":"2026-02-20T01:39:08","slug":"usmle-step-1-question-of-the-day-homozygous-delta-f","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-homozygous-delta-f","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Homozygous Delta-F508 Deletion"},"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-homozygous-delta-f\/#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-homozygous-delta-f\/#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-homozygous-delta-f\/#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-homozygous-delta-f\/#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-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-homozygous-delta-f\/#References\" >References&nbsp;<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><em>In today&#8217;s USMLE\u00ae Step 1-style practice question, test your knowledge of key medical topics. Today&#8217;s case involves a&nbsp;<strong>3-year-old boy<\/strong> with a&nbsp;<strong>productive cough <\/strong>and <strong>fever<\/strong>.&nbsp;Further <strong>genetic testing<\/strong> reveals a <strong>homozygous \u0394F508 deletion<\/strong>.&nbsp;<em><em>Can you figure it out?<\/em><\/em><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A <strong>3-year-old boy<\/strong> is brought to the clinic by his parent due to <strong>3 days of productive cough<\/strong> and <strong>fever<\/strong>. The child was adopted at the age of 1, and the <strong>history <\/strong>of the patient\u2019s biological family is <strong>unknown<\/strong>. The patient is <strong>at the 35<sup>th<\/sup>&nbsp;percentile for length <\/strong>and <strong>below the 10<sup>th<\/sup>&nbsp;for weight<\/strong>. The patient\u2019s temperature is <strong>39.0\u00b0C (102.2\u00b0F), pulse is 114\/min, respirations are 22\/min, and&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Blood_pressure,_blood_flow,_and_resistance\" target=\"_blank\" rel=\"noreferrer noopener\">blood pressure<\/a>&nbsp;is 104\/75 mmHg. <\/strong>Examination reveals <strong>tachypnea <\/strong>and <strong>use of accessory muscles<\/strong>. There are <strong>decreased breath sounds<\/strong> heard over the left lower lung. Chest x-ray reveals <strong>lower-left lobar consolidation<\/strong>. The parent states that the patient has had <strong>three similar episodes in the past year<\/strong>. Further&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Gel_electrophoresis_and_genetic_testing\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>genetic testing<\/strong><\/a>&nbsp;reveals a <strong>homozygous \u0394F508 deletion<\/strong>. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Which of the following is the <em>most likely underlying cause<\/em> for this patient\u2019s condition?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A.&nbsp;Ubiquitinated abnormal transmembrane protein&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B.&nbsp;Abnormally early stop codon that halts protein production&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.&nbsp;Degradation of mRNA encoding an ion channel<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D.&nbsp;Hypermethylated gene encoding a transmembrane protein<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E.&nbsp;Impaired glycosylation of extracellular protein&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Scroll down to find the answer!<\/em><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Everybody loves Osmosis.org\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/kizbJZ9cdLg?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<p class=\"wp-block-paragraph\"><em><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><u><em><strong>\u2192 Reinforce your understanding with more self-assessment items on Osmosis,&nbsp;<\/strong><\/em><\/u><\/a><\/em><\/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<p class=\"wp-block-paragraph\"><strong>A. Ubiquitinated abnormal transmembrane protein<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the&nbsp;<strong>Main Explanation<\/strong>, 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\"><strong>B. Abnormally early stop codon that halts protein production&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>Some mutations in the&nbsp;<strong><em>CFTR<\/em>&nbsp;gene<\/strong> encoding the <strong>transmembrane protein<\/strong> can result in an <strong>early stop codon<\/strong> that <strong>prevents <\/strong>further <strong>protein production<\/strong>. This patient\u2019s mutation, however, results in a <strong>different disruption<\/strong> in <strong>protein processing<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Degradation of mRNA encoding an ion channel<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>Specific&nbsp;<strong><em>CFTR<\/em>&nbsp;mutations<\/strong> can result in <strong>abnormal mRNA splicing<\/strong>, resulting in a <strong>decreased amount of mRNA<\/strong> available for <strong>translation<\/strong>. This patient\u2019s mutation is not associated with abnormal mRNA production.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Hypermethylated gene encoding a transmembrane protein<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect: <a href=\"https:\/\/www.osmosis.org\/learn\/Epigenetics\" target=\"_blank\" rel=\"noreferrer noopener\">Epigenetic<\/a>&nbsp;changes<\/strong>, such as <strong>hypermethylation of genes<\/strong>, can result in <strong>reduced transcription, translation, <\/strong>and <strong>protein production<\/strong>. This patient\u2019s mutation does not cause hypermethylation of the&nbsp;<em>CFTR&nbsp;<\/em>gene.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Impaired glycosylation of extracellular protein&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;<strong>Impaired glycosylation of procollagen<\/strong> results in <strong>impaired protein-protein interaction<\/strong>. This <strong>lack of stability<\/strong> can be seen in<a href=\"https:\/\/www.osmosis.org\/learn\/Osteogenesis_imperfecta\" target=\"_blank\" rel=\"noreferrer noopener\">&nbsp;<strong>osteogenesis imperfecta<\/strong><\/a>, for example, which is caused by an <strong>inability to form <\/strong>the <strong>triple helix structure<\/strong> seen in <strong>collagen<\/strong>.<\/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<p class=\"wp-block-paragraph\">This child, who is presenting with <strong>recurrent&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Pneumonia:_Pathology_review\" target=\"_blank\" rel=\"noreferrer noopener\">pneumonia<\/a>&nbsp;<\/strong>and <strong>genetic analysis <\/strong>showing <strong>homozygous \u0394F508 deletion <\/strong>in the&nbsp;<strong><em>CFTR<\/em>&nbsp;gene<\/strong>, likely has&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Cystic_fibrosis\" target=\"_blank\" rel=\"noreferrer noopener\">cystic fibrosis<\/a><\/strong>&nbsp;(CF). CF is a disorder of <strong>epithelial ion transport<\/strong> that affects fluid secretion in <strong>exocrine glands<\/strong> (e.g., <strong>pancreas<\/strong>) as well as <strong>epithelial linings<\/strong> of the <strong>gastrointestinal, respiratory, <\/strong>and <strong>reproductive tracts<\/strong>. The ion channel that is affected is the&nbsp;<strong>epithelial chloride channel<\/strong>&nbsp;that is encoded by the CF transmembrane conductance regulator (CFTR) gene. Dysfunction of this ion channel results in <strong>abnormally viscous mucous secretion<\/strong> that blocks the airways, resulting in recurrent&nbsp;<strong>pulmonary infections<\/strong>; the severity of pulmonary disease is the main determinant of life expectancy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"margin: 0px;padding: 0px\">More than 1,500 disease-causing mutations can occur in the&nbsp;<em>CFTR&nbsp;<\/em>gene, and some of them&nbsp;<\/span>present with more severe symptoms than others. The most common severe&nbsp;<em>CFTR<\/em>&nbsp;mutation is a&nbsp;<strong>deletion of three nucleotide bases<\/strong>&nbsp;coding for phenylalanine at amino acid&nbsp;<strong>position 508<\/strong>&nbsp;(\u0394F508). This mutation causes the protein to become unstable and causes an <strong>accumulation of&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Amino_acids_and_protein_folding\" target=\"_blank\" rel=\"noreferrer noopener\">misfolded proteins<\/a><\/strong>&nbsp;in the endoplasmic reticulum. In an effort to recycle this abnormal protein, there is transport of misfolded proteins back to the cytosol where they are&nbsp;<strong>ubiquitinated<\/strong>&nbsp;and&nbsp;<strong>degraded by proteasomes<\/strong>.<\/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=\"Cystic fibrosis- causes, symptoms, diagnosis, treatment, pathology\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/7gJd6OGoIkk?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=\"Major_Takeaway\"><\/span>Major Takeaway<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Cystic fibrosis is most commonly caused by the deletion of phenylalanine residue at position 508 (\u0394F508) in the&nbsp;<em>CFTR<\/em>&nbsp;gene. <\/strong>The product of this mutated gene results in a misfolded protein that is retained in the <strong>endoplasmic reticulum <\/strong>and ultimately gets ubiquitinated and degraded.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29460152\/\" target=\"_blank\" rel=\"noreferrer noopener\">Cystic Fibrosis, Cystic Fibrosis Transmembrane Conductance Regulator and Drugs: Insights from Cellular Trafficking<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27140670\/\" target=\"_blank\" rel=\"noreferrer noopener\">Cystic fibrosis<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.elsevier.com\/books\/robbins-basic-pathology\/kumar\/978-0-323-35317-5\" target=\"_blank\" rel=\"noreferrer noopener\">Robbins basic pathology<\/a><\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2021\/03\/Blog_Display_Ads_GENERAL3_2023.png\" alt=\"\" class=\"wp-image-4447\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2021\/03\/Blog_Display_Ads_GENERAL3_2023.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2021\/03\/Blog_Display_Ads_GENERAL3_2023.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><figcaption class=\"wp-element-caption\"><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><\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Want more <strong>USMLE\u00ae Step 1 practice questions<\/strong>? Get your\u00a0<strong><em><a href=\"http:\/\/osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a><\/em> <\/strong>today\u00a0and discover why millions of current and future <strong>clinicians and caregivers love learning by Osmosis<\/strong>.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Prepare for the USMLE\u00ae Step 1 exam with today\u2019s question focusing on a 3-year-old boy presenting with symptoms indicative of cystic fibrosis and learn to identify the underlying genetic cause. Strengthen your clinical assessment skills and improve your understanding of managing this common genetic condition!<\/p>\n","protected":false},"author":202,"featured_media":786,"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":[27,20,16,1369,44],"tags":[665,150,666,268,265,448,245,667,615,185],"class_list":["post-785","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-cftr-gene","tag-clinical-practice","tag-cystic-fibrosis","tag-genetic-disorders","tag-healthcare-training","tag-medical-diagnosis","tag-nursing-education","tag-pediatric-medicine","tag-respiratory-health","tag-usmle"],"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: Homozygous Delta-F508 Deletion - 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-homozygous-delta-f\" \/>\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: Homozygous Delta-F508 Deletion - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Prepare for the USMLE\u00ae Step 1 exam with today\u2019s question focusing on a 3-year-old boy presenting with symptoms indicative of cystic fibrosis and learn to identify the underlying genetic cause. 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Review the patient's family pedigree and determine the\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-inheritance-patterns.webp","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-inheritance-patterns.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-inheritance-patterns.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-inheritance-patterns.webp 2x"},"classes":[]},{"id":2107,"url":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-dyspnea-on-exertion-and-fatigue","url_meta":{"origin":785,"position":4},"title":"USMLE\u00ae Step 1 Question of the Day: Dyspnea on Exertion and Fatigue","author":"Marina Horiates Kerekes, MD &amp; Team","date":"June 8, 2022","format":false,"excerpt":"This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics.\u00a0Today's case focuses on a 68-year-old woman complaining of dyspnea on exertion, fatigue, and chest pain. 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A 68-year-old woman\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-dyspnea-on-exertion-and-fatigue.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-dyspnea-on-exertion-and-fatigue.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-question-of-the-day-dyspnea-on-exertion-and-fatigue.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/usmle-step-1-question-of-the-day-dyspnea-on-exertion-and-fatigue.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":785,"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\/785","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=785"}],"version-history":[{"count":9,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/785\/revisions"}],"predecessor-version":[{"id":9539,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/785\/revisions\/9539"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/media\/786"}],"wp:attachment":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/media?parent=785"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/categories?post=785"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/tags?post=785"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}