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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 thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 increased
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
1. Cough 2. Coryza 3. Conjunctivitis
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.

2. What enzyme of the purine salvage pathway is deficient in the following? - Lesch - Nyhan syndrome
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Superego
Osteosarcoma
HGPRT

3. What is the term for thickened - hyperpigmented skin in the axillae - groin - and skin folds associated with malignancies - obesity - and DM?
Metronidazole
Phase 1
Acanthosis nigricans
Acral - lentiginous melanoma

4. What rate removes any difference between two populations - based on a variable - to makes groups equal?
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.
Vitreous humor
Empyema
Standardized rate

5. What are the four types of signaling mechanisms?
Poliomyelitis; it is a bilateral LMN lesion.
Chromophobe adenoma
PR interval
1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors

6. Which carcinoma
Pia mater
Staphylococcus aureus (but they are more prone to salmonella infections)
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.

7. What type of spore is asexual and formed of hyphae?
One - way ANOVA
Conidia
G0 phase
Decreases

8. What hormone - produced by the Sertoli cells - is responsible for keeping testosterone levels in the seminiferous tubules nearly 50 times that of the serum?
Nephroblastoma
Androgen - binding protein
C2 deficiency
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)

9. What are the four exceptions to requirements for informed consent?
Propranolol
The splenic vein
CD40
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency

10. What syndrome is associated with the following brainstem lesions? - Occlusion of the PICA - resulting in ipsilateral limb ataxia - ipsilateral facial pain and temperature loss - contralateral pain and body temperature loss - ipsilateral Horner's synd

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11. There is no _______ of an IV- administered drug.
Craniopharyngioma
Saccule and utricle
absorption
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.

12. Describe the organism based on the following information: x Alpha - hemolytic Streptococcus; not lysed by bile; not sensitive to Optochin
Ch
Acarbose
Streptococcus viridans
mRNA

13. What cells are atypical on a peripheral blood smear in heterophil - positive mononucleosis?
ACE inhibitors (the - pril agents)
Anopheles mosquito
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
T cells - not B cells

14. A known IV drug abuser goes to the ER with respiratory depression and pinpoint pupils and in a semicomatose state. What overdose do you suspect - and What agent will you give to reverse its effects?
Thymine
Axillary nerve and posterior humeral artery
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.
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.

15. What bones make up the acetabulum?
Bronchial asthma (whorled mucous plugs)
Pubis - ilium - and ischium
Azithromycin
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)

16. What is the origin of the polyuria if a patient is dehydrated and electrolyte depleted?
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
Coxiella burnetii
Agranulocytosis; approximately 2% develop this side effect.
Phase 1

17. What is the T- cell area of the spleen?
Anterior compartment of the leg - deep peroneal nerve
The negative charge inhibits the filtration of protein anions.
Hypervariable region (three per light chain; three per heavy chain)
PALS

18. What disorder is characterized by autoantibodies to IF?
Pernicious anemia
The liver (in the mitochondria)
Shortens
The fastigial nucleus

19. What type of fatty acid is associated with a decrease in serum triglycerides and cardiovascular disease?
Verbigeration
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
Vitamin B6
Omega -3 fatty acids

20. What embryonic structure forms the adult female structures? - Ovarian and round ligaments
Gubernaculum
Aedes (the same for yellow fever)
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.

21. How many pairs of spinal nerves are associated with x Sacral vertebrae?
Disulfiram
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern - my senior resident asked me this question more times than I would like to remember.)
Pia mater
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.

22. What is the role of the negative charge on the filtering membrane of the glomerular capillaries?
Azathioprine
The surface of the medulla
Truncus arteriosus
The negative charge inhibits the filtration of protein anions.

23. Pseudopalisades
Phase 2
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
Molluscum contagiosum
Glioblastoma multiforme

24. What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?
Syringomyelia
Arginine
Chondroitin sulfate and keratan sulfate
Varicocele

25. What is the term for a single isolated antigenic determinant?
Kinesins. Dynein generates retrograde transportation of information.
Sensory
Hapten (not immunogenic)
HBsAg (incubation period)

26. Name the most common type or cause - Right heart failure
Malignant mesothelioma
Chromosome 5
Left heart failure
Ticlopidine or clopidogrel

27. What CNS demyelinating disease is characterized by diplopia - ataxia - paresthesias - monocular blindness and weakness - or spastic paresis?
Galactose and glucose
Multiple sclerosis
Punishment
Paget disease of the breast

28. What happens to free hormone levels when the liver decreases production and release of binding proteins?
CN III and IV
Middle cerebral artery
60%
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.

29. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Pancreas
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.
S2 - S3 - S4
Stable
Lead

30. What is the primary predisposing factor for vascular dementia?
Glycine/arginine
Shortens
Hypertension
Selegiline

31. What is the most common one? - Germ cell tumor of the ovary
Ligamentum venosum
Dysgerminoma
Primary hypercortisolism
presence of PMNs

32. What type of cell is surrounded by mineralized bone?
Lateral pontine syndrome
Exposure
Thiamine
Osteocyte

33. In the window phase of a hepatitis B infection - which Abs do you see?
HBcAb and HBeAb. You see the antibodies c and e.
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
Central sulcus (sulcus of Rolando)
Since they are independent events - their probabilities would be multiplied.

34. What is the most common one? - Form of muscular dystrophy
Cefuroxime and cefaclor
Duchenne muscular dystrophy
Ch
Amyloidosis

35. What ocular muscle x Depresses and abducts the eyeball?
Autoimmune hemolytic anemia
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
Thymidylate synthetase
Superior Oblique (CN IV) (LR6 SO4)3

36. What event signifies the first day of the menstrual cycle?
Pancreatic insufficiency
Onset of bleeding
Peyer's patch
Hepatitis B

37. What apoprotein is required for the release of chylomicrons from the epithelial cells into the lymphatics?
Native Americans
apo B-48
Carcinoid tumor
Vancomycin

38. Does the left or right vagus nerve innervate the SA node?
Right vagus innervates the SA node and the left vagus innervates the AV node
Staphylococcus aureus
First pharyngeal groove; all others degenerate.
LTC4 and LTD4

39. What type of Ag do T cells recognize?
Bronchiectasis
Processed antigenic peptides bound in the groove of the MHC molecule
Leiomyoma (fibroids)
Avoidant

40. What is the only neuroleptic that does not cause an increase in weight or appetite?
Angiosarcoma of the liver
Venlafaxine. (It also has a mild dopaminergic effect.)
Molindone
eIF-2 in the P site

41. From What aortic arch are the following structures derived?
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells
RNA polymerase III
Maxillary artery
Osteopetrosis (Albers - Sch

42. What are the three branches of the inferior mesenteric artery?
Left colic - superior rectal - and sigmoidal arteries
CD4+ T cells (helper)
Physiologic antagonism
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.

43. What 11- amino acid peptide is the neurotransmitter of sensory neurons that conveys pain from the periphery to the spinal cord?
Somatomedins
Substance P. (Opioids relieve pain in part by blocking substance P.)
Doxacurium
Methylphenidate (Ritalin)

44. What is the most common one? - Primary malignant tumor of the ovary
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
Increased GABA levels decrease the likelihood of learned helplessness.
Serocystadenocarcinoma
Phase I

45. What form of hormone is described as having membrane - bound receptors that are stored in vesicles - using second messengers - and having its activity determined by free hormone levels.
Water - soluble hormones are considered fast - acting hormones.
Small cell cancer of the lung
Liver (hepatocytes)
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.

46. What artery turns into the dorsalis pedis when it crosses the extensor retinaculum?
Anterior tibial artery
The vermis
Range
Menses

47. If you double the infusion rate of a drug - how long will it take to reach steady state?
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.

48. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 23/1n
Silent
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
Ampulla of the fallopian tube
Spermatid

49. Serum concentration of what substance is used as a clinical measure of a patient's GFR?
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
Creatinine
Formal operations (> 12 years)

50. Name the four right - to - left congenital cardiac shunts.
Extracellular
Ampicillin and amoxicillin
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Muscle spindles