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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 DNA virus is associated with exanthem subitum (roseola)?
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
HHV 6
Nodular sclerosis
Decreased REM sleep and REM rebound during withdrawal

2. What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
Ventral posteromedial nucleus
Raloxifene
Fovea
Medial meniscus

3. What form of bias is due to false estimates of survival rates?

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4. What is the site of action of the following? - Thiazide diuretics
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Early distal tubule
Vanillylmandelic acid (VMA)
Sphingomyelinase

5. What disorder is associated with decreased platelet count - prolonged PT and PTT - decreased fibrinogen - and increased fibrin split products (D- dimers)?
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Zero correlation
External 3' - 5' PDE bonds
Disseminated intravascular coagulation (DIC)

6. What type of fatty acid is associated with a decrease in serum triglycerides and cardiovascular disease?
Adrenarche
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.
Omega -3 fatty acids
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)

7. Name the antidote - Mercury
5' deiodinase
Physiologic dead space is the total dead space of the respiratory system.
epithelial lining
Dimercaprol - penicillamine

8. What antifungal agent is activated by fungal cytosine deaminase to form 5- FU?
Methylene blue
Lente or NPH insulin (neutral protamine Hagedorn insulin)
Flucytosine
The sensory limb is via CN IX - and the motor limb is from CN X.

9. What organelle synthesizes proteins that are intended to stay within the cell?
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.
Howell - Jolly bodies
The increased H+ moves intracellularly and is buffered by K+ leaving the cells - resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis - even though the serum
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------

10. What seronegative spondyloarthropathy is seen in HLA- B27- positive young females and presents with the triad of conjunctivitis - urethritis - and arthritis affecting the knees and ankles?
Reiter syndrome
Swan - neck deformities
Leiomyoma (fibroids)
Methicillin

11. How many high - energy bonds are used to activate an AA?
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
2 ATPs - via the amino acyl tRNA synthase enzyme
Trichophyton
Hepatitis - with or without necrosis

12. What gram - positive anaerobic rod with branching filaments is a component of the normal flora of the mouth and female genital tract and is responsible for draining abscesses with sulfur granules in the exudates?
Labetalol
Actinomyces israelii
C5b - C9
excites the neuron

13. What pyrimidine base is found x In both DNA and RNA?
Chromium (Cr)
Testicular tumors
Cytosine
VIPoma

14. Which macrolide is given as 1200 mg/week for the prophylaxis of Mycobacterium avium intracellulare complex?
Yohimbine
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages
Azithromycin
Arch of the aorta

15. What are the three stimuli that result in the reninangiotensin - aldosterone secretion?
ASD
Papillary carcinoma of the ovary
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
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.

16. Are the following responses associated with histamines H1 or H2 receptor activation? - Gastric acid secretion
Leydig cell tumor
CN VII
H 2
Lente insulin and either NPH or protamine zinc insulin (PZI)

17. Based on operant conditioning - What type of reinforcement is described when x Adding a stimulus reinforces a behavior?
Osteoarthritis
Positive reinforcement
Parvovirus (it is the only ssDNA virus)
Toxoplasma gondii

18. Name the cluster B personality disorder: x In a constant state of crisis - promiscuous - unable to tolerate anxiety- causing situations - afraid of being alone - and having intense but brief relationships
Duchenne muscular dystrophy
Borderline
Mitral valve prolapse
Malignancy

19. What is it called when levels of sex steroids increase - LH increases - and FSH increases?
Phase I
50% - with 50% of them having the child
GnRH pulsatile infusion
Hepadnavirus

20. Rheumatic fever most commonly follows pharyngeal infections with what bacteria?
Melanoma - cancer of the stomach and bladder
Group A Beta- hemolytic streptococci
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Risperidone

21. Name the most common type or cause - Urethritis in a young - newly sexually active individual
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell
Splenic flexure
Staphylococcus saprophyticus

22. What disease has multiple schwannomas - caf
It both begins and ends at T4 (sternal angle [of Louis]).
Streptococcus agalactiae
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)
Clozapine

23. What chamber of the eye lies between the iris and the lens?
Posterior chamber
Juxtaglomerular (JG) cell
Chromophobe adenoma
Raloxifene

24. What is the most potent stimulus for glucagon secretion? Inhibition?
Addition (They are mutually exclusive.)
Hypoglycemia for secretion and hyperglycemia for inhibition
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
Monocytosis

25. What is the term for different classes and subclasses of the same gene products?
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Isotypes
Sensory
Adrenarche

26. What bonds are broken by exonucleases?

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27. A 60-year - old man has back pain (compression spinal fracture) - hypercalcemia - increased serum protein - Bence - Jones proteinuria - and monoclonal M- spike on serum electrophoresis. What is your diagnosis?
Lethal dose for 50% of drug takers (median lethal dose)
Multiple myeloma
Effective dose for 50% of drug takers (median effective dose)
Hydatidiform mole

28. Ensures emancipation.
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
Pregnancy
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Neisseria gonorrhoeae and Chlamydia trachomatis

29. 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
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.
Ungated potassium channel
apo B-48

30. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Benzenes
Leukemias
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
T9
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.

31. What term is described as the prestretch on the ventricular muscle at the end of diastole?
Chromosome 11p
From the wall of the yolk sac
Phosphofructokinase -1 and costs 1 ATP
Preload (the load on the muscle in the relaxed state)

32. Name the phase of the eukaryotic cell cycle: x Cells cease replicating (i.e. - nerve cell)
G0 phase
Oblique fissure
Bactericidal
Stranger anxiety

33. Name three opsonins.
Fc portion of IgG - C3b - and mannose - binding proteins
Leptospira
C5a
Variable interval

34. What type of scheduled reinforcement states that after a desired response - the reinforcement is given x After a set number of responses?
Adenine and guanine
Aschoff bodies of rheumatic fever
GH and prolactin are produced by acidophils; all others are by basophils.
Fixed ratio (rewards set behaviors)

35. From What aortic arch are the following structures derived?
Gaucher disease
Chromosome 19
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Stapes artery

36. Name the thalamic nucleus based on its input and output - Input from globus pallidus and substantia nigra; output to primary motor cortex
Glycine/arginine
Ventral anterior nucleus
Proud flesh
Enterokinase

37. What malignant neoplasm of the bone has a soap bubble appearance on radiograph?
Constipation and miosis
90% of benign myxomas arise within the left atrium near the fossa ovalis.
Giant cell bone tumor (osteoclastoma)
Serocystadenoma

38. What are the growth factors released from the liver called?
Phallic stage (4-6 years)
Glucokinase
Somatomedins
Right nasal hemianopsia

39. What facultative intracellular fungus is associated with hepatosplenomegaly?
Glutamate
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Ataxia - telangiectasia
Diffuse proliferative GN

40. Is there a difference between mathematical and clinical steady states? If so - What are their values (half - lives)?
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Duodenal ulcer
Beta- Endorphin
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 is the greatest component of lung recoil?
Surface tension; in the alveoli - it is a force that acts to collapse the lung.
Ulnar to radial progression
Ordinal scale (e.g. - faster/slower - taller/shorter)
Metronidazole

42. 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?
Borderline
Meningococcus (Gonococcus does not)
CD4+T cells
Bainbridge reflex

43. What projective test asks the patient to tell a story about What is going on in the pictures - evaluating the conflicts - drives - and emotions of the individual?
Catalase - negative bacteria secrete H2O2 as a byproduct (remember - catalase breaks down H2O2) - allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase - positive bacterial infect
Onset of bleeding
Amantadine
TAT (Thematic apperception test)

44. Although the CSF normally contains 0 to 4 lymphocytes or monocytes - the ___________ is always considered abnormal.
IL-4 - IL-10 - and IL-13
Masochism
Cholesterolosis
presence of PMNs

45. What are the three branches of the inferior mesenteric artery?
Left colic - superior rectal - and sigmoidal arteries
Naloxone or naltrexone
The cat
eEF-1

46. What are the two absolute requirements for the cytochrome P450 enzyme system?
Psammoma bodies
Hyperkalemia
Necator americanus is treated with mebendazole and iron therapy.
NADPH and molecular O 2

47. Regarding the Lac operon - for What do the following genes code? - I gene
naked viruses
Lac repressor protein
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle

48. Name the associated chromosome - Chronic lymphocytic leukemia (CLL)
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Chromosome 12
Galactitol

49. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Liver
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)
Stable
Orotic acid (purine metabolism)
Taenia solium

50. What oral hypoglycemic agent stimulates pancreatic Beta- cell release of insulin and is given just prior to meals because of its short half - life?
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
Buffers (remember that buffers are best when they are used in a pH range near its pK)
Pancreatic cancer
Repaglinide

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USMLE Step 1 Prep

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