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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 type of scheduled reinforcement states that after a desired response - the reinforcement is given x On a set time schedule?
9.3 L - 15% of body weight
Wilms tumor
Fixed interval
Subarachnoid hematoma

2. What antitubercular agent requires vitamin B6 supplementation?
Sacrococcygeal teratoma
Missense
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
Isoniazid

3. Name the B- cell CD marker: x Used clinically to count B cells in blood
In early- morning sleep - usually between the sixth and eighth hours
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
CD19

4. Via what pathway is glycolysis increased after phagocytosis?
Trazodone
Fentanyl
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)
HMP shunt

5. Name the antimicrobial agent whose major side effect is listed - Dental staining in children
Microglia
Superior
Avidity. There is a positive correlation between valence numbers and avidity.
Tetracycline

6. What is the term for ventilation of unperfused alveoli?
Residual volume
Diacylglycerols and phosphatidic acid
Chief cell adenoma (80%)
Alveolar dead space

7. What enzyme is deficient in patients with CGD?
Phase 1
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.
Labioscrotal swelling

8. What enzyme is deficient in congenital erythropoietic porphyria?
Churg - Strauss syndrome
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Uroporphyrinogen III cosynthase
Major

9. What four factors shift the Hgb - O2 dissociation curve to the right? What is the consequence of this shift?
DNA polymerase - a
Phosphorylation of mannose residues
Because they do not block D2A receptors - they are antagonists of 5HT2 receptors.
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.

10. What four conditions result in secondary hyperaldosteronism?
Syphilitic
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
Ligamentum venosum
Zoophilia

11. At What age does a child develop x Endogenous smile?
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Lesch - Nyhan syndrome
Follicular adenoma
At birth (reflex)

12. What statistical test - using nominal data only - checks whether two variables are independent events?
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
300 mOsm/L
Chi - square (when you are in doubt and have nominal data - use chi - square)
Id

13. Heinz bodies
Cell - mediated immunity
18 years old (except if emancipated)
G-6- PD deficiency
Pancreatic cancer

14. What primary acid - base disturbance is caused by a loss in fixed acid forcing the reaction to shift to the right - thereby increasing HCO3- levels?
CD40
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
C3 deficiency
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.

15. In skeletal muscle ________ is an active event.
relaxation
Trypsin
ASA
HMP shunt

16. Name the T- cell CD marker: x Essential for Ab isotype switching (for B cell binding)
CD40 ligand
Stable
Chlortetracycline
Plasma cell

17. What gene stimulates apoptosis when DNA repair is unable to be done?
p -53
Rickets prior to fusion - osteomalacia if the deficiency occurs after epiphyseal fusion.
Corynebacterium diphtheriae
Sphingomyelinase

18. Name the most common type or cause - Nonorganic pneumoconiosis
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
Tyramine
Asbestosis
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)

19. What type of questions should you begin with when a patient seeks your medical opinion?
Nodes of Ranvier
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.
Arch of the aorta and right subclavian artery
Neuroblastoma

20. What normochromic - normocytic AD anemia has splenomegaly and increased osmotic fragility?
Adenocarcinoma of the cervix
Medial rectus (CN III) (LR6 SO4)3
Hereditary spherocytosis
Blastoconidia

21. What enzyme catalyzes the rate - limiting step of the urea cycle?
Marrow failure - cancer - and leukemia
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
Fourth M PITS for pharyngeal pouch derivatives
Carbamoyl phosphate synthetase I

22. By What age should children be able to draw the following figures? - Square
5 years old
Stroke volume
Dopamine
Autograft

23. What is the term for the first 3 to 5 days of the female reproductive cycle?
Menses. (Ovulation occurs 14 days before the beginning of menses.)
Temporal lobes
Diphyllobothrium latum
Goodpasture disease

24. Name the compartment of the mediastinum associated with the following thoracic structures: Thoracic duct
Oxytocin
Superior and posterior
Naloxone or naltrexone
42 L - 67% of body weight

25. What three substrates control the enzyme PEPCK for the conversion of oxaloacetate (OAA) to pyruvate in the cytoplasm?
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP
Urinary 17- OH steroids
gp120
One day after the LH surge and 2 days after the estrogen peak.

26. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
Methyldopa
Follicular phase
rRNA
5HT1D

27. What is the name of inflammation of the prepatellar bursa?

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28. Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid?
Gastric ulcer
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
Malignant mesothelioma
Doxycycline

29. What is the tetrad of tetralogy of Fallot?
Hyperkalemia
GH
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
LTC4 - LTD4 - and LTE4

30. Name the phase of the eukaryotic cell cycle: x Cells cease replicating (i.e. - nerve cell)
G0 phase
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
NADPH - O2 - and cytochrome b5
Alcohol. Nearly 10% of adults have a problem with alcohol.

31. What hormones - secreted in proportion to the size of the placenta - are an index of fetal well - being?
hCS and serum estriol - which are produced by the fetal liver and placenta - respectively - are used as estimates of fetal well - being.
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
Leptospira
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma

32. In high altitudes - What is the main drive for ventilation?
Incidence rate
Nodular sclerosis
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.

33. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Dorsal root ganglion?
Epidural hematoma
Femoral hernias
Sensory
Ataxia - telangiectasia

34. The increased oxygen consumption after phagocytosis is for...
ATP production
Aromatase
Estrogen
Yes

35. What is the most common one? - Primary CNS tumor in children
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
Medulla blastoma
Scleroderma
Acute cystitis

36. If a patient with a cerebellar lesion has nystagmus - which way is the fast component directed - toward or away from the lesion?
Very superior (<2.5% of the population)
The fast component is directed toward the affected side of a cerebellar lesion.
Raloxifene
There would be two Fab and Fc regions.

37. What enzyme is inhibited by disulfiram?
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
In the JG cells of the kidney
Osler nodes
Viruses

38. What is the most common one? - Bone tumor
Hydroxyproline (breakdown product of collagen)
Rate of absorption
catalase - negative
Metastatic

39. What commonly encountered overdose produces headache - tinnitus - respiratory alkalosis - metabolic acidosis - confusion - vomiting - and tachypnea?
B cells; macrophages and dendritic cells are nonspecific.
ASA (salicylate)
Medial rectus (CN III) (LR6 SO4)3
Poststreptococcal GN

40. Neurofibrillary tangles
Vitamin B6
Nicotine (but it sure has a nasty withdrawal!)
Alzheimer disease
There is a difference; it takes about 7 to 8 half - lives to reach mathematical steady state and 4 to 5 half - lives to reach clinical steady state.

41. What muscles make up the rotator cuff?
Splenic flexure
SITS
Sympathetic nervous system
NREM sleep. Night terrors are dreams that we are unable to recall.

42. What is the term to describe the inability to feel any pleasant emotions?
Anhedonia
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.
Blastomyces dermatitidis

43. Name the associated chromosomal translocation - Burkitt lymphoma
ACE inhibitors (- pril)
The poly(A) site on the DNA
Chromosome 8 - 14
Risk factors for cervical cancer

44. With what disease do you see IgA deposits in small vessels of the skin and the kidneys?
Macula densa
PGE2
Henoch - Sch
Glutamine and aspartate

45. What abdominal muscle runs horizontally - contributes to the posterior rectus sheath - and contributes to form the conjoint tendon?
Conduction aphasia
Eosin
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
Transverse abdominis

46. What condition is defined by both testicular and ovarian tissues in one individual?
Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance - taking longer to reach threshold and slowing the rate of firing.
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
Progestin
True hermaphrodism

47. Initiates rhythmic contractions associated with labor.
The Beta -2- microglobin. It is the separately encoded Beta - chain for class I Ags.
Secondary spermatocyte
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
Oxytocin

48. What CNS developmental abnormality is associated with 90% of syringomyelia?
Arnold - Chiari malformation type 2
Chromosome 4p
Primary intention
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid

49. What embryonic structure forms the adult male structure? - Scrotum
Physostigmine
Ulnar and radial arteries (ulnar is the main supplier)
Labioscrotal swelling
High - frequency sound waves

50. Name four major risk factors for atherosclerosis.
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.
Excretion is greater than filtration for net secretion to occur.
Physiologic antagonism
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).