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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 compartment of the mediastinum associated with the following thoracic structures: Splanchnic nerves
Posterior
Stages 3 and 4 (NREM)
Neomycin
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.

2. What DNA replication enzyme breaks the hydrogen bond of base pairing - forming two replication forks?
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
Helicase (requires ATP for energy)
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
Cocaine - induced coronary ischemia

3. What statistical method do you use when analyzing x Cohort studies?
Mycoplasma pneumoniae
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
IL-7 (A 7 upside down is an L; L is for Lymphoid)
Mesonephric duct

4. What Brodmann area is associated with x Premotor cortex?
Area 6
Type II hypersensitivity (cytotoxic)
The bifurcation of the abdominal aorta
IDL

5. Do the following structures pick up stain from hematoxylin or eosin? - Nucleoli
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
Misoprostol
Hematoxylin
Orbitomedial frontal lobe

6. What are the five components of portal HTN?
Pseudogout
IL-3 (3 face down is an M)
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
2 ATPs by oxidative phosphorylation

7. What hormone controls relaxation of the lower esophageal sphincter during swallowing?
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
CN VI - VII - and VIII
Hydroxyproline (breakdown product of collagen)
S2 - S3 - S4

8. What Ig prevents bacterial adherence to mucosal surfaces?
IgA
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
A high - resistance system is formed when resistors are added in a series.
Glutamine

9. A chronic alcohol abuser goes to the ER with weakness - a sore - beefy red tongue - loss of vibration and position sense - arm and leg dystaxia - elevated levels of methylmalonic acid in the urine - and anemia with an MCV above 105 fL. What is your d
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working - you will see an increased reticulocyte count on the peripheral smear in about 5 days.
Chloral hydrate
C3a - C4a - and C5a

10. Aroused EEG pattern (fast low voltage and desynchronization) - saccadic eye movements - ability to dream - and sexual arousal are all associated with what general pattern of sleep?
No - it is never acceptable to lie.
Hemolytic uremic syndrome
Autosomal recessive
REM sleep. Remember - awake brain in a sleeping body.

11. Are contraindicated in patients with SCID.
Live vaccines
Howell - Jolly bodies
Lateral fissure (fissure of Sylvius)
Day 14

12. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x Ki - ras
Pancreas and colon
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.
Hepatic adenomas
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.

13. What is the relationship between ventilation and PCO2 levels?
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
Pulmonary shunt (i.e. - pulmonary embolism)
G-6- PD deficiency

14. What is the name of the spinal cord passing within the subarachnoid space and forming the spinal nerves that exit the lumbar and sacral foramina?
Eosin
It forms a germinal tube at 37
Cauda equina
Antisocial personality

15. What are the three microscopic pathologic changes seen in Alzheimer's disease?
Salpingitis
31 pairs
transcription
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons

16. What is used as an index of the number of functioning carriers for a substance in active reabsorption in the kidney?
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
Scavenger receptor (SR- B1)
Plasmodium malariae
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.

17. With what virus are Downey type II cells associated?
EF- G of the 50S subunit
Erythema nodosum
EBV
Bile salts are actively reabsorbed in the distal ileum.

18. What is the name of the B cell that secretes Ig?
Plasma cell (mature B lymphocyte)
16S subunit
Histamine
Pantothenic acid

19. What is the most common one? - Helminth parasitic infection in the United States
Anterior hypothalamic zone; lesions here result in hyperthermia.
Filiform papillae
Enterobius vermicularis
Pia mater

20. What is pumped from the lumen of the ascending loop of Henle to decrease the osmolarity?
Convergence
Proteus
Homocysteine methyl transferase
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.

21. What toxicities are caused by the following agents? - Halothane
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Hepatitis - with or without necrosis
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
Truncus arteriosus

22. What is the physiologic storage form of iron?
Parainfluenza virus
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
Ferritin
Ascaris lumbricoides

23. How are resistance and viscosity related regarding flow?
Aminoglycosides
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.
EF-1 and GTP
Mycobacterium marinum

24. What disease has a genetically low level of UDPglucuronate transferase - resulting in elevated free unconjugated bilirubin?

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25. What disorder is due to a deficiency in tyrosinase?
embranoproliferative glomerulonephritis (MPGN)
Albinism
Extrahepatic biliary atresia
Prevalence increases.

26. Gas gangrene is associated with which Clostridium species?
Axis II
Clostridium perfrigens
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.
Succinyl CoA synthetase

27. Name the associated chromosomal translocation - Burkitt lymphoma
Th2 cells
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Chromosome 8 - 14
refractory sexual periods

28. 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
Biotin - ATP - and CO2
Internal abdominal oblique
Carbamazepine
Resorb CSF into the blood

29. How many strains of Pneumococcus capsular polysaccharides are present in the vaccine?
The parasympathetic nervous system
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
Niemann - Pick disease
The vaccine contains 23 capsular polysaccharides.

30. In high altitudes - What is the main drive for ventilation?
Monosodium urate crystals
Acute pyelonephritis
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
Azithromycin

31. What protozoal parasite forms flasked - shaped lesions in the duodenum - is transmitted via fecal - oral route - and is commonly seen in campers who drank stream water?
Stranger anxiety
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Air flows into the respiratory system.
Giardia lamblia (treat with metronidazole)

32. What is the only class of diuretics to retain Cl - used in the short - term treatment of glaucoma and of acute mountain sickness?
Histiocytes
Acetazolamide
Hepatocellular carcinoma
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).

33. What is the term for a unit of DNA that encodes a particular protein or RNA molecule?
Pirenzepine
A gene (a rather simple definition but accurate)
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
Toxoplasma gondii

34. What three carcinomas are associated with EBV?

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35. What medication is a PGE1 analog that results in increased secretions of mucus and HCO3- in the GI tract?
Blood clots
Chromosome 18
Mycoplasma
Misoprostol

36. Which cestode infection results in alveolar hydatid cyst disease?
>10 mm
Beta- Galactosidase
Echinococcus multilocularis
CN I

37. Are used in combination with estrogens to decrease the risk of endometrial cancer.
1. Propranolol 2. Timolol 3. Carteolol
Occulta All except occulta cause elevated - fetoprotein levels.
Progestins
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.

38. In a positively skewed curve the mean is ______ than the mode.
greater
G-6- PD
Crude mortality rate
5 years old

39. Are modified skeletal muscle fibers. They are the sensory component of the stretch reflexes.
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Coombs test
Muscle spindles
Succinate dehydrogenase

40. What sex cell tumor causes precocious puberty - masculinization - gynecomastia in adults - and crystalloids of Reinke?
Leydig cell tumor
Berylliosis
Chromosome 15
Down syndrome (trisomy 21)

41. What is the effect of LH on the production of adrenal androgens?
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
Nissl substances; there is a great deal of RER in neuron cell bodies - indicating high protein synthesis.
Bridging veins draining into the sagittal sinus
Areas 1 - 2 - and 3

42. What is the neurotransmitter at the d - receptor?
Echinococcus multilocularis
Enkephalin
Staphylococcus aureus
Superior vena cava

43. Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD?
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
Nicotinic acid - because its side effects include hyperuricemia and exacerbation of ulcers.
Oblique fissure
Streptococcus agalactiae

44. Will a patient with a unilateral lesion in the cerebellum fall toward or away from the affected side?
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
Absolute refractory period is due to voltage inactivation of sodium channels.
Turcot syndrome
Escherichia coli

45. What disorder - experienced more than half of the time for a 6- month period - is described as being fearful - worrisome - or impatient and having sleep disturbances - poor concentration - hyperactivity - and an overall sense of autonomic hyperactivi
Generalized anxiety disorder
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Vitamin B6
CN VII

46. Name the following descriptions associated with bacterial endocarditis: x Painful subcutaneous nodules on fingers and toes
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)
Osler nodes
Neisseria gonorrhoeae
Afterload

47. What is the triad of Felty syndrome?
1 day prior to ovulation
Ego syntonic
Neutropenia - splenomegaly - and rheumatoid arthritis
Clarke's nucleus

48. What CN nucleus receives auditory information from both ears via the cochlear nuclei?
MHC class I antigens; they are also found on the surface of platelets.
Superior olivary nucleus
Glucocerebrosidase
antiemetic

49. What is needed to initiate translation?
IF and GTP (eIF for eukaryotes)
Mean corpuscular volume (MCV)
REM
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).

50. What is the second arrested stage of development in the female reproductive cycle?
Increase enzyme concentrations
Glucagon
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Klebsiella pneumoniae