Test your basic knowledge |

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 term for a large VSD that leads to pulmonary HTN - RVH - and cyanosis due to right - to - left reversal of the shunt?
Metronidazole
well - fed and fasting
Eisenmenger syndrome - which can also occur with any left - to - right shunt
Broca's aphasia

2. Which shuttle is used to bring fatty acyl CoA from the cytoplasm for ketogenesis?
Labile
Hydrolysis
Carnitine acyl CoA transferase II
C3a - C4a - C5a

3. What is the polarity (i.e. - 5'-3' or 3'-5') of a positive sense RNA?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

4. A depressive patient who is taking paroxetine goes to the ER with pain and is given meperidine. Shortly afterward she develops diaphoresis - myoclonus - muscle rigidity - hyperthermia - and seizures. What is your diagnosis?
Adenocarcinoma (30% to 35%)
Multiple myeloma
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs - TCADs - dextromethorphan - and meperidine. Treat it with cyproheptadine.
Vaginismus; it is the female counterpart of premature ejaculation.

5. How many oogonia are present at birth?
Antigenic determinant (epitope)
None; they are not formed until a girl reaches puberty.
Intrinsic factor (IF)
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)

6. What molecule differentiates the MHC class I from II Ag? (Hint: it's in the light chain.)
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.
The Beta -2- microglobin. It is the separately encoded Beta - chain for class I Ags.
Healing by secondary intention
Primary sclerosing cholangitis

7. What is flat - circumscribed nonpalpable pigmented change up to 1 cm?
The poly(A) site on the DNA
Cholesterolosis
Astrocytoma
Macule (e.g. - a freckle)

8. What two regions of the vertebral column are considered primary curvatures?
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Thoracic and sacral
They are preganglionic sympathetic axons. They are white because they are myelinated.
Expiratory reserve volume (ERV)

9. Name the insulin preparation based on the peak effect and duration of action - Peak - 0.5 to 3 hours; duration - 5 to 7 hours
Kl
False - negative rate
Regular insulin
Stratum corneum (keratinized)

10. What family do the following viruses belong to? - California encephalitis
8 to 25 hours
Bunyavirus
Alcohol consumption
CD15 and CD30

11. What are the three reasons for the effectiveness of the blood - brain barrier?
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Sertoli cell
Isolation of affect
The thyroid gland

12. What is the term for a large - immature RBC that is spherical - blue - and without a nucleus?
Right nasal hemianopsia
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Reticulocyte
Shifts it to the right

13. Name the RNA subtype based on the following: x Carries AA to the ribosome for protein synthesis
Constriction of afferent arteriole
tRNA
Staphylococcus aureus
O2

14. Which way will the O2 dissociation curve shift with the addition of 2 - 3- bisphosphoglycerate (2 - 3- BPG) to adult hemoglobin (Hgb)?
Shifts it to the right
Nephrotoxic oxylate stones
Psoas major
4 years old

15. Name the cerebral vessel associated with the following vascular pathologies - Subarachnoid hemorrhage
Berry aneurysm in the circle of Willis
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.
Brucella
Type III hypersensitivity (immune complex)

16. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF normal - capillary pressure ?
cDNA - when it is made from mRNA
Constriction of afferent arteriole
Valence
F- Met - Peptides

17. What is the only site in the body that uses M1 receptors?
First - pass metabolism and acid lability
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
The stomach
Bile salts are actively reabsorbed in the distal ileum.

18. Name the type of hypersensitivity reaction based on the following properties - IgE- mediated release of chemical mediators from basophils and mast cells; need prior exposure to Ag in the past; eosinophils amplify and continue reaction; can be system
IL-3 (3 face down is an M)
Type I hypersensitivity (anaphylactic)
Urogenital folds
Hemangioma (benign)

19. What enzyme of the purine salvage pathway is deficient in the following? - SCID
It decreases insulin secretion.
Tyrosine
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Adenosine deaminase

20. What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells - not a fixed number?
Log - kill hypothesis (follows first order kinetics)
Ascaris lumbricoides
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
UMP

21. What ribosomal subunit binds first to the mRNA strand?
SITS
Parental assignment and culture (not biology)
The small subunit (40S) binds first.
Chromosome 7

22. What three Beta- blockers are used in the treatment of glaucoma?
1. Propranolol 2. Timolol 3. Carteolol
Terminal ileum
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.

23. What syndrome is rheumatoid arthritis with pneumoconiosis?
Ipratropium
Caplan syndrome
Arginine
Prolyl and lysyl hydroxylases

24. Renal epithelial casts in the urine
Water
Residual volume
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
Acute toxic or viral nephrosis

25. Is a membranous septal defect more commonly interventricular or interatrial?
de Quervain thyroiditis
Potency
Separation anxiety
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.

26. What is the term when the brachial artery is compressed - resulting in ischemic contracture of the hand?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

27. What triggers phase 0 of the action potential in a ventricular pacemaker cell?
Calcium influx secondary to slow channel opening
Flumazenil
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse - hyperreflexia - spastic paralysis - increased muscle tone - and weakness are commonly seen in UMN lesions.
Hepatocellular carcinoma

28. Based on operant conditioning - What type of reinforcement is described when x Adding a stimulus reinforces a behavior?
Flumazenil
Myelofibrosis with myeloid metaplasia
Positive reinforcement
Short - chain fatty acids

29. Match the pulmonary end capillary blood levels.
Sporothrix schenckii
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
Papillary carcinoma of the thyroid
The alveolar PO2 and PCO2 levels

30. What embryonic structure forms the adult female structures? - Labia minora
Ethyl alcohol
Urogenital folds
Inferior Oblique (CN III) (LR6 SO4)3
Craniopharyngioma

31. What are the three branches of the inferior mesenteric artery?
Left colic - superior rectal - and sigmoidal arteries
The affinity of the drug for its receptor
Onion skinning
Brain abscess

32. What paraphilia is defined as x Combining sex with defecation?
Proencephalon
Rhinoviruses for summer and fall; coronaviruses for winter and spring
Medullary carcinoma of the thyroid
Coprophilia

33. Name the most common cause - Infectious pancreatitis
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
CN III - VII - IX - and X
Mumps
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get

34. Name the hepatitis virus based on the following information - Enveloped DNA hepadnavirus
Inferior rectus (CN III) (LR6 SO4)3
Chloral hydrate
Proencephalon
Hepatitis B

35. What paraphilia is defined as x Having a recurrent desire to expose the genitals to strangers?
Exhibitionism
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Dihydrofolate reductase
T cells - not B cells

36. Aschoff bodies
Staphylococcus saprophyticus
Alveolar macrophages
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
Rheumatic fever

37. How many acetyl CoAs per glucose enter into the TCA cycle?
Motor nucleus of CN V
Methylphenidate (Ritalin)
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Superego

38. With an increase in arterial systolic pressure - what happens to x Vessel compliance?
Vitreous humor
almitate
Decreases
31 pairs

39. What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities - red cell aplasia - and muscle weakness?
Log - kill hypothesis (follows first order kinetics)
Myasthenia gravis
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.
Major

40. Which three aminoglycosides have vestibular toxicity?
Macula densa
Chromaffin cells (adrenal medulla)
Lactulose
1. Streptomycin 2. Gentamicin 3. Tobramycin

41. What is the term for headaches - inability to concentrate - sleep disturbances; avoidance of associated stimuli; reliving events as dreams or flashbacks following a psychologically stressful event beyond the normal range of expectation?
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
CN XII
Labioscrotal swelling

42. What enzyme of pyrimidine synthesis is inhibited by the following? - Hydroxyurea
Chlamydia psittaci
Undoing
Ribonucleotide reductase
Isovolumetric contraction

43. Name the lipoprotein based on the following characteristics - apo E
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
IDL
Positive correlation
Shine - Dalgarno sequence

44. What disease is produced by a deficiency in the enzyme tyrosinase?
Lingual nerve of CN V3
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Parainfluenza virus
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.

45. Name these narcissistic defense mechanisms: x Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.
The carotid body - which monitors arterial blood directly
Jejunum (upper)
Splitting
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.

46. What agent used in the treatment of BPH and baldness is a 5- a - reductase inhibitor?
Finasteride
Inactivated
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Pancreatic delta - cell tumors inhibit CCK secretion

47. Name the antimicrobial agent whose major side effect is listed - Altered folate metabolism
Bactericidal
Adenovirus
First - pass effect
Trimethoprim

48. What cycle is responsible for converting to glucose in the liver the lactate produced in the RBCs?
Plasma cell
Cori cycle
Ependymal cells
Excision endonuclease - which removes thiamine dimers from DNA

49. Risk factors for endometrial carcinoma.
Leuprolide
Obesity - DM - HTN - multiparity - early menarche - and late menopause
Naloxone or naltrexone
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.

50. Name the most common cause - Blindness worldwide
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis - or IHSS)
Chlamydia trachomatis
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
50% - with 50% of them having the child