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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 Freudian psyche component is described as x The urges - sex aggression - and 'primitive' processes?
Id (pleasure principle)
The kidneys excrete the excess nitrogen from the body as urea in the urine.
It is produced by the preload on the muscle prior to contraction.
Myelofibrosis with myeloid metaplasia

2. Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
EF-2 and GTP
Bile salts are actively reabsorbed in the distal ileum.
Ureaplasma urealyticum
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.

3. Are the JG cells of the nephron a part of the afferent or efferent arteriole?
Propionibacterium acnes
Mesocortical area
Afferent arteriole
Hepatic adenomas

4. What hormone excess brings about abnormal glucose tolerance testing - impaired cardiac function - decreased body fat - increased body protein - prognathism - coarse facial features - and enlargements of the hands and feet?
ACh - histamine - and gastrin
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
Increased secretion of GH postpuberty leading to acromegaly.
Chromosome 14 - 18

5. By What age should children be able to draw the following figures? - Circle
Coombs test
3 years old
Gastrinoma
Beryllium

6. Is increased in 21-Beta- hydroxylase deficiency.
Renin secretion
Permanent
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
Labioscrotal swelling

7. What is the drug of choice - which inhibits oxidative phosphorylation in cestodes - for taeniasis?
Superior and posterior
Niclosamide
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Infrapatellar bursa

8. What sided muscle weakness is seen in an UMN corticospinal tract injury above the pyramidal decussation?
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
VSD - RVH - overriding aorta - and pulmonary stenosis
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.

9. From Where is the energy for gluconeogenesis derived?
Beta- Oxidation of fatty acids
Ethyl alcohol
Thyroid hormones are necessary for conversion of carotene to vitamin A.
Vesicular stomatitis virus

10. What antiviral agents inhibit neuraminidases of influenza A and B?
Zanamivir and oseltamivir
Vimentin
Trimethoprim
Adult polycystic kidney disease

11. What type of chromatin is transcriptionally active?
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
The Purkinje cell
EBV
Staphylococcus aureus

12. What is the term for pelvic inflammatory disease of the fallopian tubes?
When the intra - alveolar pressure equals zero - there is no airflow.
Internal 3' - 5' PDE bonds
Salpingitis
Staphylococcus aureus (but they are more prone to salmonella infections)

13. What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
Left homonymous hemianopsia
GLUT 3 and 4

14. What DNA replication enzyme breaks the hydrogen bond of base pairing - forming two replication forks?
Major
Helicase (requires ATP for energy)
gag gene
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.

15. Are resistant to the effects of aminoglycosides.
Mast cells
Vimentin
Melatonin - serotonin - and CCK
Anaerobes

16. In what pathway of the basal ganglia do lesions result in hyperactive cortex with hyperkinetic - chorea - athetosis - tics - and dystonia?
ACL
Limbic system
Hepatitis D
Indirect pathway (Tourette syndrome for example)

17. Does light or darkness regulate the pineal gland?
Helicase (requires ATP for energy)
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
Preload (the load on the muscle in the relaxed state)

18. What Beta- blocker is also a membrane stabilizer?
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
Propranolol
Without children (but don't think about this one for too long)

19. Does the direct or indirect basal ganglia pathway result in a decreased level of cortical excitation?
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).
Glucocerebrosidase
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.

20. Name the most common type or cause - Nephritic syndrome in children
Methionine (start) and tryptophan are the only two AAs with only one codon.
Kayser - Fleischer rings
Rheumatoid arthritis
Minimal change disease

21. Which bacteria are associated with the following pigment production? - Black - gray pigmentation
Grasp proceeds release
Corynebacterium diphtheriae
Histoplasma capsulatum
The rate of Beta- oxidation

22. What is the most common one? - Solid tumor in children
Ticlopidine or clopidogrel
Neuroblastoma
Left eye anopsia (left nasal and temporal hemianopsia)
First - order elimination

23. Name the macrophage based on its location: x Brain macrophages
Metastatic
Microglia
Chief cell adenoma (80%)
Female pseudohermaphrodite

24. What is the most common one? - Complication of nasogastric tube feeding
Impaired ejaculation
Aspiration pneumonia
Case control studies cannot assess incidence or prevalence - but they can determine causal relationships.
Osteosarcoma

25. What is the largest nucleus in the midbrain?
1. Protest 2. Despair 3. Detachment
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
Posterior
Clonidine

26. What is the MCC of the following endocarditis scenarios? - Post dental work
ater flows from a low - solute to high - solute concentrations.
Streptococcus viridans
Cardiac output
PCT

27. What is the name for failed recanalization of the duodenum resulting in polyhydramnios - bile - containing vomitus - and a distended stomach?
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Acting out
Streptococcus pyogenes
Duodenal atresia

28. Name the aphasia based on these characteristics: x Lesion is in the parietal lobe or arcuate fibers because the connection between Broca's and Wernicke's area is severed; word comprehension preserved; inability to write or speak the statement (can't
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.
G-6- PD deficiency; pyruvate kinase deficiency is second.
Conduction aphasia
gag gene

29. What phase of the menstrual cycle is dominated by estrogen? Progesterone?
Lateral cricoarytenoid muscles
Lipoprotein lipase
Tip of the left ventricle
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.

30. What is the most common one? - Valve abnormality associated with rheumatic fever
Free ionized Ca2+
Ventral posteromedial nucleus
Correlation. No - correlation does not imply causation.
Mitral valve stenosis

31. What protein - losing enteropathy has grossly enlarged rugal fold in the body and fundus of the stomach in middle - aged males - resulting in decreased acid production and an increased risk of gastric cancer?
M
None; it degenerates.
The raphe nuclei
Lower lobe

32. Which serotypes of HPV are associated with plantar warts?
Asbestosis and silicosis
Atrial filling (venous filling) Atrial - Contraction - Venous
HPV serotypes 1 and 4
Apoptosis (Remember - there is a lack of inflammatory response.)

33. Do the following structures pick up stain from hematoxylin or eosin? - Cytoplasm
The second pharyngeal pouch and groove
Shortens
Eosin
Primary hypoaldosteronism (Addison's disease)

34. Name the most common cause - Croup
Parainfluenza virus
CN XI - vertebral arteries
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Phallus

35. What aerobic branching rod that is gram positive and partially acid - fast is associated with cavitary bronchopulmonary disease in immunosuppressed patients?
Nocardia asteroides
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
Filiform papillae

36. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Alkylating agents
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages
Leukemias and lymphomas
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine

37. What vascular injury may result from a supracondylar fracture of the femur?
Aedes mosquito
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)

38. What toxicities are caused by the following agents? - Methoxyflurane
Atropine with pralidoxime
Prolactinoma
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Nephrotoxicity

39. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 and int -2
Aged adult
Melanoma - cancer of the stomach and bladder
Lethal dose for 50% of drug takers (median lethal dose)
Terbinafine

40. What is the start codon - and What does it code for in eukaryotes? Prokaryotes?
Common and internal carotid arteries
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get
Clearance

41. What determines the overall force generated by the ventricular muscle during systole?
Allopurinol
apo A-1
Area 8
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.

42. What ocular ganglion is affected if the pupil on the affected side sluggishly responds to light with normal accommodation?
Cytosine
Ciliary ganglion producing a tonic pupil
Severe (range 20-34)
Middle meningeal artery

43. Which class of antiarrhythmics blocks sodium channels?
Class 1 (1A - 1B - and 1C)
Klebsiella pneumoniae
Bladder carcinoma
Sideroblastic anemia

44. What X- linked recessive immune disorder is characterized by recurrent infections - severe thrombocytopenia - and eczema?
Hemophilia B
Right brachiocephalic artery
Wiskott - Aldrich syndrome
VIPoma

45. At what stage of cognitive development (according to Piaget) do children x Lack law of conservation and be egocentric?
Amyl nitrate - sodium nitrate - or sodium thiosulfate
Plasmin
Preoperational (2-6 years)
H 2

46. What enzyme is deficient in hereditary protoporphyria?
Mitosis
Carnitine acyltransferase - I
Oligodendroglioma
Ferrochelatase

47. Is a marker for increased bone formation.
B cells; macrophages and dendritic cells are nonspecific.
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
An elevated serum osteocalcin level
Sigmoid colon

48. Describe the organism based on the following information: x Beta - hemolytic Streptococcus sensitive to bacitracin
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
Epinephrine
Streptococcus pyogenes
ater flows from a low - solute to high - solute concentrations.

49. What is the biochemical trigger for REM sleep?
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
NREM sleep. Night terrors are dreams that we are unable to recall.
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
Cingulate gyrus herniation (subfalcine)

50. If you double the infusion rate of a drug - how long will it take to reach steady state?
Compliance (think of it as distensibility)
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Haemophilus influenzae type B
Chi - square.