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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 enzyme is deficient in the following glycogen storage disease? - Hers' disease
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies
Luteal phase
Hepatic glycogen phosphorylase
GLUT 4

2. What is the only DNA virus that has the reverse transcriptase enzyme?
Hepadnavirus
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
HPV serotypes 1 and 4
Bronchogenic carcinoma

3. What cells of the nephron function as sodium concentration sensors of the tubular fluid?
G2 phase
AT II
Gastric carcinoma
Macula densa

4. How many days before the first day of menstrual bleeding is ovulation?
Mentally disabled
14 days in most women (Remember - the luteal phase is always constant.)
Plasmodium falciparum
Moderate (35-49)

5. What fungus is characterized by India ink staining of the CSF that produces colorless cells with a halo on a black background?
Pseudomembranous colitis
Cryptococcus neoformans
Type I pneumocytes
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.

6. What type of hypersensitivity is a T cell - mediated response to Ags that are not activated by Ab or complement?
ACh; think about the ANS.
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)
Urinary 17- ketosteroids
Hypothyroidism. (TSH levels must be monitored.)

7. What term is defined as a patient unconsciously placing his or her thoughts and feelings on the physician in a caregiver or parent role?
Transference. When it is from the physician to the patient it is called countertransference.
Saltatory conduction
Left abducens nerve
Plasmodium ovale

8. What is the only vein in the body with a high O2 content?
Dimercaprol
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Yolk sac tumor
Ewing sarcoma

9. Does the oncotic pressure of plasma promote filtration or reabsorption?
Astrocytes
Oxytocin
Squamous cell carcinoma of the lung
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.

10. Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it?
ELISA. It detects anti - p24 IgG.
Chromosome 19
Asbestosis and silicosis
Stratum lucidum

11. What is the major inorganic component of bone?
Gout
Aldehyde dehydrogenase
Hydroxyapatite
Four

12. Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade?
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Alendronate
Postinfectious GN
Venlafaxine. (It also has a mild dopaminergic effect.)

13. When the results of a test are compared to findings for a normative group - what form of reference does the objective test use?
B- cell Ag receptors
Purine nucleoside phosphorylase
Norm reference (i.e. - 75% of the students in the class will pass)
Nephroblastoma

14. Name the thalamic nucleus based on its input and output - Input from the optic tract; output projects to the primary visual cortex of the occipital lobe
Streptolysin O
LGB (think EYES)
Coarctation of the aorta
Clonidine

15. What primary acid - base disturbance is caused by a gain in fixed acid forcing the reaction to shift to the left - decreasing HCO3- and slightly increasing CO2?
Klebsiella pneumoniae
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
FSH

16. Name the thalamic nucleus based on its input and output - Input from the mammillary bodies via the mammillothalamic tract and the cingulated gyrus; output to the cingulated gyrus via the anterior limb of the internal capsule
Thoracic and sacral
Both Neisseria and Moraxella are gram - negative cocci.
Schizotypal
Anterior nuclear group (Papez circuit of the limbic system)

17. Are eukaryotic proteins that inhibit viral replication by being virus specific.
Because creatinine is filtered and a small amount is secreted
Interferons
PGI 2
50% - with 50% of them having the child

18. What prevents the down - regulation of the receptors on the gonadotrophs of the anterior pituitary gland?
The pulsatile release of GnRH
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
A right CN V lesion results in weakened muscles of mastication - and the jaw deviates to the right.

19. What type of cell can never leave the lymph node?
1. Decrease alpha -1 activity 2. Increase Beta -2 activity 3. Increase ACh levels
Plasma cell
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)

20. Name the most common type or cause - Infantile bacterial diarrhea
Clostridium perfringens
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
Arginine
Non - Hodgkin lymphoma

21. Name the most common type or cause - Cirrhosis in the United States
Spermatid
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.
Alcohol consumption
Meningioma

22. What is the most common one? - Form of necrosis
Y - W-135 - and C and A capsular polysaccharides
Coagulative
Pompe's disease
Decreases

23. 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)?
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.
Streptokinase
Plasma concentration and excretion rate
Axis IV

24. The increased oxygen consumption after phagocytosis is for...
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
Bipolar disorder (manic - depressive disorder)
Metanephros
ATP production

25. What CN is associated with the sensory innervation of x Laryngopharynx?
Ulcerative colitis
Vagus nerve
The left gastric - splenic - and common hepatic arteries
Vital capacity (VC)

26. What type of hepatitis has the highest mortality rate among pregnant women?
Hepatitis E
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Transcription factor IID
Type I hypersensitivity (anaphylactic)

27. What CN is associated with the sensory innervation of x Nasopharynx?
CN X (Remember - the vagus nerve supplies the parasympathetic information from the tip of the pharynx to the end of the midgut and all between.)
Terminal ileum
Maxillary division of CN V and glossopharyngeal nerves
G0 phase

28. Waxy casts
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
Temporal lobes
ATP/ADP Translocase
Chronic end - stage renal disease

29. What are the two opsonizing factors?
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
IgM; IgD follows shortly thereafter.
Moving objects - along with large bright objects with curves and complex designs.
The Fc region of IgG and C3b

30. Russell bodies
Respiratory depression
Multiple myeloma
Erectile dysfunction
Glucose -6- phosphatase

31. What pathology involves excessive fibrosis throughout the body via increased fibroblast activity - occurs in women more than men - and is most commonly seen in the third to the fifth decade?
Arterioles
Scleroderma
Ordinal scale (e.g. - faster/slower - taller/shorter)
Day 14

32. What prokaryotic positioning enzyme in translation is blocked by the following? - Erythromycin
EF- G of the 50S subunit
Central sulcus (sulcus of Rolando)
Dopamine
Idiotypes

33. What vector is associated with malaria?
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Latissimus dorsi
Anopheles mosquito
Corticospinal tract

34. What is the most common site for implantation of the blastocyst?
Vital capacity (VC)
ELISA test
On the superior body of the posterior wall of the uterus
An elevated serum osteocalcin level

35. What toxicities are caused by the following agents? - Occupational nitrous oxide exposure
Anemia
The reduviid bug
Langerhans cells
Osteopetrosis (Albers - Sch

36. What sensory system is affected in the late spinal cord manifestation of syphilis?
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius
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.
CD14
Ventricular contraction Atrial - Contraction - Venous

37. Do the following structures pick up stain from hematoxylin or eosin? - Nuclei
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c
1. Skin 2. Liver 3. Kidney
Hematoxylin
Decreasing potassium conductance - which results in increased excitability

38. What modified smooth muscle cells of the kidney monitor BP in the afferent arteriole?
Cerebral aqueduct
The JG cells
Dopamine antagonists
ACh - histamine - and gastrin

39. What are the three functions of surfactant?
Chromosome 15 - 17
Folic acid deficiency
Nodular sclerosis
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation

40. What is the most common cause of vitamin B6 deficiency?
Isoniazid treatment
IL-5. It also stimulates eosinophil proliferation.
Smooth muscle
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)

41. Name the product or products of arachidonic acid: x Vasodilation
Chromosome 15 - 17
PGD2 - PGE2 - and PGF 2
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
ELISA. It detects anti - p24 IgG.

42. Which bacteria are associated with the following pigment production? - Yellow pigmentation
H 2
Escherichia coli
Primitive ventricle
Staphylococcus aureus

43. Innervate the striated muscle of the bulbospongiosus and ischiocavernous muscles and result in ejaculation of semen.
TXA2
Flocculonodular lobe (one of my favorite words in all of medicine!)
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
Somatic motor neurons

44. Name the phase of the eukaryotic cell cycle: x Period of DNA replication (preparing for mitosis)
Lead
Pancreas and colon
Succinylcholine
S phase

45. What is the term for telescoping of the proximal bowel into the distal segment presenting as abdominal pain - currant jelly stools - and intestinal obstruction?
Ergosterol
Intussusception
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
Coma - convulsions - and cardiotoxicity

46. What childhood pathology involves anterior bowing of the tibia - epiphyseal enlargements - and costochondral widening - with the endochondral bones being affected?
Rickets
Native Americans
Ovarian cancer
CN IX - X - and XII

47. Name the Hgb - O2 binding site based on the following information: x Least affinity for O2; requires the highest PO 2 levels for attachment (approx. 100 mm Hg)
Muscle glycogen phosphorylase
IgA nephropathy (Berger disease)
Glycogen synthase
Site 4

48. Name the DNA virus: x Partially dsDNA circular; enveloped; virion - associated polymerases; has RNA intermediate; replicates in the nucleus
CN X
Hepadnavirus
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
Chromosome 11p

49. Is most of the coronary artery blood flow during systole or diastole?
12 days after ovulation
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Erythema nodosum
Varicocele

50. Name the B- cell CD marker: x Receptor for EBV
Stable
Previous suicide attempt
TB meningitis
CD21; it is a complement receptor for cleaved C3