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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 is the major difference between the veins in the face and the veins in the rest of the body?
Multiple sclerosis
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)
Pyelonephritis
There are no valves and no smooth muscle in the walls of the veins in the face.

2. What is the major inorganic component of bone?
Hydroxyapatite
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet
Squamous cell carcinoma
Bronchial asthma (eosinophil membranes)

3. What is the most common one? - Intramedullary spinal cord tumor in adults
Ependymoma
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Ethacrynic acid
Acute rejection

4. What is the major cell membrane sterol found in fungi?
Ergosterol
Iron (Fe)
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
CD8+ T cells (cytotoxic) Remember - 8

5. Which leukotrienes are associated with the late - phase inflammatory response?
Clozapine
These are the gross pathologic changes associated with Alzheimer's disease.
LTC4 and LTD4
Somatization

6. How many bases upstream is the eukaryotic TATA box promoter?
Parvovirus
Menstruation
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
Hydatidiform mole

7. What vessel does the right gonadal vein drain into?
Fo/F1 complex
The venae recta maintain the gradient via countercurrent flow.
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
The right gonadal vein drains into the inferior vena cava directly - and the left gonadal vein drains into the left renal vein.

8. What slow - growing CNS tumor in 30- to 50-year - old patients with a long history of seizures has fried egg cellular appearance in a network of chicken wire?
Primary follicle (in the white pulp)
C wave
Oligodendroglioma
Normal values

9. What cells lining the ventricles have cilia on their luminal surface to move CSF?
Ependymal cells
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.
GERD
Metastatic carcinoma

10. What subtype of IgG does not bind to staphylococcal A protein?
Keloid
IgG3
X- linked recessive
Spinal trigeminal nucleus

11. What is the treatment for nephrogenic diabetes insipidus induced by lithium?
For males - HTN; for females - pregnancy.
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Amiloride
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

12. Does the direct or indirect basal ganglia pathway result in a decreased level of cortical excitation?
Asparagine
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Proencephalon diencephalon derivative
1. Iliocostalis 2. Longissimus 3. Spinalis ('I Love Science' muscles)

13. At the apex of the lung - What is the baseline intrapleural pressure - and what force does it exert on the alveoli?
PRPP aminotransferase
Hepadnavirus
Magnesium ammonium phosphate (struvite)
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.

14. What artery travels with the following veins? - Great cardiac vein
T9
Left anterior descending artery
Eosin
Huntington disease

15. What is the DOC for the following protozoal infections? - Leishmaniasis
CN III and IV
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Factors II - VII - IX - X - and proteins C and S
Stibogluconate

16. What is the triad of fat embolism?
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.
Being a white male
Beta- Blockers
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)

17. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Pineal gland
5HT1D
Heart disease
Proencephalon diencephalon derivative
Neomycin

18. Depolarization of the postsynaptic membrane...
Pyelonephritis
Glutamate
Right atrium
excites the neuron

19. Which organisms have polycistronic mRNA?
Prokaryotes. Polycistronic and prokaryotes both start with P.
Phase 3
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Vitamin A

20. Have no GI tract They absorb nutrients from the host's GI tract.
Papovavirus
Hemolytic uremic syndrome
Antisocial
Cestodes

21. What is the leading cause of primary hyperparathyroidism?
Leydig cell tumor
Chief cell adenoma (80%)
Angiosarcoma of the liver
Lead

22. What forms of fatty acids are absorbed from the small intestine mucosa by simple diffusion?
Short - chain fatty acids
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)
Heroin
Leukotriene B4 (LTB4)

23. What three CNs are associated with conjugate eye movements?
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.
Latissimus dorsi
CN III - IV - and VI
Ostium secundum defects

24. What vasculitis is characterized by systemic vasculitis in small to medium - size vessels (except the lung); affecting young males; 30% HBsAg - positive; P- ANCA and autoantibodies against myeloperoxidase?
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.
Niacin (B3)
Hairy cell leukemia
Polyarteritis nodosa

25. Takes place in both the cytoplasm and the mitochondria.
The urea cycle
Listeria monocytogenes
Clostridium botulinum
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.

26. Is it acceptable to lie - even if it protects a colleague from malpractice?
Rigors - leukopenia - decrease in blood pressure - and increase in temperature
Tinea favosa (favus)
Increased GABA levels decrease the likelihood of learned helplessness.
No - it is never acceptable to lie.

27. What oral hypoglycemic agent inhibits a - glucosidase in the brush border of the small intestine?
Acarbose
They are all formed by the fifth month of fetal life.
Filtration; if hydrostatic pressure is less than oncotic pressure - reabsorption is promoted.
Flumazenil

28. Name the Plasmodium species based on the following information:Persistent hypnozoite liver stage with relapses; blood smear shows amoeboid trophozoites with oval - jagged infected RBCs; 48- hour fever spike pattern
Carbonic anhydrase
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
Molindone
Plasmodium ovale

29. What agent - in combination with a MAOI inhibitor - can cause hypertensive crisis?
Terminal bronchioles. (No gas exchange occurs here.)
Dilator pupillae muscle
Glucocerebrosidase
Tyramine

30. What substance do the JG cells of the kidney secrete in response to low blood pressure?
Parvovirus (it is the only ssDNA virus)
Serratus anterior
Renin
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.

31. What is the second leading cause of death in the United States?
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
Cancer

32. What is the classic triad of TB?
Fever - night sweats - and hemoptysis
Hypothyroidism. (TSH levels must be monitored.)
In the tuberoinfundibular pathway - dopamine release will decrease prolactin release - Which is why dopamine agonists are used in the treaatment of hyperprolactinemic states.
Simon focus

33. The increased oxygen consumption after phagocytosis is for...
Testicular tumors
A positive PPD skin test
ATP production
Puborectalis

34. What is the stimulus for the classical pathway activation?
Streptomycin
Clonidine
1. Iliocostalis 2. Longissimus 3. Spinalis ('I Love Science' muscles)
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.

35. Corticotropin - releasing hormone promotes the synthesis and release of what prohormone?
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Gout
Keloid
HBsAg (incubation period)

36. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x abl
Erythromycin
Dimorphic
Mitochondria
CML and All

37. Name these immature defense mechanisms: x Psychic feelings converted to physical symptoms
Somatization
Campylobacter jejuni
P wave
1. Short attention span 2. Impulsivity 3. Hyperactivity

38. What is the only factor of enzyme kinetics that the enzyme affects?
Mesencephalic nucleus
Yes. The only civil liberty they lose is the freedom to come and go as they please.
Ea (activation energy)
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.

39. What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
Mitosis
Integument (skin and its derivatives)
Area 6

40. The inferior mesenteric artery drains into it.
Decreases
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
Epstein - cardiac anomaly of the tricuspid valve
The splenic vein

41. What test is used to screen for HIV?
ELISA. It detects anti - p24 IgG.
Vitamin D3
Shortens
DNA polymerases

42. What is the most common one? - Solid tumor in the body
T3
Nephroblastoma
Somatization disorder
H1 histones

43. How are resistance and length related regarding flow?
Dilation of efferent arteriole
Flumazenil
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.
Phase 1

44. What subset of CD4 T cells is responsible for mast cell and eosinophil precursor proliferation?
Beta2- Adrenergic agents
Mebendazole
Th2 cells
pI (isoelectric point)

45. What personality disorder affects 75% of the prison population?
Transmembrane potential (an absolute number)
Antisocial personality
Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.
Anterior compartment of the leg - deep peroneal nerve

46. What paraphilia is defined as x Sexual urges toward children?
Progressive multifocal leukoencephalopathy
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Area 8
Pedophilia

47. What form of penicillin is stable in acid environments?
Production of oxygen free radicals
Penicillin V
Chloral hydrate
Fibrinous exudates

48. After traveling in a plane across the Atlantic Ocean - an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose?
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
CN III - VII - IX - and X
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
Roth spots

49. What is the term for the rate measured for a subgroup of a population?
Specific rate (e.g. - men aged 55-60)
Large segment deletions
Bladder cancer
Salmonella

50. Which of the following Enterobacteriaceae family members
Early collecting duct
All are lactose fermenters except Yersinia and Proteus.
Pregnancy
Primary hypercortisolism