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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 does hepatitis D virus need from hepatitis B virus to be infective?
Epidermophyton
HBsAg as its envelope
NH4+(ammonium)
Thymus - independent Ags

2. What component of the ETC is inhibited by the following? - CO
Salmonella typhi
Yersinia pestis
Cytochrome a/a3
ALA dehydrogenase and ferrochelatase

3. In prokaryotes - What is the term for a set of structural genes that code for a select group of proteins and the regulatory elements required for the expression of such gene?
Operon
Western blot
Thiazide diuretics
Glossopharyngeal nerve

4. What hereditary bone disorder is due to decreased osteoclast function - resulting in thick - sclerotic bones that fracture easily?
Osteopetrosis (Albers - Sch
Red blood cell distribution width index (RDW)
Shortens
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -

5. The vertebral artery is a branch of What artery?
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.
The subclavian artery
Enterobius vermicularis; the treatment is albendazole.
Buffers (remember that buffers are best when they are used in a pH range near its pK)

6. What agent used in the treatment of BPH and baldness is a 5- a - reductase inhibitor?
Histoplasma capsulatum
Cross - sectional studies determine prevalence - not incidence or cause and effect.
CN X (Remember - the vagus nerve supplies the parasympathetic information from the tip of the pharynx to the end of the midgut and all between.)
Finasteride

7. The surge of what hormone induces ovulation?
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Aldosterone
Cervical neoplasia
LH

8. If one event precludes another event - their probabilities are combined By what method?
Thiamine and folate
Left atrial myxoma
Rotavirus
Addition (They are mutually exclusive.)

9. What carcinoma produces hematuria - flank pain - and a palpable mass?
Glucose and galactose
This is the triad of renal cell carcinoma
Four high energy bonds - two from ATP in AA activation and two from GTP
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.

10. Abs to what hepatitis B Ag provide immunity?
Metronidazole
Abs to HBsAg
PRPP aminotransferase
Chromium (Cr)

11. What is the site of action of the following? - Osmotic diuretics
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe
Stratum corneum (keratinized)
The entire tubule barring the thick ascending limb
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.

12. Name the Hgb - O2 binding site based on the following information: x Least affinity for O2; requires the highest PO 2 levels for attachment (approx. 100 mm Hg)
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.
PDA
Site 4
Hepatic glycogen phosphorylase

13. What is the first formal IQ test used today for children aged 2 to 18?
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Eclipse period
Pseudogout
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.

14. What aerobic branching rod that is gram positive and partially acid - fast is associated with cavitary bronchopulmonary disease in immunosuppressed patients?
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
Nocardia asteroides
DiGeorge's syndrome
Adhesions and hernias

15. What is the DOC for the following protozoal infections? - Amebiasis
Medial umbilical ligaments
Metronidazole
Calcium influx secondary to slow channel opening
ACE inhibitors (the - pril agents)

16. What is the most common one? - Pancreatic islet cell tumor
PPRF
Herpesvirus
Insulinoma
Eclipse period

17. What is the lecithin:sphingomyelin ratio in respiratory distress syndrome of newborns?
<2
Urinary trigone
Negative correlation
QRS complex

18. What sided muscle weakness is seen in an UMN corticospinal tract injury above the pyramidal decussation?
Aldosterone
16S subunit
Stable
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.

19. Name the most common type or cause - Infection in a patient on a ventilator
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.
Internal iliac nodes
Pseudomonas aeruginosa
Folate - vitamin B12 - and vitamin B6

20. What complement factor or factors are associated with x Chemotaxis?
As sample size increases - the lower the chance of error.
Gastrinoma
C5a
Alveolar macrophages

21. Name these cluster A personality disorders: x Odd - strange; has magical thinking; socially isolated - paranoid - lacks close friends; has incongruous affect
Frontal lobe
Mitochondria - linked disorders are always inherited from the mother.
Lung cancer
Schizotypal

22. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 and int -2
Estriol
Melanoma - cancer of the stomach and bladder
Takayasu arteritis (medium - size to large vessels)
Cefamandole - cefoperazone - and moxalactam

23. What disorder is associated with loss of polarity - anaplasia - pleomorphism - discohesiveness - increase in the nuclear:cytoplasmic ratio - hyperchromasia - and increase in the rate of mitosis?
Necrotizing enterocolitis
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)
Blood
Malignancy

24. What is the difference between a Ghon focus and a Ghon complex?
Squamous cell carcinoma
a - Methyldopa (Guanabenz or clonidine is also used.)
Frontal lobe syndrome (lesion in the prefrontal cortex)
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.

25. Name the most common type - Learning disability
Dyslexia
The right gonadal vein drains into the inferior vena cava directly - and the left gonadal vein drains into the left renal vein.
Sublimation
X- linked recessive

26. Name the T- cell CD marker: x Interacts with MHC class II molecules
CD4
cDNA - when it is made from mRNA
Bainbridge reflex
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.

27. Which potassium - sparing drug is an aldosterone receptor antagonist ?
Spironolactone
The vaccine contains 23 capsular polysaccharides.
Clozapine
Anterior wall of the first part of the duodenum

28. What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur - humerus - and tibia?
Staphylococcus
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.
Dissociative fugue. (Patients are unaware of memory loss.)
Caisson disease

29. What embryonic structure forms the adult male structure? - Corpus cavernosus - corpus spongiosum - and glans and body of the penis
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
Phallus
Impotence

30. The clearance of what substance is the gold standard of GFR?
Inulin
Purine nucleoside phosphorylase
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Mesocortical area

31. What structure of the knee is described thus? - Prevents abduction
Medial collateral ligament
Chief cells
Bulla
Adenocarcinoma

32. What DNA replication enzyme breaks the hydrogen bond of base pairing - forming two replication forks?
Helicase (requires ATP for energy)
IL-4
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting). The needle is part of the blood - drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in th
Aspartate transcarbamylase

33. What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?
Reticulocyte
Necrotizing enterocolitis
Transverse abdominis
Syringomyelia

34. Without ADH the collecting duct would be...
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
The notochord
The fastigial nucleus
impermeable to water

35. What is the most common one? - Benign GI tumor
Leiomyoma
Streptococcus pyogenes
Selective erectile disorder
Hapten; if it is coupled with a carrier - it may become immunogenic.

36. What is the term for flattened nose - low - set ears - and recessed chin seen in patients with bilateral renal agenesis?
Potter facies
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Diphyllobothrium latum

37. What neuropsychologic test has five basic scales testing for the presence and localization of brain dysfunction?
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.
Right medial longitudinal fasciculus
All are lactose fermenters except Yersinia and Proteus.
Akathisia

38. What is the term for RBC remnants of nuclear chromatin in asplenic patients?
Howell - Jolly bodies
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.
Persistent truncus arteriosus
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids

39. Which M- protein strain of Streptococcus pyogenes is associated with acute glomerulonephritis?
M12 strains
EF- Tu and EF- Ts of the 30S ribosomal subunit
Sphingosine
IL-8 (IL-1 and TNF- gamma also)

40. What is the only diuretic that works on the blood side of the nephron?
Cortisol
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Spironolactone (binds to aldosterone receptors)
Azathioprine

41. Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
Thiamine
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
Auspitz sign
1. Tinea coli 2. Haustra 3. Epiploic appendages

42. Leukopenia - neutropenia - and mental deterioration are signs of what mineral deficiency?
Ag - Ab binding
Copper
Superior
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c

43. What is the signal to open the voltage - gated transmembrane potassium channels?
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
antiemetic
1. Liver 2. Muscle 3. Adipose tissue

44. What is the most common one? - Vasculitis
Temporal arteritis
High average
Anterior wall of the first part of the duodenum
Coccidioides immitis

45. Which type of hepatitis can cause hepatocellular carcinoma?
Hepatitis B
Turner syndrome
Somatoform pain disorder
Ventricular contraction Atrial - Contraction - Venous

46. What are the three branches of the lateral cord of the brachial plexus?
Flucytosine
Spinal trigeminal nucleus
Superficial spreading melanoma
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus

47. What statistical test - using nominal data only - checks whether two variables are independent events?
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
MEN III (or IIb)
Chi - square (when you are in doubt and have nominal data - use chi - square)

48. What cell type of the body or fundus of the stomach secretes IF?
Parietal cells (Remember - they secrete HCl - too.)
Childhood
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
The reduviid bug

49. At which three sites in the body is T4 converted to T3?

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50. What type of resistance system (i.e. - high or low) is formed when resistors are added in parallel?
Metronidazole
A low - resistance system is formed by resistors added in parallel.
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
Breast cancer