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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. Which hepatitis virus is in the Picornaviridae family?
Hepatitis A
Follicular lymphoma
Bulla
MGN

2. How many grams of protein must be excreted in 24 hours to produce the diagnosis of nephrotic syndrome?
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia
The T- test (used when comparing two groups)
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)

3. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Vinyl chloride
Angiosarcoma of the liver
Stage 4
GLUT 2
The small subunit (40S) binds first.

4. Name the most common type or cause - Chancre
GLUT 3 and 4
GH- producing adenoma
Axis III
Haemophilus ducreyi

5. With which pituitary adenoma is an elevated somatomedin C level associated?
GH- producing adenoma
emancipates
Obesity - DM - HTN - multiparity - early menarche - and late menopause
Aspiration pneumonia

6. From the fourth month of fetal life to term - what secretes the progesterone and estrogen to maintains the uterus?
The notochord
The placenta
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.

7. What paraphilia is defined as x Deriving sexual pleasure from other peoples' pain?
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
Sadism
Proximal to distal progression
Rhinovirus and hepatitis A virus

8. Do agents used in the treatment of Parkinson's disease that decrease ACh function have little effect on reducing tremors and rigidity?
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.
Atropine and 2- PAM (pralidoxime)
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
Thoracic and sacral

9. What Beta2- agonist is used as a prophylactic agent in the treatment of asthma?
Levator palpebrae superioris
Seminoma
Salmeterol
Pertussis toxin

10. What is the most common one? - Malignant tumor in the bone of teenagers
Tetralogy of Fallot
Anemia of chronic disease
Osteosarcoma
Mercury

11. Thyroid _____ is a measure of its function.
IgG
Size
Conversion disorder
Air flows into the respiratory system.

12. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Amyotrophic lateral sclerosis (Lou Gehrig's disease) is a LMN lesion at the level of the lesion and UMN lesion below the level of the lesion.
Ulcerative colitis
T3 increases both heart rate and cardiac output by increasing the number of Beta - receptors and their sensitivity to catecholamines.
Clonidine

13. What disorder is associated with jaundice - white stools - and dark urine due to biliary duct occlusion secondary to incomplete recanalization?
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Strongyloides stercoralis is treated with thiabendazole.
Extrahepatic biliary atresia
Histamine

14. What are the three main components of amyloid?
2.0 or greater
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
Fructose; both glucose and galactose are actively absorbed via secondary active transport.

15. What nerve and artery could be affected in a midshaft humeral fracture?
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
Decreases
Radial nerve and the profunda brachii artery

16. What is the most common sexual assault?
Pedophilia
The left gastric - splenic - and common hepatic arteries
VLDL
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.

17. Does REM deprivation interfere with performance on simple tasks?
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
Adenocarcinoma
Cocaine
Middle cerebral artery

18. Russell bodies
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
Homicide. It is also the leading cause of death in black females aged 15 to 24.
Proencephalon diencephalon derivative
Multiple myeloma

19. Name the most common type or cause - Viral pneumonia leading to death
Streptococcus agalactiae and Escherichia coli
RSV
PRPP aminotransferase
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------

20. What sensory system is affected in the late spinal cord manifestation of syphilis?
Chromosome 11p
Surface tension; in the alveoli - it is a force that acts to collapse the lung.
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
The vestibulo - ocular reflex

21. Is linolenic acid an omega -3 or omega -6 fatty acid?
Omega -3; linoleic is omega -6
Because creatinine is filtered and a small amount is secreted
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.
Testicular tumors

22. What are the four signs of acute inflammation?
Mitochondria - linked disorders are always inherited from the mother.
Oblique fissure
Multiple myeloma
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function

23. What case is best known for use of the 'best interest standard'?

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24. What antiepileptic agent has SIADH as a side effect?
Squamous cell carcinoma
Carbamazepine
Somatoform pain disorder
Cefamandole - cefoperazone - and moxalactam

25. What component of the trigeminal nuclei x Supplies the muscles of mastication?
Middle
Rapidly progressive glomerulonephritis (RPGN)
Prader - Willi syndrome and Angelman syndrome - respectively
Motor nucleus of CN V

26. What bile pigment is formed by the metabolism of bilirubin by intestinal bacteria - giving stool its brown color?
Risk factors for cervical cancer
Stercobilin
Bulbus cordis
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors

27. What presynaptic receptor does NE use to terminate further neurotransmitter release?
The cat
INF- gamma
Primase
alpha2- Receptors

28. Where is the cupola of the lung in relation to the subclavian artery and vein?
Middle
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
Simple diffusion; it does not use protein - mediated transport
Ventral anterior nucleus

29. A clear - hypertonic solution with higher concentrations of K + and HCO3- - than the serum.
Rhombencephalon
The short arm of chromosome 6
CSF
Anterior compartment of the leg - deep peroneal nerve

30. What is the drug of choice for asymptomatic meningitis carriers?
Hypochondriasis (they will begin with 'I think I have...')
Rifampin
CLL (B- cell origin)
Fetal alcohol syndrome

31. What neuropsychologic test has five basic scales testing for the presence and localization of brain dysfunction?
Unconjugated free bilirubin
The muscle's ATPase activity
Middle meningeal artery
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.

32. Name the compartment of the mediastinum associated with the following thoracic structures: Trachea
ACh
Superior
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.
Vimentin

33. What artery is formed by the union of the two vertebral arteries?
HPV serotypes 16 - 18 - 31 - and 33
The basilar artery is formed at the pontomedullary junction.
Passive - aggressive
Vitreous humor

34. From what pharyngeal pouch is the following structure derived? - Inferior parathyroid gland and thymus
None; it degenerates.
Third M PITS for pharyngeal pouch derivatives
Persistent truncus arteriosus
Urogenital folds

35. What is the name of the process that ensures that each B cell produces only one heavy- chain variable domain and one light chain?
Ovarian fibroma
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
GnRH

36. What is the DOC for CMV retinitis?
Ganciclovir
Hematoxylin
Renal plasma flow (decrease flow - increase FF)
Axis V

37. To what host cell receptor does the rabies virus attach?
Listeria monocytogenes
ACh receptor
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)
H 2

38. What oral hypoglycemic agent stimulates pancreatic Beta- cell release of insulin and is given just prior to meals because of its short half - life?
Repaglinide
Ticlopidine or clopidogrel
Areas 41 and 42
With arteriolar constriction both the flow and pressure downstream decrease.

39. What subtype of schizophrenia is characterized by x Stuporous mute echopraxia and automatic obedience - waxy flexibility with rigidity of posture?
Catatonic schizophrenia
G2 phase
16S subunit
CD8+ T cells

40. What is the most common form of elderly abuse?
V wave
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%.
Biotin - ATP - and CO2
Congenital heart disease

41. What are the five branches of the superior mesenteric artery?
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Concentration force and electrical force
Single - strand DNA binding protein
Pituitary adenoma

42. What are the pharmacologic effects seen sexually with x Beta- Blockers?
Impotence
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.
Rathke's pouch; they can result in compression of the optic chiasm.
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.

43. What part of the heart forms x Base?
Left atrium and tip of the right atrium
Primary follicle (in the white pulp)
The alveolar PO2 and PCO2 levels
Pneumocystis carinii

44. Name the Hgb - O2 binding site based on the following information: x Least affinity for O2; requires the highest PO 2 levels for attachment (approx. 100 mm Hg)
PALS
Flea - bitten kidney (can also be seen in pyelonephritis)
Site 4
Nystagmus and ataxia

45. What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
Type III hypersensitivity (immune complex)
Basal cell carcinoma
Proton pump inhibitors

46. 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
Pneumococcus (Streptococcus pneumoniae)
Riboflavin (B2) deficiency
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.

47. Based on operant conditioning - What type of reinforcement is described when x Adding a stimulus reinforces a behavior?
SSRIs
Positive reinforcement
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
Decreases

48. What type of scheduled reinforcement states that after a desired response - the reinforcement is given x Varying in the number of responses?
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
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.
MGB

49. What sex cell tumor causes precocious puberty - masculinization - gynecomastia in adults - and crystalloids of Reinke?
Hypervariable region (three per light chain; three per heavy chain)
The liver (in the mitochondria)
Leydig cell tumor
Streptococcus pyogenes

50. What hormone causes milk letdown?
The venae recta maintain the gradient via countercurrent flow.
Oxytocin
Red blood cell distribution width index (RDW)
1. Cefamandole 2. Cefoperazone 3. Moxalactam