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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. In which syndrome does a person present with intentionally produced physical ailments with the intent to assume the sick role?
Meclizine
Candida albicans
Giardia lamblia (treat with metronidazole)
M

2. What is the function of the arachnoid granulations?
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Resorb CSF into the blood
HMG CoA reductase
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)

3. What is the triad of Reiter syndrome?

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4. What type of bilirubin is found in neonatal jaundice?
Renal cell carcinoma
Area 22 and occasionally 39 and 40
Indirect or unconjugated
Antidigoxin Fab fragments

5. What is the term for nonneoplastic abnormal proliferation of cell size - shape - and cellular organization?
Supraoptic nuclei; lesions here result in diabetes insipidus.
Dysplasia
Plasma cell
Bronchogenic carcinoma

6. What type of chromatin is transcriptionally active?
Phase I
Ostium secundum defects
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
G-6- PD deficiency

7. What liver enzyme - for triglyceride synthesis - converts glycerol to glycerol -3- phosphate?
Middle meningeal artery
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Third week; they are derived from the wall of the yolk sac.
Glycerol kinase

8. What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
Superior and middle
Operant conditioning (reinforcement is after a response)
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
DNA polymerase -?

9. What is the most common one? - Kidney stone type
Calcium oxalate
Superior and middle
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.)
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.

10. Name the most common type or cause - Diarrhea in children
Iodine (I)
HMG- CoA reductase
Minimal change disease
Rotavirus

11. What benign cardiac tumor is associated with tuberous sclerosis?
Kimmelstiel - Wilson disease
Down syndrome
Rhabdomyoma
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.

12. What is secretin's pancreatic action?
Achalasia
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.
Kayser - Fleischer rings
Secondary hypoparathyroidism (vitamin D toxicity)

13. What component of the ETC is inhibited by the following? - Oligomycin
Fo/F1 complex
Aged adult
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Basophilic stippling

14. Name the macrophage based on its location: x Lung macrophages
Obesity - DM - HTN - multiparity - early menarche - and late menopause
Femoral hernias
Medial collateral ligament
Pulmonary alveolar macrophages

15. What type of chromatin is transcriptionally inactive?
O2 has a higher driving force but is only one - twenty- fourth as soluble as CO2. CO 2 has a very small partial pressure difference across the alveolar membrane (47-40 = 7 mmHg) - but it is extremely soluble and therefore diffuses readily across the
Hepatitis B
Serocystadenocarcinoma
Heterochromatin - the light stuff in the nucleus on an electron microscope image.

16. Name the antidote - Warfarin
By causing rebound insomnia and decrease in REM sleep
CD4+ T cells (helper)
Vitamin K
Hormone - sensitive lipase

17. What fissure of the cerebral cortex runs perpendicular to the lateral fissure and separates the frontal and the parietal lobes?
Mean
Central sulcus (sulcus of Rolando)
Kimmelstiel - Wilson disease
Hypospadia

18. With what stage of sleep are bruxisms associated?
Flucytosine
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Teeth grinding is associated with stage 2 sleep.
Isolation of affect

19. What cell in the heart has the highest rate of automaticity?
Anterior compartment of the leg - deep peroneal nerve
SA node; it is the reason it is the primary pacemaker of the heart.
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
Leydig cell tumor

20. Name the antidote - Mercury
Pneumothorax
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
Dimercaprol - penicillamine
Cytochrome a/a3

21. During what stage of B- cell development is IgM first seen on the surface?
Mees lines
Immature B cells
HBsAg (incubation period)
Borderline

22. What urinary metabolite is elevated in pheochromocytoma?
Basal ganglia
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
Riboflavin (B2)
Vanillylmandelic acid (VMA)

23. What is the only Ig that crosses the placenta?
Rho-immunoglobin
IgG
Middle
ASA (salicylate)

24. What is the most common one? - Viral cause of myocarditis
Corticospinal tract
Aminoglycosides
Coxsackie B
Pulmonary infections

25. What organism is associated with the following types of diarrhea? Diarrhea associated with raw or undercooked shellfish
T wave
0.21; it is a fancy way of saying 21% of the air is O2.
Melanocytes
Vibrio parahaemolyticus

26. What region of the brain houses the central chemoreceptors responsible for control of ventilation?
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
The surface of the medulla
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Vanillylmandelic acid (VMA)

27. What cells of the epidermis carry the pigment melanin?
Labile
Gastric carcinoma
It decreases insulin secretion.
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.

28. What tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum - helping monitor and modulate muscle movements?
MHC class II Ags. This is accomplished via CD4 T cells.
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
Fixed interval
Vmax

29. What is the label given to an individual whose IQ is x 120 to 129
Hepatitis C
Vitamin B12 deficiency and folate deficiency
snRNA
Superior

30. What are the nonoxidative enzymes of the HMP shunt? Are the reactions they catalyze reversible or irreversible?
Roth spots
Shigella
Seasonal affective disorder (treat with bright light therapy)
Transketolase and transaldolase. The reactions they catalyze are reversible.

31. What abdominal muscle runs in a posteroinferior direction - splits to contribute to the rectus sheath - contributes to the formation of the conjoint tendon - and in men gives rise to the middle spermatic fascia and the cremasteric muscle of the sperm
gp120
Internal abdominal oblique
Metaphase II
Lesch - Nyhan syndrome

32. What is the most common chromosomal disorder?
PGE2 and PGF2a
Streptokinase
Down syndrome
They are all formed by the fifth month of fetal life.

33. What cell converts androgens to estrogens?
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.
Granulosa cell
Because it is the largest vessel and has the highest velocity in systemic circulation
Hormone - sensitive lipase

34. How does ventricular depolarization take place - base to apex or vice versa?
Depolarization is from apex to base and from endocardium to epicardium.
Methylene blue
Bitemporal heteronymous hemianopsia
Increased leukocyte alkaline phosphatase (LAP)

35. With What thoracic vertebra or vertebrae does rib 7 articulate?
Carbidopa and benserazide
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Megaloblasts
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.

36. What IL - produced by macrophages - is chemotactic for neutrophils?
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
Calicivirus
Sickle cell disease
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.

37. Name the structure that enters or exits the following foramina: x Foramen rotundum
CN III - VII - IX - and X
AT II
1. Large sample size 2. Large effect size 3. Type I error is greater
CN V2

38. What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur - humerus - and tibia?
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
Cystadenoma
Niacin (B3)
Caisson disease

39. What IL is important in myeloid cell development?
EBV
HBcAb IgG and HBsAb IgG
Chi - square.
IL-3 (3 face down is an M)

40. What commonly encountered overdose produces headache - tinnitus - respiratory alkalosis - metabolic acidosis - confusion - vomiting - and tachypnea?
Pheochromocytoma
Affinity decreases; they are inversely proportional.
Urogenital folds
ASA (salicylate)

41. What disorder is associated with spider angiomas - palmar erythema - gynecomastia - testicular atrophy - encephalopathy - abnormalities in clotting factors - and portal HTN?
Cirrhosis
Exhibitionism
Iatrogenesis
Sj

42. If a sample of DNA has 30% T - What is the percent of C?

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43. What is the name of the B cell - rich area of the spleen?
Primary follicle (in the white pulp)
CD21; it is a complement receptor for cleaved C3
PGE 1 - PGI 2 (most potent) - and TXA 2
Compliance (think of it as distensibility)

44. In what rare AR disorder do you see neutropenia - defective degranulation - and delayed microbial killing due to a problem in chemotaxis and migration?
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.
Ch
TCA cycle.
BPH

45. What is the most widely used class of antidepressants?
Leydig cell tumor
SSRIs
Thiabendazole
S phase

46. What vitamin deficiency may result in sideroblastic anemia?
Saltatory conduction
Vitamin B6
NH4+(ammonium)
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.

47. What is the term for the number of new events occurring in a population divided by the population at risk?
Mycobacterium leprae
Taenia solium
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
Incidence rate

48. What type of jaundice is seen in Dubin - Johnson syndrome?
Mural infarct
Conjugated (direct) hyperbilirubinemia - a transport defect
Resistance of the system increases. (Remember - when resistors are connected in a series - the total of the resistance is the sum of the individual resistances.)
Volume of distribution is decreased when a large percentage of drug is protein bound.

49. What phase of the cell cycle are the following antineoplastic agents specific for? - Vincristine
2.0 or greater
Mitosis
Both
extrapyramidal dysfunction

50. What is the term for how well a drug produces its desired response?
Serotonin
Alcohol consumption
Extinction
Efficacy