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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 AA is a precursor of the following substances? - NAD
None; it degenerates.
Graves disease
Tryptophan
No enzymes are needed. When the stop codon reaches the A site - it results in termination.

2. What form of estrogen is of placental origin?
Bronchogenic carcinoma
Free - unprocessed Ag
Estriol
The number of Ags that the Ab can bind

3. What medication is a PGE1 analog that results in increased secretions of mucus and HCO3- in the GI tract?
Teratoma (dermoid cyst)
Misoprostol
Hypervariable region (three per light chain; three per heavy chain)
The reduviid bug

4. What two AAs require vitamin C for hydroxylation?
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
Male pseudohermaphrodite (dude looks like a lady!)
Left homonymous hemianopsia
Proline and lysine

5. What cells contribute to the blood - brain barrier and proliferate in response to CNS injury?
Jejunum (upper)
Astrocytes
Pedophilia
Chi - square (when you are in doubt and have nominal data - use chi - square)

6. Name the valve abnormality based on the following criteria: x Diastolic murmur; increased preload - stroke volume - and aortic pulse pressure; decreased coronary blood flow; no incisura; and peripheral vasodilation
Alkaline phosphatase
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
tRNA
Aortic insufficiency

7. What is the most common one? - Site of Crohn disease
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
Vitamin B 6 (pyridoxine)
Streptococci
Terminal ileum

8. In what stage of psychosexual development - according to Freud - do children resolve the Oedipus complex?
Medial nuclear group (limbic system)
Latency stage (6-12 years)
Hypoglycemia for secretion and hyperglycemia for inhibition
Poxvirus replicates its DNA in the cytoplasm.

9. What is the term that refers to the number of channels open in a cell membrane?
Clarke's nucleus
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
Dimercaprol
Membrane conductance (think conductance = channels open)

10. What type II hypersensitivity disorder is defined as x Autoantibodies directed against ACh receptors?
Left atrium and tip of the right atrium
C4 (the upper border of the thyroid cartilage)
Acute rejection
Myasthenia gravis

11. All Proteus species are...
Alveolar macrophages (dust cells)
urease positive
PKU
RSV

12. What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?
Macula densa
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.
Osteosarcoma

13. What AA undergoes N- glycosylation?
GnRH constant infusion
Chromium (Cr)
Asparagine
Suprachiasmatic nucleus

14. What phase of Food and Drug Administration approval tests x The protocol and dose levels in a small group of patient volunteers?
Phase II
Fanconi - like syndrome
C3a - C4a - C5a
Left ventricle and auricle of left atrium

15. Prolactin levels can serve as a rough indicator of...
Asbestosis
Ferrochelatase
overall dopamine activity
Vitamin B6

16. What component of the basement membrane binds to collagen type IV and heparin sulfate and is a cell surface receptor?
Trichuris trichiura is treated with albendazole.
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe
Laminin
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)

17. What type of drug elimination is characterized by the following? - Elimination independent of plasma concentration; constant amount eliminated per unit time; no fixed half - life
Zero - order elimination
Acute pyelonephritis
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
Interferons

18. With What thoracic vertebra or vertebrae does rib 7 articulate?
Macule (e.g. - a freckle)
CD15 and CD30
Estrone
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.

19. What is the only trematode that is not hermaphroditic?
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma
Edrophonium
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase
Schistosoma have separate males and females.

20. Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia?
Rhinovirus and hepatitis A virus
Sensitivity (it deals with the sick)
d - Tubocurarine
Leucine and lysine

21. What is the most common one? - Complication of PDA
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Chordae tendineae
Urogenital sinus
Subacute bacterial endocarditis

22. Name the associated chromosome - Familial hypercholesterolemia
Mycobacterium leprae
de Quervain thyroiditis
Chromosome 19
Stibogluconate

23. Name the antidote - Digoxin
The AR form is malignant and AD is benign.
Repression
Antidigoxin Fab fragments
Hypervariable region (three per light chain; three per heavy chain)

24. What law states that an enlarged - palpable gallbladder is more likely due to cancer than stone obstruction?

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25. What organism is associated with the following types of diarrhea? Rice water stools
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Streptococcus pyogenes
Vibrio cholera
MEN I (or Wermer syndrome)

26. Name the valve abnormality based on the following criteria: x Diastolic murmur - increased right ventricular pressure - left atrial pressure - and atrial to ventricular pressure gradient; decreased left ventricular filling pressure
Ischemic heart disease (MIs)
Chromosome 15 - 17
Superior Oblique (CN IV) (LR6 SO4)3
Mitral stenosis

27. What is the term for the total volume of air moved in and out of the respiratory system per minute?
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
Glucagon and epinephrine
Fluconazole
Total ventilation (minute ventilation or minute volume)

28. What embryonic week sees the formation of the notochord and the neural tube?
Increase (5- HT and dopamine levels do the same)
Prefrontal cortex; it is in front of the premotor area.
Third week
The lateral vestibular nucleus

29. What is the most common one? - Tumor in men aged 15 to 35
Mesencephalon
Muscle spindles
Testicular tumors
Stable

30. What percent of sexual abuse cases are committed by family members?
Visceral pleura
Anorgasmia. (The overall prevalence is 30%.)
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Macula densa

31. What commonly encountered overdose produces headache - tinnitus - respiratory alkalosis - metabolic acidosis - confusion - vomiting - and tachypnea?
Wiskott - Aldrich syndrome
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns
ASA (salicylate)
IgA nephropathy (Berger disease)

32. Which antihypertensive class is used to help stop the progression of microalbuminuria?
Mikulicz syndrome
ACE inhibitors (- pril)
Chromosome 18
Hydatidiform mole

33. What syndrome is associated with the following brainstem lesions? - Occlusion of the PICA - resulting in ipsilateral limb ataxia - ipsilateral facial pain and temperature loss - contralateral pain and body temperature loss - ipsilateral Horner's synd

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34. What are the rules of 2 for Meckel diverticulum?
Diphyllobothrium latum
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors

35. With a decrease in arterial diastolic pressure - what happens to x Heart rate?
Trichuris trichiura is treated with albendazole.
90% as HCO3- - 5% as carbamino compounds - and 5% as dissolved CO2
Decreases
Pyridoxine (B6)

36. Name the neurotransmitter at the neuromuscular junctions for all of the voluntary muscles in the body.
Hepatitis C
The carotid sinus reflex
ACh; think about the ANS.
Thoracic and sacral

37. Name the cluster C personality disorder: x Sensitive to criticism - shy - anxious; socially isolated but yearns to be in the crowd
Avoidant
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Periaortic lymph nodes
Sj

38. What two substances stimulate Sertoli cells?
From age 5 onward IQ stabilizes.
Breast and lung cancer - respectively.
Ulcerative colitis
FSH and testosterone

39. What antiviral agent is used to treat RSV - influenza A and B - Lassa fever - and hantavirus and as an adjunct to IFN- in hepatitis C?
Ribavirin
Huntington disease
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
Epispadia

40. Name the most common type or cause - Breast lump in females
Pott disease
Fibrocystic change of the breast
Vibrio cholera
Testicular tumors

41. During What embryonic week does the intraembryonic coelom form?
CML
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Third week
Hepatitis C

42. How is velocity related to the total cross - sectional area of a blood vessel?
Mesonephric duct
Doxycycline
Macula densa
Velocity is inversely related to cross - sectional area.

43. What cestode causes cysticercosis?
Taenia solium
MEN III (or IIb)
Copper deficiency
The fast component is directed toward the affected side of a cerebellar lesion.

44. What neuronal cell bodies are contained in the intermediate zone of the spinal cord? (T1- L2)
Preganglionic sympathetic neurons
Adenovirus
Vanillylmandelic acid (VMA)
Inspiratory capacity

45. What Ig prevents bacterial adherence to mucosal surfaces?
IgA
Lithium
Galactoside permease
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.

46. What are the two MCC of acute epididymitis in males? - More than 35 years old
Enterokinase
Atrial filling (venous filling) Atrial - Contraction - Venous
Escherichia coli and Pseudomonas sp.
Secondary hypoparathyroidism (vitamin D toxicity)

47. What organelle synthesizes proteins that are intended to stay within the cell?
Isovolumetric contraction
Lewy bodies
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.
Dysplasia

48. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Psychosocial and environmental problems (stressors)?
Axis IV
cDNA - when it is made from mRNA
Leydig cell tumor
Deficiency in surfactant

49. A urethral swab of a patient shows gram - negative diplococci in PMNs; what organism do you diagnose?
Neisseria gonorrhoeae
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
Transference. When it is from the physician to the patient it is called countertransference.
Protamine sulfate

50. What are the two MCC of acute epididymitis in males? - Less than 35 years old
Neisseria gonorrhoeae and Chlamydia trachomatis
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
JC virus
7 years old

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