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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. What disorder is associated with loss of polarity - anaplasia - pleomorphism - discohesiveness - increase in the nuclear:cytoplasmic ratio - hyperchromasia - and increase in the rate of mitosis?
5' deiodinase
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)
Rhabdomyoma
Malignancy

2. What is the term for the amount of blood in the ventricle after maximal contraction?
Subarachnoid hematoma
Residual volume
Superego
CD8+ T cells

3. What statistical test compares the means of many groups (>2) of a single nominal variable by using an interval variable?
One - way ANOVA
Obese patients
Gonorrhea
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT - which means warfarin - extrinsic - PT; heparin - intrinsic - PTT)

4. What is the most common one? - Congenital heart defect in adults
Filiform papillae
At 8 to 9 years of age. Prior to this age they view death as a form of punishment.
ASD
Hapten; if it is coupled with a carrier - it may become immunogenic.

5. Name the type of hypersensitivity reaction based on the following properties - IgG or IgM Abs against a specific target cell or tissue; complement - dependent or ADCC.
Iron (Fe)
Type II hypersensitivity (cytotoxic)
Being a white male
Selenium (Se)

6. If the pH is low with increased CO2 levels and decreased HCO3- levels - What is the acid - base disturbance?
Combined metabolic and respiratory acidosis
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Finasteride
Dorsal prefrontal cortex

7. Name the lung measurement based on the following descriptions: x The maximal volume inspired from FRC
Sciatic nerve
Phase III. It is considered the definitive test.
Phallic stage (4-6 years)
Inspiratory capacity

8. What is the term to describe how easily a vessel stretches?
Compliance (think of it as distensibility)
Hapten (not immunogenic)
Permanent
Neisseria gonorrhoeae and Chlamydia trachomatis

9. How is the eye affected by use of opioids?
Levator palpebrae superioris
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans

10. After a longstanding left - to - right shunt reverses - causing cyanosis - and becomes a right - to - left shunt - What is it termed?

11. Have catalase.
Streptococci
SSRIs
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
Middle cerebral artery

12. Where is the most frequent site of ectopic pregnancy?
Glucagon and epinephrine
Ampulla of the fallopian tube
GP IIb and IIIa receptors
Brushfield spots

13. What is the renal compensation mechanism for alkalosis?
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
More Ab is produced in less time in a secondary immune response (shorter lag period).
The energy of activation

14. Bloody tap on lumbar puncture
The number of Ags that the Ab can bind
Subarachnoid hemorrhage
ASA (salicylate)
Minoxidil (orally and topically - respectively!)

15. Name the most common type or cause - UTIs
Epstein - cardiac anomaly of the tricuspid valve
Pseudohyphae
Coronavirus
Escherichia coli

16. In regard to motor development during infancy - choose the motor response that happens first - Palms up or down
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
Conjugated (direct) hyperbilirubinemia
Palms - up before palms - down maneuvers
Toxic or viral hepatitis

17. What is the name of RER in neurons?
Ewing sarcoma
1. ADP 2. PG 3. TXA2
First pharyngeal groove; all others degenerate.
Nissl substances; there is a great deal of RER in neuron cell bodies - indicating high protein synthesis.

18. What are the adult remnants of the following structures? - Ductus venosus
Riedel thyroiditis
C wave
Ventral posterolateral nucleus
Ligamentum venosum

19. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Denies being blind - cortical blindness

20. What inflammatory bowel disorder is continuous - with extensive ulcerations and pseudopolyps - and is associated with HLA- B27?
C5a
S phase
Ulcerative colitis
Efficacy

21. In what form are triglycerides sent to adipose tissue from the liver?
VLDLs
Somatoform disorder
Gain of hypertonic fluid (mannitol or hypertonic saline)
Limbic system

22. What adrenal enzyme deficiency results in hypertension - hypernatremia - and virilization?
Succinyl CoA synthetase
Anticipation - associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.
Subacute bacterial endocarditis
11- Beta - Hydroxylase deficiency results in excess production of 11- deoxycorticosterone - a weak mineralocorticoid. It increases BP - Na+ - and ECF volume along with production of adrenal androgens.

23. With what stage of sleep are night terrors associated?
Vitreous humor
NREM sleep. Night terrors are dreams that we are unable to recall.
Decreased REM sleep and REM rebound during withdrawal
Down syndrome

24. What type of estrogen is produced in peripheral tissues from androgens?
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
IgG
Rhinovirus and hepatitis A virus
Estrone

25. Are the following major or minor Jones criteria of rheumatic fever? - Migratory polyarthritis
Roth spots - and they are seen in bacterial endocarditis.
Major
N- formyl - methionine LTB4 C5a IL-8
Ventricular fibrillation (V fib)

26. What water - soluble - vitamin deficiency may result from eating raw eggs?
HBcAb IgG and HBsAb IgG
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Biotin (only if eaten in large quantities)
GLUT 4

27. Results in vitamin B12 deficiencies.
Removal of the ileum
Choriocarcinoma
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.

28. With which CN are preganglionic parasympathetic axons arising from the Edinger - Westphal nucleus associated?
Osteosarcoma
Sulfonamides
IgA
CN III

29. What diseases are associated with the HLA- DR3 allele

30. What Ag is needed to diagnose an infectious patient with hepatitis B?
IgA
Vitamin D
HBeAg
Reye syndrome

31. What component of an ECG is associated with the following? - Ventricular depolarization
Phentolamine and phenoxybenzamine
Minor
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
QRS complex

32. What Vi - encapsulated gram - negative motile anaerobic rod that produces H2S is associated with enteric fever - gastroenteritis - and septicemia?
HPVs 16 and 18
Secondary hypocortisolism (pituitary)
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Salmonella typhi

33. On the venous pressure curve - What do the following waves represent? - V wave?
Mesencephalon
Nodular sclerosis
Hirschsprung disease
Atrial filling (venous filling) Atrial - Contraction - Venous

34. Which bacteriostatic drug whose major side effect is the lepra reaction inhibits folic acid synthesis?
VSD
Positive
Dapsone
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament

35. Is used to detect Abs in a patient?
Propranolol
IF-2 of the 30S subunit
MstII; changing codon 6 (from A to T) destroys the restriction site.
Direct fluorescent Ab test

36. Name the end product or products: x Fatty acid oxidation
Creutzfeldt - Jakob's disease. Patients first develop vague somatic complaints and anxiety - rapidly followed by dysarthria - myoclonus - ataxia - and choreoathetosis.
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
These are the gross pathologic changes associated with Alzheimer's disease.
Acetyl CoA and propionyl CoA (in odd chain fatty acids)

37. What Brodmann area is associated with x Primary auditory cortex?
Areas 41 and 42
Shifts it to the right
Chlamydia trachomatis
Parental assignment and culture (not biology)

38. A tropical fish enthusiast has granulomatous lesions and cellulitis; What is the most likely offending organism?
Aldosterone
Mycobacterium marinum
From the wall of the yolk sac
Neutrophils - eosinophils - and basophils

39. What seronegative spondyloarthropathy is seen in HLA- B27- positive young females and presents with the triad of conjunctivitis - urethritis - and arthritis affecting the knees and ankles?
Chylomicrons
Acetazolamide
Internal 3' - 5' PDE bonds
Reiter syndrome

40. What nucleus supplies the preganglionic parasympathetic fibers to the ciliary ganglion?
Empyema
Edinger - Westphal nucleus (via CN III)
Terbinafine
Lingual nerve of CN V3

41. What vitamin deficiency is evidenced by poor wound healing - loose teeth - bleeding gums - petechiae - and ecchymosis?
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
Flutamide
X- linked dominant
Prefrontal cortex; it is in front of the premotor area.

42. What is the term for the difference between systolic and diastolic pressures?
Clostridium botulinum
Pulse pressure
Apneustic center (deep breathing place)
The fast component is directed toward the affected side of a cerebellar lesion.

43. Name the associated chromosome - Down syndrome
Turner syndrome
The vagina
Chromosome 21
Macula densa

44. Early menses - late menopause - history of breast cancer - obesity - and multiparity.
Phase II
Risk factors for breast cancer
Onset of bleeding
Type IV collagen

45. What Brodmann area is associated with x Primary somatosensory cortex?
Areas 1 - 2 - and 3
hyperventilation
IgG
Aedes mosquito

46. What cerebral lobes are most commonly affected in herpes encephalitis?
enveloped
Type 2
Clofazimine
Temporal lobes

47. What lysosomal enzyme is deficient in x Gaucher's disease?
Complex I
Proencephalon
Glucocerebrosidase
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.

48. What X- linked recessive disorder that is due to an abnormality in the dystrophin gene - has onset by age 5 with progressive proximal muscle weakness - calf pseudohypertrophy - and elevated CPK levels?

49. Name the structure that enters or exits the following foramina: x Foramen magnum
Antimicrobial agents
1. Cough 2. Coryza 3. Conjunctivitis
Asbestosis
CN XI - vertebral arteries

50. What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
Astrocytoma
Cryptococcus
Chromaffin cells (adrenal medulla)
Clozapine