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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 antidote - Ethylene glycol
Ethyl alcohol
Kimmelstiel - Wilson disease
Legionella (think air conditioners)
Iron deficiency anemia

2. A 60-year - old man has back pain (compression spinal fracture) - hypercalcemia - increased serum protein - Bence - Jones proteinuria - and monoclonal M- spike on serum electrophoresis. What is your diagnosis?
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
Alzheimer disease
Multiple myeloma
Prostatic carcinoma

3. What three Beta- blockers are used in the treatment of glaucoma?
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Excretion is greater than filtration for net secretion to occur.
Elongation factor - G and GTP
1. Propranolol 2. Timolol 3. Carteolol

4. What Ig activates the complement cascade most efficiently?
Giant cell bone tumor (osteoclastoma)
IgM
Stratum corneum (keratinized)
The alveolar PO2 and PCO2 levels

5. What tick is the vector for babesiosis?
1. Cytosine 2. Uracil (only in RNA) 3. Thymidine
Ixodes (also the vector for Lyme disease)
Crigler - Najjar syndrome
CMV - Toxoplasma gondii - and Listeria

6. What muscle of the middle ear is innervated by CN VII?
Diphyllobothrium latum
The stapedius muscle
Lateral cricoarytenoid muscles
RSV

7. What aphasia produces a nonfluent pattern of speech with the abilty to understand written and spoken language seen in lesions in the dominant hemisphere?
Expressive aphasia
C3 deficiency
Lactulose
Antithyroglobulin and antimicrosomal Abs

8. Name the phase of the eukaryotic cell cycle: x Cells cease replicating (i.e. - nerve cell)
Medial rectus (CN III) (LR6 SO4)3
GERD
G0 phase
Vitamin E

9. Name the most common type or cause - Chronic metal poisoning
Lead
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
Cystadenocarcinoma

10. What tumor is derived from primitive streak remnants and often contains bone - hair - or other tissue types?
Sacrococcygeal teratoma
Mallory- Weiss syndrome
Fourth M PITS for pharyngeal pouch derivatives
Hemangioblastoma

11. What is the term for diffusion of water across a semipermeable or selectively permeable membrane?
Succinyl CoA
G0 phase
Metformin
Osmosis; water will diffuse from higher to lower water concentrations.

12. What syndrome is characterized by the triad of renal tubular acidosis - nephrosis - and amino aciduria?
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
Fanconi - like syndrome
GLUT 2
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+

13. Name the most common type or cause - Spontaneous pneumothorax
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Emphysematous bleb
1. Covalent bonding between the hapten and carrier 2. B- cell exposure to hapten twice 3. T- cell exposure to carrier twice
Pituitary adenoma

14. What do LMNs innervate?
Oxazepam - temazepam - and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation - not via the cytochrome p450 system.
Histamine
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
They innervate skeletal muscle.

15. What is the rate - limiting enzyme of the HMP shunt?
Area 4
G-6- PD
Amygdala; it helps imprint an emotional response in memory.
Schizotypal

16. How many ATPs are generated per acetyl coenzyme A (CoA)?
Ultralente
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
Bladder cancer
Metaproterenol and albuterol

17. Lack platelets.
Blood clots
Granulosa/thecal cell tumor of the ovary
Gout
VLDLs

18. What somatoform disorder is described as x La belle indiff
HMG CoA synthase
Processed antigenic peptides bound in the groove of the MHC molecule
Paranoid
Conversion disorder

19. What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities - red cell aplasia - and muscle weakness?
Hirschsprung disease
Myasthenia gravis
Venlafaxine. (It also has a mild dopaminergic effect.)
BPH

20. What pathology is associated with elevated levels of Ca2+ - cardiac arrhythmias - bone resorption - kidney stones - and metastatic calcifications?
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
Primary hyperparathyroidism
Paramyxovirus
Extrahepatic biliary atresia

21. What is the most common one? - Cardiac anomaly in children
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT - which means warfarin - extrinsic - PT; heparin - intrinsic - PTT)
PDA
Negative
Ipsilateral loss at and below the level of the lesion

22. Name the most common type or cause - Rectal bleeding
CD8+ T cells (cytotoxic) Remember - 8
Measurement bias
Diverticulosis
Cytochrome c

23. If a virus has positive sense RNA - can it be used as mRNA or is a template needed?
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

24. What is the effect of T3 on the glucose absorption in the small intestine?
Decreases
Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine.
IgA
Fibrinoid necrosis

25. With which DNA virus are Guarnieri bodies associated?
Cerebellum
Variola (smallpox)
Embolism
Aspartate and carbomoyl PO4

26. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x cyclin D
Anopheles mosquito
The carotid sinus reflex
Mantle cell lymphoma
Brucella and Listeria (has tumbling motility)

27. Name the type of exudate - given the following examples - Parasitic infection
Eosinophilic exudates
Hypercortisolism (Cushing syndrome)
Palindrome
greater

28. What is absorbed in the gallbladder to concentrate bile?
Carbamazepine
Water
Yes - it decreases fat and muscle uptake of glucose - thereby increasing blood glucose levels.
Adenocarcinoma

29. What vasculitis affects a 30-year - old Asian female having visual field deficits - dizziness - decreased blood pressure - and weakened pulses in the upper extremities?
Proximal to distal progression
Down syndrome (trisomy 21)
Takayasu arteritis (medium - size to large vessels)
Melanin

30. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - aggression - inability to learn new material - and memory problems
Limbic system
Pontocerebellar angle syndrome
C5- C9
Muscles of the internal eye

31. What antiviral agent for ganciclovir - resistant infections has limited utility because of its nephrotoxic side effect?
Kayser - Fleischer rings
Foscarnet
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Fibrous pericardium

32. What is the name of hydrophilic pores that allow the direct passage of ions and particles between two adjacent cells?
Folate - vitamin B12 - and vitamin B6
Gap junctions
1. Liver 2. Muscle 3. Adipose tissue
Accidents

33. What hormone is characterized by the following renal effects? - Calcium reabsorption - phosphate excretion
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)
PTH
Streptomycin
Pernicious anemia

34. Are the following major or minor Jones criteria of rheumatic fever? - Pericarditis
Mitochondrial inheritance
Major
Pedophilia
Candida

35. What negative sense RNA virus is associated with intracytoplasmic inclusion bodies called Negri bodies?
Regression
Red pulp (Remember - Red pulp and RBCs begin with R.)
Rabies
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)

36. What hematologic malignancy is treated with the monoclonal antibody rituximab?
Thyroid hormones are necessary for conversion of carotene to vitamin A.
Estriol
Non - Hodgkin lymphoma
Fibrocystic change of the breast

37. What is the most common one? - Benign tumor of the ovary
Misoprostol
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Serocystadenoma
Ependymoma

38. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebellum
McArdle's syndrome
Rhombencephalon
Primary erectile disorder
Log - kill hypothesis (follows first order kinetics)

39. Where is ADH synthesized?
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Dihydrotestosterone
Head of the pancreas
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.

40. What cells contribute to the blood - brain barrier and proliferate in response to CNS injury?
Astrocytes
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
Metaphase of meiosis II (in the oocyte of the graafian follicle)
0.21; it is a fancy way of saying 21% of the air is O2.

41. In what compartment of the thigh is the profundus femoris artery found?

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42. Which hepatitis B Ag correlates with infectivity and viral proliferation?
HBeAg
The carotid body - which monitors arterial blood directly
Obturator nerve
Vancomycin

43. What nerve is associated with the following functions? - Flex the shoulder - flex the elbow - and supinate the elbow
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Myasthenia gravis
Musculocutaneous nerve
Palms - up before palms - down maneuvers

44. What artery is formed by the union of the two vertebral arteries?
Pons
7
The basilar artery is formed at the pontomedullary junction.
Systematic desensitization

45. In what stage of sleep is it hardest to arouse a sleeping individual?
During stage 3 and 4 (remember - it is called deep sleep.)
Humor
Excretion is greater than filtration for net secretion to occur.
Thermogenic

46. What are the three surrogate criteria?

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47. What is the DOC for Beta- blocker - induced bronchospasms?
Ipratropium
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Enterobius vermicularis
Stable

48. What myeloid disorder is characterized by increased hematocrit - blood viscosity - basophils - and eosinophils; intense pruritus; and gastric ulcers due to histamine release from basophils - increased LAP - and plethora?
Birds
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
Trazodone
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)

49. In which region of the lung are 75% of the pulmonary infarcts seen?
Lower lobe
High average
Musculocutaneous nerve
Placental alkaline phosphatase

50. What small gram - negative aerobic rod requires Regan - Lowe or Bordet - Gengou medium for growth?
Bordetella pertussis
Progressive multifocal leukoencephalopathy
Panacinar
GP120