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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. Name the insulin preparation based on the peak effect and duration of action - Peak - 8 to 16 hours; duration - 24 to 36 hours
Common peroneal nerve
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
INF- gamma
Ultralente

2. What is the renal compensation mechanism for acidosis?
Areas 18 and 19
Staphylococcus aureus
Biotin - ATP - and CO2
Production of HCO3- - shifting the reaction to the left and thereby decreasing H+

3. What primary acid - base disturbance is caused by a gain in fixed acid forcing the reaction to shift to the left - decreasing HCO3- and slightly increasing CO2?
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)

4. What is the term for making up stories regarding past experiences because of an inability to retrieve them?

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5. Name the lung measurement based on the following descriptions: x Volume in the lungs at the end of passive expiration
Posterior cruciate ligament
Functional residual capacity (FRC)
MI
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.

6. What is the term for gastric ulcers associated with severely burned or traumatic patients?
Curling ulcers (think curling iron = burn)
Urachus
The time it takes ACh to diffuse to the postjunctional membrane
Secondary lysosome (think of the primary as inactive and secondary as active)

7. What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
Fitz - Hugh - Curtis syndrome
CN IV
Ampicillin and amoxicillin
LDL

8. What type II hypersensitivity disorder is defined as x Autoantibodies directed against the TSH receptor?
Silicosis - Coal worker's pneumoconiosis is synonymous with black lung disease - an upper lobe occupational disorder
Graves disease
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.

9. What type of correlation is defined as x Two variables with no linear relation to one another?
Zero correlation
Finasteride
12 days after ovulation
Filovirus

10. What prokaryotic positioning enzyme in translation is blocked by the following? - Streptomycin
Dihydrotestosterone
Raloxifene
Residual volume
IF-2 of the 30S subunit

11. Which form of alcohol toxicity results in ocular damage?
Third week
PCR
Methanol
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+

12. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x sis
Hot pink with PAS and grey to black with silver stain
Pulmonary shunt (i.e. - pulmonary embolism)
Astrocytoma
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)

13. What protein allows Mycoplasma to attach to the respiratory epithelium?
P1 protein
gamma and delta chains
Water - soluble hormones are considered fast - acting hormones.
Minoxidil (orally and topically - respectively!)

14. A clear - hypertonic solution with higher concentrations of K + and HCO3- - than the serum.
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
Outside the cell
CSF
A transport maximum (Tm) system

15. Have catalase.
No change in length
During stage 3 and 4 (remember - it is called deep sleep.)
Histidine
Streptococci

16. Can advance directives be oral?
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Yes
Congenital heart disease

17. Name the DNA virus: x ssDNA; naked; icosahedral; replicates in the nucleus
One - and it provides the energy for mechanical contraction.
Parvovirus
LDL
Substantia nigra

18. What is the MCC of inherited mental retardation?
Down syndrome
Ventricular fibrillation (V fib)
Type III hypersensitivity reaction
ACE inhibitors (- pril)

19. What are two causes of diffusion impairment in the lungs?
Enterococcus faecalis
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)

20. If the pH is more acidic than the pI - does the protein carry a net positive or net negative charge?
3 years old
Glucose -6- phosphatase
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.
Metaraminol (a1 - Beta1 )

21. What primary acid - base disturbance is cause by a decrease in alveolar ventilation (increasing CO2 levels) resulting in the reaction shifting to the right and increasing H+ and HCO3- levels?
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors
Enterobius vermicularis
Mitochondria

22. Name the ventricular muscle membrane channel: x Closed at rest; depolarization causes channels to open slowly
Voltage - gated calcium channel
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
Androgens are 19- carbon steroids.
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?

23. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 - int -2 - erb -2 - and erb -3
Breast cancer
CD8
Afterload
Farnesyl pyrophosphate (FPP)

24. What cell type in the bone is responsible for bone deposition?
Osteoblast (Remember - blasts make - clasts take)
Hepatitis - with or without necrosis
presence of PMNs
Waterhouse - Friderichsen syndrome

25. What is the only 17- hydroxysteroid with hormonal activity?
Rotavirus
Cortisol - a 21- carbon steroid - has a - OH group at position 17.
Kl
Entamoeba histolytica

26. What are the first intermediate hosts for trematodes?
Snails
Vaginismus; it is the female counterpart of premature ejaculation.
Progressive multifocal leukoencephalopathy
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.

27. Name the antidote - Acetaminophen
Western blot
Amyl nitrate - sodium nitrate - or sodium thiosulfate
N- Acetylcysteine
Regression

28. Oxidation of Hgb forms what bodies in patients with G-6- PD deficiency?
Dimercaprol - D- penicillamine
Heinz bodies
Introjection (a sports fan is a good example)
Bacterial meningitis

29. Name the bony articulations of the following sites. Be specific - Shoulder
Primary hypoaldosteronism (Addison's disease)
Streptomycin
Clavicle - acromion - and glenoid fossa of the scapula and the humerus
Snails

30. What type of skin carcinoma occurring on sun - exposed sites has a low level of metastasis?
Squamous cell carcinoma
Nonsense
Herpes virus
X- linked dominant

31. What structure or structures cross the diaphragm at x T12 level?
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.
Plasmodium falciparum
Pyelonephritis
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12

32. What is the most common one? - Melanoma in dark - skinned persons
Permanent
Acral - lentiginous melanoma
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
Transcription factor IID

33. Name at least three bacteria that use capsules to prevent immediate destruction from the host's defense system.
Ascending limb
Brain - spleen - and kidney
Lingual nerve of CN V3
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus

34. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH
Neisseria meningitides
Pituitary hypogonadism
Venous pressure above the heart is subatmospheric - so a puncture there has the potential to introduce air into the system.
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)

35. What is the DOC for blastomycoses and sporotrichoses?
Itraconazole
Agranulocytosis; approximately 2% develop this side effect.
Recall bias. These problems arise in retrospective studies.
extrapyramidal dysfunction

36. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x abl
CML and All
Enterococcus faecalis
Elevated ASO titers and serum complement levels
VLDLs

37. What component of the ANS is responsible for movement of semen from the epididymis to the ejaculatory ducts?
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
NE
Sympathetic nervous system
CN VII

38. Are the following major or minor Jones criteria of rheumatic fever? - Subcutaneous nodules
Major
Epidermophyton
Clozapine
Thalassemia minor

39. Name the structure that enters or exits the following foramina: x Foramen ovale
Griseofulvin
CN V3 and the lesser petrosal nerve
Cryptococcus neoformans
Procainamide

40. What is the main factor determining GFR?
Severe (range 20-34)
Leiomyoma (fibroids)
Propranolol
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)

41. Which extravascular chemoreceptor detects low NaCl concentrations?
Malingering
Small cell cancer of the lung
Carbamoyl phosphate synthetase I
Macula densa

42. What is the name of the process in which cells migrate toward an attractant along a concentration gradient?
PPRF
Prostatic carcinoma
Mesencephalic nucleus
Chemotaxis

43. Which hepatitis strain is a defective virus that can replicate only inside HBV- infected cells?
NADPH and molecular O 2
Hepatitis D
Mebendazole
Squamous cell carcinoma

44. What embryonic structure forms the adult male structure? - Scrotum
CD14
Effective dose for 50% of drug takers (median effective dose)
Labioscrotal swelling
Angiosarcoma of the liver

45. What prokaryotic positioning enzyme in translation is blocked by the following? - Erythromycin
Escherichia coli and Pseudomonas sp.
EF- G of the 50S subunit
Factor XII for the intrinsic; factor VII for the extrinsic pathway
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.

46. Males are more likely to develop _______ than females.
Pyruvate carboxylase
Cryptococcus
Femoral hernias
Prinzmetal variant angina

47. Marriage ______ a child less than 17 years old.
Measurement bias
emancipates
Nephrotoxicity
Melatonin - serotonin - and CCK

48. Name the RNA subtype based on the following: x Found only in the nucleus of eukaryotes and functions to remove introns from mRNA
snRNA
Luteal phase
Epinephrine
Microglia

49. What are the first signs of overdose from phenobarbitals?
Polycystic ovaries
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
H 1
Nystagmus and ataxia

50. In what form are triglycerides sent to adipose tissue from the liver?
VLDLs
Phenytoin
D- Penicillamine
Ethacrynic acid