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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. Do high levels of estrogen and progesterone block milk synthesis?
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
Candida albicans
Swan - neck deformities
Inspiratory reserve volume (IRV)

2. In men - At What embryonic week do the primordial germ cells migrate to the indifferent gonad?
Cori cycle
Interferons
Estradiol
Week four - and they remain dormant there until puberty.

3. At what stage of cognitive development (according to Piaget) do children x Lack law of conservation and be egocentric?
Latissimus dorsi
Preoperational (2-6 years)
When the intra - alveolar pressure equals zero - there is no airflow.
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.

4. From What aortic arch are the following structures derived?
Lateral collateral ligament
Suppression
Liquefaction necrosis
Arch of the aorta and right subclavian artery

5. What are the longest - acting and shortest - acting benzodiazepines?
Sheehan syndrome
Streptolysin O
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Diazepam is longest acting and midazolam is shortest acting.

6. What is the most common sexual assault?
Mixed (both cholesterol and calcium)
Pedophilia
CO
Salmonella typhi

7. Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
Remember the mnemonic PAM SMIDT P - (hyper) Parathyroid/ Paget disease A - Addison's disease M - Milk - alkali syndrome/metastatic cancer S - Sarcoidosis M - Multiple myeloma I - Immobilization/idiopathic D - Vitamin D intoxication T - Tumors
M 2
Copper deficiency
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.

8. Where is the most frequent site of ectopic pregnancy?
Chromosome 13
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
PCR
Ampulla of the fallopian tube

9. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH decreased - Ca2+ decreased - Pi increased
Ligamentum venosum
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
Primary hypoparathyroidism
Rickets prior to fusion - osteomalacia if the deficiency occurs after epiphyseal fusion.

10. What enzyme of pyrimidine synthesis is inhibited by the following? - Methotrexate
Proud flesh
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Dihydrofolate reductase
Latissimus dorsi

11. What do the following values indicate? - TD50
Megaloblasts
Polycystic ovary disease (Stein - Leventhal syndrome)
Toxic dose for 50% of drug takers (median toxic dose)
The lateral vestibular nucleus

12. What antifungal agent is activated by fungal cytosine deaminase to form 5- FU?
Thymidylate synthase
Flucytosine
G-6- PD deficiency
Primary intention

13. Circulating levels of what hormone cause the cervical mucus to be thin and watery - allowing sperm an easier entry into the uterus?
Norm reference (i.e. - 75% of the students in the class will pass)
Tetralogy of Fallot
50% - with 50% of them having the child
Estrogen

14. Which two negative sense RNA viruses have neuraminidase enzymes?
Alzheimer disease
Mast cells
Mumps and influenza virus
Severe combined immunodeficiency disease

15. Are reabsorbed in the gallbladder.
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
Hypotonia (rag doll appearance)
Bile pigments and bile salts

16. What cell in the heart has the highest rate of automaticity?
SA node; it is the reason it is the primary pacemaker of the heart.
The stapedius muscle
Janeway lesions
Atropine - 2- PAM (pralidoxime)

17. Per Freud - with What part of the unconscious are sex and aggression (instincts) associated?
Lysosomal a -1 - 4- glucosidase
D- Penicillamine
Id
PKU

18. What syndrome is associated with the following brainstem lesions? - Vertebral artery or anterior spinal artery occlusion - resulting in contralateral corticospinal tract and medial lemniscus tract deficits and an ipsilateral CN XII lesion
Rheumatoid arthritis
Medial medullary syndrome
Doxacurium
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.

19. Which kidney is lower? Why?
RSV
Ergosterol
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
Anemia of chronic disease

20. Name the most common type or cause - Meningitis in renal transplantation patients
The DCML system. (Remember - everything but pain and temperature.)
Thyroid gland
Listeria monocytogenes
Subclavian vein

21. What is the only 17- hydroxysteroid with hormonal activity?
Succinyl CoA
Varicella
Cortisol - a 21- carbon steroid - has a - OH group at position 17.
IL-8 (IL-1 and TNF- gamma also)

22. What enzyme is deficient in alkaptonuria?
PPRF
Coccidioides immitis
Galactose and glucose
Homogentisic oxidase

23. What is the most common one? - Malignant carcinoma of the ovaries
CD28
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
Disorganized schizophrenia
Cystadenocarcinoma

24. Where is the lesion that produces these symptoms when a patient is asked to look to the left? Neither eye can look left with a slow drift to the right
Libman - Sacks endocarditis
mRNA
Extinction
Left abducens nucleus or right cerebral cortex

25. What are the four posttranslational modifications done by the Golgi apparatus?
The cat
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
Sensitivity (it deals with the sick)
Hirschsprung disease

26. What is the term for the summation of mechanical stimuli due to the skeletal muscle contractile unit becoming saturated with calcium?
Being awake
IgG
Tetany
A low - resistance system is formed by resistors added in parallel.

27. What is the name of inflammation of the prepatellar bursa?

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28. What are the two most important features in the diagnosis of malaria?
Fentanyl
Splenomegaly and anemia (with a high index of suspicion)
Copper deficiency
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes

29. What is the term for the difference between the highest and the lowest score in a population?
Range
C3 - C4 - and C5 keep the diaphragm alive!
IQ
Atrial contraction Atrial - Contraction - Venous

30. What nematode is known as whipworms? What is the treatment?
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Clostridium botulinum
Trichuris trichiura is treated with albendazole.
rRNA

31. What is the most common one? - Type of hernia seen in males more than 50 years old
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Direct; in males less than 50 years old indirect hernias are the most common type.
Left atrial myxoma
HPVs 16 and 18

32. What is the term for pupils that react normally to accommodation but have bilateral loss of constriction in response to light?
Pyelonephritis
Argyll Robertson pupils
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet
Necator americanus is treated with mebendazole and iron therapy.

33. Name the antidote - Carbon monoxide (CO)
It increases Ca2+ excretion from the kidney and increases bone mineralization.
Hydatidiform mole
HPV
Oxygen

34. What commonly encountered overdose produces headache - tinnitus - respiratory alkalosis - metabolic acidosis - confusion - vomiting - and tachypnea?
Low average
ASA (salicylate)
Griseofulvin
HBcAb IgG and HBsAb IgG

35. What two substances stimulate Sertoli cells?
FSH and testosterone
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major
Caisson disease
Epinephrine

36. What is the antidote for organophosphate ingestion?
The interposed nucleus
Atropine and 2- PAM (pralidoxime)
Minimal change disease
Parasympathetics (parasympathetics point - sympathetics shoot)

37. Name the period described by the following statement: no matter how strong a stimulus is - no further action potentials can be stimulated.
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>
Pseudogout
Absolute refractory period is due to voltage inactivation of sodium channels.
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.

38. What is the label given to an individual whose IQ is x 120 to 129
Superior
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
Hepatitis B
Gastric cancer

39. How many ATPs are hydrolyzed every time a skeletal muscle cross - bridge completes a single cycle?
The increased H+ moves intracellularly and is buffered by K+ leaving the cells - resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis - even though the serum
Superior and middle
C3 deficiency
One - and it provides the energy for mechanical contraction.

40. What type of scheduled reinforcement states that after a desired response - the reinforcement is given x Varying in the number of responses?
Musculophrenic and superior epigastric arteries
Decreases
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.
Pneumocystis carinii

41. What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls?
Bcl -2
External abdominal oblique
Neutropenia - splenomegaly - and rheumatoid arthritis
Bronchioloalveolar carcinoma

42. What components of the complement cascade form the MAC?
C5b - C9
CD3
Negative predictive value
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.

43. What enzyme requires molybdenum as a cofactor?
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
Xanthine oxidase
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
Tetany

44. What is the term for diffusion of water across a semipermeable or selectively permeable membrane?
Diabetes mellitus
Osmosis; water will diffuse from higher to lower water concentrations.
Transposons
IgD; IgM is also correct.

45. What phase of the female cycle occurs during days 1 to 15?
M- cells
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
Heart disease
Follicular phase

46. What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Tropomyosin
Thoracic splanchnic fibers
T9
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.

47. What occurs when the lower esophageal sphincter fails to relax during swallowing due to abnormalities of the enteric nervous plexus?
C2 deficiency
Achalasia
The larger the volume of distribution - the lower the plasma concentration of a drug.
Temporal arteritis

48. What nucleus of the hypothalamus is the satiety center - regulating food intake?
Stable
Sympathetic chain ganglion
Ventromedial nucleus; lesions here result in obesity.
The number of Ags that the Ab can bind

49. 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
Crohn disease
Tryptophan
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Kayser - Fleischer ring

50. Is linolenic acid an omega -3 or omega -6 fatty acid?
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.
HMG- CoA reductase
Omega -3; linoleic is omega -6
Parallel circuit

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USMLE Step 1 Prep

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