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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 exotoxin Shigella dysenteriae produces - which interferes with the 60S ribosomal subunit and results in eukaryotic protein synthesis inhibition?
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)
CN IX
Fluconazole
emancipates

2. What is characterized by an intense inflammatory reaction - an increase in the amounts of granulation tissue and wound contraction by myofibroblasts?
Hirschsprung disease
Histiocytosis X
Healing by secondary intention
Coombs test

3. What branch off the vertebral artery supplies x The ventrolateral two - thirds of the cervical spinal cord and the ventrolateral part of the medulla?
Anterior spinal artery
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
a1- Receptors

4. What happens to flow and pressure in capillaries with arteriolar dilation? Arteriolar constriction?
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT - which means warfarin - extrinsic - PT; heparin - intrinsic - PTT)
Insulin
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
Chromosome 15

5. What are the four posttranslational modifications done by the Golgi apparatus?
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
When the intra - alveolar pressure equals zero - there is no airflow.
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
Small to medium - sized cerebral vessels

6. When do hCG concentrations peak in pregnancy?
In the first 3 months
Superior
Zafirlukast
Gastric carcinoma

7. What is the DOC for the following protozoal infections? - Amebiasis
Scrotal cancer - due to the high exposure to polycyclic aromatic hydrocarbons
Increased GABA levels decrease the likelihood of learned helplessness.
Metronidazole
Osteosarcoma

8. What small gram - negative facultative intracellular rod is transmitted to human host by Dermacentor tick bite?
Francisella tularensis
Transcortical aphasia
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Sphingomyelinase

9. What three vitamin deficiencies are associated with homocystinemia?
Folate - vitamin B12 - and vitamin B6
The lateral vestibular nucleus
Dependent
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids

10. What protein carries free fatty acids to the liver?
Albumin
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.
The stapedius muscle
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.

11. What three PGs are potent platelet aggregators?
Lentigo maligna melanoma
NADPH oxidase
IgE
PGE 1 - PGI 2 (most potent) - and TXA 2

12. From What do catalase - superoxide dismutase - and glutathione peroxidase defend the cell?
Cohort studies determine incidence and causality - not prevalence.
Production of oxygen free radicals
CN XI - vertebral arteries
Urinary trigone

13. What antifungal agent is activated by fungal cytosine deaminase to form 5- FU?
More than 75% of the vessel
Calcium oxalate
Flucytosine
ATP production

14. What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord?
Stroke volume
C1 inhibitor (C1- INH)
The fasciculus cuneatus
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism

15. What paraphilia is defined as x Deriving sexual pleasure from watching others having sex - grooming - or undressing?
Enterococcus faecalis
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
Voyeurism
Echinococcus multilocularis

16. What type of cerebral bleed is due to a rupture of a berry aneurysm in the circle of Willis?
Churg - Strauss syndrome
CN II and ophthalmic artery
Site 2
Subarachnoid hematoma

17. What is the term for the same results achieved again on testing a subject a second or third time?
Nocardia asteroides
Test - retest reliability
Arboviruses (bunyavirus - flavivirus - and togavirus)
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.

18. What bactericidal agents are resistant to Beta- lactamases and are used to treat in - hospital life - threatening infections?
Imipenem and meropenem
Red muscle
Nicotinic acid - because its side effects include hyperuricemia and exacerbation of ulcers.
Scleroderma

19. Name the antimicrobial agent whose major side effect is listed - Dental staining in children
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Tetracycline
Secondary hypoparathyroidism (vitamin D toxicity)
Midazolam

20. What components of the coagulation cascade are affected by estrogen?
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.
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Campylobacter jejuni

21. What syndrome is associated with the following brainstem lesions? - Occlusion of the PICA - resulting in ipsilateral limb ataxia - ipsilateral facial pain and temperature loss - contralateral pain and body temperature loss - ipsilateral Horner's synd

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22. What phase of the cell cycle are the following antineoplastic agents specific for? - Bleomycin
Lateral fissure (fissure of Sylvius)
Doxycycline and minocycline
G2 phase
Granulosa cells

23. What is the name of demyelination of the corticospinal tract and the dorsal column in the spinal cord due most commonly to a vitamin B12 deficiency?
Serous exudates
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Subacute combined degeneration - Which is bilateral below the level of the lesion.
PTH

24. Name the compartment of the mediastinum associated with the following thoracic structures: Brachiocephalic vein
Superior
Absolutely not! Answer any question you are asked.
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
Leydig cell tumor

25. What two requirements must be met for the Lac operon to be activated?
Streptococcus viridans
Upper outer quadrant (left more than right)
Lactose must be present and glucose must be absent
X- linked recessive

26. What wave is the cause of the following venous pulse deflections? - The contraction of the right atrium
Erythromycin
Toxic dose for 50% of drug takers (median toxic dose)
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
wave

27. What is the term for the number of new events occurring in a population divided by the population at risk?
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
Incidence rate
Middle cerebral artery
Gabapentin

28. What is the most common one? - Cardiac pathology in patients with SLE
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.
Superior
DNA polymerase - d
Libman - Sacks endocarditis

29. 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)
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
ACE inhibitors (- pril)

30. Which fungus is found worldwide on plants - is a cigar - shaped yeast in tissue form - and results in rose gardener's disease?
Water
For males it's prostate cancer - and for females it's breast cancer.
Carnitine acyltransferase - I
Sporothrix schenckii

31. On the venous pressure curve - What do the following waves represent? - A wave?
Log - kill hypothesis (follows first order kinetics)
Atrial contraction Atrial - Contraction - Venous
Bronchogenic carcinoma
Citrate - via the citrate shuttle

32. What are the two most common viral infections in HIV?
CMV retinitis and HSV-2
1. Protest 2. Despair 3. Detachment
Pulse pressure
Decreases

33. What is the name of the SER of striated muscle?
Cystadenocarcinoma
300 mOsm/L
Melatonin - serotonin - and CCK
Sarcoplasmic reticulum

34. What is the term for the total percentage of correct answers selected on a screening test?
Guillain - Barr
Accuracy (think of it as all the trues - because they are the ones correctly identified)
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells
Hydroxyapatite

35. What two HIV regulatory genes down - regulate MHC class I expression in the host?
Ea (activation energy)
1 day prior to ovulation
nef and tat genes
Schatzki ring

36. What chamber of the eye lies between the iris and the lens?
Vitreous humor
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
Posterior chamber
Menses

37. Is used to detect Abs in a patient?
At least six
Direct fluorescent Ab test
Filtration is greater than excretion for net reabsorption to occur.
Molluscum contagiosum

38. What cell surface marker is found on activated helper T cells?
CD40
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Lewy bodies
Adult polycystic kidney disease

39. What mast cell mediator is a chemotactic agent?
HBcAb IgM - HBV- DNA - HBeAg - HBsAg
Measurement bias
Multiple myeloma
Eosinophil chemotactic factor A

40. What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
HIV
Reinforcement
EBV
Clostridium botulinum

41. What agent antagonizes the effects of heparin?
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
Nephrotoxicity
Zafirlukast
Protamine sulfate

42. Name the Hgb - O2 binding site based on the following information: x Greatest affinity of the three remaining sites for attachment; requires PO2 levels of 26 mm Hg to remain attached
Aortic insufficiency
Site 2
Burkitt lymphoma
Arch of the aorta

43. What CNS tumor commonly produces tinnitus and hearing loss?
Schwannoma
Projective test. Most tests with a wide range of possibilities for the answers are projective.
Neonatal respiratory distress syndrome (NRDS)
Calcium oxalate

44. Which protozoal parasitic vaginal infection produces a positive whiff test with KOH staining?
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
Trichomonas vaginalis (treat with metronidazole)
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.

45. What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels?
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.
Bile pigments and bile salts
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
urease positive

46. What happens to NE levels in x Major depression?
Decrease (5- HT and dopamine levels do the same)
Bunyavirus
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.

47. Neurofibrillary tangles
Alzheimer disease
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
Dorsal prefrontal cortex

48. How much dietary iodine is necessary to maintain normal thyroid hormone secretion?
G2 phase
The subclavian artery
Chromosome 1
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.

49. Match the pulmonary end capillary blood levels.
The alveolar PO2 and PCO2 levels
Histidine
RSV
Midazolam

50. Is CO2 a perfusion - or diffusion - limited O2 gas?
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
Look for broken blood vessels in the baby's eyes.
Atrial filling (venous filling) Atrial - Contraction - Venous
Quinolones