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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 is the primer for the synthesis of the second strand in production of cDNA from mRNA?

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2. Eating fava beans can produce the Mediterranean type of what deficiency?
Mallory- Weiss syndrome
G-6- PD deficiency
Chromosome 9 - 22 (Philadelphia chromosome)
With arteriolar constriction both the flow and pressure downstream decrease.

3. What two substances stimulate Sertoli cells?
FSH and testosterone
Enterohemorhagic Escherichia coli
Secondary hypoparathyroidism (vitamin D toxicity)
At least 5 lobes

4. Is the Lac operon activated or inactivated in the presence of both glucose and lactose?
Ego dystonic
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
CD16 and CD56
igantism

5. What are two causes of diffusion impairment in the lungs?
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
Streptococcus agalactiae
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid

6. Name these anxiety defense mechanisms: x Separating oneself from the experience. The facts are accepted but the form is changed for protection.
Dissociation
Thermogenic
At the end of the PCT 25% of the original volume is left
Metaphase of meiosis II (in the oocyte of the graafian follicle)

7. What pineal hormone's release is inhibited by daylight and increased dramatically during sleep?
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.
Autosomal dominant
1. ADP 2. PG 3. TXA2
Azathioprine

8. Name the hypochromic microcytic anemia based on the following laboratory values - Normal iron - TIBC - percent saturation - and ferritin
Thalassemia minor
Itraconazole
Breast
HHV-8

9. What gluconeogenic mitochondrial enzyme requires biotin?
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
Left eye anopsia (left nasal and temporal hemianopsia)
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.
Pyruvate carboxylase

10. Patients with ___________ have no Barr bodies.
Doxacurium
Regression
Turner syndrome
Sympathetic chain ganglion

11. What form of anemia is diagnosed with sucrose lysis test and Ham test?
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Paroxysmal nocturnal hemoglobinuria
G0 phase

12. Name the compartment of the mediastinum associated with the following thoracic structures: Thoracic duct
T cells - B cells - and macrophages
Superior and posterior
Stage 2 - which accounts for approximately 45% of total sleep time - with REM occupying 20%.
Thiogalactoside transacetylase

13. Name the DNA virus: x Linear dsDNA; naked; replicates in the nucleus
Dominant temporal lobe
Id
Adenovirus
Insulinoma

14. What water - soluble - vitamin deficiency may result from eating raw eggs?
1. The child poses an imminent danger to self or others. 2. The child is unable to self - care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety e
PGE (along with low oxygen tension)
Polycystic ovaries
Biotin (only if eaten in large quantities)

15. What protective covering adheres to the spinal cord and CNS tissue?
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
Type III hypersensitivity (immune complex)
Pia mater
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function

16. What is the most common one? - Vasculitis
Staphylococcus aureus
Temporal arteritis
ACh receptor
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.

17. In prokaryotes - What is the name of the RNA sequence that ribosomes bind to so translation can occur?
Shine - Dalgarno sequence
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Riedel thyroiditis

18. What is the drug of choice for threadworm - trichinosis - and larva migrans?
Thiabendazole
Glucosyl cerebroside
Kayser - Fleischer rings
Alveolar macrophages (dust cells)

19. Name the hepatitis virus based on the following information - Enveloped DNA hepadnavirus
Hepatocellular carcinoma
Extinction
Borderline
Hepatitis B

20. What encapsulated lymphoid organ is characterized by presence of Hassall's corpuscles - and absence of germinal centers and B cells?
Leukotriene B4 (LTB4)
Broca's aphasia
Thymus gland. (Thymus gland is essential for T cell maturation.)
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.

21. What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb - containing area?
Target cell
Stable angina
LGB (think EYES)
C1 esterase inhibitor (C1INH)

22. What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex- mediated; and is seen as lumpy- bumpy subepithelial deposits?
Dysgerminoma
Mesothelioma and bronchogenic carcinoma
Berylliosis
Postinfectious GN

23. What is the major inorganic component of bone?
Bactericidal
Leydig cell tumor
Hydroxyapatite
Nystagmus and ataxia

24. What vascular injury may result from a supracondylar fracture of the femur?
Gonococcus
Fungi
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.

25. What is the most common one? - Malignant carcinoma of the ovaries
Cystadenocarcinoma
Friedreich ataxia
Reye syndrome
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)

26. What scale assesses a rank order classification but does not tell the difference between the two groups?
Kayser - Fleischer rings
Streptococcus pyogenes
Minor
Ordinal scale (e.g. - faster/slower - taller/shorter)

27. What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells?
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Medullary carcinoma of the thyroid
Parietal lobe
Lithium

28. What is a plasma cell's life expectancy?
Mitral valve stenosis
Gastric ulcer
7 to 14 days
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion

29. What is the most common one? - Esophageal carcinoma
Squamous cell carcinoma
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Bronchioloalveolar carcinoma
Nasal polyps - rhinitis - and aspirin hypersensitivity

30. What is the major hormone produced in the following areas of the adrenal cortex? - Zona reticularis
DHEA (androgens) Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
Bunyavirus
Myasthenia gravis

31. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
Spleen
Clonidine
NE

32. Name the nephritic disease based on the immunofluorescent staining - Mesangial deposits of IgA and C3
IgA nephropathy (Berger disease)
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Relative refractory period
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.

33. Name the compartment of the mediastinum associated with the following thoracic structures: Trachea
Parasympathetics (parasympathetics point - sympathetics shoot)
Vmax
Superior
Mentally disabled

34. Fact without feeling (la belle indiff
Isolation of affect
Atrial contraction Atrial - Contraction - Venous
In the mouth with salivary a - amylase (ptyalin)
Plasmodium falciparum

35. A complete opposite expression of your inward feeling (e.g. - arguing all the time with someone you are attracted to when your feelings are not known)
Picornaviridae
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Reaction formation
IgA

36. In what stage of sleep is it easiest to arouse a sleeping individual?
Clozapine
Midazolam
During REM sleep
Marfan syndrome

37. What ganglion receives preganglionic sympathetic fibers from T1 to L1-2 and innervates smooth muscle - cardiac muscle - glands - head - thoracic viscera - and blood vessels of the body wall and limbs?
Potency
Sympathetic chain ganglion
Escherichia coli
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase

38. What is the most common one? - Site of ischemia in the GI tract
First - order elimination
Splenic flexure
Chromosome 8 - 14
Glutamate dehydrogenase

39. What is the only Plasmodium that is quartan?
Recall bias. These problems arise in retrospective studies.
Plasmodium malariae; the others are tertian.
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.
Medial compartment of the thigh - obturator nerve

40. What enzyme of the purine salvage pathway is deficient in the following? - Selective T- cell immunodeficiency
Purine nucleoside phosphorylase
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Transient ischemic attack
Chorda tympani of CN VII

41. Which thalamic nucleus receives auditory input from the inferior colliculus?
MGB
There is a difference; it takes about 7 to 8 half - lives to reach mathematical steady state and 4 to 5 half - lives to reach clinical steady state.
CD4+ T cells (helper)
Streptococcus pneumoniae

42. What parasite is associated with squamous cell carcinoma of the urinary bladder?
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
Radial nerve
Schistosoma haematobium
Primary erectile disorder

43. Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms?
Nimodipine
Non - Hodgkin lymphoma
Amygdala; it helps imprint an emotional response in memory.
One day after the LH surge and 2 days after the estrogen peak.

44. By removing Na+ from the renal tubule and pumping it back into the ECF compartment - What does aldosterone do to the body's acid - base stores?
Maxillary division of CN V and glossopharyngeal nerves
The thyroid gland
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
Langerhans cells (found in the stratum spinosum)

45. By What age should children be able to draw the following figures? - Square
Melatonin - serotonin - and CCK
5 years old
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.

46. Name the macrophages by location: x Lungs
Because the large drop in TPR is accompanied by a large increase in cardiac output - resulting in a minimal change in BP.
Alveolar macrophages
Middle cerebral artery
Third week; they are derived from the wall of the yolk sac.

47. What branch off the vertebral artery supplies x The cerebellum and the dorsolateral part of the medulla?
Heroin
Chromosome 19
Down syndrome (it is slightly more common than fragile X syndrome.)
PICA

48. Where are the postganglionic neuron cell bodies - the CNS or the PNS?
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae
Trypsin
They are in ganglia in the PNS.
Breast cancer

49. Why is O2 content depressed in anemic patients?
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
Bone deposition increases with increased Ca2+ or PO 4- concentrations - whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
11- Beta - Hydroxylase deficiency results in excess production of 11- deoxycorticosterone - a weak mineralocorticoid. It increases BP - Na+ - and ECF volume along with production of adrenal androgens.
External abdominal oblique

50. What term is an index of the effort needed to expand the lungs (i.e. - overcomes recoil)?
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
Cohort studies determine incidence and causality - not prevalence.
Compliance; the more compliant a lung is - the easier it is to inflate.
Lipoxygenase pathway - from arachidonic acid