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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. Name the type of necrosis - Soft - friable - cottage - cheese appearing; characteristically seen in TB
Specificity (it deals with the healthy)
Caseous necrosis
Vitamin B6
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.

2. Name the type of exudate - given the following examples - Parasitic infection
Common peroneal nerve
Altruism
Trichomonas vaginalis (treat with metronidazole)
Eosinophilic exudates

3. What is the most common one? - Pituitary tumor
Chromophobe adenoma
Group A Beta- hemolytic streptococci
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
Functions of hepatocytes

4. Name the associated chromosome - Neurofibromatosis type 1
Chromosome 17
C wave
Leiomyoma
Series circuit

5. What cells of the thyroid gland are stimulated in response to hypercalcemia?
1. Liver 2. Muscle 3. Adipose tissue
The raphe nuclei
eIF-2 in the P site
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.

6. What AD syndrome involves 1000 or more edematous polyps - most commonly affects the colorectal area - and is associated with chromosome 5q21?
Familial polyposis coli
CD15 and CD30
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)
Rheumatic fever

7. What enzyme catalyzes the rate - limiting step in glycogenolysis?
Prophase of meiosis I (between 12th and 22nd week in utero)
Hypocalcemia and hypophosphatemia
Glycogen phosphorylase
CD40

8. What happens to dopamine levels when we awaken?
Thymine (B1)
Eclipse period
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Medial midbrain (Weber's) syndrome

9. What statistical test - using nominal data only - checks whether two variables are independent events?
Progestins
Laminin
Snails
Chi - square (when you are in doubt and have nominal data - use chi - square)

10. Innervate the striated muscle of the bulbospongiosus and ischiocavernous muscles and result in ejaculation of semen.
CN XI and X
Somatic motor neurons
The left gastric - splenic - and common hepatic arteries
Microglia

11. What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
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
TCR
HMG- CoA reductase

12. When does cortisol secretion peak?
In early- morning sleep - usually between the sixth and eighth hours
ydroxyproline
Arginine
Medial meniscus

13. Name the type of mutation: x New codon specifies for the same AA
Serratia
They are in the grey matter of the CNS.
Silent
prior to birthThe foramen ovale closes just...

14. Which genus of dermatophytes is associated with the following sites of infection? - Skin - hair - and nails
Enkephalin
CHF
Trichophyton
Pseudomonas sp.

15. What nucleus - found in the intermediate zone of the spinal cord - sends unconscious proprioception to the cerebellum?

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16. Are more Abs produced in a primary or a secondary immune response?
More Ab is produced in less time in a secondary immune response (shorter lag period).
Mentally disabled
Squamous cell carcinoma of the lung
Onset of bleeding

17. What prevents the down - regulation of the receptors on the gonadotrophs of the anterior pituitary gland?
ydroxyproline
CD21; it is a complement receptor for cleaved C3
Bender Visual Motor Gestalt Test
The pulsatile release of GnRH

18. Name the macrophage based on its location: x Brain macrophages
Microglia
B- cell Ag receptors
With arteriolar constriction both the flow and pressure downstream decrease.
0.21; it is a fancy way of saying 21% of the air is O2.

19. What is the primary end product of pyrimidine synthesis?
Goodpasture syndrome
UMP
Gonads
Guanethidine and bretylium

20. Are the following responses associated with histamines H1 or H2 receptor activation? - Inotropic action and automaticity
Ovarian cancer
H 2
Northern blot
Increased androgen secretion at puberty drives the increased GH secretion.

21. What complement factor or factors are associated with x Membrane attack complex (MAC)?
Filiform papillae
C5- C9
Plasmodium falciparum
Superior and posterior

22. What is the term for making up stories regarding past experiences because of an inability to retrieve them?

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23. What type of Plasmodium affects x Only reticulocytes?
Internal iliac nodes
Hypoxia
Androgen - binding protein
Plasmodium vivax

24. Which organism releases endotoxins prior to cell death?
Anopheles mosquito
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
Early collecting duct
Neisseria meningitidis

25. What is the most common one? - Primary malignant tumor of the ovary
Prevalence rate
The Fc region of IgG and C3b
Pseudomonas aeruginosa
Serocystadenocarcinoma

26. Myelin is produced by which cells in the PNS? In the CNS?
Oblique fissure
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
Stratum corneum (keratinized)
a - and Beta- chains are on most T cells.

27. What operant conditioning therapy or modification is described as x Providing the person with information regarding his or her internal responses to stimuli with methods of controlling them?
Insulin
Alcoholics Anonymous
Biofeedback
1. Glycine 2. Aspartate 3. Glutamine

28. What blotting technique uses the following for analysis? - Protein
Western blot
Axon hillock
Labile
Type II

29. A patient can ______ a feeding tube.
refuse
Boutonni
Middle
Increase the concentration of enzymes

30. What genetic defect is characterized by coarse facial features - gingival hyperplasia - macroglossia - psychomotor and growth retardation - club foot - claw hand - cardiorespiratory failure - and death in the first decade of life?
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency
Lumbar splanchnics
CD4

31. What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
Osteoarthritis
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Atelectasis

32. What mineral is associated with hypothyroidism?
Unstable (crescendo) angina
Iodine (I)
In men it is prostate cancer - and in women it is breast cancer.
Streptococcus pyogenes

33. What is the only diuretic that works on the blood side of the nephron?
Multiple myeloma
Hematogenous
Spironolactone (binds to aldosterone receptors)
GP120

34. What is the most common form of dementia?

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35. What is the term for the type of pupil seen in neurosyphilis - and what ocular reflexes are lost?
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
14 L - 33% of body weight
REM latency; normally it is about 90 minutes.
Obese patients

36. What lower extremity nerve is described by the following motor loss? - Loss of eversion; inversion - dorsiflexion - and plantarflexion of the foot
Mild (50-70)
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
Common peroneal nerve
Disulfiram

37. What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis?
Agoraphobia. It also means having a sense of humiliation or hopelessness.
Swan - neck deformities
Guillain - Barr
The Fc region of IgG and C3b

38. What is the term for osteophyte formation at the proximal interphalangeal (PIP) joints in osteoarthritis? In the distal interphalangeal (DIP) joints?
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
VSD
Laminin
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.

39. RBCs in the urine
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
Phase I
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Bladder carcinoma

40. Which cerebral herniation results in compression of the anterior cerebral artery?
IgM
Cingulate gyrus herniation (subfalcine)
Gain of hypertonic fluid (mannitol or hypertonic saline)
Iodine - resulting in congenital hypothyroidism

41. Is T3 or T4 responsible for the negative feedback loop on to the hypothalamus and anterior pituitary gland?
Teeth grinding is associated with stage 2 sleep.
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.
Rhombencephalon
The subclavian artery

42. What embryonic structure forms the adult female structures? - Labia majora
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
Stereocilia
Metastatic calcification
Labioscrotal swelling

43. Neurofibrillary tangles
Alzheimer disease
Hypervariable region (three per light chain; three per heavy chain)
Staphylococcus aureus
Chromosome 4p

44. What tumor constitutes 40% of testicular tumors in children?
Superior
positive correlation
Teratoma
Mitochondria

45. What is the most common one? - Cardiac anomaly in children
Biotin - ATP - and CO2
PDA
H 1
Liver

46. Name the insulin preparation based on the peak effect and duration of action - Peak - 0.5 to 3 hours; duration - 5 to 7 hours
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase
60%
Regular insulin
Mycobacterium marinum

47. As what AAs do muscles send nitrogen to the liver?
Alanine and glutamine
Projective test. Most tests with a wide range of possibilities for the answers are projective.
Factitious disorder
G-6- PD deficiency; pyruvate kinase deficiency is second.

48. What embryonic structure forms the adult male structure? - Testes - seminiferous tubules - and rete testes
Giant cell tumor of the bone
Gonads
Liver (hepatocytes)
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain

49. What protozoal parasite results in dysentery with blood and pus in the stool - is transmitted via fecal - oral route - is diagnosed by cysts or trophozoites in the stool - and forms liver abscesses and inverted flask - shaped lesions in the large int
Entamoeba histolytica (treat with metronidazole)
Listeria monocytogenes
Arterioles
Semicircular duct

50. What structure or structures cross the diaphragm at x T10 level?
Prophase of meiosis I (between 12th and 22nd week in utero)
Axis IV
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12