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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. All AAs have titration plateaus At what pH values?
ASA (salicylate)
pH of 2 and 9
Microcytotoxic assay
Sporothrix schenckii

2. What area of the lymph node is considered the thymic - dependent area?
Prolactinoma
The inner cortex (paracortex) contains the T cells - so it is considered the thymic - dependent area.
Eisenmenger's syndrome
Paget disease of the breast

3. Has no underlying pathology.

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4. What are the four DNA oncogenic viruses?
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
Unipolar disorder (major depression)
Monocytosis
Superficial spreading melanoma

5. What sided muscle weakness is seen in an UMN corticospinal tract injury above the pyramidal decussation?
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
Pregnancy
Paranoid

6. What is the most common one? - Tumor in men aged 15 to 35
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
Testicular tumors
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
The Beta- subunit; remember - the a - subunit is nonspecific.

7. Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery?
Propofol
Preganglionic sympathetic neurons
Ribozymes
Accuracy (think of it as all the trues - because they are the ones correctly identified)

8. What is the most common lysosomal storage disorder?
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
Proton pump inhibitors
Gaucher disease

9. What is the renal compensation mechanism for acidosis?
Production of HCO3- - shifting the reaction to the left and thereby decreasing H+
GnRH
Giardia lamblia (treat with metronidazole)
IgA nephropathy

10. What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
Prokaryotes. Polycistronic and prokaryotes both start with P.
Amanita phalloides
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.
CN X (Remember - the vagus nerve supplies the parasympathetic information from the tip of the pharynx to the end of the midgut and all between.)

11. Which medication used in the treatment of bipolar disorder decreases the release of T 4 from the thyroid gland?
Reject it
Stable angina
Conversion disorder
Lithium

12. What receptors are the best markers for NK cells?
Glutamine and aspartate
Superego
Triazolam
CD16 and CD56

13. A migrating myoelectric complex is a propulsive movement of undigested material of undigested material from the stomach to the small intestine to the colon. During a fast - What is the time interval of its repeats?
Afferent arteriole
Physostigmine
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.

14. What hormone has the following effects: chondrogenic in the epiphyseal end plates of bones; increases AA transport for protein synthesis; increases hydroxyproline (collagen); and increases chondroitin sulfate synthesis?
Myasthenia gravis
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
Ischemic heart disease (MIs)
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.

15. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Biotin. Avidin is found in raw egg whites.
Type II hypersensitivity reaction
Infection
The courts. These are legal - not medical terms.

16. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Ventral rami?
Pontocerebellar angle syndrome
Calicivirus
1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity
Both

17. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Humerus with ulna (major) and radius (minor)
Leukemias
The bifurcation of the abdominal aorta
Ipsilateral loss at and below the level of the lesion

18. When referring to a series circuit - what happens to resistance when a resistor is added?
Resistance increases as resistors are added to the circuit.
Osteosarcoma
Primary hypothyroidism (Low T4 has a decreased negative feedback loop - resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release - respectively.)
Naloxone or naltrexone

19. What disorder of aldosterone secretion is characterized by x Increased total body sodium - ECF volume - plasma volume - BP - and pH; decreased potassium - renin and AT II activity; no edema?
AML- M3
Primary hyperaldosteronism (Conn syndrome)
N- Acetylcysteine
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.

20. What are the two exceptions to the rule 'all cocci are gram positive'?
Lateral pontine syndrome
Methanol
Both Neisseria and Moraxella are gram - negative cocci.
Confabulation; it is commonly seen in Korsakoff's syndrome.

21. What branch off the vertebral artery supplies x The ventrolateral two - thirds of the cervical spinal cord and the ventrolateral part of the medulla?
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)
Anterior spinal artery
INF- gamma

22. What disorder is due to a deficiency in tyrosinase?
Albinism
1. Short attention span 2. Impulsivity 3. Hyperactivity
Isotonic contraction
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)

23. What is the term for hypoperfusion of an area involving only the inner layers?
Cancer
Mural infarct
Narcissistic
0.2

24. When a patient closes the eyes while standing with feet together - the visual and cerebellar components of proprioception are removed - so you are testing the dorsal columns. Swaying with eyes closed is a positive Romberg's sign indicating a lesion i
Mitral valve prolapse
Wegener granulomatosis
By asking a patient to close the eyes while standing with feet together
Dopamine levels rise with waking; dopamine is associated with wakefulness.

25. What is the first human disease successfully treated with gene therapy?
Adenosine deaminase (ADA) deficiency
Bacteria
Western blot
Arsenic - thorotrast - and vinyl chloride

26. Name the associated chromosomal translocation - Follicular lymphoma
Chromosome 14 - 18
Middle cerebral artery
Very superior (<2.5% of the population)
CN VII and VIII

27. What primary acid - base disturbance is cause by a decrease in alveolar ventilation (increasing CO2 levels) resulting in the reaction shifting to the right and increasing H+ and HCO3- levels?
Klinefelter syndrome
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
Areas 5 and 7
Ciliary ganglion producing a tonic pupil

28. Is DM a contraindication to use of a Beta- blocker in a patient who is having an MI?
Creutzfeldt - Jakob's disease. Patients first develop vague somatic complaints and anxiety - rapidly followed by dysarthria - myoclonus - ataxia - and choreoathetosis.
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Rhabdovirus
Aspiration pneumonia

29. What commonly encountered overdose produces headache - tinnitus - respiratory alkalosis - metabolic acidosis - confusion - vomiting - and tachypnea?
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.
ASA (salicylate)
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.
Diazoxide

30. What glycogen storage disease is due to the following enzyme deficiencies? - Muscle phosphorylase

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31. What IL down - regulates cell mediated immunity?
Acetyl CoA - FADH2 - and NADH
Metastatic
Succinate dehydrogenase
IL-10

32. What topoisomerase makes ssDNA cuts - requires no ATP - relaxes supercoils - and acts as the swivel in front of the replication fork?
almitate
Calcium oxylate
Topoisomerase I (Relaxase)
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood

33. What Beta2- agonist is used as a prophylactic agent in the treatment of asthma?
Ultralente
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
Salmeterol
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)

34. Because of their vasodilation action - these cause migraines.
Ergotamines
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
Meningococcus (Gonococcus does not)
Effective dose for 50% of drug takers (median effective dose)

35. Name the antimicrobial agent whose major side effect is listed - Grey baby syndrome
Chloramphenicol
Heart disease
Head of the pancreas
Vitamin D3

36. What is the only way to increase O2 delivery in the coronary circulation?
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
HPV serotypes 16 - 18 - 31 - and 33
External 3' - 5' PDE bonds
Eaton - Lambert syndrome

37. Name the most common type or cause - Cirrhosis in the United States
G-6- PD
Yes. The only civil liberty they lose is the freedom to come and go as they please.
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
Alcohol consumption

38. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Spinal nerve?
Both
Adenovirus
Eosinophilic exudates
Ristocetin

39. What are the two most common AAs found in histones?
LH
Lysine and arginine
Calcitriol
Hurler syndrome and Hunter syndrome - respectively

40. What is the difference between a Ghon focus and a Ghon complex?
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Medullary carcinoma of the thyroid
Stretch receptors prevent overdistension of the lungs during inspiration.
Itraconazole

41. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - poor grooming - poor ability to think abstractly - decreased drive - poor attention span (Hint: if the lesion is in the
Granulosa cell
Dorsal prefrontal cortex
Scrofula
Bacillus anthracis

42. What embryonic structure forms the adult male structure? - Ventral part of the penis
Ventromedial nucleus; lesions here result in obesity.
Separation anxiety
Urogenital folds
Medial pontine syndrome

43. An 80-year - old woman presents to you with right - sided temporal headache - facial pain and blurred vision on the affected side - and an elevated ESR. Your diagnosis?
Temporal arteritis (giant cell arteritis)
Ovarian cancer
Obese patients
NE - via its vasoconstrictive action on blood vessels

44. What drug that penetrates the blood - brain barrier is found in asthma preparations and used as a nasal decongestant?
Diphyllobothrium latum
Humerus with ulna (major) and radius (minor)
Ephedrine
Preload. It is the load on a muscle Prior to contraction.

45. What three structures increase the surface area of the GI tract?
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
Glutamine and aspartate
Melanosis coli
Left atrium and tip of the right atrium

46. What syndrome is characterized by dynein arm abnormality resulting in chronic sinusitis - recurrent pulmonary infections - and infertility?

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47. What condition is defined by both testicular and ovarian tissues in one individual?
C1 esterase inhibitor (C1INH)
Myasthenia gravis
Adenocarcinoma
True hermaphrodism

48. What statistical test compares the means of groups generated by two nominal variables by using an interval variable?
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve
Homocysteine methyl transferase
Stable
Two - way ANOVA. It allows the test to check several variables at the same time.

49. Where in the spinal cord are the presynaptic opioid receptors?
Duchenne muscular dystrophy
Escherichia coli
In the dorsal horn of the spinal cord on the primary afferent neurons
Aspartic acid and glutamic acid

50. Name the RNA subtype based on the following: x Found only in the nucleus of eukaryotes and functions to remove introns from mRNA
Primary hypogonadism (postmenopausal women)
snRNA
ELISA test
IgA nephropathy