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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. Eating fava beans can produce the Mediterranean type of what deficiency?
IL-7 (A 7 upside down is an L; L is for Lymphoid)
FSH and testosterone
G-6- PD deficiency
Stercobilin

2. Name the compartment of the mediastinum associated with the following thoracic structures: Splanchnic nerves
Vanillylmandelic acid (VMA)
Trichomonas vaginalis (treat with metronidazole)
Anterior compartment of the thigh - femoral nerve
Posterior

3. What is absorbed in the gallbladder to concentrate bile?
Alkaline phosphatase
Carbamazepine
Water
Adulthood

4. What neurotransmitter is essential for maintaining a normal BP when an individual is standing?
NE - via its vasoconstrictive action on blood vessels
Anopheles mosquito
Increased GABA levels decrease the likelihood of learned helplessness.
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)

5. What is the most common site for an aneurysm in cerebral circulation?
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia
Borderline
Reinforcement
Vitamin A is responsible for vision and epithelial health.

6. Signet ring cells
Sympathetic chain ganglion
Glucose and galactose
Gastric carcinoma
T wave

7. What AD dementia has a defect in chromosome 4 - onset between the ages of 30 and 40 - choreoathetosis - and progressive deterioration to an infantile state?
PKU
Huntington's chorea. (Death in 15-20 years - often via suicide.)
The sensory limb is via CN IX - and the motor limb is from CN X.
Preload. It is the load on a muscle Prior to contraction.

8. How is the eye affected by use of opioids?
The lateral vestibular nucleus
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
Hepatoma and nonseminomatous testicular germ cell tumors
Cancer

9. What is the most common cause of vitamin B6 deficiency?
Isoniazid treatment
Intercellular adhesion molecule (ICAM) 1
GABA and glutamic acid
Folate - vitamin B12 - and vitamin B6

10. What Ig mediates ADCC via K cells - opsonizes - and is the Ig of the secondary immune response?
Flutamide
IgG
Chromosome 4p
Osteosarcoma

11. What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?
Schistosoma haematobium
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.
Filiform papillae
G2 phase (gap 2)

12. T3 increases bone ossification through synergistic effect with what hormone?
Cirrhosis
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
LTC4 and LTD4
GH

13. When a person goes from supine to standing - what happens to the following? - Dependent venous pressure
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Celecoxib
The pH of CSF is 7.33 - acidotic.
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma

14. What phase of the menstrual cycle is dominated by estrogen? Progesterone?
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Carbamazepine
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)

15. What is the most common cancer diagnosed in men? In women?
Propranolol
Middle meningeal artery
In men it is prostate cancer - and in women it is breast cancer.
Fructose; both glucose and galactose are actively absorbed via secondary active transport.

16. Initiates rhythmic contractions associated with labor.
Oxytocin
Stercobilin
Thyroid hormones are necessary for conversion of carotene to vitamin A.
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino

17. What condition results in the following CSF results? - Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
Hematoxylin
Glucagon
Bacterial meningitis
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>

18. What is the stimulus for the classical pathway activation?
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>
Alcohol consumption
Clear cell

19. What is the term for a venous embolus in the arterial system?
Sensory
One - way ANOVA
refuse
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.

20. What statistical test compares the means of many groups (>2) of a single nominal variable by using an interval variable?
One - way ANOVA
Sucralfate
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
Excess estradiol in the blood

21. What cell type is commonly elevated in asthma?
Eosinophil
Aschoff bodies of rheumatic fever
Waterhouse - Friderichsen syndrome
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids

22. What purine base is contained in inosine monophosphate?
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
F- Met - Peptides
Catatonic schizophrenia
CN IX

23. What AA is a precursor of the following substances? - N2O
Western blot
Arginine
RBCs. That is why it is called red pulp.
Basophilic stippling

24. What acid - base disturbance is produced from vomiting?
Membranous glomerulonephritis
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.
Common and internal carotid arteries
The venae recta maintain the gradient via countercurrent flow.

25. Is it acceptable to lie - even if it protects a colleague from malpractice?
Sporothrix schenckii
Purkinje cell is the fastest - and the AV node is the slowest.
No - it is never acceptable to lie.
Prevalence rate

26. What disorder is characterized by a depressed mood and a loss of interest or pleasure for more than 2 years?
Y - W-135 - and C and A capsular polysaccharides
Voltage - gated sodium channel
Constrictor pupillae and ciliary muscles
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)

27. What enzyme - induced by insulin and activated by apo C- II - is required for chylomicron and VLDL metabolism?
Positive
Lipoprotein lipase
Roth spots
Rhabdovirus

28. Why will turbulence first appear in the aorta in patients with anemia?
Type II hypersensitivity (cytotoxic)
Juxtaglomerular (JG) cell
Because it is the largest vessel and has the highest velocity in systemic circulation
Lispro insulin

29. How does sympathetic stimulation to the skin result in decreased blood flow and decreased blood volume? (Hint: what vessels are stimulated - and how?)
Hemochromatosis
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.
Visceral pleura
Breast cancer

30. In prokaryotes - What is the name of the RNA sequence that ribosomes bind to so translation can occur?
Nucleus pulposus
Somatoform disorder
Dominant parietal lobe (Gerstmann's syndrome)
Shine - Dalgarno sequence

31. What type II hypersensitivity disorder is defined as x Autoantibodies directed against RBC Ag I?
Autoimmune hemolytic anemia
Ovarian fibroma
Caseous necrosis
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?

32. What is the term for a large - immature RBC that is spherical - blue - and without a nucleus?
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
Homeodomain proteins
NREM sleep. Night terrors are dreams that we are unable to recall.
Reticulocyte

33. What is the site of action of the following? - Osmotic diuretics
Type IV collagen
Pseudomonas aeruginosa
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.
The entire tubule barring the thick ascending limb

34. When a patient closes the eyes while standing with feet together - the visual and cerebellar components of proprioception are removed - so you are testing the dorsal columns. Swaying with eyes closed is a positive Romberg's sign indicating a lesion i
Pontocerebellar angle syndrome
By asking a patient to close the eyes while standing with feet together
Peutz - Jeghers syndrome
Agglutination test

35. Name the period described by the following statement: no matter how strong a stimulus is - no further action potentials can be stimulated.
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Absolute refractory period is due to voltage inactivation of sodium channels.
Chromosome 5 - 21
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid

36. What is the epithelial cell lining the nasopharynx?
Internal carotid artery and sympathetic plexus
Spironolactone (binds to aldosterone receptors)
Site 1
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.

37. What is the respiratory compensation mechanism for metabolic alkalosis?
Macule (e.g. - a freckle)
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
PRPP aminotransferase

38. Is excretion greater than or less than filtration for net secretion to occur?
Excretion is greater than filtration for net secretion to occur.
Asparagine
Glycerol kinase
Temporal lobe

39. Males are more likely to develop _______ than females.
Early collecting duct
45XO
5- hydroxyindoleacetic acid (5- HIAA)
Femoral hernias

40. In what stage of psychosexual development - according to Freud - do children resolve the Oedipus complex?
Latency stage (6-12 years)
1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors
Doxycycline and minocycline
Kidney

41. Can committed mentally ill patients refuse medical treatment?
17- alpha - Hydroxylase deficiency
Yes. The only civil liberty they lose is the freedom to come and go as they please.
Decreasing potassium conductance - which results in increased excitability
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)

42. What blotting technique uses the following for analysis? - RNA
Northern blot
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Megaloblasts
Neisseria meningitides

43. What vitamin deficiency is evidenced by poor wound healing - loose teeth - bleeding gums - petechiae - and ecchymosis?
Urogenital sinus
Acetaminophen
Vagus nerve
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)

44. What is the term to describe a man who has x The ability to have an erection sometimes and other times not?
Motilin
Dysplasia
Ventral anterior nucleus
Selective erectile disorder

45. Which hepatitis strain is a defective virus that can replicate only inside HBV- infected cells?
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
Hepatitis D
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
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.

46. What region of the brain houses the central chemoreceptors responsible for control of ventilation?
The surface of the medulla
Accommodation
EF- G of the 50S subunit
Clostridium tetani

47. Name the antidote - Anticholinergics
Prophase of meiosis I (between 12th and 22nd week in utero)
IgG
pH of 2 and 9
Physostigmine

48. All aluminum - containing antacids can cause...
hypophosphatemia
Stage 2
Malignant mesothelioma
At least 5 lobes

49. Name the ocular lesion; be specific - A right LGB lesion (in the thalamus)
Cortisol - a 21- carbon steroid - has a - OH group at position 17.
Left homonymous hemianopsia
Glycogen synthase
Choriocarcinoma

50. What disconnect syndrome results from a lesion in the corpus callosum secondary to an infarct in the anterior cerebral artery - so that the person can comprehend the command but not execute it?

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