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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. Which direction is air flowing when the intra - alveolar pressure is zero?
Negative reinforcement
Sarcoplasmic reticulum
PCT
When the intra - alveolar pressure equals zero - there is no airflow.

2. Which IL increases IgA synthesis?
IL-5. It also stimulates eosinophil proliferation.
Cryptococcus neoformans
Orbitomedial frontal lobe
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)

3. Name the area of the cerebral cortex with the function described: x Language - memory - and emotion (Hint: herpesvirus infects here commonly)
Temporal lobe
Listeria
Inhibited orgasm
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)

4. What direction does RNA polymerase move along the template strand of DNA during transcription?

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5. To differentiate central from nephrogenic diabetes insipidus - after an injection of ADH - which will show a decreased urine flow?
Central. Remember - there is a deficiency in ADH production in the central form.
Mode
Deferoxamine - penicillamine
Dopamine

6. To What is the diffusion rate indirectly proportional?
Xenograft
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Blocking
Cancer

7. What ascending sensory system carries joint position - vibratory and pressure sensation - and discriminative touch from the trunk and limbs?
Hematoxylin
The DCML system. (Remember - everything but pain and temperature.)
Sympathetic chain ganglion
Toxoplasma gondii

8. Do high levels of estrogen and progesterone block milk synthesis?
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Reticulocyte
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.

9. What primary acid - base disturbance is cause by a decrease in alveolar ventilation (increasing CO2 levels) resulting in the reaction shifting to the right and increasing H+ and HCO3- levels?
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
The entire tubule barring the thick ascending limb
Propionibacterium acnes

10. What embryonic structure forms the adult female structures? - Labia minora
Succinylcholine and halothane (Treatment is with dantrolene.)
Seminoma
Chlamydia trachomatis
Urogenital folds

11. What three steps of the TCA cycle generate NADH?
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
Cancer
Glucokinase
Sheehan syndrome

12. What is the DOC for the following protozoal infections? - Pneumocystis carinii pneumonia
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
Trimethoprim/sulfamethoxazole (TMP- SMX)
First - pass metabolism and acid lability
Yes. It increases the rate of suicide to nearly 50 times that of the general population.

13. What is the DOC for the following protozoal infections? - Trichomoniasis
Metronidazole
Shifts it to the right
Acute glomerulonephritis
Nephrotoxicity

14. What is the most common one? - Malignant tumor of the esophagus
Yolk sac tumor
Radial Immuno Diffusion (RID) for Ig levels.
Squamous cell carcinoma
PR interval

15. Name the most common type or cause - Nephritic syndrome in children
Minimal change disease
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.
Relative refractory period
Type II hypersensitivity reaction

16. Inhibits glucose uptake in skeletal muscle.
HPV serotypes 1 and 4
Sphingomyelin (lecithin also - but it is not a sphingolipid)
Cortisol
O2

17. What is the term for thymic induction of T cells with high - affinity Ag receptors for self that are programmed to undergo apoptosis?
Proencephalon diencephalon derivative
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
Posterior
Negative selection. This helps to prevent autoimmune diseases.

18. What is the only dsRNA virus?
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol
IgM
Reovirus
Staphylococcus aureus

19. Which drug is used to treat respiratory depression associated with an overdose of opioids?
Nissl substances; there is a great deal of RER in neuron cell bodies - indicating high protein synthesis.
Hepatic glycogen phosphorylase
Mesencephalic nucleus
Naloxone or naltrexone

20. Name the compartment of the mediastinum associated with the following thoracic structures: SVC
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.
H 1
Superior and middle
Calcium oxylate

21. Name these cluster A personality disorders: x Odd - strange; has magical thinking; socially isolated - paranoid - lacks close friends; has incongruous affect
Procainamide
Kidney
Thymine
Schizotypal

22. What is given to pregnant women within 24 hours after birth to eliminate Rh+ fetal blood cells from their circulation?
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
More than 75% of the vessel
Rho (D) immune globulin (RhoGAM) - an anti - RhD IgG antibody - prevents generation of RhD- specific memory B cells in the mother.
Hypospadia

23. How does L- tryptophan affect sleep?
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)
It increases REM and total sleep time.
Preganglionic sympathetic neurons
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.

24. What cycle is responsible for converting to glucose in the liver the lactate produced in the RBCs?
Cori cycle
Pyelonephritis
Functional residual capacity (FRC)
FSH and testosterone

25. Abs to what hepatitis B Ag provide immunity?
Orotic acid (purine metabolism)
presence of PMNs
Abs to HBsAg
apo A-1

26. Homer - Wright rosettes
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
Neuroblastoma
Aversive conditioning
Schistosoma have separate males and females.

27. What is the DOC for the following protozoal infections? - Amebiasis
V wave
Asparagine
Aminoglycosides
Metronidazole

28. Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism?
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)
Factors II - VII - IX - X - and proteins C and S
Acute pyelonephritis
Physiologic antagonism

29. To what viral family does the polio virus belong?
Phentolamine and phenoxybenzamine
Alanine cycle
ACL
Picornaviridae

30. What is the most common one? - Female genital tract malignancy resulting in death
Breast cancer
Apneustic center (deep breathing place)
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
Ovarian cancer

31. What are the three reasons for the effectiveness of the blood - brain barrier?
Musculophrenic and superior epigastric arteries
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Porcelain gallbladder
Enterobius vermicularis

32. Which benzodiazepine has the longest half - life?
Flurazepam
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Thick skin
CD8+ T cells

33. What is the first formal IQ test used today for children aged 2 to 18?
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
To provide attachment between contiguous cells and to maintain a semipermeable barrier
Lateral pontine syndrome

34. Where is lithium metabolized and excreted?

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35. What is the DOC for treating torsade de pointes?
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
IgG
TCA cycle.
Magnesium

36. What complement factor or factors are associated with x Membrane attack complex (MAC)?
Staphylococcus
Smooth muscle
Serotonin
C5- C9

37. What is the term for the number of trinucleotide repeats increasing with successive generations and correlating with increased severity of disease?

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38. What inflammatory bowel disorder is continuous - with extensive ulcerations and pseudopolyps - and is associated with HLA- B27?
Subscapularis
Ulcerative colitis
Phase 4
Vibrio cholera

39. What is the DOC for bipolar disorder?
HPV serotypes 1 and 4
All
Negative predictive value
Lithium

40. What skin type on the palms and soles is characterized by the absence of hair follicles and presence of stratum lucidum?
H1 histones
Thick skin
Antithyroglobulin and antimicrosomal Abs
Guanethidine and bretylium

41. What happens to intrapleural pressure when the diaphragm is ontracted during inspiration?
Dihydrotestosterone
Intrapleural pressure decreases (becomes more negative).
Chromosome 9 - 22 (Philadelphia chromosome)
Convergence

42. What DNA virus is associated with heterophile - negative mononucleosis?
Amantadine
Reliability (think of it as 'nice grouping' or 'precise')
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
RES(Reticular endothelial system)

43. What small gram - negative facultative intracellular rod is transmitted to human host by Dermacentor tick bite?
Francisella tularensis
Marfan syndrome
Cestodes
Berry aneurysm

44. Name the pattern of genetic transmission characterized thus: both M and F affected; no M- to - M transmission; affected M passes trait to all daughters - every generation; affected F passes trait to both sons and daughters; a single mutant allele can
Microglia (Microglia and mesoderm both begin with M)
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
Haemophilus ducreyi
X- linked dominant

45. With an increase in arterial systolic pressure - what happens to x Stroke volume?
Short - chain fatty acids
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.
Squamous cell carcinoma
Increases

46. What viruses are associated with Cowdry type A intranuclear inclusions?
CN III - IV - and VI
Penicillin V
Herpes virus I and II
The portal tract of the liver lobule

47. Name the hypochromic microcytic anemia based on the following laboratory values - Normal iron - TIBC - percent saturation - and ferritin
Stable
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone - whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.
Thalassemia minor

48. What is the venous and arterial stretch receptors' function regarding the secretion of ADH?
ydroxyproline
Left homonymous hemianopsia
Rheumatoid arthritis
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.

49. What is the term for a venous embolus in the arterial system?
Dominant temporal lobe
Prefrontal cortex; it is in front of the premotor area.
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
Galactitol

50. What percent of unwed mothers are teenagers?
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
50% - with 50% of them having the child
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
Pneumocystis carinii