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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 cells are atypical on a peripheral blood smear in heterophil - positive mononucleosis?
Childhood
Neurofibromatosis
Metronidazole
T cells - not B cells

2. What is the only dsRNA virus?
Reovirus
Zero - order elimination
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
Chromosome 18

3. What organelles make ATP - have their own dsDNA - and can synthesize protein?
Avidity (more than one binding site)
Mitochondria
The Fc region of IgG and C3b
The time it takes ACh to diffuse to the postjunctional membrane

4. What pancreatic islet cell tumor is associated with watery diarrhea - hypokalemia - and achlorhydria?
Granulosa/thecal cell tumor of the ovary
gamma and delta chains
VIPoma
Gain of hypotonic fluid (water intoxication or hypotonic saline)

5. How many acetyl CoAs per glucose enter into the TCA cycle?
Lipoid nephrosis
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
Erythema nodosum
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)

6. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Medulla
The sensory limb is via CN IX - and the motor limb is from CN X.
Parasympathetics (parasympathetics point - sympathetics shoot)
Rhombencephalon
Chromosome 15

7. What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
Class II
Antithyroglobulin and antimicrosomal Abs
18 years old (except if emancipated)
Operant conditioning (reinforcement is after a response)

8. What DNA virus is associated with exanthem subitum (roseola)?
HHV 6
At least 15%
Saccule and utricle
Chromosome 7

9. What does a loss of afferent activity from the carotid sinus onto the medulla signal?
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Reovirus

10. What is the most common one? - Cardiac tumor of infancy
Anemia of chronic disease
Prolactinoma
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Rhabdomyoma

11. What Ab is an indication of recurrent disease for hepatitis?
ACh
HBc Ab
Staphylococcus saprophyticus
Right ventricle

12. Is a subdural hematoma an arterial or venous bleed?
Repression
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Mycobacterium leprae
Gabapentin

13. What phase of the cell cycle are the following antineoplastic agents specific for? - Cisplatin
Waldenstr
CN III and IV
G0 phase
M

14. What do the risk factors late menopause - early menarche - obesity - nulliparity - excessive estrogen - genetic factor p53 - and brc - abl characterize?
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Breast cancer
Specificity (it deals with the healthy)
Sorbitol (resulting in cataracts)

15. What is the name for failure of the allantois to close - resulting in a urachal fistula or sinus?
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Rhombencephalon
Patent urachus
epithelial lining

16. Name these narcissistic defense mechanisms: x Person takes his or her own feelings - beliefs - wishes - and so on and thinks they are someone else's. (e.g. - a cheating man thinks his wife is unfaithful)
REM sleep. Remember - awake brain in a sleeping body.
B- cell Ag receptors
Graves disease
Projection

17. What part of the heart forms x Apex?
Dihydrofolate reductase
Streptococcus viridans
Tip of the left ventricle
Eosinophils

18. Name the antidote - Mercury
Trypsin
Krukenberg tumor
Chromosome 20q (deficiency in adenosine deaminase)
Dimercaprol - penicillamine

19. What type of Plasmodium affects x Only reticulocytes?
Proencephalon
GABA and glutamic acid
Plasmodium vivax
Janeway lesions

20. Which class of antiarrhythmics are potassium channel blockers?
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Vitamin B12 deficiency and folate deficiency
Class III

21. Where in the kidney are the long loops of Henle and the terminal regions of the collecting ducts?
IgE
Saccule and utricle
In the medulla; all the other structures are cortical.
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)

22. Name the most common type or cause - Diarrhea in children
Mycobacterium leprae
Sigmoid colon
Neomycin
Rotavirus

23. What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
CN IX
Atracurium
Heroin
Uracil

24. What apoprotein on HDL activates lecithin - cholesterol acyltransferase (LCAT)?
Hepatocellular carcinoma
apo A-1
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
CD19

25. What gene stimulates apoptosis when DNA repair is unable to be done?
An internal elastic lamina
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
Constipation and miosis
p -53

26. What urease - producing gram - negative curved rod is associated with PUD and chronic gastritis?
Helicobacter pylori - Which is also associated with an increased risk of gastric carcinoma
Streptococcus agalactiae
NREM sleep. Remember awake body - sleeping brain
The carotid sinus reflex

27. What fissure of the cerebral cortex separates the frontal and temporal lobes rostrally and partially separates the parietal and temporal lobes?
Lateral fissure (fissure of Sylvius)
Laminin
M- cells
Virchow triad - associated with the formation of a thrombus.

28. What is the term for a complete aversion to all sexual contact?
REM latency; normally it is about 90 minutes.
Sexual aversion disorder
This is the triad of renal cell carcinoma
Macula densa

29. Which virus is treated with the monoclonal antibody palivizumab?
Chronic alcoholic
Thrush
The myotatic reflex is responsible for the tension present in all resting muscle.
RSV

30. What CN is associated with the x Fourth pharyngeal arch?
Rochalimaea quintana (now called Bartonella quintana)
CN X
Right vagus innervates the SA node and the left vagus innervates the AV node
Chronic rejection

31. What is the term for ventilation of unperfused alveoli?
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
Alveolar dead space
With arteriolar constriction both the flow and pressure downstream decrease.
Norm reference (i.e. - 75% of the students in the class will pass)

32. What type II hypersensitivity disorder is defined as x Autoantibodies against the type IV collagen in the basement membrane of the kidneys and lungs?
Valproic acid
Goodpasture syndrome
Gastric carcinoma
Eclipse period

33. What adult structures are derived from preotic somites?
Blastomyces dermatitidis
Cortisol
Para - aminohippurate (PAH)
Muscles of the internal eye

34. What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
Herpes I
Chloramphenicol
HIV
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.

35. In an adult - Where does the spinal cord terminate and What is it called?
HMG CoA synthase
The conus medullaris terminates at the level of the second lumbar vertebra.
CN VII
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.

36. What is the central chemoreceptor's main drive for ventilation?
Plasmin
Chi - square (when you are in doubt and have nominal data - use chi - square)
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)

37. What is the most common site for an aneurysm in cerebral circulation?
The small subunit (40S) binds first.
Pseudomonas aeruginosa
Hepatitis C
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia

38. What is the most common one? - Viral cause of myocarditis
HBsAg (incubation period)
Coxsackie B
Thyroid hormones
Scrofula

39. Name at least three bacteria that use capsules to prevent immediate destruction from the host's defense system.
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
Plasmodium malariae
Addition (They are mutually exclusive.)
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.

40. What is the most common one? - Germ cell tumor in boys
Pseudomonas
Yolk sac tumor
Somatoform pain disorder
Wegener granulomatosis

41. What inflammatory bowel disorder is continuous - with extensive ulcerations and pseudopolyps - and is associated with HLA- B27?
Osteoma
Generalized anxiety disorder
Ulcerative colitis
Ewing's sarcoma

42. How far below ideal body weight are patients with anorexia nervosa?
Pseudomonas aeruginosa
Enteroendocrine (EE) cells; they also secrete secretin.
Aged adult
At least 15%

43. What are the two functions of the thymus in T- cell differentiation?
Folate - vitamin B12 - and vitamin B6
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
G0 phase
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).

44. When referring to a series circuit - what happens to resistance when a resistor is added?
Membrane conductance (think conductance = channels open)
Minor
Positive
Resistance increases as resistors are added to the circuit.

45. What is flat - circumscribed nonpalpable pigmented change up to 1 cm?
Acute cystitis
It causes a buildup of dATP - which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate - a precursor of DNA - resulting in overall bone marrow suppression.
Macule (e.g. - a freckle)
Trypsin

46. What form of renal tubular reabsorption is characterized by high back leak - low affinity for substance - and absence of saturation and is surmised to be a constant percentage of a reabsorbed filtered substance?
Gradient - time system
True hermaphrodism
Amantadine
Mycobacterium leprae

47. Name the most common one - Heart defect in Down syndrome
Treacher Collins syndrome
Clofazimine
Pernicious anemia
Endocardial cushion defect

48. A Japanese man has weight loss - anorexia - early satiety - epigastric abdominal pain - and a palpable left supraclavicular lymph node. On endoscopy you find a large - irregular ulcer with elevated margins on the lesser curvature of the stomach. What
Meningocele All except occulta cause elevated - fetoprotein levels.
Middle meningeal artery
Gastric carcinoma
The first trimester

49. What reflex - seen in lesions of the corticospinal tract - is an extension of the great toe with fanning the of remaining toes?
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.
Lithium
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
G0 phase

50. From which two substances are phospholipids made?
Diacylglycerols and phosphatidic acid
Medullary carcinoma of the thyroid
External 3' - 5' PDE bonds
B cells; macrophages and dendritic cells are nonspecific.