USMLE Step 1 Content Outline Aligned

Know the Mechanism
Behind the Step 1 Vignette

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

Try 20 questions free. Full access includes 15 focused practice blocks and 300 Step 1-style biochemistry questions.
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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.

Exam-style practice blocks

BiochemStep includes focused Step 1-style questions across recurring foundational science mechanisms, organized into timed and tutor-style practice blocks.

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

Amino acid catabolism, nitrogen handling, urea cycle chemistry, heme-related pathways, and inherited metabolic disease mechanisms.

Carbohydrate Metabolism

Glycolysis, gluconeogenesis, glycogen metabolism, monosaccharide metabolism, the pentose phosphate pathway, and metabolic regulation.

Glycogen Storage Diseases

Glycogen synthesis, glycogen breakdown, lysosomal glycogen handling, fasting hypoglycemia, exercise intolerance, and organ-specific storage patterns.

Lipid Metabolism

Fatty acid oxidation, ketone body metabolism, cholesterol and lipoprotein regulation, lipid transport, and pathway-targeted pharmacology.

Nucleotide Metabolism

Purine and pyrimidine synthesis, salvage pathways, nucleotide degradation, antimetabolite mechanisms, and pharmacogenomic toxicity.

Vitamins & Cofactors

Water-soluble and fat-soluble vitamin mechanisms, cofactor-dependent reactions, trace elements, hematologic effects, and neurologic consequences.

Nutrition

Protein-energy malnutrition, micronutrient deficiency, refeeding physiology, and nutrition-linked biochemical consequences.

Molecular Biology

DNA repair, transcription, RNA processing, translation, chromatin regulation, protein folding, genome maintenance, and toxin effects on protein synthesis.

Lab Techniques

Molecular diagnostics, cytogenetics, sequencing, immunologic detection, protein detection, gene-editing concepts, and separation methods.

Genetics & Cell Biology

Inheritance patterns, chromosomal disorders, imprinting, trinucleotide repeats, lysosomal biology, cell signaling, apoptosis, and tumor suppressor pathways.

Integrated Metabolism & Physiology

Fed and fasting metabolism, acid-base physiology, oxidative phosphorylation, hemoglobin biochemistry, membrane transport, and hormone-mediated regulation.

Enzyme Kinetics

Michaelis-Menten reasoning, Km, Vmax, inhibitor patterns, irreversible inhibition, allosteric regulation, and clinically relevant enzyme defects.

Immunology & Hematologic Mechanisms

Red-cell biochemistry, coagulation regulation, complement biology, phagocyte function, lymphocyte signaling, antigen processing, and immune-effector mechanisms.

Practice the science behind the vignette.