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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 name of the pathway that produces leukotrienes?
Lipoxygenase pathway - from arachidonic acid
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
Surface tension; in the alveoli - it is a force that acts to collapse the lung.
Prolyl and lysyl hydroxylases

2. What three factors do Sertoli cells produce for normal male development?
alpha - Cells; glucagon has stimulatory effects on - cells and inhibitory effects on - cells.
Actinomyces israelii
Inhibin - m
Liver

3. Prolactin levels can serve as a rough indicator of...
overall dopamine activity
HPV
Rathke's pouch; they can result in compression of the optic chiasm.
Macule (e.g. - a freckle)

4. Name the most common type or cause - Neonatal bowel obstruction
Ethyl alcohol
Autoimmune thrombocytopenia purpura
Collecting ducts - which make them readily permeable to water reabsorption.
Hirschsprung disease

5. Name the type of necrosis - Soft - friable - cottage - cheese appearing; characteristically seen in TB
Acral - lentiginous melanoma
Caseous necrosis
Chief cells
Left homonymous hemianopsia

6. At what stage of cognitive development (according to Piaget) do children x Have abstract thinking?
HGPRT
Tyramine
Clozapine
Formal operations (> 12 years)

7. Name the associated chromosomal translocation - Follicular lymphoma
Chromosome 14 - 18
Syringomyelia
Umbilical vein and ductus venosus (80%)
Teratoma (dermoid cyst)

8. What enzyme system is the most common form of phase II biotransformation?
Yes - because they both activate the BZ1- receptors - which can be reversed by flumazenil.
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Glucuronidation
The outer cortex contains most of the germinal centers and therefore also most B cells.

9. What tumor marker is associated with seminomas?
Lysine and arginine
refractory sexual periods
Placental alkaline phosphatase
The aorta has the greatest velocity and the capillaries have the slowest velocity.

10. What oral hypoglycemic agent inhibits a - glucosidase in the brush border of the small intestine?
Acarbose
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Cones (C for color and cones)
Androgens are 19- carbon steroids.

11. Name the muscle type based on the histological features: x Actin and myosin in sarcomeres; striated; uninuclear; gap junctions; troponin:calcium binding complex; T tubules and SR forming dyadic contacts; voltage - gated calcium channels
Hepatitis A
Succinyl CoA synthetase
Cardiac muscle
Ketoconazole

12. What cardiac reflex is characterized by stretch receptors in the right atrium - afferent and efferent limbs via the vagus nerve - and increased stretch leading to an increase in heart rate via inhibition of parasympathetic stimulation?
Alveolar macrophages
Aldolase B deficiencies are treated by eliminating fructose from the diet.
Wiskott - Aldrich syndrome
Bainbridge reflex

13. What is the main mechanism for exchange of nutrients and gases across a capillary membrane?
Simple diffusion; it does not use protein - mediated transport
S1 nuclease
Posterior compartment of the thigh - tibial nerve
Spinal trigeminal nucleus

14. What leukemia affects a 4-year - old child with 3 months of fever - fatigue - generalized lymphadenopathy - CNS involvement - hepatosplenomegaly - bleeding - and platelet count below 100 - 000?
Posterior cruciate ligament
ll
Ultraviolet B (UVB) sunlight
5- hydroxyindoleacetic acid (5- HIAA)

15. What is the term for any region of the respiratory system that is incapable of gas exchange?
Antisocial
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
VSD
Anatomical dead space - which ends at the level of the terminal bronchioles.

16. What is the only specific Ag - presenting cell?
Cryptococcus
RBCs
Silent
B cells; macrophages and dendritic cells are nonspecific.

17. Soap bubble appearance on radiograph
The carotid sinus is a pressure - sensitive (low) receptor - while the carotid body is an oxygen - sensitive (low) receptor. (Remember 'Sinus Pressure').
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
Giant cell tumor of the bone
Primary hypercortisolism

18. What Ig activates the alternate pathway - neutralizes bacterial endotoxins and viruses - and prevents bacterial adherence?
IgA
Subthreshold potential
Moving objects - along with large bright objects with curves and complex designs.
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)

19. What preganglionic sympathetic fibers are responsible for innervating the smooth muscle and glands of the pelvis and the hindgut?
Primary sclerosing cholangitis
Streptomycin
Lumbar splanchnics
Gastrinoma

20. What are the four effects of suckling on the mother?
Superior
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
Eosin
Middle

21. What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
Spearman correlation
Zanamivir and oseltamivir
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
Factor XII for the intrinsic; factor VII for the extrinsic pathway

22. What seven structures are found in more than one mediastinum?
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve
MEN II and III syndromes
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
First - order elimination

23. What is the term for the external urethra opening onto the dorsal surface of the penis?
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
HBcAb IgG and HBsAb IgG
Epispadia
Metanephros

24. Name these mature defense mechanisms: x Forgetting on purpose (so you can actually remember it)
Suppression
Vibrio cholera
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
Increases

25. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Pituitary hypogonadism
Astrocytes
Ipsilateral flaccid paralysis
Acetaldehyde dehydrogenase

26. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Osteoblasts
Reverse transcriptase
NE
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Nominal scale (categorical - e.g. - male or female)

27. What ocular muscle x Elevates and adducts the eyeball?
Mitochondria
Superior rectus (CN III) (LR6 SO4)3
Northern blot
Clear cell

28. What three structures are in contact with the left colic flexure? With the right colic flexure?
Enteroendocrine (EE) cells; they also secrete secretin.
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
CO
Prostatic carcinoma

29. What embryonic structure forms the adult male structure? - Ventral part of the penis
Filtration is greater than excretion for net reabsorption to occur.
Ethyl alcohol
Ethyl alcohol
Urogenital folds

30. What syndrome results when there is a deletion to paternal chromosome 15? Maternal?
1. Propranolol 2. Timolol 3. Carteolol
Clonorchis sinensis
Prader - Willi syndrome and Angelman syndrome - respectively
Positive

31. How many oogonia are present at birth?
Adenocarcinoma (because of Barrett esophagus)
None; they are not formed until a girl reaches puberty.
Endometrial cancer
X- linked recessive

32. What bilateral AR disorder seen in infancy as progressive renal failure has multiple small cysts at right angles to the cortical surface?
It increases Ca2+ excretion from the kidney and increases bone mineralization.
Leiomyoma
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Polycystic kidney disease of childhood

33. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol decreased - ACTH increased

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34. What is used as an index for both adrenal and testicular androgens?
Glucose -6- phosphatase
Mesencephalic nucleus
Urinary 17- ketosteroids
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.

35. What enzyme of the TCA cycle catalyzes the substrate level phosphorylation?
Preload. It is the load on a muscle Prior to contraction.
Ritodrine and terbutaline
Serratus anterior
Succinyl CoA synthetase

36. What protein allows Mycoplasma to attach to the respiratory epithelium?
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
Chromosome 12
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
P1 protein

37. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 46/2n (divide meiotically)
Breast cancer
PALS
Spermatogonia (type A)
Look for broken blood vessels in the baby's eyes.

38. What parasite found in raw fish can produce vitamin B12 deficiency?
Physiologic antagonism
Diphyllobothrium latum
Lesch - Nyhan syndrome
Urogenital sinus

39. If a virus has positive sense RNA - can it be used as mRNA or is a template needed?
Ratio scale
Functions of hepatocytes
Coarctation of the aorta
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.

40. How many ATPs per glucose are generated in glycolysis?
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
Clostridium tetani
Familial polyposis coli
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.

41. What antiviral agent is used in the treatment of drug - induced Parkinson's disease?
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
Femoral nerve
Amantadine
Heinz bodies

42. What part of the inner ear contains the gravity receptors for changes in the position of the head?
Saccule and utricle
The poly(A) site on the DNA
60%
Class II

43. From What aortic arch are the following structures derived?
Follicular phase
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
Amnesia. (The person is aware of the memory loss.)
Arch of the aorta and right subclavian artery

44. What acid form of H+ in the urine cannot be titrated?
NH4+(ammonium)
Right vagus innervates the SA node and the left vagus innervates the AV node
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.
Chloral hydrate

45. What paraphilia is defined as x Combining sex with defecation?
Coprophilia
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Paramesonephric ducts
MHC class II Ags. This is accomplished via CD4 T cells.

46. What disorder is characterized by an alternating pattern of depressed mood with periods of hypomania for more than 2 years?
G0 phase
CN XII
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
Superior and middle

47. Name the most common type or cause - Diarrhea in children
Rotavirus
Ischemia
GP IIb and IIIa receptors
Rhombencephalon

48. What enzyme catalyzes the rate - limiting step in heme synthesis?
B cells; macrophages and dendritic cells are nonspecific.
d - ALA synthase
Alcohol. Nearly 10% of adults have a problem with alcohol.
Gubernaculum

49. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Clonidine
Pubis - ilium - and ischium
Unconjugated free bilirubin
Nondominant temporal lobe

50. Auer rods
Kartagener's syndrome (also known as immotile cilia syndrome) -------------------------------------------------------------------------------
Cytochrome a/a3
AML- M3
Magnesium ammonium phosphate (struvite)