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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 is the name of the postganglionic parasympathetic ganglion that innervates x The submandibular and sublingual glands?
Pedophilia
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Diacylglycerols and phosphatidic acid
Riedel thyroiditis

2. What does failure of PaO2 to increase with supplemental O2 indicate?
Macule (e.g. - a freckle)
Pulmonary shunt (i.e. - pulmonary embolism)
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.

3. What water - associated organism is a weakly stained gram - negative rod that requires cysteine and iron for growth?
Legionella (think air conditioners)
Nodular sclerosis
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland
Disorganized schizophrenia

4. How many strains of Pneumococcus capsular polysaccharides are present in the vaccine?
The vaccine contains 23 capsular polysaccharides.
IF-2 of the 30S subunit
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.

5. Which antihistamine is one of the DOCs for treatment of vertigo?
Correlation. No - correlation does not imply causation.
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.
Volume of distribution is decreased when a large percentage of drug is protein bound.
Meclizine

6. What type of hypersensitivity is a T cell - mediated response to Ags that are not activated by Ab or complement?
Dominant temporal lobe
Cilia
Transcortical aphasia
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)

7. What percentage of CO2 is carried in the plasma as HCO3- ?
90% as HCO3- - 5% as carbamino compounds - and 5% as dissolved CO2
Multiple myeloma
Clonidine
Mitochondria

8. What connects the lateral ventricles to the third ventricle?
The rectouterine pouch (of Douglas)
Foramen of Monro
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
Caisson disease

9. What muscles insert in or on the intertubercular groove of the humerus?

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10. What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
Primase
Raloxifene
Vibrio parahaemolyticus
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)

11. What happens to capillary oncotic pressure with dehydration?
Invasive ductal carcinoma
HTN
Oncotic pressure increases because of the removal of water.
Folate - vitamin B12 - and vitamin B6

12. What aspects of sleep are affected during benzodiazepine use?
REM and stage 4 sleep; they decrease.
Sigmoid colon
Fibrous pericardium
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.

13. Which trematode is associated with bladder carcinoma in Egypt and Africa?
Ipratropium
Chromosome 15q
Schistosoma haematobium
Aldehyde dehydrogenase

14. What three substrates control the enzyme PEPCK for the conversion of oxaloacetate (OAA) to pyruvate in the cytoplasm?
Edward syndrome (trisomy 18)
Tyramine
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).

15. What three chemical agents are associated with angiosarcomas of the liver?
Arsenic - thorotrast - and vinyl chloride
Rhabdomyoma
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Homogentisic oxidase

16. If you report a suspected case of child abuse and are wrong - are you protected from legal liability?
IgA - IgD - IgE - IgG - and IgM
REM sleep. Remember - awake brain in a sleeping body.
Hyperpolarization (i.e. - K+ influx)
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.

17. What is the MCC of the following meningitides? - In adults
Sarcoidosis
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
Streptococcus pneumoniae
The fast component is directed toward the affected side of a cerebellar lesion.

18. What artery travels with the following veins? - Great cardiac vein
Left anterior descending artery
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
Resistance decreases as resistors are added in parallel.

19. What disorder is characterized by a depressed mood and a loss of interest or pleasure for more than 2 years?
The folding of an AA chain
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
Microglia (Microglia and mesoderm both begin with M)

20. What is the name for the following RBC indices? - Average Hgb concentration/given volume of packed RBCs
Klinefelter syndrome
Mean corpuscular hemoglobin concentration (MCHC)
Bladder cancer
Physostigmine

21. Name the most common type or cause - Diarrhea in children
pI (isoelectric point)
Epidermophyton
Rotavirus
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.

22. What segments of the lumbosacral plexus form the following nerves? - Common peroneal nerve
impermeable to water
G-6- PD deficiency
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>

23. Increased urinary excretion of what substance is used to detect excess bone demineralization?
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.
ydroxyproline
Incidence rate
Topoisomerase I (Relaxase)

24. What enzyme catalyzes the rate - limiting step in fatty acid oxidation?
Acetyl CoA carboxylase
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
Carnitine acyltransferase - I
Cleft palate

25. What disorder is due to a 5-- reductase deficiency - resulting in testicular tissue and stunted male external genitalia?
HBcAb IgG and HBsAb IgG
C3a - C4a - and C5a
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
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

26. What linkage of complex CHOs does pancreatic amylase hydrolyze? What three complexes are formed?
Carbamazepine
CN IX
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.
Enterococcus (Streptococcus faecalis)

27. Name the most common type or cause - Urethritis in a young - newly sexually active individual
Mycoplasma
Renal failure
Staphylococcus saprophyticus
Xanthine oxidase

28. Name the antimicrobial agent whose major side effect is listed - CN VIII damage (vestibulotoxic)
Aminoglycosides
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti - Ab
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
Eosinophil

29. What MHC class functions as a target for elimination of abnormal host cells?
Ischemic
C1 through C4
Acetyl CoA (pyruvate to acetyl CoA)
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells

30. What is the name of violent projectile movements of a limb resulting from a lesion in the subthalamic nuclei of the basal ganglia?
Hemiballismus
Frontal lobe
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)
Mantle cell lymphoma

31. In What three areas of the body are sympathetics the predominant tone?
Haemophilus influenzae type B
1. Sweat glands 2. Arterioles 3. Veins
G1 phase (gap 1)
REM sleep. Nightmares are frightening dreams that we recall.

32. Does ELISA or Western blot confirm whether a patient is HIV- positive?
This is the triad of renal cell carcinoma
Hemangioblastoma
ELISA screens and Western blot confirms the diagnosis.
Aortic insufficiency

33. What is the most widely used class of antidepressants?
Poststreptococcal GN
C2 deficiency
Caisson disease
SSRIs

34. What syndrome is associated with the following brainstem lesions? - Posterior cerebral artery occlusion resulting in a contralateral corticospinal tract signs - contralateral corticobulbar signs to the lower face - and ipsilateral CN III palsy

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35. What Ig is the major protective factor in colostrum?
Femoral hernias
Liver
IgA
LTB4

36. What nerve is associated with the following functions? - Flex the shoulder - flex the elbow - and supinate the elbow
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Lung and bronchus cancer
Musculocutaneous nerve
extrapyramidal dysfunction

37. What do UMNs innervate?
RBCs. That is why it is called red pulp.
Sphingomyelinase
They innervate LMNs.
Embolism

38. What is the name of the process that ensures that each B cell produces only one heavy- chain variable domain and one light chain?
Urogenital sinus
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
a1- Receptors
Clozapine

39. What enzyme is deficient in patients with CGD?
alpha - Cells; glucagon has stimulatory effects on - cells and inhibitory effects on - cells.
G2 phase
Ostium secundum defects
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.

40. What area of the limbic system is responsible for attaching emotional significance to a stimulus?
Amygdala; it helps imprint an emotional response in memory.
PGE2
Alcoholism
Water

41. What is the name of the pathway that produces leukotrienes?
Hydroxyapatite
Congenital heart disease
Velocity is inversely related to cross - sectional area.
Lipoxygenase pathway - from arachidonic acid

42. Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia?
d - Tubocurarine
Intercellular adhesion molecule (ICAM) 1
Sarcoidosis
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase

43. What muscle keeps the stapes taut against the oval window?
3'-5' direction - synthesizing RNA in the 5'-3' direction
G0 phase
Stapedius muscle
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.

44. What does Candida albicans do that distinguishes it from other fungi?
Intercellular adhesion molecule (ICAM) 1
All (nearly 15-20 times the normal risk)
It forms a germinal tube at 37
Hemosiderin

45. Do the following structures pick up stain from hematoxylin or eosin? - Calcium
Hematoxylin
Median nerve
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Internal iliac nodes

46. What factors are needed for elongation in eukaryotes?
Missense
Effective dose for 50% of drug takers (median effective dose)
Free ionized Ca2+
EF-1 and GTP

47. What benign bone tumor is associated with Gardner syndrome?
Mikulicz syndrome
Osteoma
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
Persistent truncus arteriosus

48. What is the most common one? - Cancer of the vulva
after abortion
Yersinia pestis
Squamous cell carcinoma
Pulse pressure

49. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Withdrawn - fearful - explosive moods - violent outbursts - and loss of inhibitions
Hepatitis - with or without necrosis
PR interval
Respiratory depression
Orbitomedial frontal lobe

50. What complement factor or factors are associated with x Anaphylaxis?
Venlafaxine. (It also has a mild dopaminergic effect.)
C3a - C4a - C5a
Nicotine (but it sure has a nasty withdrawal!)
Paroxysmal nocturnal hemoglobinuria