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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
Papillary carcinoma of the ovary
Atrial contraction Atrial - Contraction - Venous
Hepatitis D
Tylosis

2. Which trophoblast layer of the placenta remains until the end of pregnancy?
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
Are inactivated vaccines available in the United States
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Mean corpuscular volume (MCV)

3. Which hepatitis B serology markers
CN V2
HBsAb IgG
Diazepam is longest acting and midazolam is shortest acting.
Calcarine sulcus

4. What case is known as 'let nature take its course'?
Preductal (infantile)
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
Aspiration
Venlafaxine. (It also has a mild dopaminergic effect.)

5. What tumor marker is associated with seminomas?
Azithromycin
Increase (5- HT and dopamine levels do the same)
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
Placental alkaline phosphatase

6. Name the MCC - Pneumonia in an HIV- positive patient with CD4 less than 200
Pneumocystis carinii
1. Sweat glands 2. Arterioles 3. Veins
Dantrolene
Thymus gland. (Thymus gland is essential for T cell maturation.)

7. What syndrome is associated with the following brainstem lesions? - Vertebral artery or anterior spinal artery occlusion - resulting in contralateral corticospinal tract and medial lemniscus tract deficits and an ipsilateral CN XII lesion
Parental assignment and culture (not biology)
Bainbridge reflex
Medial medullary syndrome
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)

8. What CNs are affected if there is a lesion in x The upper pons?
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
CN V
Ovarian fibroma
Type I pneumocytes

9. How does ventricular depolarization take place - base to apex or vice versa?
Depolarization is from apex to base and from endocardium to epicardium.
Antisocial
Repolarization is from base to apex and from epicardium to endocardium.
Intellectualization

10. What cardiac reflex is characterized by stretch receptors in the right atrium - afferent and efferent limbs via the vagus nerve - and increased stretch leading to an increase in heart rate via inhibition of parasympathetic stimulation?
Cardiac muscle
Bainbridge reflex
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
Epidermophyton

11. Where are the LMN cell bodies of the corticospinal tract?
Rhinovirus
Risk factors for cervical cancer
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.
1. Cytosine 2. Uracil (only in RNA) 3. Thymidine

12. Name the end product or products: x Fatty acid oxidation
Methyldopa
Free ionized Ca2+
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Enkephalin

13. What is the term for a large - immature RBC that is spherical - blue - and without a nucleus?
Primary Hemochromatosis
Bender Visual Motor Gestalt Test
Ungated channels
Reticulocyte

14. In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
Medial medullary syndrome
Malignant mesothelioma
Squamous cell carcinoma (skin - lung) and angiosarcoma of the liver
Functions of hepatocytes

15. Is there a shift in p50 values with anemia? Polycythemia?
igantism
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
Stable
Aromatase

16. What abdominal muscle runs horizontally - contributes to the posterior rectus sheath - and contributes to form the conjoint tendon?
Transverse abdominis
The time it takes ACh to diffuse to the postjunctional membrane
Frontal lobe
Acute tubular necrosis

17. What is the most common one? Esophageal cancer in the United States
Tetralogy of Fallot
HBsAg (incubation period)
The larger the volume of distribution - the lower the plasma concentration of a drug.
Adenocarcinoma (because of Barrett esophagus)

18. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 46/2n (divide mitotically)
Lispro insulin
Spermatogonia (type B)
Toxoplasmosis
The reduviid bug

19. What type of hypersensitivity is a result of high circulating levels of soluble immune complexes made up of IgG or IgM Abs?
Type III hypersensitivity reaction
Mannitol
Churg - Strauss syndrome
Flumazenil

20. What form of anemia is associated with IgG Abs against Rh antigens - positive direct Coombs test - and splenomegaly?
Pubis - ilium - and ischium
All (nearly 15-20 times the normal risk)
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
Autoimmune hemolytic anemia

21. Eating fava beans can produce the Mediterranean type of what deficiency?
G-6- PD deficiency
Ristocetin
Placental alkaline phosphatase
Persistent truncus arteriosus

22. What classical conditioning therapy or modification is described as x Triage of a hierarchy of fears (from least to most) - then teaching muscle relaxation techniques in the presence of those fears until the subject is not afraid anymore?
Systematic desensitization
Ventricular contraction Atrial - Contraction - Venous
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Triazolam

23. What Ab is an indication of low transmissibility for hepatitis?
Isotonic contraction
Parasites
ACE inhibitors (the - pril agents)
HBeAb

24. What DNA virus is associated with heterophile - negative mononucleosis?
Arch of the aorta and right subclavian artery
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
Ventral posterolateral nucleus
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.

25. What enzyme catalyzes the rate - limiting step in cholesterol metabolism?
Paget disease (osteitis deformans)
HMG- CoA reductase
Cleft palate
CN XI - vertebral arteries

26. Which virus is treated with the monoclonal antibody palivizumab?
RSV
Cricothyroid muscles
An internal elastic lamina
The folding of an AA chain

27. There is no hormonal control to the...
TCA cycle.
Fluconazole
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.
Thymic epithelial cells - dendritic cells - and macrophages

28. What water - soluble - vitamin deficiency is associated with neural tube defects in the fetus?
Folic acid
Unipolar disorder (major depression)
Anterior compartment of the thigh - femoral nerve
Acetoacetate - acetone - and Beta- hydroxybutyrate

29. What type of bias is it when the sample population is not a true representative of the population?
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe
No. Remember - tests do not diagnose - they confirm or refute your diagnosis. Also - diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI - elevated cardiac enzymes consistent with MI - and ST segment elevati
VSD
Selection bias

30. What is the most common chromosomal abnormality associated with CLL?
Normal values
Huntington's chorea. (Death in 15-20 years - often via suicide.)
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)

31. What vitamin deficiency causes a glove - and - stocking neuropathy seen in alcoholics?
Live vaccines
Primary follicle (in the white pulp)
Bell pad
Pyridoxine (B6) deficiency

32. What AA is a precursor of the following substances? - Creatine
Teeth grinding is associated with stage 2 sleep.
Superior
Median nerve
Glycine/arginine

33. What subtype of schizophrenia is characterized by x Stuporous mute echopraxia and automatic obedience - waxy flexibility with rigidity of posture?
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Tetanospasmin (also called tetanus toxin)
Catatonic schizophrenia

34. It degenerates 4 to 5 days post fertilization - and implantation occurs __ days post fertilization!
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
7
Glyceraldehyde dehydrogenase

35. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Thalamus
Pneumothorax
Proencephalon
H1 histones
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.

36. What component of the trigeminal nuclei x Receives sensory input (all but pain and temperature) from the face - scalp - dura - and the oral and nasal cavities?
Squamous cell carcinoma
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
Spinal trigeminal nucleus
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns

37. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Kidney
Ventral posteromedial nucleus
Stable
None; it degenerates.
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes

38. What cestode causes cysticercosis?
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
Taenia solium
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.

39. What do the following values indicate? - LD50
Right nasal hemianopsia
Lethal dose for 50% of drug takers (median lethal dose)
Thyroid hormones are necessary for conversion of carotene to vitamin A.
HHV 6

40. What law states that an enlarged - palpable gallbladder is more likely due to cancer than stone obstruction?

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41. Is suicidal ideation a component of normal grief?
It is rare with normal grief; however - it is relatively common in depression
Smooth muscle
Type III
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.

42. What Brodmann area is associated with x Primary somatosensory cortex?
Ag - Ab binding
Cyanide
Plasmodium vivax
Areas 1 - 2 - and 3

43. What structure of a protein describes the interaction among subunits?
Fat necrosis
Quaternary structure
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Penicillin V

44. What antifungal agent is used in the treatment of androgen receptor - positive cancers?
Cytochrome a/a3
Insulinoma
Mode
Ketoconazole

45. Blue - domed cysts
Arcuate line
Histiocytosis X
Levator palpebrae superioris
Fibrocystic change of the breast

46. In What trimester is the fetus most vulnerable to congenital rubella syndrome?
The first trimester
Phase 2
Variable interval
Hemochromatosis

47. What syndrome has loss of deep tendon reflexes - muscle weakness - and ascending paralysis preceded by a viral illness?
Negative
Erythema marginatum
Purine nucleoside phosphorylase
Guillain - Barr

48. What is the name of the major chemotactic agent released from x Neutrophils?
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
The surface of the medulla
Leukotriene B4 (LTB4)
Temporal lobe

49. 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?
Nasopharynx
Low interstitial free Ca2+ concentrations
IF
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)

50. What antiviral agent is used to treat RSV - influenza A and B - Lassa fever - and hantavirus and as an adjunct to IFN- in hepatitis C?
Ribavirin
Roth spots - and they are seen in bacterial endocarditis.
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
Insulin

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USMLE Step 1 Prep

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