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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 DOC for the following protozoal infections? - Leishmaniasis
Stibogluconate
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
Clofazimine
Ligamentum venosum

2. What is the only site in the body that uses M1 receptors?
Obsessive - compulsive
CMV - Toxoplasma gondii - and Listeria
Chromosome 15 - 17
The stomach

3. What form of GN is characteristically associated with crescent formation?
Penicillin V
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
Transference. When it is from the physician to the patient it is called countertransference.
Rapidly progressive glomerulonephritis (RPGN)

4. If you double the infusion rate of a drug - how long will it take to reach steady state?
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Group A Beta- hemolytic streptococci
The pulsatile release of GnRH
Hypotonia (rag doll appearance)

5. By removing Na+ from the renal tubule and pumping it back into the ECF compartment - What does aldosterone do to the body's acid - base stores?
PALS
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
Verbigeration
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)

6. What vitamin is needed for the production of heme?
Midazolam
Paranoid schizophrenia
Pyridoxine (B6)
Autoimmune thrombocytopenia purpura

7. How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle?
3 ATPs by oxidative phosphorylation
HBeAb
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
Plasmodium malariae

8. What is the term to describe the inability to feel any pleasant emotions?
Opsonization
Dysmetria; this is seen in a finger - to - nose test.
Anhedonia
Urogenital sinus

9. What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?
Musculophrenic and superior epigastric arteries
Legionella (think air conditioners)
Gastric ulcer
Chemotaxis

10. Who decides competency and sanity?
The courts. These are legal - not medical terms.
Emphysema
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells
Primary spermatocyte

11. Name the structure that enters or exits the following foramina: x Foramen ovale
Arch of the aorta
CN V3 and the lesser petrosal nerve
G0 phase
Northern blot

12. Which leukotriene is chemotactic for neutrophils?
Pancreas and colon
Depression
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.
LTB4

13. During a prolonged fast - why is the brain unable to use fatty acids?
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
Zona fasciculata and zona reticularis
Malpighian layer (made up of the stratum basale and stratum spinosum)
Repolarization is from base to apex and from epicardium to endocardium.

14. What is the physiologically active form of Ca2+?
B- cell Ag receptors
Hydrolysis
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
Free ionized Ca2+

15. What component of the ETC is inhibited by the following? - CO
There is a difference; it takes about 7 to 8 half - lives to reach mathematical steady state and 4 to 5 half - lives to reach clinical steady state.
Without children (but don't think about this one for too long)
Cytochrome a/a3
Popliteus

16. What nerve or nerves supply general sensation and taste to the posterior third of the tongue?
Creatinine
Urachus
Adenosine deaminase (ADA) deficiency
CN XI and X

17. What is the name of a thin brown ring around the outer edge of the cornea - seen in Wilson's disease?
There would be a Fab' region; thus - it would still be able to participate in precipitation and agglutination.
Site 4
Kayser - Fleischer ring
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.

18. What lymphoma is associated with bleeding and cryoglobulin precipitation at low temperatures - headache and confusion due to hyperviscosity - IgM M- protein spike on serum electrophoresis - and Russell bodies?
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
Plasmin
Waldenstr
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)

19. The closure of what valve indicates the beginning of the isovolumetric relaxation phase of the cardiac cycle?
Chlamydia
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
Reverse transcriptase
Streptococcus viridans

20. Two weeks after her son has a throat infection - a mother takes the boy to the ER because he has fever - malaise - HTN - dark urine - and periorbital edema. What is your diagnosis?
Meningococcus (Gonococcus does not)
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Poststreptococcal GN
None; they are the storage sites for ADH and oxytocin.

21. What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficile - ischemia - Staphylococcus - Shigella - or Candida infection?
Femoral hernias
Pseudomembranous colitis
Altruism
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12

22. Are the JG cells of the nephron a part of the afferent or efferent arteriole?
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
Afferent arteriole
GLUT 3 and 4
Macula densa

23. Use of an outlet for emotions (stuff flows downhill).
Displacement
Ephedrine
H1 histones
Histamine

24. Name the most common type or cause - Mallory- Weiss syndrome
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.
Alcoholism
Group A Beta- hemolytic streptococci
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.

25. What is the costliest health care problem in the United States?
Adulthood
Alcohol and its related problems cost the country approximately $100 billion a year.
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.

26. How can you differentiate between a medial temporal lobe and a hippocampal lesion based on memory impairment?
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
Bridging veins draining into the sagittal sinus
Pyridoxine (B6)
IDL

27. Is a subdural hematoma an arterial or venous bleed?
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Ligamentum venosum
At least 5 lobes
Invariant chain

28. What lipoprotein is formed if an IDL particle acquires cholesterol from a HDL particle?
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
LDL
Inulin
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)

29. What enzyme is deficient in the following glycogen storage disease? - McArdle's disease
Muscle glycogen phosphorylase
AML- M3
Glossopharyngeal nerve
On the superior body of the posterior wall of the uterus

30. Excess bone demineralization and remodeling can be detected by checking urine levels of what substance?
Hydroxyproline (breakdown product of collagen)
When it crosses the teres major
CD15 and CD30
CN IX - X - and XII

31. Is hirsutism a side effect of estrogen or progestin therapy?
Type I hypersensitivity (anaphylactic)
Progestin
Pregnancy
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.

32. How many months in How many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
3 months of symptoms in 2 consecutive years
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
VSD
Cause - specific mortality rate

33. What aspects of sleep are affected during benzodiazepine use?
REM and stage 4 sleep; they decrease.
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
On the superior body of the posterior wall of the uterus
Ulnar to radial progression

34. Which bacteriostatic drug whose major side effect is the lepra reaction inhibits folic acid synthesis?
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
Ipsilateral loss at and below the level of the lesion
Dapsone
Streptococcus viridans

35. What syndrome is described by a lesion in the angular gyrus (area 39) resulting in alexia - agraphia - acalculia - finger agnosia - and right - left disorientation?

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36. According to Freud - what facet of the psyche represents the internalized ideals and values of one's parents?
Cohort studies determine incidence and causality - not prevalence.
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
Superego
Vesicle (e.g. - poison ivy)

37. Name the hypochromic microcytic anemia based on the following laboratory values - Decreased iron - percent saturation - and ferritin; increased TIBC
Iron deficiency anemia
IgA
Hepatitis B
Job syndrome

38. Acts as the vertebral body of C1 allowing lateral rotation of the head. The first cervical vertebra has no vertebral body.
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
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Medullary carcinoma of the thyroid
The odontoid process of C2

39. What is the amount in liters and percent body weight for the following compartments? - Interstitial fluid
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.
9.3 L - 15% of body weight
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.
Autograft

40. What type of resistance system (i.e. - high or low) is formed when resistors are added in parallel?
A low - resistance system is formed by resistors added in parallel.
Hypoxia
Left atrium and tip of the right atrium
Pancreatic cancer

41. What is the largest nucleus in the midbrain?
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
total body water
By asking a patient to close the eyes while standing with feet together
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.

42. Name the form of spina bifida - Defect in the vertebral arch
Posterior compartment of the thigh - tibial nerve
Being a female physician increases the risk of suicide nearly four times the general population.
Occulta All except occulta cause elevated - fetoprotein levels.
Sphingomyelin

43. What vein drains the lower third of the thoracic wall?
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.
Oxytocin
Hemiazygous vein
Type III

44. Are the following conditions associated with a negative or positive nitrogen balance? - Kwashiorkor
Escherichia coli
Maxillary artery
1. Posterior auricular vein 2. Posterior division of the retromandibular vein
Negative

45. What CNs are affected if there is a lesion in x The upper medulla?
CN IX - X - and XII
No - it is never acceptable to lie.
EBV
Multiple sclerosis

46. What two stress hormones are under the permissive action of cortisol?
Hydralazine - isoniazid - and procainamide (HIP)
Sacrococcygeal teratoma
Right nasal hemianopsia
Glucagon and epinephrine

47. What is the term for failure of the testes to descend into the scrotum?
In the tuberoinfundibular pathway - dopamine release will decrease prolactin release - Which is why dopamine agonists are used in the treaatment of hyperprolactinemic states.
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
Dendritic cells - macrophages - and thymic epithelial cells
Pneumotaxic center (short - fast breaths)

48. What are the CAGE questions?
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
Proportionate mortality rate
G2 phase
HBc Ab

49. On the venous pressure curve - What do the following waves represent? - V wave?
Staphylococcus saprophyticus
refuse
Repression
Atrial filling (venous filling) Atrial - Contraction - Venous

50. What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
Turcot syndrome
Carbonic anhydrase
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III) - B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.