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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. At what vertebral level does the common carotid artery bifurcate?
Thoracic and sacral
C4 (the upper border of the thyroid cartilage)
1. Large sample size 2. Large effect size 3. Type I error is greater
Vitamin B6

2. What do the risk factors late menopause - early menarche - obesity - nulliparity - excessive estrogen - genetic factor p53 - and brc - abl characterize?
Breast cancer
Skeletal muscles
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
Gradient - time system

3. Name the eukaryotic RNA polymerase based on the following: x Synthesizes hnRNA - mRNA - and snRNA
42 L - 67% of body weight
RNA polymerase II
Biofeedback
Priapism

4. Which medication used in the treatment of bipolar disorder decreases the release of T 4 from the thyroid gland?
Acute CO poisoning
Lithium
Legionella (think air conditioners)
Vitamin D

5. What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
Listeria
LC4 - LD4 - and LE 4
Bisphosphonates
Syringomyelia

6. What is the label given to an individual whose IQ is x 80 to 89
Medial rectus (CN III) (LR6 SO4)3
The Beta- subunit; remember - the a - subunit is nonspecific.
Low average
Plasma cell

7. What CN is associated with the x First pharyngeal arch?
Mitochondrial inheritance
Cancer
CN V
Courvoisier's law

8. What rate is indicated by 1- sensitivity?
They block the midcycle surge of LH.
Histrionic
False - negative rate
By asking a patient to close the eyes while standing with feet together

9. What sweat gland type is associated with odor production and hair follicles and is found in the axilla?
Roth spots
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva
Testicular tumors
Parvovirus

10. Is seen in TB.
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
Temporal lobes
Monocytosis

11. Require NaCl in its growth medium.
Vibrio parahaemolyticus
Isotonic contraction
Argyll Robertson pupils
DNA polymerase I

12. What day of the menstrual cycle does ovulation take place?
Dendrites receive information - whereas axons send information.
Isovolumetric contraction
Neuroblastoma
Day 14

13. What thyroid abnormality has the following? - TRH increased - TSH decreased - T4 decreased
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Left abducens nerve
Angiosarcoma of the liver

14. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Eukaryotic cell - 15 to 25 microns - 80S ribosomes - no cell walls - replicates via cytokinesis with mitosis and meiosis
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
Parasites
Primary sclerosing cholangitis
Endometriosis

15. What is the major Ig of the secondary immune response in the mucosal barriers?
IgA
Ristocetin
Tyrosine
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)

16. What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex- mediated; and is seen as lumpy- bumpy subepithelial deposits?
Postinfectious GN
Duodenum
Urinary 17- ketosteroids
G0 phase

17. Below the ___________ - all the aponeurotic fibers run anterior to the rectus abdominis.
Streptococcus viridans
Arcuate line
The energy of activation (Ea)
Minor

18. Name three purine bases that are not found in nucleic acids.
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
Musculocutaneous nerve
Vital capacity (VC)
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.

19. Which dimorphic fungus is endemic in the Ohio - Mississippi - Missouri - and Eastern Great Lakes - is found in soil with bird and bat feces - and is associated with infections in spelunkers and chicken coop cleaners?
Histoplasma capsulatum
Cancer
Progestins
Dopamine levels rise with waking; dopamine is associated with wakefulness.

20. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Euphoria - delusions - thought disorders - Wernicke's aphasia - auditory hallucinations (Hint: the lesion is in the left hemisph
Sympathetic chain ganglion
Dominant temporal lobe
Metaraminol (a1 - Beta1 )
The folding of an AA chain

21. What primary acid - base disturbance is caused by an increase in alveolar ventilation (decreasing CO2 levels) resulting in the reaction shifting to the left and decreasing both H+ and HCO3- levels?
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
Meclizine
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
catalase - negative

22. Can committed mentally ill patients refuse medical treatment?
Papillary carcinoma of the ovary
Prevalence increases. (Incidence does not change.)
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Yes. The only civil liberty they lose is the freedom to come and go as they please.

23. What type of chromatin is transcriptionally active?
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
IgA nephropathy
Allotypes
ACTH

24. What cells of the parathyroid gland are simulated in response to hypocalcemia?
Transference. When it is from the physician to the patient it is called countertransference.
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
Altruism

25. What wave is the cause of the following venous pulse deflections? - The bulging of the tricuspid valve into the right atrium
C wave
Medial umbilical ligaments
The poly(A) site on the DNA
Fentanyl

26. Aroused EEG pattern (fast low voltage and desynchronization) - saccadic eye movements - ability to dream - and sexual arousal are all associated with what general pattern of sleep?
MEN I (or Wermer syndrome)
REM sleep. Remember - awake brain in a sleeping body.
The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated.
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)

27. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Calcitonin
Red blood cell distribution width index (RDW)
Acute rejection
Enterokinase
Medullary carcinoma of the thyroid

28. Which encapsulated fungus is found in soil enriched with pigeon droppings?
Generalized anxiety disorder
Aminophylline
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Cryptococcus neoformans

29. What enzyme of the purine salvage pathway is deficient in the following? - SCID
Adenosine deaminase
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
Excretion is greater than filtration for net secretion to occur.
Posterior

30. What virus is associated with body cavity large B- cell lymphomas?
M 2
Magnesium
Proximal tubule
HHV-8

31. What three muscles constitute the erector spinae?

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32. Name the most common type or cause - Intestinal obstructions in adults
Paracortex
Liver - kidney - and GI epithelium
Adhesions and hernias
Thalassemia minor

33. Does subatmospheric pressure act to expand or collapse the lung?
The respiratory system
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.
The affinity of the drug for its receptor
CN III and IV

34. What substance is secreted by parietal glands and is required for life?
Chronic alcoholic
Intrinsic factor (IF)
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.

35. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF normal - capillary pressure ?
Areas 44 and 45
Conjugated (direct) hyperbilirubinemia - a transport defect
Constriction of afferent arteriole
Wegener granulomatosis

36. Where is the lesion that produces these symptoms when a patient is asked to look to the left? - Right eye can't look left - left eye nystagmus - and convergence is intact
Klebsiella pneumoniae
Rationalization
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Right medial longitudinal fasciculus

37. What component of the ETC is inhibited by the following? - Oligomycin
Haemophilus influenzae type B
Heart disease
Lymphoblastic lymphoma
Fo/F1 complex

38. Which two cephalosporins cross the blood - brain barrier?
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Cefuroxime and cefaclor
Prophase of meiosis I (between 12th and 22nd week in utero)
Cingulate gyrus herniation (subfalcine)

39. Name the macrophages by location: x Kidney
Chronic rejection
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
Mesangial macrophages
EF-2 and GTP

40. Name the most common type or cause - Hypothyroidism in the United States
Dihydrofolate reductase
Iatrogenesis
Succinyl CoA
X- linked recessive

41. What elongation factor is inactivated by ADP ribosylation - preventing translation?
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c
a1- Receptors
CHF

42. What Beta- blocker is also a membrane stabilizer?
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)
Propranolol
Voltage - gated potassium channels
Xenograft

43. What are the two most common chains of the TCR?
Bronchogenic carcinoma
Extinction
In men it is prostate cancer - and in women it is breast cancer.
a - and Beta- chains are on most T cells.

44. What enzyme is deficient in acute intermittent porphyria?
Achondroplasia
Uroporphyrinogen I synthetase
Mitosis
Tay- Sachs disease

45. What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Volvulus
Propranolol
Phase 4; NE increases the slope of the prepotential - allowing threshold to be reached sooner - and increases the rate of firing.

46. What statistical test - using nominal data only - checks whether two variables are independent events?
LTB4
Chi - square (when you are in doubt and have nominal data - use chi - square)
Yohimbine
Prevalence increases.

47. Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
Phase 4
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts
Agranulocytosis; approximately 2% develop this side effect.
Increased androgen secretion at puberty drives the increased GH secretion.

48. What is the most common one? - Route for infectious arthritis
Chlamydia psittaci
Ketamine
Alcohol. Nearly 10% of adults have a problem with alcohol.
Hematogenous

49. Name these narcissistic defense mechanisms: x Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.
Serocystadenocarcinoma
Splitting

50. What component of an ECG is associated with the following? - Atrial depolarization
Mycoplasma pneumoniae
Ischemic
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed - thereby increasing the secretion of prolactin.
P wave