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Human Development — Step 1 practice questions
97 questions in this area, with an explanation for every answer choice.
Three samples below, free and without an account.
How this shows up on Step 1
Developmental milestones are examined as "is this normal for this age", so the ages have to be secure rather than approximate. Questions span the whole lifespan, including ageing, and often arrive embedded in a paediatric or geriatric vignette rather than as a standalone fact.
Sample questions
Sample question 1
A 7-year-old boy is at the 10th percentile for height. His growth velocity is normal, he is tracking steadily along his percentile, and his mid-parental target height is also near the 10th percentile. Which of the following is the most appropriate interpretation?
Explanations
A. Mid-parental height has no bearing on interpreting a child's stature
Mid-parental height establishes the expected genetic target.
B. Familial short stature — normal growth velocity with height consistent with genetic potential — which requires reassurance rather than endocrine evaluation · correct
Interpreting short stature depends less on the percentile than on GROWTH VELOCITY and genetic context. A child tracking steadily along a low percentile with NORMAL velocity and a height consistent with MID-PARENTAL target height has FAMILIAL short stature — a normal variant requiring reassurance. CROSSING percentiles downward, or a subnormal growth velocity, is what signals pathology and warrants evaluation. CONSTITUTIONAL delay is the other common normal variant, featuring delayed BONE AGE, delayed puberty, a family history of "late bloomers," and normal eventual adult height, whereas familial short stature has bone age matching chronologic age.
C. Growth velocity is less informative than a single height measurement
Velocity over time is far more informative than a single measurement.
D. Growth hormone deficiency requiring stimulation testing
Normal velocity with an appropriate genetic target argues against deficiency.
E. Any child below the 25th percentile requires endocrine evaluation
Percentile alone does not determine the need for evaluation.
Sample question 2
Parents of a 4-month-old ask when their infant will sleep through the night. Which of the following best describes normal infant sleep development?
Explanations
A. Night waking beyond 4 months always indicates a sleep disorder
Brief night waking remains developmentally normal.
B. Newborns have a well-established circadian rhythm from birth
Circadian rhythm develops over the first months of life.
C. Infants should be placed prone to promote longer sleep
Prone positioning substantially increases the risk of sudden infant death.
D. Sleep consolidates gradually over the first year as circadian rhythm matures, with many infants sleeping longer stretches by 4–6 months, and brief night wakings remaining normal thereafter · correct
Newborns lack a mature CIRCADIAN rhythm, sleeping in short bouts distributed across day and night, with melatonin secretion and day-night entrainment developing over the first months. Sleep gradually CONSOLIDATES, and many infants sleep longer nocturnal stretches by 4–6 months, though brief night wakings persist normally well beyond that — infants who "sleep through" typically still wake briefly and self-soothe. Newborns also spend far more time in REM (active) sleep than adults. Safe sleep guidance remains SUPINE positioning on a firm surface, and introducing solids does not improve sleep.
E. Introducing solids at 3 months reliably produces sleeping through the night
Early solids do not improve sleep and carry other risks.
Sample question 3
Which fetal structure allows the majority of oxygenated blood from the umbilical vein to bypass the pulmonary circulation by shunting from the pulmonary artery directly to the aorta?
Explanations
A. Foramen ovale
The foramen ovale shunts blood from the right ATRIUM to the left ATRIUM, not from the pulmonary artery to the aorta.
B. Ductus venosus
The ductus venosus allows umbilical venous blood to bypass the LIVER, not the pulmonary circulation.
C. Ligamentum teres
The ligamentum teres is the postnatal remnant of the umbilical vein, not a fetal shunt structure itself.
D. Umbilical artery
The umbilical arteries carry deoxygenated blood FROM the fetus back to the placenta, not a shunt bypassing the lungs within the fetal circulation itself.
E. Ductus arteriosus · correct
The ductus arteriosus connects the pulmonary artery directly to the aorta, allowing blood to bypass the (fluid-filled, non-functional for gas exchange) fetal lungs, directing it toward the systemic circulation instead.
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