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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. Can a patient refuse life - saving treatment for religious reasons?

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2. What cancer is particularly likely to affect English chimney sweeps?
Fungiform papillae
LTC4 - LTD4 - and LTE4
Eosin
Scrotal cancer - due to the high exposure to polycyclic aromatic hydrocarbons

3. What phase of the cell cycle are the following antineoplastic agents specific for? - Cytarabine
S phase
Adulthood
Live vaccines
Mesocortical area

4. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Pancreas
Stable
Antidigoxin Fab fragments
Free - unprocessed Ag
Lithium

5. In prokaryotes - What is the name of the RNA sequence that ribosomes bind to so translation can occur?
Arboviruses (bunyavirus - flavivirus - and togavirus)
Shine - Dalgarno sequence
It is rare with normal grief; however - it is relatively common in depression
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.

6. What is the triad of Wiskott - Aldrich syndrome?
Sigma factor
Estrogen use
1. Cytosine 2. Uracil (only in RNA) 3. Thymidine
Thrombocytopenia - eczema - and immunodeficiency is the triad of this X- linked recessive disorder.

7. The proportion of truly diseased persons in the screened population who are identified as diseased refers to?
Triazolam
Factors II - VII - IX - X - and proteins C and S
The conversion of CHO to pregnenolone via the enzyme desmolase
Sensitivity (it deals with the sick)

8. Which centrally acting a2- adrenergic agonist is safe for use in renal dysfunction and in HTN during pregnancy?
Methyldopa
Chromosome 22q
Integument (skin and its derivatives)
Succinate dehydrogenase

9. What somatoform disorder is described as x Preoccupied with illness or death - persisting despite reassurance - lasting longer than 6 months?

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10. On the venous pressure curve - What do the following waves represent? - V wave?
Cocaine
Atrial filling (venous filling) Atrial - Contraction - Venous
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.

11. What rate is indicated by 1- specificity?
False - positive rate
Opposite the second upper molar tooth
IDL
Zollinger - Ellison syndrome

12. What parasite is associated with squamous cell carcinoma of the urinary bladder?
wave
Accessory nucleus
D- Penicillamine
Schistosoma haematobium

13. What cell transports IgA - is secreted by plasma cells - and is in Peyer's patches to the gastrointestinal lumen?
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
Primary hypercortisolism
ACL
M- cells

14. What is the period between falling asleep and REM sleep called?
Rhombencephalon
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.
GLUT 4
REM latency; normally it is about 90 minutes.

15. What disorder is described as having x Conscious symptoms with conscious motivation?
Series circuit
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).
Malingering
Creatinine

16. Name the form of spina bifida - An open neural tube lying on the surface of the back
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Staphylococcus aureus
Herpes II
Id (pleasure principle)

17. Caf
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
Carbidopa and benserazide
Neurofibromatosis
Hydralazine - isoniazid - and procainamide (HIP)

18. What seronegative spondyloarthropathy is seen in HLA- B27- positive young men - involves the sacroiliac joints - has no subcutaneous nodules - and has a bamboo spine appearance on radiograph?
Ankylosing spondylitis
Cancer
Urogenital folds
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius

19. What is the monoamine oxidase B (MAOB) inhibitor?
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Selegiline
Mitral stenosis
Leucine and lysine

20. Name these anxiety defense mechanisms: x Use of explanations to justify unacceptable behaviors.
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
Rationalization
C5a
Methanol (wood alcohol)

21. Can parents withhold treatment from their children?
Janeway lesions
Cancer
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.
Musculophrenic and superior epigastric arteries

22. Bence - Jones proteinuria
Proencephalon
Multiple myeloma
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.
Lactose must be present and glucose must be absent

23. The closure of what valve indicates the beginning of isovolumetric contraction?
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
Vaginismus; it is the female counterpart of premature ejaculation.
Hepadnavirus
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia

24. What factors are needed for translation in prokaryotes?
Cancer of the lung - stomach - colon - and breast
Galactoside permease
Elongation factor - G and GTP
Rabies

25. What is the key issue surrounding teenagers' maturation?
Formation of an identity through issues of independence and rebellion; they define who they are.
Vitreous humor
Cardiac output
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.

26. What is the most common chromosomal disorder?
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.
Fibroadenoma
Down syndrome
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.

27. Why is there an increase in FF if the GFR is decreased under sympathetic stimulation?
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
Absolute refractory period is due to voltage inactivation of sodium channels.
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.
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).

28. Is the AD or AR form of osteopetrosis malignant?
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
The AR form is malignant and AD is benign.
Cohort studies determine incidence and causality - not prevalence.
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.

29. Name the type of mutation: x Unequal crossover in meiosis with loss of protein function
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
The greater the myelination - the greater the conduction velocity.
Large segment deletions
CD8

30. Are seen in medullary carcinoma of the thyroid.
eIF-2 in the P site
Psammoma bodies
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
Ventral anterior nucleus

31. What is the term for the ability of a test to measure something consistently?

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32. Name the aphasia based on these characteristics: x Nonfluent speech - telegraphic and ungrammatical; lesion in Brodmann's area 44; unimpaired comprehension

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33. What is the only dsRNA virus?
C5- C8 deficiency
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.
Confidence interval. It is a way of admitting estimation for the population.
Reovirus

34. Is bone deposition or resorption due to increased interstitial Ca2+concentrations?
Bone deposition increases with increased Ca2+ or PO 4- concentrations - whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
Zero - order elimination
Adenosine (it is an excellent agent to use in emergencies because its half - life is 30 seconds)
Areas 18 and 19

35. What agent used in the treatment of BPH and baldness is a 5- a - reductase inhibitor?
Carbonic anhydrase
Hepadnavirus
JC virus
Finasteride

36. What type of resistance system - high or low - is formed when resistors are added in a series?
Hypertension
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
A high - resistance system is formed when resistors are added in a series.
Phase 0

37. Name the antidote - Warfarin
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
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
Fragile X syndrome
Vitamin K

38. Name the Hgb - O2 binding site based on the following information: x Requires a PO2 level of 40 mm Hg to remain attached
Anemia of chronic disease
Salmonella
Site 3
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh

39. What fat - soluble vitamin is connected to selenium metabolism?
Arterioles have the largest drop - whereas the vena cava has the smallest pressure drop in systemic circulation.
Vitamin E
Alcohol. Nearly 10% of adults have a problem with alcohol.
Duchenne muscular dystrophy (Remember - Becker's is slower in progress - less severe - later in onset - and lacks cardiac involvement.)

40. What paraphilia is defined as x Deriving sexual pleasure from being abused or in pain?
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Crude mortality rate
Huntington disease
Masochism

41. Is filtration greater than or less than excretion for net reabsorption to occur?
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -
Pancreatic insufficiency
Enterococcus faecalis
Filtration is greater than excretion for net reabsorption to occur.

42. What is the rate - limiting enzyme of the HMP shunt?
Ethambutol
Microcytotoxic assay
G-6- PD
Skeletal muscles

43. What is the term for precipitation of calcium phosphate in dying or necrotic tissue?
RBCs. That is why it is called red pulp.
Oxytocin
Good Samaritan Law. (Physicians are not required to stop and help.)
Dystrophic calcification

44. At high doses aspirin has ________ properties.
Uricosuric
Enterococcus (Streptococcus faecalis)
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Aspiration pneumonia

45. Name the associated chromosome - Chronic lymphocytic leukemia (CLL)
Left atrium and tip of the right atrium
Proencephalon diencephalon derivative
Chromosome 12
IgG3

46. What are the pharmacologic effects seen sexually with x Trazodone?
Priapism
Surface tension; in the alveoli - it is a force that acts to collapse the lung.
Area 8
Expiratory reserve volume (ERV)

47. What intermediate of cholesterol synthesis anchors proteins in the membranes and forms CoA?
Farnesyl pyrophosphate (FPP)
Capillaries
Distal convoluted tubules
Gonorrhea

48. 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.
Ego syntonic
MEN II and III syndromes
Fetal alcohol syndrome

49. When a person goes from supine to standing - what happens to the following? - Cardiac output
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
Glycine and succinyl - CoA
Somatoform disorder
Anterior wall of the first part of the duodenum

50. What genus of bacteria is described by catalase - positive - gram - positive cocci in clusters?
Kayser - Fleischer rings
Staphylococcus
Beta- Endorphin
Iron (Fe)