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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 site of action of the following? - Osmotic diuretics
Herpesvirus
Trypsin
CD40 ligand
The entire tubule barring the thick ascending limb

2. 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)?
Hairy cell leukemia
Glucagon and epinephrine
Medullary carcinoma of the thyroid
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.

3. What vitamin is needed for the production of heme?
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Low average
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>
Pyridoxine (B6)

4. When does the primitive gut herniate out of the embryo? When does it go back into the embryo?
6 weeks 10 weeks
Phenylalanine hydroxylase
Alzheimer disease
IgG

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

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6. What is the term for new made - up words?

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7. Name the type of exudate - given the following examples - Diphtheria infection
Pterygopalatine ganglion (I remember this as the only ganglion left.)
Neisseria meningitides
Pseudomembranous exudates
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.

8. What is the term for hyphae with constrictions at each septum that are commonly seen in Candida albicans?
Two - way ANOVA. It allows the test to check several variables at the same time.
Pseudohyphae
FSH
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.

9. Name the product or products of arachidonic acid: x Vasodilation - bronchospasm - and increased vascular permeability
Yolk sac tumor
LTC4 - LTD4 - and LTE4
Cancer of the lung - stomach - colon - and breast
Hyperpolarization (i.e. - K+ influx)

10. How many days prior to ovulation does estradiol peak in the menstrual cycle?
2 days prior to ovulation
Axis V
Aminophylline
Patent urachus

11. Cannot be diagnosed until puberty.
Klinefelter syndrome
Fibrocystic change of the breast
Prostatic carcinoma
Liver - kidney - and GI epithelium

12. What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting - fissuring - and oozing?
Superior and middle
VLDL
Paget disease of the breast
Chromosome 17

13. Results in vitamin B12 deficiencies.
Removal of the ileum
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.

14. What part of the heart forms x Base?
Popliteus
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
Left atrium and tip of the right atrium
Ribonucleotide reductase

15. What type of cell can never leave the lymph node?
3 months of symptoms in 2 consecutive years
Pheochromocytoma
Tay- Sachs disease
Plasma cell

16. Name the compartment of the mediastinum associated with the following thoracic structures: Descending aorta
Posterior
9.3 L - 15% of body weight
NSAIDs
Dimercaprol

17. Which medication used in the treatment of bipolar disorder decreases the release of T 4 from the thyroid gland?
Lithium
Type II hypersensitivity reaction
Neuroblastoma
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)

18. Name the four ventral mesentery derivatives.
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
First - order elimination
Anhedonia

19. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ increased - Pi decreased
Atrial filling (venous filling) Atrial - Contraction - Venous
Primary hyperparathyroidism
Spironolactone
gram positive

20. Name the compartment of the mediastinum associated with the following thoracic structures: Azygos vein
Hypoxia
Acetaminophen
Superior and posterior
Proximal to distal progression

21. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x c - myc
Secondary hypocortisolism (pituitary)
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
It forms a germinal tube at 37
Burkitt lymphoma

22. Name these anxiety defense mechanisms: x Separating oneself from the experience. The facts are accepted but the form is changed for protection.
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP
Dissociation
BPH
Th2 cells

23. Name the most common cause - Chronic pancreatitis
Alcohol abuse
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Carbamazepine
Range

24. Which penicillin can cause interstitial nephritis?
1. Sleep paralysis 2. Hypnagogic hallucinations (while falling asleep) 3. Sleep attacks with excessive daytime sleepiness 4. Cataplexy (pathognomonic) Narcolepsy is a disorder of REM sleep - with REM occurring within 10 minutes of sleep.
HMP shunt
Being awake
Methicillin

25. What childhood pathology involves anterior bowing of the tibia - epiphyseal enlargements - and costochondral widening - with the endochondral bones being affected?
Residual volume (RV)
Pia mater
Rickets
Stereocilia

26. What is the most common one? - Esophageal carcinoma
Squamous cell carcinoma
CD14
No - unsaturated fatty acids have double bonds.
Homogentisic oxidase

27. Can be secreted.
1. Big 2. Bilateral 3. Berry aneurysm
B- cell Ag receptors
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
Knee

28. What two pituitary hormones are produced by acidophils?
C3 deficiency
Left colic - superior rectal - and sigmoidal arteries
GH and prolactin are produced by acidophils; all others are by basophils.
Methanol

29. Fact without feeling (la belle indiff
Isolation of affect
Langerhans cells (found in the stratum spinosum)
Paget disease (osteitis deformans)
Lateral compartment of the leg - superficial peroneal nerve

30. Readily diffuses across the blood - brain barrier.
Glucose
Positive
Purine nucleoside phosphorylase
Hydroxyapatite

31. What vessel does the right gonadal vein drain into?
Dependent
Short - chain fatty acids
The right gonadal vein drains into the inferior vena cava directly - and the left gonadal vein drains into the left renal vein.
Sarcoplasmic reticulum

32. What ascending sensory system carries joint position - vibratory and pressure sensation - and discriminative touch from the trunk and limbs?
The DCML system. (Remember - everything but pain and temperature.)
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
Amantadine
Sheehan syndrome

33. What is the MCC of the following meningitides? - In adults
Streptococcus pneumoniae
Flumazenil
Patent urachus
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.

34. What is the most common one? - Bladder tumor
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
Altruism
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
Transitional cell carcinoma

35. What is the term for a deficiency or absence of sexual fantasies or desires?
Hypoactive sexual desire disorder
gram positive
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.

36. What AA is broken down into N2O - causing an increase in cyclic guanosine monophosphate (cGMP) of smooth muscle - hence vasodilation?
IF
Lesch - Nyhan syndrome
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
Arginine

37. What is the most superficial layer of the epidermis?
unprocessed Ags
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Stratum corneum (keratinized)
RSV

38. Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
M 2
Masochism
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies
Shaping (successive approximation)

39. What fungus causes endocarditis in IV drug users?
Ungated potassium channel
Campylobacter jejuni
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
Candida albicans

40. How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery?
G1 phase; G2 and S phase are diploid (2N).
Aldolase B deficiencies are treated by eliminating fructose from the diet.
Rickets
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.

41. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x alpha - Fetoprotein
GnRH
Hepatoma and nonseminomatous testicular germ cell tumors
Transtentorial (uncal)
Calicivirus

42. Name the product or products of arachidonic acid: x Vasoconstriction and platelet aggregation produced by platelets
TXA2
Atropine - 2- PAM (pralidoxime)
Th2 cells
Osteoporosis

43. What protein prevents ssDNA from reannealing during DNA replication?
Chemotaxis
Boutonni
Single - strand DNA binding protein
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)

44. What diseases are associated with HLA- DR4
Medullary carcinoma of the thyroid
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
Thymus gland. (Thymus gland is essential for T cell maturation.)

45. What factors are needed for translocation in eukaryotes?
EF-2 and GTP
Histidine
The conversion of CHO to pregnenolone via the enzyme desmolase
Elevated ASO titers and serum complement levels

46. Regarding the Lac operon - for What do the following genes code? - A gene
Infection
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
Primary biliary cirrhosis
Thiogalactoside transacetylase

47. What is the most common primary malignant tumor in bone?
Osteosarcoma
The first trimester
Depolarization (i.e. - Na+ influx)
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.

48. What are the four posttranslational modifications done by the Golgi apparatus?
Major
Short - chain fatty acids
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
Zero - order elimination

49. How many pairs of spinal nerves are associated with x Thoracic vertebrae?
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.
Pseudomembranous exudates
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
Meningocele All except occulta cause elevated - fetoprotein levels.

50. The surge of what hormone induces ovulation?
RES(Reticular endothelial system)
pI (isoelectric point)
LH
Hemangioma (benign)