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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 amount in liters and percent body weight for the following compartments? - Vascular fluid
4.7 L - 5% of body weight
Log - kill hypothesis (follows first order kinetics)
Cocaine
Major

2. Name the antidote - Methyl alcohol
Aspiration pneumonia
Ethyl alcohol
Ewing's sarcoma
Pompe's disease

3. What X- linked recessive disease involves mental retardation - self - mutilation - choreoathetosis - spasticity - a decrease in HGPRT - and an increase in uricemia?
Masochism
Glucosyl cerebroside
Factors II - VII - IX - and X and proteins C and S.
Lesch - Nyhan syndrome

4. What cell of the duodenum secretes CCK?
1. Sweat glands 2. Arterioles 3. Veins
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
Enteroendocrine (EE) cells; they also secrete secretin.
Aminoglycosides

5. What are the three branches of the celiac trunk?
Proton pump inhibitors
Albumin
The left gastric - splenic - and common hepatic arteries
Down syndrome (trisomy 21)

6. Name the area of the cerebral cortex with the function described: x Speech; critical for personality - concentration - initiating and stopping tasks (do one thing and begin a new without completion of the first) - abstract thought - and memory and hi
Frontal lobe
Jejunum (upper)
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
IgD; IgM is also correct.

7. What Brodmann area is associated with x Primary auditory cortex?
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases
Areas 41 and 42
Small to medium - sized cerebral vessels
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland

8. What equals the total tension on a muscle minus the preload?
Down syndrome (trisomy 21)
Afterload
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
Pyelonephritis

9. If the pH is more acidic than the pI - does the protein carry a net positive or net negative charge?
Small cell cancer of the lung
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.
The tsetse fly
Thyroid gland

10. What lysosomal enzyme is deficient in x Tay- Sachs disease?
Interval scale (a ruler - for example)
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Priapism
Hexosaminidase A

11. Name the most common type or cause - Right heart failure
Left heart failure
Tidal volume (VT)
Standardized rate
Amiloride

12. On a graphical representation of filtration - reabsorption - and excretion - When does glucose first appear in the urine?
Trazodone
Akathisia
The urine becomes hypertonic because of water reabsorption in the collecting duct.
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.

13. What are the vitamin K- dependent coagulation factors?
HBeAb
Factors II - VII - IX - X - and proteins C and S
Diacylglycerols and phosphatidic acid
Medial midbrain (Weber's) syndrome

14. What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
Adrenarche
It is rare with normal grief; however - it is relatively common in depression
Left homonymous hemianopsia
Median (think of it as the halfway point)

15. What period is described when a larger - than - normal stimulus is needed to produce an action potential?
On the superior body of the posterior wall of the uterus
Bitemporal heteronymous hemianopsia
Relative refractory period
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.

16. What growth factors are chondrogenic - working on the epiphyseal end plates of bone?
Lente insulin and either NPH or protamine zinc insulin (PZI)
There are no valves and no smooth muscle in the walls of the veins in the face.
Somatomedins (IGF-1)
NSAIDs

17. How many pairs of spinal nerves are associated with x Coccygeal vertebrae?
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
Gubernaculum
Palms - up before palms - down maneuvers
Nominal scale (categorical - e.g. - male or female)

18. Failure to accurately recall the past leads to what form of bias?
X- linked recessive
Shaping (successive approximation)
Loose association
Recall bias. These problems arise in retrospective studies.

19. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Testosterone
Lysine and tyrosine
Type II hypersensitivity reaction
Bernard - Soulier syndrome

20. What is the only vein in the body with a high O2 content?
Trypsin
Unconjugated free bilirubin
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Bacillus anthracis

21. What muscle of the middle ear is innervated by CN VII?
ICF volume decreases when there is an increase in osmolarity and vice versa.
The stapedius muscle
H2PO4- (dihydrogen phosphate)
Uracil

22. What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
DNA polymerase I
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Amygdala; it helps imprint an emotional response in memory.

23. What is the major hormone produced in the following areas of the adrenal cortex? - Zona glomerulosa
Mitochondrial inheritance
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)
CN III and IV

24. What drug is used to differentiate a cholinergic crisis from myasthenia gravis?
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
Tip of the left ventricle
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 -
Edrophonium

25. What right - to - left shunt occurs when only one vessel receives blood from both the right and left ventricles?
Increased leukocyte alkaline phosphatase (LAP)
Obturator nerve
3 ATPs by oxidative phosphorylation
Persistent truncus arteriosus

26. Does T3 or T4 have a greater affinity for its nuclear receptor?
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
The AR form is malignant and AD is benign.
Id (pleasure principle)
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e. - pill rolling) is seen in basal ganglia lesions.

27. From what pharyngeal groove is the external auditory meatus derived?
Pompe's disease
Range
IgA
First pharyngeal groove; all others degenerate.

28. What disorder is associated with jaundice - white stools - and dark urine due to biliary duct occlusion secondary to incomplete recanalization?
Extrahepatic biliary atresia
The muscle's ATPase activity
Melanoma
Anterior wall of the first part of the duodenum

29. What area of the retina consists of only cones and has the greatest visual acuity?
Left ventricle and auricle of left atrium
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
Fovea

30. What is the site of action of the following? - Loop diuretics
Alveolar macrophages
IF
Ascending limb
Hepatitis C

31. What is the most common one? - Organism associated with mastitis
Vesicular stomatitis virus
Staphylococcus aureus
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.

32. Name the hepatitis virus based on the following information - Naked capsid RNA calicivirus
Hepatitis E
Huntington disease
Because creatinine is filtered and a small amount is secreted
Hydroxyproline (breakdown product of collagen)

33. How many ATPs are produced from cytoplasmic NADH oxidation using the glycerol phosphate shuttle?
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
The carotid sinus is a pressure - sensitive (low) receptor - while the carotid body is an oxygen - sensitive (low) receptor. (Remember 'Sinus Pressure').
2 ATPs by oxidative phosphorylation
Atrial contraction Atrial - Contraction - Venous

34. What AD syndrome involves 1000 or more edematous polyps - most commonly affects the colorectal area - and is associated with chromosome 5q21?
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
Clindamycin
Familial polyposis coli
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.

35. What is found in the R group if the AA is acidic? Basic?
Type I hypersensitivity (anaphylactic)
Type II hypersensitivity reaction
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
Gardnerella vaginalis

36. What cytoplasmic organelle carries the enzymes for elongation and desaturation of fatty acyl CoA?
H 1
SER
The conus medullaris terminates at the level of the second lumbar vertebra.
False - positive rate

37. What three factors increase simple diffusion?
Cytochrome a/a3
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
Test - retest reliability
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.

38. What fungus is seen as colored cauliflower lesions?
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
Chromomycosis
EF- G of the 50S subunit
PGE2 and PGF2a

39. Where is renin produced?
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
Proud flesh
Pancreatic cancer
In the JG cells of the kidney

40. What is the term for RBC remnants of nuclear chromatin in asplenic patients?
Blastoconidia
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
Streptococcus viridans
Howell - Jolly bodies

41. What disorder is characterized by a depressed mood and a loss of interest or pleasure for more than 2 years?
Middle meningeal artery
Chromosome 11 - 22
Procainamide
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)

42. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ decreased - Pi decreased
Rhombencephalon
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
For males it's prostate cancer - and for females it's breast cancer.
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.

43. What is the renal compensation mechanism for acidosis?
Eosin
Posterior
Production of HCO3- - shifting the reaction to the left and thereby decreasing H+
The aorta has the greatest velocity and the capillaries have the slowest velocity.

44. What happens to dopamine levels when we awaken?
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Thiazide diuretics
Cross - sectional studies determine prevalence - not incidence or cause and effect.
Gynecomastia

45. What are the two most important features in the diagnosis of malaria?
CN III and IV
Splenomegaly and anemia (with a high index of suspicion)
T cells - not B cells
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.

46. What somatoform disorder is described as x Preoccupied with illness or death - persisting despite reassurance - lasting longer than 6 months?

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47. Is excretion greater than or less than filtration for net secretion to occur?
Excretion is greater than filtration for net secretion to occur.
HBsAg (incubation period)
HBcAb IgM
REM and stage 4 sleep; they decrease.

48. Do the following structures pick up stain from hematoxylin or eosin? - Collagen
Eosin
Anterior spinal artery
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
Maxillary artery

49. Which direct - acting vasodilator is used clinically to treat hypertensive emergencies - insulinomas - and as a uterine smooth muscle relaxant?
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.
ACh
Diazoxide
Hemangioblastoma

50. What genus is known as the smallest free living bacteria? (hint: has no cell wall and has sterols in the membrane)
Mycoplasma
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)
Acetoacetate - acetone - and Beta- hydroxybutyrate
Lysine and arginine