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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 are the primary neurotransmitters at the following sites? - All motor neurons - postganglionic parasympathetic neurons
The parasympathetic nervous system
Periaortic lymph nodes
GLUT 2
ACh

2. At high doses aspirin has ________ properties.
Axon hillock
Fibroadenoma
Primary sclerosing cholangitis
Uricosuric

3. Which dimorphic fungus is found as hyphae with nondescript conidia in rotting wood in the Upper Great Lakes - Ohio - Mississippi - eastern seaboard of the United States - and southern Canada?
Blastomyces dermatitidis
They are in ganglia in the PNS.
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
Ependymoma

4. What cell of the nephron is responsible for renin production and secretion?
Extracellular
Juxtaglomerular (JG) cell
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result) - these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease - when obstructive symptoms begin to occur.
Intrapleural pressure decreases (becomes more negative).

5. What is the term for the pH range where the dissociation of H+ occurs?
Mikulicz syndrome
pK (think of it as where half is base and half is acid)
The inner membrane of the mitochondria (cristae)
Testicular tumors

6. What form of hemophilia is X- linked recessive and due to a deficiency in factor VIII?
Hemophilia A
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).

7. What CN nucleus receives auditory information from both ears via the cochlear nuclei?
Superior olivary nucleus
Velocity is inversely related to cross - sectional area.
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.
Superego

8. What very aggressive lung cancer metastasizes early and is associated with smoking and paraneoplastic syndromes?
Myeloperoxidase
Pneumothorax
Albinism
Small cell carcinoma (oat cell)

9. Increases your risk of suicide.
Hydatidiform mole
School phobia
Histiocytes
Being single

10. What enzyme of pyrimidine synthesis is inhibited by the following? - 5- FU
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
CD21; it is a complement receptor for cleaved C3
Thymidylate synthase
Dominant temporal lobe

11. Name the type of exudate - given the following examples - Sunburn
Serous exudates
Pheochromocytoma
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
Oncotic pressure increases because of the removal of water.

12. What is the most common one? - Histologic variant of breast cancer
gram positive
Infiltrating ductal carcinoma
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Kidney

13. What are the two ways to leave the prevalence pot?
Radial nerve
Recovery and death
Phentolamine and phenoxybenzamine
Zona fasciculata and zona reticularis

14. What Freudian psyche component is described as x The urges - sex aggression - and 'primitive' processes?
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
The cat
Id (pleasure principle)
CLL (B- cell origin)

15. Call - Exner bodies
HPV serotypes 6 and 11
Granulosa/thecal cell tumor of the ovary
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III) - B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.

16. Describe the organism based on the following information: x Beta - Hemolytic Streptococcus; positive cAMP test; hydrolyzes hippurate
Propionic acid
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Streptococcus agalactiae
Galactose and glucose

17. What is the amount in liters and percent body weight for the following compartments? - Interstitial fluid
Jejunum (upper)
Francisella tularensis
SER
9.3 L - 15% of body weight

18. What lower extremity nerve is described by the following motor loss? - Loss of adduction of the thigh
Phototherapy
Obturator nerve
Positive sense RNA means it can serve as mRNA and therefore has 5'-3' polarity
The inner cortex (paracortex) contains the T cells - so it is considered the thymic - dependent area.

19. What vascular pathology is associated with HTN in the upper extremities - hypotension in the lower extremities - and a radial - femoral delay?
Mycobacterium leprae
The hallmarks of LMN lesion injury are absent or decreased reflexes - muscle fasciculations - decreased muscle tone - and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget - LMN lesions are ipsilateral at the level of the
Postductal coarctation of the aorta (adult)
It is rare with normal grief; however - it is relatively common in depression

20. What is the term for an inhibited female orgasm?
Anorgasmia. (The overall prevalence is 30%.)
Superficial spreading melanoma
Short - chain fatty acids
Mitral valve stenosis

21. What structure or structures cross the diaphragm at x T12 level?
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12
Purkinje cell is the fastest - and the AV node is the slowest.
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.
Nodular melanoma

22. Name the type of exudate - given the following examples - Diphtheria infection
Edward syndrome (trisomy 18)
Hepatitis C
Pseudomembranous exudates
Osteosarcoma

23. What is the DOC for the following protozoal infections? - Trichomoniasis
Factors II - VII - IX - and X and proteins C and S.
Superior
Theca cell
Metronidazole

24. What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting - fissuring - and oozing?
Posterior cruciate ligament
Paget disease of the breast
Ethyl alcohol
Urinary trigone

25. What is the term to describe how easily a vessel stretches?
G0 phase
Arterial PCO2 levels are proportional to cerebral blood flow.
Compliance (think of it as distensibility)
C5- C9

26. What is the name of the tumor when gastric carcinoma spreads to the ovaries?
Krukenberg tumor
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)

27. Metformin is contraindicated in ________ because of weight gain as its side effect.
Obese patients
PCR
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.
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)

28. During what stage of B- cell development is IgM first seen on the surface?
Disorganized schizophrenia
M3 (promyelocytic leukemia)
Immature B cells
Loose association

29. What is the term for flattened nose - low - set ears - and recessed chin seen in patients with bilateral renal agenesis?
Transverse abdominis
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
Urinary 17- OH steroids
Potter facies

30. What bacterium found in poorly preserved canned food causes flaccid paralysis?
Tetracycline
Clostridium botulinum
Urinary 17- ketosteroids
Major

31. What is the most energy- demanding phase of the cardiac cycle?
Isovolumetric contraction
CD40
Methyldopa
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency

32. What drug is being given to HIV- positive mothers during labor and to the children after birth to decrease the risk of mother - to - child HIV transmission?
Glucagon and epinephrine
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.
Mitral valve prolapse

33. What is the rate - limiting step in the production of steroids?
The conversion of CHO to pregnenolone via the enzyme desmolase
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
Eosin
Heinz bodies

34. Name the most common type or cause - Right heart failure
1. Skin 2. Liver 3. Kidney
Adenocarcinoma (because of Barrett esophagus)
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
Left heart failure

35. What aspects of sleep are affected during benzodiazepine use?
Left heart failure
Fibrinoid necrosis
REM and stage 4 sleep; they decrease.
Fanconi - like syndrome

36. What term describes the inability to recall personal information - commonly associated with trauma?
Elevated ASO titers and serum complement levels
Amnesia. (The person is aware of the memory loss.)
Hyperventilation - which decreases CO2 - shifting the reaction to the left and decreasing H+
Low interstitial free Ca2+ concentrations

37. What gluconeogenic mitochondrial enzyme requires biotin?
Pyruvate carboxylase
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
They are all formed by the fifth month of fetal life.
Absolute refractory period is due to voltage inactivation of sodium channels.

38. What two Beta- blockers decrease serum lipids?
Degenerates
Acebutolol and Pindolol
Labile
Lipoid nephrosis

39. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Benzenes
Because the large drop in TPR is accompanied by a large increase in cardiac output - resulting in a minimal change in BP.
T lymphocyte
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
Leukemias

40. Which dopamine receptor excites the direct pathway of the basal ganglia?
Meckel diverticulum
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
Clofazimine
Incidence rate

41. Who is responsible for passing on mitochondrial DNA genetic disorders?
Mitochondria - linked disorders are always inherited from the mother.
Urogenital folds
Th2 cells
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.

42. Should information flow from the patient to the family or vice versa?

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43. What is the DOC for severe infections with Sporothrix - Mucor - Histoplasma - Cryptococcus - Candida - and Aspergillus?
Melanoma - cancer of the stomach and bladder
hypophosphatemia
Phase I
Amphotericin B

44. What family do the following viruses belong to? - Ebola
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
REM sleep. Nightmares are frightening dreams that we recall.
catalase - negative
Filovirus

45. What is the DOC for coccidioidomycosis?
Pheochromocytoma
C3 - C4 - and C5 keep the diaphragm alive!
Fluconazole
Mumps

46. What form of hormone is described as having membrane - bound receptors that are stored in vesicles - using second messengers - and having its activity determined by free hormone levels.
31 pairs
Water - soluble hormones are considered fast - acting hormones.
Proencephalon diencephalon derivative
Superior and posterior

47. What form of oxidation takes place with the addition of a water molecule and breakage of bonds?
Alveolar macrophages
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Hydrolysis
Volvulus

48. What vasculitis affects a 30-year - old Asian female having visual field deficits - dizziness - decreased blood pressure - and weakened pulses in the upper extremities?
Major basic protein
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
Bladder carcinoma
Takayasu arteritis (medium - size to large vessels)

49. What enzyme - induced by insulin and activated by apo C- II - is required for chylomicron and VLDL metabolism?
Lipoprotein lipase
Hodgkin lymphoma
Labetalol
Integument (skin and its derivatives)

50. What CNS tumor arises from Rathke's pouch?
The T- test (used when comparing two groups)
Bordetella pertussis
Cryptococcus neoformans
Craniopharyngioma