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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. In the classical conditioning model - when a behavior is learned - what must occur to break the probability that a response will happen?
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
1. VSD 2. ASD 3. PDA
IL-3 (3 face down is an M)
Projection

2. What water - soluble - vitamin deficiency may result from eating raw eggs?
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
Biotin (only if eaten in large quantities)
HBcAb IgG - HBV- DNA - HBeAg - HBsAg
Malassezia furfur (treat with selenium sulfide)

3. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x PSA and prostatic acid phosphatase
A high - resistance system is formed when resistors are added in a series.
An elevated serum osteocalcin level
Lipid - soluble hormones are considered slow - acting hormones.
Prostate cancer

4. What are the three C's of a TCAD overdose?
2 NADPHs per acetyl CoA
Sideroblastic anemia
Listeria monocytogenes
Coma - convulsions - and cardiotoxicity

5. What muscle acts in all ranges of motion of the arm?
T3
Deltoid
Thymus gland. (Thymus gland is essential for T cell maturation.)
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.

6. Which organism causes trench fever?
Rochalimaea quintana (now called Bartonella quintana)
Serotonin
Area 8
Epispadia

7. What virus lies dormant in the x Sensory ganglia of S2 and S3?
Herpes II
The resistance increases 16- fold.
Clearance
The liver (in the mitochondria)

8. How many acetyl CoAs per glucose enter into the TCA cycle?
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle

9. Is excretion greater than or less than filtration for net secretion to occur?
Shifts it to the right
Pons
Excretion is greater than filtration for net secretion to occur.
The left is a branch of the aortic arch - while the right is a branch of the brachiocephalic trunk.

10. What test is done to diagnose CGD?
Are live attenuated vaccines available in the United States
Type III hypersensitivity (immune complex)
Clear cell
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.

11. Match the pulmonary end capillary blood levels.
Alveoli; they are part of the respiratory portion.
The alveolar PO2 and PCO2 levels
The aorta has the greatest velocity and the capillaries have the slowest velocity.
The number of Ags that the Ab can bind

12. What diagnosis ensues from finding well - demarcated erythematous plaques with silvery scales on the knees - elbows - and scalp along with nail bed pitting and discoloration?
Psoriasis
Cell - mediated immunity
Adipose tissue
Al - Anon

13. What is the most common one? - Helminth parasitic infection in the United States
Paget disease of the breast
Site 1
Enterobius vermicularis
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.

14. Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism?
Four
Physiologic antagonism
Pseudomembranous exudates
Brushfield spots

15. What mineral - via excessive depositions in the liver - causes hemochromatosis?
At least six
Plasmin
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Iron (Fe)

16. What gram - positive anaerobic rod with branching filaments is a component of the normal flora of the mouth and female genital tract and is responsible for draining abscesses with sulfur granules in the exudates?
Actinomyces israelii
The rectouterine pouch (of Douglas)
Acarbose
Vesicle (e.g. - poison ivy)

17. Name the eukaryotic RNA polymerase based on the following: x Synthesizes tRNA - snRNA - and the 5S rRNA
Skeletal muscles
RNA polymerase III
For males - HTN; for females - pregnancy.
Because the large drop in TPR is accompanied by a large increase in cardiac output - resulting in a minimal change in BP.

18. What type of correlation compares two ordinal variables?
Spearman correlation
Dilation of afferent arteriole
The basilar artery is formed at the pontomedullary junction.
Fever - night sweats - and hemoptysis

19. Name the MCC - Aspiration pneumonia in an alcoholic
NADPH - O2 - and cytochrome b5
Klebsiella pneumoniae
TB meningitis
Exposure

20. What is the name of the superficial subcutaneous fascia of the abdomen containing fat?

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21. Cowdry type A bodies
9.3 L - 15% of body weight
Mantle cell lymphoma
Al - Anon
Herpesvirus

22. Are the following parameters associated with an obstructive or restrictive lung disorder: decreased FEV1 - FVC - peak flow - and FEV1/FVC; increased TLC - FRC - and RV?
Left abducens nucleus or right cerebral cortex
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
Competitive antagonist
Functional residual capacity (FRC)

23. What is the term to describe how easily a vessel stretches?
Compliance (think of it as distensibility)
Metastatic calcification
Stratum spinosum
As the standard deviation increases - the greater the chance of error.

24. Name the most common reported STD - In males
Gonorrhea
Ultraviolet B (UVB) sunlight
Transmembrane potential (an absolute number)
Borrelia burgdorferi

25. What rate is indicated by 1- sensitivity?
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
False - negative rate
Insulinoma
G-6- PD deficiency

26. What is the most common form of elderly abuse?
Dantrolene
Clindamycin
Nephrotoxic oxylate stones
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.

27. What hormone has the following effects: chondrogenic in the epiphyseal end plates of bones; increases AA transport for protein synthesis; increases hydroxyproline (collagen); and increases chondroitin sulfate synthesis?
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Ipsilateral flaccid paralysis
Epinephrine
Isolation of affect

28. What are the four functions of saliva?
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
CHF
Listeria monocytogenes

29. What is the most common site for implantation of the blastocyst?
Gastric cancer
On the superior body of the posterior wall of the uterus
Hematoxylin
Hemorrhagic exudates

30. What are the two MCC of acute epididymitis in males? - More than 35 years old
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Hepatitis E
Escherichia coli and Pseudomonas sp.
von Gierke's disease

31. What wave is the cause of the following venous pulse deflections? - The rise in right atrial pressure secondary to blood filling and terminating when the tricuspid valves opens
Hemosiderin
Complex I
V wave
Androgen - binding protein

32. What toxin - produced by Clostridium tetani - binds to ganglioside receptors and blocks the release of glycine and GABA at the spinal synapse?
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
Mycosis fungoides (cutaneous T- cell lymphoma)
Tetanospasmin (also called tetanus toxin)
Copper

33. Which bacteria are associated with the following pigment production? - Black - gray pigmentation
The lung will expand; also the opposite is true.
Corynebacterium diphtheriae
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Diabetes mellitus

34. Which overdose carries a higher mortality rate - that of benzodiazepines or barbiturates?
Superior
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
Cushing's ulcers
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.

35. What protein is required by prokaryotic RNA polymerases to initiate transcription at the promoter region of DNA?
Interferons
Right medial longitudinal fasciculus
Sigma factor
HPV serotypes 16 - 18 - 31 - and 33

36. Name the type of graft described by these transplants: x From one species to another
Xenograft
Acetazolamide
Shaping (successive approximation)
Excess lead

37. Does alcoholism increase the rate of suicide?
300 mOsm/L
eIF-2 in the P site
Creutzfeldt - Jakob disease
Yes. It increases the rate of suicide to nearly 50 times that of the general population.

38. Is T3 or T4 responsible for the negative feedback loop on to the hypothalamus and anterior pituitary gland?
HBcAb IgM
Gastric ulcer
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.
Parkinson disease

39. What are the vitamin K- dependent coagulation factors?
Hepatitis B
Hepadnavirus
Factors II - VII - IX - X - and proteins C and S
Fibrinous exudates

40. How are flow through the loop of Henle and concentration of urine related?
White muscle; short term too
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)
As flow increases - the urine becomes more dilute because of decreased time for H2O reabsorption.
Red muscle

41. What is the main factor determining FF?
Type 2
Renal plasma flow (decrease flow - increase FF)
G0 phase
Thalassemia minor

42. In a diabetic patient - to What does aldose reductase convert glucose?
Reliability (think of it as 'nice grouping' or 'precise')
Sorbitol (resulting in cataracts)
Blastoconidia
Prevalence rate

43. What are the four segmented RNA viruses?
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
Autoimmune hemolytic anemia
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)

44. Acts as the vertebral body of C1 allowing lateral rotation of the head. The first cervical vertebra has no vertebral body.
The odontoid process of C2
Thermogenic
Treacher Collins syndrome
Medial compartment of the thigh - obturator nerve

45. Name the type of necrosis - Soft - friable - cottage - cheese appearing; characteristically seen in TB
Caseous necrosis
ACh receptor
Microglia
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.

46. Name the MCC - Walking pneumonia - seen in teens and military recruits
Paranoid schizophrenia
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.
Mycoplasma pneumoniae
Circumvallate papillae

47. How many carbons do androgens have?
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
von Hippel - Lindau syndrome
Cestodes
Androgens are 19- carbon steroids.

48. Where are the lowest resting PO2 levels in a resting individual?
Nitroprusside
Friedreich ataxia
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
Coronary circulation

49. What is the term for the difference between the highest and the lowest score in a population?
GH
Complex 4
Affinity (one of each)
Range

50. When attempting to make up sleep - what stage of sleep is recovered?
Impaired ejaculation
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.
Afterload
Obsessive - compulsive