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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Which hepatitis B serology markers
Meningomyelocele All except occulta cause elevated - fetoprotein levels.
Taenia saginata
Malignant mesothelioma
HBcAb IgG - HBV- DNA - HBeAg - HBsAg

2. What two HIV regulatory genes down - regulate MHC class I expression in the host?
HBcAb and HBeAb. You see the antibodies c and e.
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
0.21; it is a fancy way of saying 21% of the air is O2.
nef and tat genes

3. Name the insulin preparation based on the peak effect and duration of action - Peak - 0.3 to 2 hours; duration - 3 to 4 hours
Trypsin
Lispro insulin
REM latency; normally it is about 90 minutes.
Nearly 25% of patients taking lithium develop polyuria and polydipsia.

4. What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?
Empyema
One - way ANOVA
Gastric ulcer
Ferritin

5. What form of hormone is described as having membrane - bound receptors that are stored in vesicles - using second messengers - and having its activity determined by free hormone levels.
CN VII
Water - soluble hormones are considered fast - acting hormones.
Stroke volume
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.

6. Which dopamine receptor excites the direct pathway of the basal ganglia?
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
The DCML system. (Remember - everything but pain and temperature.)
Libman - Sacks endocarditis
Y - W-135 - and C and A capsular polysaccharides

7. Name the most common type or cause - Hypothyroidism in the United States
Decreases
Iatrogenesis
Clarke's nucleus
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.

8. In what disease do you see horseshoe kidneys - rockerbottom feet - low - set ears - micrognathia - and mental retardation?
Duodenal ulcer
MstII; changing codon 6 (from A to T) destroys the restriction site.
An elevated serum osteocalcin level
Edward syndrome (trisomy 18)

9. Where is lithium metabolized and excreted?

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10. What stromal tumor in males is characterized histologically with crystalloids of Reinke?
Leydig cell tumor
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
EBV
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases

11. How does myelination affect conduction velocity of an action potential?
Physiologic dead space is the total dead space of the respiratory system.
The greater the myelination - the greater the conduction velocity.
Rhabdomyoma
Native Americans

12. What disease is produced by a deficiency in the enzyme tyrosinase?
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
EF- Tu and EF- Ts of the 30S ribosomal subunit
G0 phase
Sucralfate

13. What cells contribute to the blood - brain barrier and proliferate in response to CNS injury?
Ulcerative colitis
Transitional cell carcinoma
Atrial contraction Atrial - Contraction - Venous
Astrocytes

14. What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ?
Hurler syndrome and Hunter syndrome - respectively
Aspartic acid and glutamic acid
Aminophylline
Staphylococcus aureus

15. What primary acid - base disturbance is caused by a loss in fixed acid forcing the reaction to shift to the right - thereby increasing HCO3- levels?
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
Eosinophil chemotactic factor A
Wilms tumor
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)

16. What type of hemostasis in an intravascular space consists of fibrin - platelets - RBCs - and WBCs?
Thrombus
Eosinophils
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
Procainamide

17. Which CNS ACh receptor or receptors are excitatory? Inhibitory?
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
Because creatinine is filtered and a small amount is secreted
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva
Cardiac muscle

18. Name three opsonins.
T lymphocyte
Limbic system
Fc portion of IgG - C3b - and mannose - binding proteins
Chromaffin cells (adrenal medulla)

19. What is the most common causative organism of acne vulgaris?
Double - blind study. It is the most scientifically rigorous study known.
Propionibacterium acnes
Schizotypal
Bell pad

20. Name the antimicrobial agent whose major side effect is listed - Teratogenicity
The urea cycle
Zafirlukast
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Metronidazole

21. How can a genetic deficiency of carbamoyl phosphate synthetase be differentiated from an ornithine transcarbamoylase deficiency?
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Childhood
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
Chromosome 3p

22. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF normal - capillary pressure ?
Western blot
Constriction of afferent arteriole
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
IgG

23. What pancreatic islet cell secretes glucagons?
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Positive correlation
Major
alpha - Cells; glucagon has stimulatory effects on - cells and inhibitory effects on - cells.

24. What type of hepatitis has the highest mortality rate among pregnant women?
Glycogen phosphorylase
Hepatitis E
Graves disease
Nystagmus and ataxia

25. What is the first membrane - bound Ig on B cell membranes?
The pulsatile release of GnRH
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
IgM; IgD follows shortly thereafter.
C1 - C2 - or C4 deficiency

26. Name the bony articulations of the following sites. Be specific. Wrist
Staphylococcus
Smooth muscle
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
First - pass metabolism and acid lability

27. Name the type of graft described by these transplants: x From one species to another
Cyanocobalamin (B12)
Xenograft
IgG4
Formation of an identity through issues of independence and rebellion; they define who they are.

28. What branch of the immune system is acquired in response to an Ag?
Mycoplasma pneumoniae
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)
Lethal dose for 50% of drug takers (median lethal dose)
Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.

29. What area of the GI tract has the highest activity of brush border enzymes?
CN IX - X - and XII
Jejunum (upper)
Phase 1
Down syndrome (trisomy 21)

30. Are used in combination with estrogens to decrease the risk of endometrial cancer.
Tylosis
PGE (along with low oxygen tension)
Progestins
ASA (salicylate)

31. What muscle or muscles are innervated by the following nerves? - Long thoracic nerve
Pseudomonas aeruginosa
Large segment deletions
Serratus anterior
Haemophilus influenzae type B

32. Name the most common cause - Hospitalization in children younger than 1 year of age
RSV
Superior
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
Lente insulin and either NPH or protamine zinc insulin (PZI)

33. What is the amount in liters and percent body weight for the following compartments? - ICF
Sulfonamides
Coccidioides immitis
28 L - 40% of body weight
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).

34. What type of saliva is produced under parasympathetic stimulation?
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
Hapten; if it is coupled with a carrier - it may become immunogenic.
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
Spironolactone

35. What cells of the retina sees in color and needs bright light to be activated?
Down syndrome (it is slightly more common than fragile X syndrome.)
Metronidazole
Cones (C for color and cones)
Limbic system

36. What CN is associated with the sensory innervation of x Laryngopharynx?
Visceral pleura
Negative
Vagus nerve
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies

37. After fertilization - what cells of the corpus luteum x Secrete progesterone?
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
Free form determines hormone activity and is responsible for the negative feedback loop.
Atelectasis
Labioscrotal swelling

38. Increases your risk factor for testicular cancer.
Stratum corneum (keratinized)
Hematogenous
Hypervariable region (three per light chain; three per heavy chain)
Being a white male

39. What two pituitary hormones are produced by acidophils?
Areas 5 and 7
The second pharyngeal pouch and groove
Somatomedins (IGF-1)
GH and prolactin are produced by acidophils; all others are by basophils.

40. Name the antidote - Cyanide
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Pseudomonas
The myotatic reflex is responsible for the tension present in all resting muscle.
Amyl nitrate - sodium nitrate - or sodium thiosulfate

41. By removing Na+ from the renal tubule and pumping it back into the ECF compartment - What does aldosterone do to the body's acid - base stores?
CD4+T cells
CMV retinitis and HSV-2
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
The right gonadal vein drains into the inferior vena cava directly - and the left gonadal vein drains into the left renal vein.

42. What area of the retina consists of only cones and has the greatest visual acuity?
Fovea
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
Enterobius vermicularis
Paroxysmal nocturnal hemoglobinuria

43. What is the name of the major chemotactic agent released from x Bacteria?
refractory sexual periods
F- Met - Peptides
Adenocarcinoma of the cervix
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.

44. What pneumoconiosis is associated with exposure to the following occupations or materials? - Shipyards - brake linings - insulation - and old building construction
Asbestosis
Left homonymous hemianopsia
Facial expression (the second is vocal intonation)
S1 nuclease

45. Increases the risk of developing squamous cell carcinoma of the penis.
Elongation factor - G and GTP
HPV infection
Ventral posterolateral nucleus
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)

46. What antihypertensive agent produces cyanide and thiocyanate as byproducts?
Nitroprusside
Where the cell bodies for the DCML and spinothalamic sensory systems are...
CN VII
CD3

47. What is the term for nonneoplastic abnormal proliferation of cell size - shape - and cellular organization?
Bronchiectasis
Dysplasia
Gastrin - releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)
The T- test (used when comparing two groups)

48. What disorder is due to a 5-- reductase deficiency - resulting in testicular tissue and stunted male external genitalia?
Clearance
Pyridoxine
It decreases insulin secretion.
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.

49. Which direction is air flowing when the intra - alveolar pressure is zero?
Necator americanus is treated with mebendazole and iron therapy.
IgG
When the intra - alveolar pressure equals zero - there is no airflow.
C3a - C4a - C5a

50. What is the term for diffusion of water across a semipermeable or selectively permeable membrane?
Osmosis; water will diffuse from higher to lower water concentrations.
Osler nodes
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
IgM

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USMLE Step 1 Prep

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