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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. Which direction does the uvula deviate in a left vagus nerve lesion?
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Crossover study
Sexual aversion disorder
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)

2. Which acid - fast rod is an obligate intracellular parasite?
Testicular lymphoma
Mycobacterium leprae
Contralateral loss below and bilateral loss at the level of the lesion
CN II and ophthalmic artery

3. All Proteus species are...
Dimercaprol - penicillamine
Because creatinine is filtered and a small amount is secreted
urease positive
Wiskott - Aldrich syndrome

4. What tumor is seen in the 2- to 4-year - old age group; does not cross the midline; has immature glomeruli - tubules - and stroma; and metastasizes late to the lungs?
Wilms tumor
Metronidazole
Staphylococcus aureus
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.

5. What vitamin deficiency produces homocystinuria and methylmalonic aciduria?
Molluscum contagiosum
Proencephalon diencephalon derivative
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
Pyloric stenosis

6. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral aqueduct
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
Operant conditioning (reinforcement is after a response)
EF- G of the 50S subunit
Mesencephalon

7. Name the associated chromosome - Huntington disease
Hepatitis - with or without necrosis
Chromosome 4p
Positive
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)

8. What is the term for the amount of a drug that is needed to produce the desired effect?
Class 1 (1A - 1B - and 1C)
Potency
Thoracic and sacral
Acute CO poisoning

9. Patients with ___________ have no Barr bodies.
Heroin
Primary hyperparathyroidism
Turner syndrome
Graves disease

10. What is the MCC of the following endocarditis scenarios? - Non - IV drug user
Staphylococcus aureus
Hurler syndrome and Hunter syndrome - respectively
Vitamin A
gag gene

11. What form of hemophilia is X- linked recessive and is due to a deficiency in factor IX?
Hemophilia B
Succinate dehydrogenase
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).
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.

12. What antifungal agent is activated by fungal cytosine deaminase to form 5- FU?
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
Ulcerative colitis
Flucytosine
Metronidazole

13. What skin condition is a localized proliferation of melanocytes presenting as small - oval - light brown macules?
Burkitt lymphoma
Trazodone
Benign lentigo
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)

14. What viral infection is known to cause intracerebral calcifications?
Monosodium urate crystals
Chief cells
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
Biotin - ATP - and CO2

15. Which fungus is found worldwide on plants - is a cigar - shaped yeast in tissue form - and results in rose gardener's disease?
Prostatic carcinoma
Sporothrix schenckii
IgG
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)

16. What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
SER
Vitamin D3
Klinefelter syndrome
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.

17. What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
Both
Ampulla
The second pharyngeal pouch and groove
Syphilitic

18. Does the left or right vagus nerve innervate the SA node?
Chlamydia
Right vagus innervates the SA node and the left vagus innervates the AV node
Since they are independent events - their probabilities would be multiplied.
Hypercortisolism (Cushing syndrome)

19. Where are the postganglionic neuron cell bodies - the CNS or the PNS?
The rectouterine pouch (of Douglas)
They are in ganglia in the PNS.
ACE inhibitors (- pril)
Affinity

20. What muscle is the chief flexor of the hip?
Psoas major
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
Dihydrofolate reductase
Hepadnavirus

21. What two viruses get their envelope not from budding but from coding?
HIV and poxvirus
Rheumatoid arthritis
Gastrinoma
Mesothelioma and bronchogenic carcinoma

22. A single mRNA strand translated by a ribosome is termed what?

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23. What spinal nerves contribute to the pelvic splanchnic (parasympathetic) nerves that innervate the detrusor muscle of the urinary bladder?
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
S2 - S3 - S4
>15 mm
Sarcoplasmic reticulum

24. What diseases are associated with HLA- DR4
Medulla blastoma
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
Nodular sclerosis
Rate of absorption

25. What is the term for the strength of association between multiple Abbinding sites and multiple antigenic determinants?
Dominant parietal lobe (Gerstmann's syndrome)
Sigma factor
Coma - convulsions - and cardiotoxicity
Avidity (more than one binding site)

26. What X- linked recessive immune disorder is characterized by recurrent infections - severe thrombocytopenia - and eczema?
The hallmarks of LMN lesion injury are absent or decreased reflexes - muscle fasciculations - decreased muscle tone - and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget - LMN lesions are ipsilateral at the level of the
Splitting
CML
Wiskott - Aldrich syndrome

27. What vitamin is needed for the production of heme?
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.
Total lung capacity (TLC)
Prostate and lung cancer - respectively
Pyridoxine (B6)

28. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
PGE2
rRNA
Paneth cells
Chromosome 1

29. What paraphilia is defined as x Sexual fantasies or practices with animals?
Missense
Occipital lobe
Low interstitial free Ca2+ concentrations
Zoophilia

30. What is the term for nonneoplastic abnormal proliferation of cell size - shape - and cellular organization?
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Renal failure
Dysplasia
Thymine

31. Codman triangle on radiograph
Edrophonium
Osteosarcoma
Coxiella burnetii
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.

32. What is the relationship between preload and the passive tension in a muscle?
Labetalol
Emphysema
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
Selegiline

33. What enzyme catalyzes the rate - limiting step in fatty acid oxidation?
Neutrophils - eosinophils - and basophils
Carnitine acyltransferase - I
SITS
Churg - Strauss syndrome

34. What Ig is responsible for activation of complement - opsonization - and ADCC and is actively transported across the placenta?
Demeclocycline
IgG
Lesch - Nyhan syndrome
Streptococcus agalactiae

35. What are the three left - to - right shunts?
Thyroid hormones are necessary for conversion of carotene to vitamin A.
1. VSD 2. ASD 3. PDA
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
NREM sleep. Remember awake body - sleeping brain

36. What disorder is associated with decreased platelet count - prolonged PT and PTT - decreased fibrinogen - and increased fibrin split products (D- dimers)?
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
Chronic rejection
Lung cancer
Disseminated intravascular coagulation (DIC)

37. What is the effect of insulin on intracellular K+ stores?
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
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.
Clostridium botulinum
Insulin increases intracellular K+ stores while decreasing serum K+ levels.

38. How many bronchopulmonary segments are on the right lung? Left lung?
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)
Roth spots
There are 10 bronchopulmonary segments on the right and 8 on the left.
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.

39. What percentage of cardiac output flows through the pulmonary circuit?
Anemia
Haemophilus ducreyi
First M PITS for pharyngeal pouch derivatives
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.

40. What are the five pieces of information considered necessary for fully informed consent?

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41. What is the direction of growth for the primitive streak - caudal to rostral or rostral to caudal?
Pott disease
GABA - quantitatively
The primitive streak grows caudal to rostral.
Metaraminol (a1 - Beta1 )

42. What organ functions to keep blood glucose levels normal through both well - fed and fasting states and produces ketones in response to increased fatty acid oxidation?
Liver
Cefamandole - cefoperazone - and moxalactam
The fastigial nucleus
Cardiac muscle

43. What is the first epidermal layer without organelles and nuclei
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.
Stratum lucidum
Hemiballismus
Cushing's ulcers

44. Name the RNA subtype based on the following: x RNA molecules with enzymatic activity
Ribozymes
Mantle cell lymphoma
Motor nucleus of CN V
Ankylosing spondylitis

45. What two pituitary hormones are produced by acidophils?
GH and prolactin are produced by acidophils; all others are by basophils.
Chromosome 22q
env structural protein
Shortens

46. The 'tea - and - toast' diet is classically associated with what cause of megaloblastic anemia?
Blood clots
Folate deficiency (very common in the elderly)
Lateral pontine syndrome
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.

47. What are the three mechanisms of action for atrial natriuretic peptide's diuretic and natriuretic affects?
Fossa ovale
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts

48. What urease - producing gram - negative curved rod is associated with PUD and chronic gastritis?
ACh receptor
Helicobacter pylori - Which is also associated with an increased risk of gastric carcinoma
8 weeks (response to a face)
Proud flesh

49. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Polycyclic aromatic hydrocarbons
Bronchogenic carcinoma
Stage 3 and 4
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
prior to birthThe foramen ovale closes just...

50. Which drug is used to treat opioid withdrawal - ADHD - and sometimes Tourette's syndrome?
Without children (but don't think about this one for too long)
Clonidine
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
Adenocarcinoma