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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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 happens to dopamine levels when we awaken?
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Neuroblastoma
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.
Autoimmune thrombocytopenia purpura

2. What is the leading cause of school dropout?
hnRNA
Squamous cell carcinoma
Pregnancy
Lesch - Nyhan syndrome

3. What are effects of PTH in the kidney?
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
ELISA. It detects anti - p24 IgG.
Pancreatic delta - cell tumors inhibit CCK secretion
G2 phase

4. What paraphilia is defined as x Deriving sexual pleasure from watching others having sex - grooming - or undressing?
Treacher Collins syndrome
Bulbus cordis
Brucella and Listeria (has tumbling motility)
Voyeurism

5. Which organisms have polycistronic mRNA?
Prokaryotes. Polycistronic and prokaryotes both start with P.
Isotypes
Risk factors for cervical cancer
Eisenmenger's syndrome

6. What is the most common one? - Primary CNS tumor
Glioblastoma multiforme
Breast cancer
Fixation (arrested development)
IgA

7. What syndrome is characterized by bilateral medial temporal lobe lesion - placidity - hyperorality - hypersexuality - hyperreactivity to visual stimuli - and visual agnosia?
Kl
Prevalence increases.
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Severe (range 20-34)

8. Which form of emphysema is associated with an alpha1- antitrypsin deficiency?
Acetazolamide
Fibrocystic change of the breast
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
Panacinar

9. What type of resistance system (i.e. - high or low) is formed when resistors are added in parallel?
Being a white male
Ea (activation energy)
A low - resistance system is formed by resistors added in parallel.
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)

10. In a topographical arrangement of the cerebellar homunculus map - What area or lobe x Controls distal musculature?
1. Liver 2. Kidney 3. Pituitary gland (via 5'- deiodinase enzyme)
Intermediate part of the hemispheres
Burkitt lymphoma
Fetal alcohol syndrome

11. Which major cell type is found in the red pulp of the spleen?
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
6 weeks 10 weeks
RBCs. That is why it is called red pulp.
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.

12. With what stage of sleep are night terrors associated?
Probenecid
robenecid - a uricosuric agent
NREM sleep. Night terrors are dreams that we are unable to recall.
Clostridium perfringens

13. What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Thoracic splanchnic fibers
Acetaldehyde dehydrogenase
The fasciculus cuneatus
Series circuit

14. Does ELISA or Western blot confirm whether a patient is HIV- positive?
1. Protest 2. Despair 3. Detachment
ELISA screens and Western blot confirms the diagnosis.
RSV
Residual volume (RV)

15. Name the laryngeal muscle described by the following: x Pulls the arytenoids cartilages closer to the thyroid - relaxing the vocal ligaments and thereby decreasing the pitch
Variola (smallpox)
Thyroarytenoid muscles
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
Chromosome 11 - 22

16. What is the term for formation of a stable fibrin - platelet plug to stop bleeding?
Abs to HBsAg
Posterior cruciate ligament
Pneumocystis carinii
Hemostasis

17. What viral infection is known to cause intracerebral calcifications?
ACh - histamine - and gastrin
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
Resistance increases as resistors are added to the circuit.
Vesicle (e.g. - poison ivy)

18. What is the most common form of non - Hodgkin lymphoma in the United States?
Follicular lymphoma
Ribozymes
Papovavirus
Urinary trigone

19. Which three aminoglycosides have vestibular toxicity?
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
1. Streptomycin 2. Gentamicin 3. Tobramycin
PICA
Rheumatic fever

20. What disease is seen in the 20- to 40-year - old age group - is more prevalent in women than men - involves diarrhea with or without bloody stools - starts in the rectum and ascends without skipping areas - includes pseudopolyps - and has a thickness
Ulcerative colitis
Multiple myeloma
Diethylcarbamazine
prognostic predictors

21. Name the cerebral vessel associated with the following vascular pathologies - Subarachnoid hemorrhage
Beta2- integrins
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
Berry aneurysm in the circle of Willis
Pseudogout

22. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Osmolarity
1. Streptomycin 2. Gentamicin 3. Tobramycin
Squamous cell carcinoma
Disulfiram
300 mOsm/L

23. Which of the following
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
Superior and posterior
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
MGN

24. Name the RNA subtype based on the following: x Only type of RNA that is translated
Liquefaction necrosis
McArdle's syndrome
mRNA
Prokaryotes. Polycistronic and prokaryotes both start with P.

25. What percent of sexual abuse cases are committed by family members?
IgA nephropathy
HPV serotypes 16 - 18 - 31 - and 33
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Radial Immuno Diffusion (RID) for Ig levels.

26. What is the term to describe how easily a vessel stretches?
Temporal lobes
Clonidine
Compliance (think of it as distensibility)
Squamous cell carcinoma

27. What is the DOC for the following protozoal infections? - Leishmaniasis
IgG4
Parainfluenza virus
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Stibogluconate

28. What are the three polymorphonuclear leukocytes? Be specific.
Hematoxylin
During REM sleep
Neutrophils - eosinophils - and basophils
Smoking

29. What receptor is in the smooth muscle cells of the small bronchi - is stimulated during inflation - and inhibits inspiration?
Trimethoprim/sulfamethoxazole (TMP- SMX)
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Buffers (remember that buffers are best when they are used in a pH range near its pK)
Stretch receptors prevent overdistension of the lungs during inspiration.

30. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Pons
Rhombencephalon
Hemolytic uremic syndrome
Bactericidal
Repaglinide

31. What syndrome results when there is a deletion to paternal chromosome 15? Maternal?
Acetyl CoA - FADH2 - and NADH
Neisseria meningitides
Prader - Willi syndrome and Angelman syndrome - respectively
X- linked dominant

32. What type of DNA library is made from the mRNA from a tissue expressing a particular gene?
overall dopamine activity
Left atrium
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.
D- Penicillamine

33. What fructose metabolism enzyme is deficient in patients with vomiting - apathy - diarrhea - jaundice - proximal renal tubular acidosis - hypoglycemia - and hyperuricemia?
Aldolase B deficiencies are treated by eliminating fructose from the diet.
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
Borrelia recurrentis
B cells; macrophages and dendritic cells are nonspecific.

34. What is the most common one? - Sites for abdominal aorta aneurysm
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Mees lines
Between the renal arteries and at the bifurcation of the abdominal aorta
There would be two Fab and Fc regions.

35. What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria?
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working - you will see an increased reticulocyte count on the peripheral smear in about 5 days.
Metastatic
Histidine
Bcl -2

36. How are flow through the loop of Henle and concentration of urine related?
Silent
As flow increases - the urine becomes more dilute because of decreased time for H2O reabsorption.
Constrictor pupillae and ciliary muscles
B- cell Ag receptors

37. What is the only glycosaminoglycan (GAG) that binds to the linker portion of the proteoglycan?
Metronidazole
Mumps
Hyaluronic acid (all sulfates bind to the core protein)
Right brachiocephalic artery

38. What is the major ketone body produced during alcoholic ketoacidosis?
Eosin
Streptococcus pneumoniae
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
Beta- Hydroxybutyrate

39. What is the most common one? - Cardiac pathology in patients with SLE
Libman - Sacks endocarditis
Staphylococcus aureus
Alternative hypothesis (What is left after the null has been defined)
Scavenger receptor (SR- B1)

40. What is the term for a substance secreted by a leukocyte in response to a stimulus?
Hepadnavirus
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
Histiocytosis X
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)

41. Name the compartment of the mediastinum associated with the following thoracic structures: Descending aorta
Boutonni
Because creatinine is filtered and a small amount is secreted
Posterior
Tay- Sachs disease

42. What happens to REM - REM latency - and stage 4 sleep during major depression?
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Thick skin
Metformin
ACTH

43. What drug that penetrates the blood - brain barrier is found in asthma preparations and used as a nasal decongestant?
2 - 4- Dinitrophenol
Ephedrine
Sertoli cell
Echinococcus multilocularis

44. What is the most common lethal AR disorder affecting white Americans?
Cystic fibrosis
Look for broken blood vessels in the baby's eyes.
Four
Lower lobe

45. In the elderly - what happens to total sleep time - percentage of REM sleep - and percentage of NREM sleep?
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Alcoholism
3' end. Phosphate (PO4) is at the 5' end.

46. What aspects of sleep are affected during benzodiazepine use?
REM and stage 4 sleep; they decrease.
The primitive streak grows caudal to rostral.
Lysine and arginine
NADPH - O2 - and cytochrome b5

47. What DNA virus is associated with exanthem subitum (roseola)?
HHV 6
Lateral pontine syndrome
Bacillus anthracis
Ergosterol

48. Name the four components of the narcoleptic tetrad.
Medullary carcinoma of the thyroid
1. Sleep paralysis 2. Hypnagogic hallucinations (while falling asleep) 3. Sleep attacks with excessive daytime sleepiness 4. Cataplexy (pathognomonic) Narcolepsy is a disorder of REM sleep - with REM occurring within 10 minutes of sleep.
SER
Lipoid nephrosis

49. What vascular injury may result from a supracondylar fracture of the femur?
Trimethoprim/sulfamethoxazole (TMP- SMX)
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Protein A
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.

50. What drug is an M1- specific antispasmodic?
embranoproliferative glomerulonephritis (MPGN)
Breast
Pirenzepine
Pituitary hypogonadism

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USMLE Step 1 Prep

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