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Test your basic knowledge |
USMLE Step 1 Prep
Start Test
Study First
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 most common one? - Primary tumor metastasis to the bone
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
Breast
The energy of activation
ASA
2. What three things are needed to produce a double bond in a fatty acid chain in the endoplasmic reticulum?
Transudative; exudative has the opposite values and has an elevated cellular content.
NADPH - O2 - and cytochrome b5
Marfan syndrome
Berry aneurysm in the circle of Willis
3. What three structures increase the surface area of the GI tract?
Pseudomembranous colitis
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
Temporal lobes
4. Auer rods
Lower lobe
AML- M3
A transport maximum (Tm) system
Ependymal cells
5. What hormone - produced by the Sertoli cells - is responsible for keeping testosterone levels in the seminiferous tubules nearly 50 times that of the serum?
Middle meningeal artery
Mikulicz syndrome
Androgen - binding protein
Gastric carcinoma
6. In regards to solute concentration - how does water flow?
ater flows from a low - solute to high - solute concentrations.
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.
Efficacy
RU 486
7. What B- cell neoplasm is seen in males with massive splenomegaly - produces dry tap on bone marrow aspirations - and stains positive for tartrate - resistant acid phosphatase (TRAP)?
Carbidopa and benserazide
Hairy cell leukemia
Bunyavirus
Silent
8. How many pairs of spinal nerves are associated with x Thoracic vertebrae?
Neisseria meningitidis
Paget disease of the breast
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.
Primary spermatocyte
9. What form of bias is due to false estimates of survival rates?
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10. What is the most superficial layer of the epidermis?
Erythromycin
Area 22 and occasionally 39 and 40
Stratum corneum (keratinized)
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.
11. What is the most common one? - Cancer of the esophagus in the world
Stage fright (discrete performance anxiety)
Squamous cell carcinoma
Plasmodium ovale
MHC class I antigens; they are also found on the surface of platelets.
12. At what vertebral levels does the aortic arch begin and end?
It both begins and ends at T4 (sternal angle [of Louis]).
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
Dissociative fugue. (Patients are unaware of memory loss.)
Parasites
13. What maintains the osmotic gradient that is critical to the concentrating ability of the kidney?
Superior vena cava
Oxytocin
Hepatitis D
The venae recta maintain the gradient via countercurrent flow.
14. What very aggressive lung cancer metastasizes early and is associated with smoking and paraneoplastic syndromes?
Vitamin D3
Atrial filling (venous filling) Atrial - Contraction - Venous
Small cell carcinoma (oat cell)
Oxytocin
15. What Brodmann area is associated with x Premotor cortex?
Hepatitis D
Umbilical vein and ductus venosus (80%)
Area 6
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.
16. What three muscles constitute the erector spinae?
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17. Name the antimicrobial agent whose major side effect is listed - Hemolytic anemia
Normal values
Omega -3 fatty acids
Nitrofurantoin
Zonula occludens (tight junctions)
18. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Small prokaryotic cells; no histones; 70S ribosomes; no sterols in cell membrane; peptidoglycans in cell wall; replicate by binary fission
28 L - 40% of body weight
Type I hypersensitivity (anaphylactic)
Ribozymes
Bacteria
19. 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?
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20. Are the following responses associated with histamines H1 or H2 receptor activation? - Pain and pruritus
QRS complex
H 1
Vibrio cholera
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
21. What enzyme of the purine salvage pathway is deficient in the following? - Lesch - Nyhan syndrome
HGPRT
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Doxycycline
LTC4 - LTD4 - and LTE4
22. Which overdose carries a higher mortality rate - that of benzodiazepines or barbiturates?
Osteoporosis
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
Kinesins. Dynein generates retrograde transportation of information.
Volvulus
23. What are the first intermediate hosts for trematodes?
Snails
Dyslexia
Left coronary artery
Hemostasis
24. What parasympathetic neurotransmitter of the GI tract stimulates the release of gastrin?
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25. What two factors determine the clearance of a substance?
Plasma concentration and excretion rate
Saccule and utricle
Rhinoviruses for summer and fall; coronaviruses for winter and spring
H 1
26. Name the antidote - Lead
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
Cryptococcus
Inactivated
27. A 30-year - old woman goes to your office with bilateral multiple breast nodules that vary with menstruation and have cyclical pain and engorgement. What is your diagnosis?
Legionella (think air conditioners)
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Ovarian cancer
Tylosis
28. What is the term for the external urethra opening onto the dorsal surface of the penis?
Motor aspect
Biofeedback
Epispadia
Dorsal prefrontal cortex
29. What facultative intracellular fungus is associated with hepatosplenomegaly?
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
M3 (promyelocytic leukemia)
HPV
Hepatitis A (infectious)
30. What virus causes hoof - and - mouth disease?
Vesicular stomatitis virus
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Macule (e.g. - a freckle)
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.
31. Which streptococcal species is associated with dental caries and infective endocarditis in patients with poor oral hygiene?
EF- Tu or EF- ts and GTP
Stibogluconate
Streptococcus viridans
G-6- PD deficiency
32. When does most REM sleep occur - in the first or second half of sleep?
Gubernaculum
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
Primary spermatocyte
33. What cell surface modification of ependymal cells and respiratory epithelium has a 9 + 2 microtubular configuration and movement as its function?
Aminophylline
Cystadenocarcinoma
Cilia
DNA ligase
34. What is the MCC of the following meningitides? - In military recruits
Alanine and glutamine
Ligament of Treitz
Listeria monocytogenes
Neisseria meningitides
35. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral aqueduct
Mesencephalon
Isograft
Folic acid
X- linked recessive
36. Which of the following
Ethacrynic acid
Lead poisoning
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Poxvirus
37. Name the structure that enters or exits the following foramina: x Foramen magnum
Neomycin
CN XI - vertebral arteries
Ipsilateral loss at and below the level of the lesion
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
38. Can incidence - prevalence - and cause and effect be assessed in x Cross - sectional studies?
Rotavirus
Atrial contraction Atrial - Contraction - Venous
Cross - sectional studies determine prevalence - not incidence or cause and effect.
Alveolar dead space
39. What antiviral agents inhibit neuraminidases of influenza A and B?
Ciliary ganglion
Zanamivir and oseltamivir
Herpes II
Ganglioside
40. What Freudian psyche component is described as x The conscience - morals - beliefs (middle of the road)?
Pneumococcus (Streptococcus pneumoniae)
Measurement bias
Superego
Stratum spinosum
41. What is the most common one? - Primary malignant tumor of the ovary
Periaortic lymph nodes
CMV - Toxoplasma gondii - and Listeria
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
Serocystadenocarcinoma
42. Will a patient with a unilateral lesion in the cerebellum fall toward or away from the affected side?
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
C4 (the upper border of the thyroid cartilage)
Conversion disorder
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
43. Fracture of the fibular neck - resulting in foot drop - is an injury of what nerve?
Alzheimer disease
Common peroneal nerve
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.
High average
44. Is a membranous septal defect more commonly interventricular or interatrial?
Healing by secondary intention
Adenovirus
Pyloric stenosis
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.
45. What two factors result in the base of the lung being hyperperfused?
Diphyllobothrium latum
Hapten; if it is coupled with a carrier - it may become immunogenic.
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
46. What restriction endonuclease site is destroyed in sickle Beta- globin allele?
Formation of an identity through issues of independence and rebellion; they define who they are.
Plasmodium malariae; the others are tertian.
Primary hyperparathyroidism
MstII; changing codon 6 (from A to T) destroys the restriction site.
47. What type of collagen is associated with the basement membrane?
Thermogenic
Type IV collagen
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
Hypospadia
48. What is the only fatty acid that is gluconeogenic?
Ribozymes
Coronary circulation
Propionic acid
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
49. Why does carbon monoxide diffusion in the lung (DLCO) decrease in emphysema and fibrosis but increase during exercise?
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
Klinefelter syndrome
The respiratory system
Complex I
50. What hormone excess produces adrenal hyperplasia?
Constrictor pupillae and ciliary muscles
ACTH
Eosin
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.