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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 10 retroperitoneal organs.
Chromosome 5 - 21
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum
14 L - 33% of body weight
DiGeorge syndrome

2. What organelles make ATP - have their own dsDNA - and can synthesize protein?
Hepatitis A
Temporal arteritis
Mitochondria
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.

3. A suspected dermatophyte infection is stained with KOH. What spore type do you expect to see?
Sleep latency
Arthroconidia with hyphae
IGF-1 (somatomedin C)
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)

4. What are the genetic variants of a molecule within members of the same species?
1 day prior to ovulation
Allotypes
Haemophilus influenzae type B
Parafollicular C cells

5. Is the pH of CSF acidotic - alkalotic - or neutral?
Histidine - because of the imidazole ring found in the R group - is basic.
Hepatitis E
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)
The pH of CSF is 7.33 - acidotic.

6. Name the thalamic nucleus based on its input and output - Input from the amygdala - prefrontal cortex - and temporal lobe; output to the prefrontal lobe and the cingulated gyrus
Medial nuclear group (limbic system)
Streptococci
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
Graves disease

7. Name the most common type or cause - Chronic metal poisoning
Clonorchis sinensis
IgA
Lead
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.

8. What are the three Beta - lactamase inhibitors?
Pertussis toxin
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Indirect or unconjugated
Scrofula

9. What negative sense RNA virus is associated with parotitis - pancreatitis - and orchitis?
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
Streptococcus agalactiae (Group B Streptococcus - or GBS)
Ethyl alcohol
Mumps

10. Which antihistamine is one of the DOCs for treatment of vertigo?
Sacrococcygeal teratoma
Enterococcus faecalis
Uracil
Meclizine

11. What part of the ANS is affected in the biofeedback model of operant conditioning?
Bactericidal
Hypertrophic scar
CN V
The biofeedback model is based on the parasympathetic nervous system.

12. Based on operant conditioning - What type of reinforcement is described when x Removing a stimulus reinforces a behavior?
As the standard deviation increases - the greater the chance of error.
Metaplasia (usually to a more protective cell type)
G0 phase
Negative reinforcement

13. What five cofactors and coenzymes are required by pyruvate dehydrogenase?
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)
Elevated ASO titers and serum complement levels
Middle cerebral artery
45XO

14. Macro - ovalocytes in the peripheral blood smear are formed From what cell in the bone marrow?
Megaloblasts
Atrial filling (venous filling) Atrial - Contraction - Venous
The liver (in the mitochondria)
C1 esterase inhibitor (C1INH)

15. What disorder is associated with decreased platelet count - prolonged PT and PTT - decreased fibrinogen - and increased fibrin split products (D- dimers)?
Frontal eye field (Brodmann area 8)
Antigenic determinant (epitope)
Disseminated intravascular coagulation (DIC)
Left ventricle and tip of right ventricle

16. Can a physician commit a patient?
Salmonella
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
Riboflavin (B2)

17. What IL do T cells secrete to induce T- and B- cell division?
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
C3 - C4 - and C5 keep the diaphragm alive!
BPH
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.

18. What drug of choice for ascaris causes neuromuscular blockade of the worm?
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
Cocaine - induced coronary ischemia
Pyrantel pamoate
DNA polymerase - d

19. From what pharyngeal groove is the external auditory meatus derived?
Clear cell
The death of a spouse. The higher the score - the greater the risk of developing an illness in the next 6 months.
First pharyngeal groove; all others degenerate.
Fever - night sweats - and hemoptysis

20. What AD disorder due to a mutation in fibroblast growth factor receptor 3 results in normal - size vertebral column and skull and short - thick extremities?
Anhedonia
Achondroplasia
Sporothrix schenckii
Pituitary hypogonadism

21. What cell surface marker is found on blood B cells?
CD19
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
a1- Receptors
Ipsilateral loss below the level of the lesion

22. Name the most common type or cause - Pyogenic osteomyelitis
Campylobacter jejuni
Lactose must be present and glucose must be absent
Cleft palate
Staphylococcus aureus

23. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Calcitonin
1. Liver 2. Muscle 3. Adipose tissue
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero - order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than i
Albendazole
Medullary carcinoma of the thyroid

24. What is the effect of insulin on intracellular K+ stores?
Ungated potassium channel
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid
Fluconazole

25. Which bacteria are associated with the following pigment production? - Red pigmentation
Serratia
Thioridazine
Standardized rate
PRPP aminotransferase

26. What is the most common one? - Malignant tumor in the bone of teenagers
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
The poly(A) site on the DNA
Truncus arteriosus
Osteosarcoma

27. What enzyme is inhibited by disulfiram?
EF-2 and GTP
Atelectasis
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
Histidine - because of the imidazole ring found in the R group - is basic.

28. What structure of the knee is described thus? - Prevents posterior displacement and has medial - to - lateral attachment on the tibia
Posterior cruciate ligament
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Papovavirus

29. What is the most common primary malignant tumor in bone?
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Short - chain fatty acids
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)
Osteosarcoma

30. Name the compartment of the lower extremity and the nerve based on its movements - Adduct the thigh and flex the hip
Hypersegmented neutrophils
Mycobacterium leprae
Projection
Medial compartment of the thigh - obturator nerve

31. How can you differentiate vitamin K from vitamin C deficiency by bleeding time and PT levels?
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
Class III
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.
Cones (C for color and cones)

32. RBC casts in the urine
Acute glomerulonephritis
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Chromosome 14 - 18
The greater the myelination - the greater the conduction velocity.

33. What is the term for days 1 to 7 of the female cycle?
RBCs
Tetanospasmin (also called tetanus toxin)
Menses
Folic acid

34. What CNs arise from x The pons?
Hydatidiform mole
CN V - VI - VII - and VIII
Patau syndrome (trisomy 13)
Phase 4

35. Why is the cell's resting membrane potential negative?
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Streptococcus viridans
Succinylcholine and halothane (Treatment is with dantrolene.)

36. Which of the following is not a risk factor for cholesterol gallstones: pregnancy - OCP use - female gender - hemolytic anemia - cirrhosis - and obesity? (May be more than one answer.)
pI (isoelectric point)
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Trazodone
These are the gross pathologic changes associated with Alzheimer's disease.

37. In which syndrome does a person present with intentionally produced physical ailments with the intent to assume the sick role?
M
Mean corpuscular hemoglobin concentration (MCHC)
Huntington disease
Basal ganglia

38. What virus lies dormant in the x Dorsal root ganglia?
Retinoblastoma
X- linked recessive
Varicella
Systemic lupus erythematosus

39. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CEA
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA
Frotteurism
Cancer of the lung - stomach - colon - and breast

40. What is the only sphingolipid that contains choline and PO4?
Sphingomyelin (lecithin also - but it is not a sphingolipid)
Limbic system
Mixed (both cholesterol and calcium)
As flow increases - the urine becomes more dilute because of decreased time for H2O reabsorption.

41. What is the most common one? - Complication of PDA
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+
Subacute bacterial endocarditis
CN V2
Entamoeba histolytica

42. What are five clinical signs of portal HTN?
Osteogenesis imperfecta
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Bone deposition increases with increased Ca2+ or PO 4- concentrations - whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
Gradient - time system

43. What is the most common one? - Bone disorder in the United States
almitate
Hapten (not immunogenic)
Acetaldehyde dehydrogenase
Osteoporosis

44. A 20-year - old black woman goes to you with nonspecific joint pain - fever - and a malar rash over the bridge of her nose and on her cheeks. This is a classic example of What autoimmune disease? What are three autoantibody tests you could order to m
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Phase 4; NE increases the slope of the prepotential - allowing threshold to be reached sooner - and increases the rate of firing.
Pseudomonas aeruginosa

45. The first area to be oxygenated in the liver.
The portal tract of the liver lobule
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.

46. How many NADPHs are used per addition of acetyl CoA into a fatty acid chain?
Shifts it to the right
Familial hypercholesterolemia
Osteocyte
2 NADPHs per acetyl CoA

47. What hormone's release is strongly associated with stage 4 sleep?
Propionic acid
Isotypes
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
Degenerates

48. What is the most serious form of tinea capitis - which results in permanent hair loss and is highly contagious?
Tinea favosa (favus)
DNA polymerases
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
It forms a germinal tube at 37

49. What is the largest nucleus in the midbrain?
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
Testicular feminization syndrome (Dude looks like a lady!)
Multiple myeloma
The entire tubule barring the thick ascending limb

50. All Proteus species are...
Conus arteriosus of the right ventricle and right and left auricles
urease positive
Cytosine
von Hippel - Lindau syndrome