USMLE Step 1 Content Outline Aligned

Know the Mechanism
Behind the Step 1 Vignette

BiochemStep is a USMLE Step 1 biochemistry question bank with focused practice questions in metabolism, genetics, molecular biology, laboratory techniques, nutrition, and integrated physiology.

20-question free preview. Full access includes a growing library of focused Step 1-style questions as new content is added.

Why BiochemStep?

Focused practice for the mechanism-heavy foundational science questions that often sit underneath clinical vignettes.

Mechanism-first reasoning

Practice the multi-step logic behind Step 1 vignettes: recognize the presentation, identify the pathway defect, and reason through the biochemical consequence.

Focused launch library

BiochemStep includes focused Step 1-style questions across recurring foundational science mechanisms, with new questions added as the library expands.

Distractor explanations that teach

Correct and incorrect answer explanations are written to help you rule out similar conditions, pathways, and mechanisms on future questions.

Foundational science
across systems

BiochemStep focuses on recurring foundational science concepts that appear across organ-system questions, including metabolism, genetics, molecular biology, laboratory techniques, nutrition, acid-base physiology, and homeostasis.

Built around how Step 1 tests

Clinical presentationMechanismConsequenceAnswer-choice reasoning

Each question is designed to connect the presentation to the underlying pathway, molecular defect, physiologic change, or treatment mechanism.

Coverage by Foundational Science Domain

Amino Acid Metabolism

Urea cycle disorders, phenylketonuria (PKU), maple syrup urine disease (MSUD), homocystinuria, alkaptonuria, cystinuria, tyrosinemia

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Carbohydrate Metabolism

Glycolysis, TCA cycle, pyruvate dehydrogenase deficiency, G6PD deficiency, fructose intolerance, galactosemia, lactic acidosis

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Glycogen Storage Diseases

Von Gierke disease, Pompe disease, Cori disease, McArdle disease, glucose-6-phosphatase deficiency, acid maltase deficiency

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Lipid Metabolism

Beta-oxidation, ketogenesis, MCAD deficiency, cholesterol synthesis, HMG-CoA reductase, carnitine shuttle, familial hypercholesterolemia

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Nucleotide Metabolism

Purine synthesis, pyrimidine synthesis, HGPRT deficiency, Lesch-Nyhan syndrome, orotic aciduria, adenosine deaminase deficiency, antimetabolites

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Vitamins & Cofactors

Vitamin B12 deficiency, folate deficiency, megaloblastic anemia, thiamine deficiency, Wernicke encephalopathy, biotin deficiency, niacin, pellagra, vitamins A, D, E, and K

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Nutrition

Kwashiorkor, marasmus, refeeding syndrome, zinc deficiency, protein-energy malnutrition, nutritional deficiencies

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Molecular Biology

DNA replication, DNA repair, nucleotide excision repair, mismatch repair, xeroderma pigmentosum, transcription, translation, protein trafficking, oncometabolites

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Laboratory Techniques & Molecular Diagnostics

PCR, RT-PCR, qPCR, Sanger sequencing, next-generation sequencing, Southern blot, Northern blot, Western blot, ELISA, FISH, microarray analysis

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Genetics & Cell Biology

Autosomal dominant, autosomal recessive, X-linked inheritance, genomic imprinting, Prader-Willi syndrome, Angelman syndrome, trinucleotide repeats, Huntington disease, Down syndrome, lysosomal storage diseases

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Integrated Metabolism & Physiology

Acid-base disorders, metabolic acidosis, metabolic alkalosis, anion gap, renal tubular acidosis, fed and fasted state, starvation, gluconeogenesis

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Enzyme Kinetics

Michaelis-Menten kinetics, Km, Vmax, competitive inhibition, noncompetitive inhibition, uncompetitive inhibition, Lineweaver-Burk plot, allosteric regulation

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Immunology & Hematologic Mechanisms

Complement pathway, C1 esterase inhibitor deficiency, hereditary angioedema, paroxysmal nocturnal hemoglobinuria (PNH), terminal complement deficiency

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Practice the science behind the vignette.