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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. Avidin decreases the absorption of what vitamin?
Haemophilus influenzae type B
a - Methyldopa (Guanabenz or clonidine is also used.)
H1 histones
Biotin. Avidin is found in raw egg whites.

2. What part of the heart forms x Base?
Left atrium and tip of the right atrium
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).
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Dynorphin

3. What condition results in the following CSF results? - Opening pressure 100 mm H2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17
Demeclocycline
Pituitary adenoma
igantism
Viral meningitis

4. What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
Fitz - Hugh - Curtis syndrome
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Lateral medullary (Wallenberg's) syndrome

5. What vertebral level is marked by the xiphoid process?
Superior gluteal nerve
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Listeria monocytogenes
T9

6. What is the term for the number of Ag - binding sites on an Ig?
Valence
Red blood cell distribution width index (RDW)
Bronchiectasis
Type II pneumocytes

7. What variant of polyarteritis nodosa is associated with bronchial asthma - granulomas - and eosinophilia?
Kidney
Churg - Strauss syndrome
Two major or one major and two minor
GERD

8. Clarke's nucleus is the second ascending sensory neuron of which spinocerebellar tract?
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
MGB

9. Which type of hepatitis can cause hepatocellular carcinoma?
Hepatitis B
Mast cells
Craniopharyngioma
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.

10. Where is renin produced?
Papillary carcinoma of the thyroid
In the JG cells of the kidney
HBeAg
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed - thereby increasing the secretion of prolactin.

11. What is the primary screening test used to detect HIV- infected individuals? Confirmatory test?
Gout
ELISA is used as a screening test because it is very sensitive; Western blot is used as a confirmatory test because it detects antibodies (protein) to the HIV virus.
HHV-8
Transferrin

12. What subset of CD4 T cells is responsible for mast cell and eosinophil precursor proliferation?
Th2 cells
>10 mm
NSAIDs
Multiple myeloma

13. What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia?
Gonorrhea
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
S phase
Chloramphenicol

14. Based on operant conditioning - What type of reinforcement is described when x Removing a stimulus stops a behavior?
Chromosome 15 - 17
Extinction
Somatomedins (IGF-1)
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.

15. What germ cell tumor is seen in the 15- to 35-year - old age group - peaks when the person is 35 years of age - and is a bulky mass that spreads via the lymphatic system?
Gradient - time system
Boutonni
Down syndrome (trisomy 21)
Seminoma

16. Which organisms have polycistronic mRNA?
Prokaryotes. Polycistronic and prokaryotes both start with P.
Arterioles have the largest drop - whereas the vena cava has the smallest pressure drop in systemic circulation.
Yolk sac tumor
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells

17. What branch off the vertebral artery supplies x The cerebellum and the dorsolateral part of the medulla?
Arcuate line
PICA
Lateral collateral ligament
Prostatic carcinoma

18. What is the most common one? - Malignancy of the female genital tract
Pancreatic delta - cell tumors inhibit CCK secretion
Meclizine
Endometrial cancer
Type III hypersensitivity (immune complex)

19. What negative sense RNA virus is associated with intracytoplasmic inclusion bodies called Negri bodies?
Streptococcus viridans
Rabies
Extinction
Chromosome 21

20. Abs to what hepatitis B Ag provide immunity?
Abs to HBsAg
C1 inhibitor (C1- INH)
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.
Cysticerci

21. Does O2 or CO2 have a higher driving force across the alveolar membrane?
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
Rotavirus
O2 has a higher driving force but is only one - twenty- fourth as soluble as CO2. CO 2 has a very small partial pressure difference across the alveolar membrane (47-40 = 7 mmHg) - but it is extremely soluble and therefore diffuses readily across the
Tyramine

22. What phase of the cell cycle are the following antineoplastic agents specific for? - Hydroxyurea
Sinus venosus
Major
Microsporum
S phase

23. What is the term to describe the limited portion of an Ag that is recognized by an Ab?
Antigenic determinant (epitope)
Major
Squamous cell carcinoma
Visceral pleura

24. For what disease are SS- A(Ro) - SS- B(La) - and R- ANA diagnostic markers?
Osteosarcoma
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
Sj
MstII; changing codon 6 (from A to T) destroys the restriction site.

25. What portion of the pericardium adheres to the tunica adventitia of the great vessels?
Fibrous pericardium
Previous suicide attempt
Nucleus pulposus
Bulla

26. What three carcinomas are associated with EBV?

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27. Which three organisms cause heterophilic negative mononucleosis?
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
Aminoglycosides
CMV - Toxoplasma gondii - and Listeria
Transcription factor IID

28. From What aortic arch are the following structures derived?
Spleen
A right CN V lesion results in weakened muscles of mastication - and the jaw deviates to the right.
HPV serotypes 6 and 11
Common and internal carotid arteries

29. What is the term for formation of a stable fibrin - platelet plug to stop bleeding?
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
Hypothyroidism. (TSH levels must be monitored.)
Hemostasis

30. What causes a skeletal muscle contraction to terminate?
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Erythema multiforme
Priapism
Bronchiectasis

31. Name these anxiety defense mechanisms: x Separating oneself from the experience. The facts are accepted but the form is changed for protection.
HBcAb IgG - HBV- DNA - HBeAg - HBsAg
DNA polymerase -?
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).
Dissociation

32. What T- cell surface projection recognizes and reacts to foreign Ags (presented by APCs)?
T cells - not B cells
TCR
well - fed and fasting
a - and Beta- chains are on most T cells.

33. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x c - myc
Lipoprotein lipase
Phentolamine and phenoxybenzamine
Burkitt lymphoma
H 2

34. How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented?
At least 5 lobes
Repolarization is from base to apex and from epicardium to endocardium.
Shigella
Testicular lymphoma

35. T3 increases bone ossification through synergistic effect with what hormone?
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
GH
Disorganized schizophrenia
Specific rate (e.g. - men aged 55-60)

36. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral hemispheres
Proencephalon
Extrahepatic biliary atresia
The AR form is malignant and AD is benign.
Substituted judgment. It is made by the person who best knows the patient - not the closest relative.

37. What is the most stressful event as determined by the Holmes and Rahe scale?
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
The death of a spouse. The higher the score - the greater the risk of developing an illness in the next 6 months.
Parvovirus B-19
Yes - by three to four times. Having multiple sexual partners - being overweight - and pelvic pain and/or inflammatory disorders are also likely to be seen in sexually abused females.

38. What X- linked recessive immune disorder is characterized by recurrent infections - severe thrombocytopenia - and eczema?
refuse
Wiskott - Aldrich syndrome
d - ALA synthase
Uroporphyrinogen I synthetase

39. Describe What type of fluid is either gained or lost with the following changes in body hydration for the ECF volume - ICF volume - and body osmolarity - respectively: x ECF - decrease; ICF - no change; body - no change
Chromosome 5p
Strongyloides stercoralis is treated with thiabendazole.
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)

40. What is the vector of African sleeping sickness?
Cyanocobalamin (B12)
Viral meningitis
Neuroblastoma
The tsetse fly

41. What is the name of the T cell - rich area of the lymph node?
CD40 ligand
Paracortex
Infection
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.

42. What sphingolipid cannot be produced without sialic acid and amino sugars?
Amnesia. (The person is aware of the memory loss.)
Efficacy
Ganglioside
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.

43. What lysosomal enzyme is deficient in x Tay- Sachs disease?
Physiologic dead space is the total dead space of the respiratory system.
Hexosaminidase A
Aspiration pneumonia
More Ab is produced in less time in a secondary immune response (shorter lag period).

44. Is the coding or the template strand of DNA identical to mRNA (excluding the T/U difference)?
Papovavirus
Superior
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
Rheumatoid arthritis

45. What muscle or muscles are innervated by the following nerves? - Upper subscapularis nerve
Subscapularis
Measurement bias
Oblique fissure
Streptococcus viridans

46. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Ventral root?
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
Adenovirus
Motor

47. Name at least three causes of metastatic calcification.

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48. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Denial of illness - hemineglect - construction apraxia (can't arrange matchsticks)
Proline and lysine
Right coronary artery
Integument (skin and its derivatives)
Nondominant parietal lobe

49. What is the term for gastric ulcers associated with increased intracranial pressure?

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50. What are the first signs of overdose from phenobarbitals?
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
Nystagmus and ataxia
School phobia
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)