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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 are the three surrogate criteria?

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2. Name the area of the cerebral cortex with the function described: x Skill - based memory - verbal recall - balance - refined voluntary movements
Right medial longitudinal fasciculus
Cerebellum
Decreases
Bunyavirus

3. Which macrolide is used in the treatment of gastroparesis?
Carnitine acyl CoA transferase II
MEN IIa (or Sipple syndrome)
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
Erythromycin

4. What diseases are associated with HLA- DR4
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
Blood clots
Thymic epithelial cells - dendritic cells - and macrophages
M12 strains

5. What is the most common chromosomal abnormality associated with CLL?
Truncus arteriosus
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)
Edinger - Westphal nucleus (via CN III)
Rhabdomyoma

6. What is the MCC of the following meningitides? - In military recruits
Neisseria meningitides
The entire tubule barring the thick ascending limb
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
Internal iliac nodes

7. What deep cerebellar nuclei receive Purkinje cell projections in x The flocculonodular lobe?
The lateral vestibular nucleus
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Isolation of affect
Primary hypoaldosteronism (Addison's disease)

8. Notching of the ribs - seen on chest radiograph in patients with postductal coarctation of the aorta - is due to collateralization of What arteries?
Amyl nitrate - sodium nitrate - or sodium thiosulfate
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Copper deficiency

9. What ocular muscle x Abducts the eyeball and is involved in horizontal conjugate gaze?
Astrocytes
Lateral rectus (CN VI) (LR6 SO4)3
Ventral posteromedial nucleus
Mitral valve stenosis

10. What is the most common one? - Congenital heart defect in adults
Priapism
Spermatid
Incidence rate
ASD

11. Name the Plasmodium species based on the following information: Persistent hypnozoite liver stage with relapses; blood smear shows amoeboid trophozoites; 48- hour fever spike pattern; the most prevalent form worldwide
Common peroneal nerve
Aged adult
Acute cystitis
Plasmodium vivax

12. IgE- mediated mast cell release - C3a and C5a - and IL-1 all trigger the release of what vasoactive amine?
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Histamine
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
Atropine with pralidoxime

13. What embryonic structure forms the following adult structures? - External genitalia
Vitamin B6
Hepadnavirus
Phallus - urogenital folds - and labioscrotal swellings
Hereditary spherocytosis

14. What do the following values indicate? - TD50
Toxic dose for 50% of drug takers (median toxic dose)
Stratum corneum (keratinized)
Lipoprotein lipase
T cells - not B cells

15. What cell surface modification of ependymal cells and respiratory epithelium has a 9 + 2 microtubular configuration and movement as its function?
HBsAg (incubation period)
Friedreich ataxia
Menstruation
Cilia

16. Which carcinoma
HPV serotypes 16 - 18 - 31 - and 33
They innervate skeletal muscle.
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.

17. What type of metal poisoning causes mental retardation - somnolence - convulsions - and encephalopathy?
C- peptide levels
Burkitt lymphoma
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Lead

18. Name the antimicrobial agent whose major side effect is listed - Cholestatic hepatitis
3 ATPs by oxidative phosphorylation
Protein A
Erythromycin
Rickets

19. What CN is associated with the x First pharyngeal arch?
CN V
Pregnancy
3 ATPs by oxidative phosphorylation
Neisseria gonorrhoeae

20. Is an irreversible collapse of a lung.
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Atelectasis
LDL
Epidermophyton

21. Name the most common type - Mental retardation
Fetal alcohol syndrome
Goodpasture syndrome
Gubernaculum
Stroke volume

22. Name the product or products of arachidonic acid: x Vasodilation - bronchospasm - and increased vascular permeability
Chemotaxis
Disorganized schizophrenia
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
LTC4 - LTD4 - and LTE4

23. With a decrease in arterial diastolic pressure - what happens to x Stroke volume?
GH- producing adenoma
Respiratory depression
7 to 14 days
Decreases

24. What type of chromatin is transcriptionally inactive?
Vitamin A is responsible for vision and epithelial health.
Familial polyposis coli
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
Heterochromatin - the light stuff in the nucleus on an electron microscope image.

25. What are the top three causes of infant mortality?
Toxic dose for 50% of drug takers (median toxic dose)
Pterygopalatine ganglion (I remember this as the only ganglion left.)
Isoleucine - leucine - and valine
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS

26. What are the four muscles of mastication?
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid
Coagulative
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+

27. Which protein prevents internal binding of self proteins within an MHC class II cell?
CD3
Invariant chain
Methylphenidate (Ritalin)
Southern blot

28. What primary acid - base disturbance is caused by an increase in alveolar ventilation (decreasing CO2 levels) resulting in the reaction shifting to the left and decreasing both H+ and HCO3- levels?
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
Median nerve
Direct fluorescent Ab test

29. Name the macrophages by location: x Liver
HBeAg
Poliomyelitis; it is a bilateral LMN lesion.
Kupffer cells
RSV

30. The nucleus is the site of...
transcription
Mild (50-70)
Gaucher disease
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.

31. Can advance directives be oral?
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.
Friedreich ataxia
Yes
Cervical neoplasia

32. What ascending sensory system carries joint position - vibratory and pressure sensation - and discriminative touch from the trunk and limbs?
Fetal alcohol syndrome
Ulcerative colitis
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
The DCML system. (Remember - everything but pain and temperature.)

33. What is the most common one? - Malignant tumor of the breast
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.
Thrush
Invasive ductal carcinoma
Unconjugated (indirect)

34. Name the aphasia based on these characteristics: x Lesion in Brodmann area 22; impaired comprehension; incoherent rapid - fluent speech; verbal paraphrasias; trouble repeating statements

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35. What ocular muscle x Elevates and adducts the eyeball?
Folic acid deficiency
Transposons
Superior rectus (CN III) (LR6 SO4)3
Arginine

36. Name the associated chromosome - Tay- Sachs disease
HBc Ab
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
Chromosome 15q
IgM; IgD follows shortly thereafter.

37. What type of scheduled reinforcement states that after a desired response - the reinforcement is given x Varying in the number of responses?
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.
Choriocarcinomas and trophoblastic tumors
Para - aminohippurate (PAH)
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)

38. What are the four most common causes of femoral head necrosis?
G1 phase; G2 and S phase are diploid (2N).
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
Intussusception
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia

39. What is the most common one? - Bone disorder in the United States
The primitive streak grows caudal to rostral.
Sporozoites
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.
Osteoporosis

40. People who believe that luck - chance - or the actions of others control their fate have an internal locus of control.
Social learning theory
a1- Receptors
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
Streptococcus agalactiae

41. What type of mortality rate is defined as the number of deaths x From a specific cause per all deaths?
Bronchogenic carcinoma
Proportionate mortality rate
Mees lines
Grasp proceeds release

42. Name the type of mutation: x The deletion or addition of a base
Glucocerebrosidase
The placenta
Frameshift
Amanita phalloides

43. Can an acute MI be diagnosed only by looking at an ECG?
Entamoeba histolytica (treat with metronidazole)
REM latency; normally it is about 90 minutes.
Amygdala; it helps imprint an emotional response in memory.
No. Remember - tests do not diagnose - they confirm or refute your diagnosis. Also - diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI - elevated cardiac enzymes consistent with MI - and ST segment elevati

44. What disorder is characterized by autoantibodies to IF?
Lung cancer
Pernicious anemia
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Supraoptic nuclei; lesions here result in diabetes insipidus.

45. Name the structure that enters or exits the following foramina: x Foramen rotundum
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Primary hyperparathyroidism
CN V2
Unconjugated free bilirubin

46. What is the most common one? - Malignant tumor in women
Ulcerative colitis
Staphylococcus aureus
Purine nucleoside phosphorylase
Breast

47. What area of the brain is responsible for emotion - feeding - mating - attention - and memory?
Yes - it decreases fat and muscle uptake of glucose - thereby increasing blood glucose levels.
P1 protein
External abdominal oblique
The limbic system

48. What is the name of the B cell - rich area of the spleen?
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
Catalase - negative bacteria secrete H2O2 as a byproduct (remember - catalase breaks down H2O2) - allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase - positive bacterial infect
Phenylephrine
Primary follicle (in the white pulp)

49. Name the most common type or cause - Childhood heart disease in the United States
Urogenital folds
Metastatic carcinoma
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.
Congenital heart disease

50. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Hypothalamus
Labioscrotal swelling
Proencephalon diencephalon derivative
Valence
Alcoholics Anonymous