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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. Are necessary for normal menstrual cycles.
Prader - Willi syndrome and Angelman syndrome - respectively
Molybdenum (Mb)
Crohn disease
Thyroid hormones

2. What chronic inflammatory WBC is associated with IgE- mediated allergic reactions and parasitic infections?
Pseudomonas
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
Eosinophils
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.

3. What embryonic structure forms the following adult structures? - External genitalia
Phallus - urogenital folds - and labioscrotal swellings
Smooth muscle
Flea - bitten kidney (can also be seen in pyelonephritis)
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus

4. What obligate extracellular fungus is silver stain - positive and is associated with pneumonia in patients with AIDS?
Pneumocystis carinii
It increases Ca2+ excretion from the kidney and increases bone mineralization.
Brucella
Nitrofurantoin

5. What cell type in the bone is responsible for bone deposition?
Enterobius vermicularis; the treatment is albendazole.
Beta- Endorphin
Osteoblast (Remember - blasts make - clasts take)
Iron deficiency anemia

6. Name the hypochromic microcytic anemia based on the following laboratory values - Decreased iron - percent saturation - and ferritin; increased TIBC
Homocysteine methyl transferase
Obese patients
Iron deficiency anemia
Myasthenia gravis

7. What protein of the HIV virus does ELISA detect to determine whether a patient is HIV positive?
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
P24
The folding of an AA chain
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis

8. What condition is characterized by a 46XY karyotype - testes present - and ambiguous or female external genitalia?
One - way ANOVA
The basilar artery is formed at the pontomedullary junction.
Male pseudohermaphrodite (dude looks like a lady!)
Haemophilus influenzae type B

9. Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
1. Skin 2. Liver 3. Kidney
Being awake
M 2
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)

10. All primary oocytes in females are formed By What age?
The resistance will decrease one - sixteenth of the original resistance.
They are all formed by the fifth month of fetal life.
env structural protein
Ribonucleotide reductase

11. Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Dantrolene
Bacillus cereus
Semicircular duct

12. What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1?
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
The fasciculus cuneatus
Lisch nodules
Cyanocobalamin (B12)

13. Patients with sickle cell anemia are at increased risk for infection From what type of organisms?
Ribonucleotide reductase
Encapsulated bacteria
N- formyl - methionine LTB4 C5a IL-8
Sigmoid colon

14. What vasculitis is characterized by systemic vasculitis in small to medium - size vessels (except the lung); affecting young males; 30% HBsAg - positive; P- ANCA and autoantibodies against myeloperoxidase?
Lateral fissure (fissure of Sylvius)
Erythema multiforme
Hydroxyapatite
Polyarteritis nodosa

15. Name the associated chromosome - Albinism
Minocycline
Chromosome 11p
Transtentorial (uncal)
Chromosome 15

16. How many strains of Pneumococcus capsular polysaccharides are present in the vaccine?
Ischemic
Proencephalon
Oxygen
The vaccine contains 23 capsular polysaccharides.

17. What is the term for the external urethra opening onto the ventral surface of the penis?
Hypospadia
Succinylcholine
Chorda tympani of CN VII
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.

18. Near the end of pregnancy - what hormone's receptors increase in the myometrium because of elevated plasma estrogen levels?
Oxytocin
Flea - bitten kidney (can also be seen in pyelonephritis)
No change in length
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.

19. If capillary hydrostatic pressure is greater than oncotic pressure - is filtration or reabsorption promoted?
Lispro insulin
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Filtration; if hydrostatic pressure is less than oncotic pressure - reabsorption is promoted.
Isovolumetric contraction

20. What is the most common one? - Route for infectious arthritis
Hematogenous
Operant conditioning (reinforcement is after a response)
Stage fright (discrete performance anxiety)
GLUT 4

21. Name the macrophage based on its location: x Brain macrophages
Microglia
Foramen of Monro
Ribozymes
The central vein of the liver lobule

22. What organism is associated with the following types of diarrhea? Diarrhea associated with raw or undercooked shellfish
EBV
IgA
Vibrio parahaemolyticus
1. Decrease alpha -1 activity 2. Increase Beta -2 activity 3. Increase ACh levels

23. Does being a female physician increase or decrease the risk of suicide?
Being a female physician increases the risk of suicide nearly four times the general population.
The number of Ags that the Ab can bind
Glutamate
Carbamazepine

24. What is the drug of choice for treating ADHD?
Methylphenidate (Ritalin)
Sensory
Being a white male
Distal convoluted tubules

25. What protozoal parasite results in dysentery with blood and pus in the stool - is transmitted via fecal - oral route - is diagnosed by cysts or trophozoites in the stool - and forms liver abscesses and inverted flask - shaped lesions in the large int
Acute toxic or viral nephrosis
Entamoeba histolytica (treat with metronidazole)
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
Medullary carcinoma of the thyroid

26. What is the most common one? - Site for colonic diverticula
Cocaine
Sigmoid colon
Thick skin
Pubis - ilium - and ischium

27. What is the first branch of the abdominal artery?
Preload (the load on the muscle in the relaxed state)
Inferior phrenic artery
Hydatidiform mole
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)

28. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Acellular; some are enveloped; replicate within the host cell; no cell walls
Allograft
Viruses
Vitamin D
Musculocutaneous nerve

29. Name the thalamic nucleus based on its input and output - Input from the amygdala - prefrontal cortex - and temporal lobe; output to the prefrontal lobe and the cingulated gyrus
Enkephalins
GLUT 2
After the latent period
Medial nuclear group (limbic system)

30. What is the only organ in the body that can produce ketone bodies?
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
The liver (in the mitochondria)
Creutzfeldt - Jakob's disease. Patients first develop vague somatic complaints and anxiety - rapidly followed by dysarthria - myoclonus - ataxia - and choreoathetosis.

31. What three substances stimulate glycogenolysis?
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Nicotine (but it sure has a nasty withdrawal!)
Hypoactive sexual desire disorder
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.

32. How does the sympathetic nervous system affect insulin secretion?
Berry aneurysm in the circle of Willis
Malassezia furfur (treat with selenium sulfide)
It decreases insulin secretion.
Salmeterol

33. Name the DNA virus: x Linear dsDNA; naked; replicates in the nucleus
Adenovirus
Mixed (both cholesterol and calcium)
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
CN III - VII - IX - and X

34. What AR disorder of copper metabolism can be characterized by Kayser - Fleischer rings - decreased ceruloplasmin levels - and increased urinary copper excretion and tissue copper levels?
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
MGB
Calicivirus
Kidney

35. Should you refer a patient to a form of folk medicine even if you don't believe in it?

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36. What pattern of inheritance does G-6- PD deficiency follow?
Bitemporal heteronymous hemianopsia
ATP production
X- linked recessive
Oxygen

37. Do the following structures pick up stain from hematoxylin or eosin? - Cytoplasm
Eosin
Klinefelter syndrome
Streptococcus viridans
NREM sleep. Night terrors are dreams that we are unable to recall.

38. What enzyme catalyzes the rate - limiting step in cholesterol metabolism?
Disseminated intravascular coagulation (DIC)
Intrapleural pressure decreases (becomes more negative).
HMG- CoA reductase
Female pseudohermaphrodite

39. What Staphylococcus aureus protein inhibits phagocytosis?
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Protein A
Osteoclasts
prior to birthThe foramen ovale closes just...

40. What type of correlation is defined as x One variable that diminishes in the presence of the other?
Dihydropteroate synthetase
In the tuberoinfundibular pathway - dopamine release will decrease prolactin release - Which is why dopamine agonists are used in the treaatment of hyperprolactinemic states.
Negative correlation
Beta- Hydroxybutyrate

41. What a1- agonist - not inactivated by catechol - O- methyl transferase (COMT) - is used as a decongestant and for treatment of paroxysmal atrial tachycardia?
Phenylephrine
Rhombencephalon
Oxytocin
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.

42. What enzyme of the purine salvage pathway is deficient in the following? - Selective T- cell immunodeficiency
Lipid - soluble hormones are considered slow - acting hormones.
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
Purine nucleoside phosphorylase

43. More Ag is needed to produce a ____________ than a first immune response.
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
secondary immune response
Middle
Iron (Fe)

44. What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
Primary sclerosing cholangitis
Gangrenous necrosis
Staphylococcus aureus (but they are more prone to salmonella infections)
In the medulla; all the other structures are cortical.

45. What hormone constricts afferent and efferent arterioles (efferent more so) in an effort to preserve glomerular capillary pressure as the renal blood flow decreases?
Schistosoma have separate males and females.
AT II
Maxillary artery
ACTH

46. Are the following major or minor Jones criteria of rheumatic fever? - Elevated acute phase reactants (e.g. - ESR)
Proencephalon
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available - but the renal collecting ducts are impermeable to its actions.
Bulbus cordis
Minor

47. Which CNS ACh receptor or receptors are excitatory? Inhibitory?
Proencephalon
CD21; it is a complement receptor for cleaved C3
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
Arnold - Chiari malformation type 2

48. What are the primary neurotransmitters at the following sites? - All motor neurons - postganglionic parasympathetic neurons
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
They are preganglionic sympathetic axons. They are white because they are myelinated.
ACh
Doxycycline

49. How do elevated blood glucose levels decrease GH secretion? (Hint: what inhibitory hypothalamic hormone is stimulated by IGF-1?)
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.
Vital capacity (VC)
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.

50. The clearance of what substance is the gold standard of renal plasma flow?
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
Intercellular adhesion molecule (ICAM) 1
Para - aminohippurate (PAH)