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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 only tongue muscle innervated by CN X?
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
Positive
1. Short attention span 2. Impulsivity 3. Hyperactivity
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.

2. Name the muscle type based on the histological features: x Actin and myosin in sarcomeres; striated; multinuclear; lacks gap junctions; troponin:calcium binding; T tubules and SR forming triadic contacts; highest ATPase activity; no calcium channels
Reovirus
Skeletal muscle
Mesocortical area
This is the triad of renal cell carcinoma

3. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Ventral rami?
Both
Competitive antagonist
Hypertension
Potter facies

4. What portion of the pericardium adheres to the tunica adventitia of the great vessels?
Rickets
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death
Fibrous pericardium
Stibogluconate

5. What component of the trigeminal nuclei x Forms the sensory component of the jaw jerk reflex?
Zona fasciculata and zona reticularis
Phase 2
Preoperational (2-6 years)
Mesencephalic nucleus

6. Name the insulin preparation based on the peak effect and duration of action - Peak - 8 to 16 hours; duration - 24 to 36 hours
Ultralente
Class III
Brucella
Wiskott - Aldrich syndrome

7. Only men have...
Blastomyces dermatitidis
Liquids - CHO - protein - fat
PKU
refractory sexual periods

8. Under resting conditions - What is the main determinant of cerebral blood flow?
Amiloride
Arterial PCO2 levels are proportional to cerebral blood flow.
Social learning theory
Homeodomain proteins

9. What nonmotile gram - negative - non - lactose - fermenting facultative anaerobic rod uses the human colon as its only reservoir and is transmitted by fecal - oral spread?
PALS (Parietolateral lymphocytic sheath)
Arnold - Chiari malformation type 2
Shigella
Isotonic contraction

10. What transmural inflammatory bowel disease can be found from the mouth to anus - has noncaseating granulomas - is discontinuous (skip lesions) - and has a cobblestone appearance - thickening of the bowel wall - linear fissures - and aphthous ulcers w
Rapid cycling bipolar disorder
Terbinafine
Crohn disease
REM sleep. Remember - awake brain in a sleeping body.

11. What Brodmann area is associated with x Somatosensory association cortex?
6 weeks 10 weeks
The larger the volume of distribution - the lower the plasma concentration of a drug.
Areas 5 and 7
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)

12. Name the associated chromosomal translocation - Adult familial polyposis
GH deficiency
Chromosome 5 - 21
Ataxia - telangiectasia
Chromosome 5p

13. Name the area of the cerebral cortex with the function described: x Recall of objects - distances - and scenes; visual input processed here
Hepatitis D
C5a
Occipital lobe
Hydroxyapatite

14. At what stage of cognitive development (according to Piaget) do children x Have abstract thinking?
Formal operations (> 12 years)
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Medial meniscus

15. What tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum - helping monitor and modulate muscle movements?
Transudative; exudative has the opposite values and has an elevated cellular content.
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.)
Macula densa
ACh

16. What enzyme is deficient in patients with PKU?
The subclavian artery
Plasma concentration and excretion rate
Phenylalanine hydroxylase
The conversion of CHO to pregnenolone via the enzyme desmolase

17. How can a deficiency in adenosine deaminase be a bone marrow suppressor?
Chromosome 5p
Amyl nitrate - sodium nitrate - or sodium thiosulfate
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.
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.

18. What happens to dopamine levels when we awaken?
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Tolcapone and entacapone
PGD2 - PGE2 - and PGF 2
Follicular adenoma

19. Name three products of HIV's pol gene.
Proximal tubule
Paramesonephric ducts
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
Protease - integrase - and reverse transcriptase

20. What is the label given to an individual whose IQ is x 110 to 119
C1 inhibitor (C1- INH)
High average
Gubernaculum
CN XII

21. What is the most common one? - Complication of nasogastric tube feeding
9.3 L - 15% of body weight
Aspiration pneumonia
Water - soluble hormones are considered fast - acting hormones.
Pasteurella multocida

22. What component of the ETC is inhibited by the following? - CO
Zero correlation
Cytochrome a/a3
Alternative hypothesis (What is left after the null has been defined)
Rate of absorption

23. What fungus is characterized by India ink staining of the CSF that produces colorless cells with a halo on a black background?
First - order elimination
Right brachiocephalic artery
Short - chain fatty acids
Cryptococcus neoformans

24. Which IL is associated with increases of IgG and IgE?
IL-4
Ethyl alcohol
IgM
The Purkinje cell

25. Name the cluster C personality disorder: x Sensitive to criticism - shy - anxious; socially isolated but yearns to be in the crowd
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
Avoidant
Dystrophic calcification
Dihydropteroate synthetase

26. Name the structure that enters or exits the following foramina: x Cribriform plate
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
CN I
Reye syndrome
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis

27. What is the most common one? - Site of pancreatic cancer
Ipratropium
Histrionic
Head of the pancreas
Thoracic and sacral

28. What is the name of the postganglionic parasympathetic ganglion that innervates x The submandibular and sublingual glands?
Pterygopalatine ganglion (I remember this as the only ganglion left.)
Clear cell
Herpes virus
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)

29. How are pulse pressure and compliance related?
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
Chlamydia
16S subunit
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.

30. What form of anemia is diagnosed with sucrose lysis test and Ham test?
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.
Megaloblasts
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Paroxysmal nocturnal hemoglobinuria

31. Which hepatitis B Ab indicates low transmissibility?
Ergotamines
HBeAb
The basilar artery is formed at the pontomedullary junction.
Histidine

32. What type of mortality rate is defined as the number of deaths x In the population?
Crude mortality rate
presence of PMNs
Generalized anxiety disorder
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.

33. Name the most common type or cause - Chronic metal poisoning
Head of the pancreas
G1 phase (gap 1)
Lead
Selegiline

34. What is the most important determinant of drug potency?
Cystic fibrosis
Removal of the ileum
Alcoholics Anonymous
The affinity of the drug for its receptor

35. What are the two broad - spectrum penicillins?
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
Ampicillin and amoxicillin
Erythema multiforme
Chromosome 17

36. What intermediate enables propionyl CoA to enter into the TCA cycle?
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
Diphenhydramine
Succinyl CoA
IgG

37. If a peripheral blood smear shows schistocytes - reticulocytes - and thrombocytopenia - is it more commonly seen in patients with ITP or TTP?
Increased secretion of GH postpuberty leading to acromegaly.
Enkephalin
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.

38. Name the phase of the ventricular muscle action potential based on the following information: x Slight repolarization secondary to potassium and closure of the sodium channels
Phase 1
Decreasing potassium conductance - which results in increased excitability
VSD
The triad of respiratory depression - pinpoint pupils - and coma in an IV drug abuser suggests opioid overdose (e.g. - heroin) - and you should give naloxone.

39. If inserting a needle to perform a pleural tap or insertion of a chest tube - do you use the inferior or the superior border of a rib as your landmark? Why?
robenecid - a uricosuric agent
greater
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Xanthine oxidase

40. Name the most common type or cause - Restrictive cardiomyopathy
Dendrites receive information - whereas axons send information.
Infrapatellar bursa
CN IX - X - and XI; sigmoid sinus
Amyloidosis

41. Name the DNA virus: x Linear dsDNA; naked; replicates in the nucleus
Carbonic anhydrase
Klatskin tumor
Adenovirus
First M PITS for pharyngeal pouch derivatives

42. What type of foods should patients taking MAOIs avoid? Why?
Trypanosoma cruzi
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Variable ratio If it is based on time - it is an interval - and if it is based on the number of responses - it is a ratio.

43. What is the only DNA virus that is not icosahedral?
Serocystadenocarcinoma
Bisphosphonates
Poxvirus
Rods

44. Are the following conditions associated with a negative or positive nitrogen balance? - Kwashiorkor
Negative
Argyll Robertson pupils
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
Haemophilus ducreyi

45. Prolactin levels can serve as a rough indicator of...
The courts. These are legal - not medical terms.
overall dopamine activity
total body water
Dynorphin

46. Name the nephritic disease based on the immunofluorescent staining - Mesangial deposits of IgA and C3
IgA nephropathy (Berger disease)
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
Posterior cruciate ligament
CD40

47. What viral infection in patients with sickle cell anemia results in aplastic crisis?
Streptococcus agalactiae and Escherichia coli
Excretion is greater than filtration for net secretion to occur.
Parvovirus B 19
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.

48. In what syndrome does the patient have angiomatosis; renal cell carcinomas; pheochromocytomas; retinal - cerebellar - medulla - or spinal cord hemangioblastomas; and epidermal cysts?
Punishment
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland
von Hippel - Lindau syndrome
Echinococcus multilocularis

49. More Ag is needed to produce a ____________ than a first immune response.
Major
Filtration is greater than excretion for net reabsorption to occur.
secondary immune response
Chromosome 3p

50. What is the term for an immunogenic agent that is too small to elicit an immune response?
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
Hapten; if it is coupled with a carrier - it may become immunogenic.
Middle
Bernard - Soulier syndrome