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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 is the treatment for nephrogenic diabetes insipidus induced by lithium?
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
Amiloride
Left heart failure
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.

2. What is the most energy- demanding phase of the cardiac cycle?
Kidney
Autoimmune hemolytic anemia
Isovolumetric contraction
G-6- PD deficiency

3. Inhibits glucose uptake in skeletal muscle.
Cortisol
M 2
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
M3 (promyelocytic leukemia)

4. What sided muscle weakness is seen in an UMN corticospinal tract injury above the pyramidal decussation?
Pheochromocytoma
Amygdala; it helps imprint an emotional response in memory.
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
Prolactin

5. What lower extremity nerve is described by the following motor loss? - Loss of abduction of the hip resulting in Trendelenburg gait
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.
Superior gluteal nerve
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
The subclavian artery

6. Shuffling gait - cogwheel rigidity - masklike facies - pill - rolling tremor - and bradykinesia describe what form of dementia?

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7. What component of the cardiovascular system has the largest blood volume? Second largest blood volume?
Look for broken blood vessels in the baby's eyes.
Superego
Histidine - because of the imidazole ring found in the R group - is basic.
The systemic veins have the largest blood volume - and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.

8. What is the only DNA virus that is not icosahedral?
Microglia
Poxvirus
Infection
Primary follicle (in the white pulp)

9. What is the confirmatory test for HIV?
Western blot
Prostate cancer
Caseous necrosis
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).

10. What are the three mechanisms of action for atrial natriuretic peptide's diuretic and natriuretic affects?
Dimercaprol - D- penicillamine
Disseminated intravascular coagulation (DIC)
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts
Suprachiasmatic nucleus

11. Craniopharyngiomas are remnants of what?

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12. Have analgesic - antipyretic - anti - inflammatory - and antiplatelet activities.
Shortens
NSAIDs
Absolutely not! Answer any question you are asked.
Primary follicle (in the white pulp)

13. What is the rate - limiting enzyme of glycogen synthesis?
Ulnar to radial progression
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.
Production of oxygen free radicals
Glycogen synthase

14. With an increase in arterial systolic pressure - what happens to x Heart rate?
Squamous cell carcinoma (skin - lung) and angiosarcoma of the liver
Melanin
Decreases
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.

15. How many carbons do estrogens have?
Somatoform pain disorder
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
Meningomyelocele All except occulta cause elevated - fetoprotein levels.
Staphylococcus aureus

16. What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
After the eclipse period
Kimmelstiel - Wilson disease
Parvovirus B 19
Molluscum contagiosum

17. What are the adult remnants of the following structures? - Right and left umbilical arteries
Aldolase B deficiencies are treated by eliminating fructose from the diet.
Medial umbilical ligaments
Mees lines
Bacillus cereus

18. What is the term for a deficiency or absence of sexual fantasies or desires?
14 days in most women (Remember - the luteal phase is always constant.)
Primary hypoaldosteronism (Addison's disease)
Hypoactive sexual desire disorder
Herpesvirus

19. What is the drug of choice for filariasis and onchocerciasis?
Anterior compartment (it's the blood supply to the posterior compartment)
G0 phase
2 and 5HT3 receptors
Diethylcarbamazine

20. What AR disorder of copper metabolism can be characterized by Kayser - Fleischer rings - decreased ceruloplasmin levels - and increased urinary copper excretion and tissue copper levels?
DNA polymerases
Arginine
Hypoglycemia for secretion and hyperglycemia for inhibition
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)

21. What hormone - produced by the syncytiotrophoblast - stimulates the production of progesterone by the corpus luteum?
Left coronary artery
Major
hCG
Accessory nucleus

22. Name the most common type or cause - Cystitis
Hydralazine - isoniazid - and procainamide (HIP)
T lymphocyte
At least 5 lobes
Escherichia coli

23. What stage of male development is characterized by the following LH and testosterone levels? - LH secretion drives testosterone production - with both levels paralleling each other.
Adulthood
Proton pump inhibitors
cDNA - when it is made from mRNA
At the end of the PCT 25% of the original volume is left

24. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH
IgA
Pituitary hypogonadism
Beta- Blockers
Quaternary structure

25. What are the three end products of amylase digestion?
ALA dehydrogenase and ferrochelatase
Residual volume
Prolactinoma
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)

26. What type of spore is defined as an asexual budding daughter yeast cell?
Blastoconidia
Pseudomembranous colitis
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
Type III hypersensitivity (immune complex)

27. In what disease is there a genetic absence of UDP- glucuronate transferase - resulting in an increase in free unconjugated bilirubin?
Crigler - Najjar syndrome
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
Al - Anon
Posterior

28. Name these narcissistic defense mechanisms: x Person takes his or her own feelings - beliefs - wishes - and so on and thinks they are someone else's. (e.g. - a cheating man thinks his wife is unfaithful)
Dissociative fugue. (Patients are unaware of memory loss.)
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
Projection
Gametocytes

29. Name the most common type or cause - Lobar pneumonia
HPV serotypes 6 and 11
First - pass effect
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.
Streptococcus pneumoniae

30. What negative sense RNA virus is associated with parotitis - pancreatitis - and orchitis?
0.21; it is a fancy way of saying 21% of the air is O2.
Mumps
Cocaine
Staphylococcus aureus

31. What disease that involves mental retardation - flat face - muscle hypotonia - and a double - bubble sign on radiograph poses an increased risk of Alzheimer's disease and All?
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)
Down syndrome (trisomy 21)
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone

32. Heinz bodies
Urogenital sinus
G-6- PD deficiency
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
t the end of the PCT 25% of Na+ - Cl - - K+ is left

33. What classical conditioning therapy or modification is described as x Triage of a hierarchy of fears (from least to most) - then teaching muscle relaxation techniques in the presence of those fears until the subject is not afraid anymore?
Systematic desensitization
Popliteus
CHF - cirrhosis - and nephrosis
Volume of distribution is decreased when a large percentage of drug is protein bound.

34. What equals the total tension on a muscle minus the preload?
Afterload
CN III - IV - and VI
Eosinophilic exudates
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.

35. What syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands?
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
Choriocarcinoma
Waterhouse - Friderichsen syndrome

36. What is the term for the load on a muscle in the relaxed state?
Area 17
Parasympathetic
Preload. It is the load on a muscle Prior to contraction.
Internal 3' - 5' PDE bonds

37. In what X- linked recessive disease is there a decrease in the HMP shunt - along with Heinz body formation?
Arnold - Chiari malformation type 2
Carbamazepine
G-6- PD deficiency
Acetoacetate - acetone - and Beta- hydroxybutyrate

38. What four CN carry preganglionic parasympathetic fibers?
Repolarization is from base to apex and from epicardium to endocardium.
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Factor XII for the intrinsic; factor VII for the extrinsic pathway
CN III - VII - IX - and X

39. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 and int -2
Melanoma - cancer of the stomach and bladder
Formation of an identity through issues of independence and rebellion; they define who they are.
Asbestosis
Neurofibromatosis

40. What is the first formal IQ test used today for children aged 2 to 18?
Superior
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Osteocyte
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs - TCADs - dextromethorphan - and meperidine. Treat it with cyproheptadine.

41. What occurs when the lower esophageal sphincter fails to relax during swallowing due to abnormalities of the enteric nervous plexus?
Enkephalin
Microvillus
Achalasia
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse - hyperreflexia - spastic paralysis - increased muscle tone - and weakness are commonly seen in UMN lesions.

42. Is a brush border enzyme.
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
Functional residual capacity (FRC)
Enterokinase
Picornaviridae

43. What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia - tetany - and T- cell deficiency?
Middle
Marijuana
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
DiGeorge syndrome

44. Name the antimicrobial agent whose major side effect is listed - Dental staining in children
Positive
Selenium (Se)
Tetracycline
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)

45. What two stress hormones are under the permissive action of cortisol?
Glucagon and epinephrine
7 to 14 days
C1 - C2 - or C4 deficiency
HIV

46. On the venous pressure curve - What do the following waves represent? - C wave?
Ventricular contraction Atrial - Contraction - Venous
nef and tat genes
Early collecting duct
The first trimester

47. What axis I disorder is characterized by pronoun reversal - preference for inanimate objects - obliviousness to the external environment - lack of separation anxiety - and abnormalities in language development?
T cells - not B cells
Hereditary spherocytosis
Third week
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.

48. What coronary artery vasculitis is seen in Japanese infants and children less than 4 years old with acute febrile illness - conjunctivitis - maculopapular rash - and lymphadenopathy?
Vancomycin
Facial expression (the second is vocal intonation)
Kawasaki disease
Patients with unilateral cerebellar lesions fall toward the side of the lesion.

49. What is the term for taking an mRNA molecule and arranging the AA sequence forming a protein?
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
Ventromedial nucleus; lesions here result in obesity.
Translation
Osteoclasts

50. What is the pancreatic action of CCK?
CCK stimulates the pancreas to release amylase - lipase - and proteases for digestion.
Anorgasmia. (The overall prevalence is 30%.)
Hepatitis D
Thick skin