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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 term for days 1 to 7 of the female cycle?
Menses
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Schwannoma
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.

2. What are the three reasons for the effectiveness of the blood - brain barrier?
Melanosis coli
Oblique fissure
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
D- Penicillamine

3. What are the growth factors released from the liver called?
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.
Somatomedins

4. What syndrome is due to a deficiency of surfactant?
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
Cryptococcus
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.

5. What stromal tumor in males is characterized histologically with crystalloids of Reinke?
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
The sandfly
Leydig cell tumor
Dependent

6. What is the renal compensation mechanism for alkalosis?
Glucagon
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+
Enterococcus faecalis

7. What hormone is characterized by the following renal effects? - Calcium reabsorption - phosphate excretion
Pelvic splanchnics (They all begin with P.)
Transtentorial (uncal)
PTH
Huntington's chorea. (Death in 15-20 years - often via suicide.)

8. What stage of male development is characterized by the following LH and testosterone levels? - LH pulsatile amplitude and levels increase - with increased testosterone production.
Puberty
3' end. Phosphate (PO4) is at the 5' end.
Neuroblastoma
Cestodes

9. Describe What type of fluid is either gained or lost with the following changes in body hydration for the ECF volume - ICF volume - and body osmolarity - respectively: x ECF: increase; ICF: no change; body: no change
Gain of isotonic fluid (isotonic saline)
GnRH
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Rhombencephalon

10. Which direction is air flowing when the intra - alveolar pressure is zero?
When the intra - alveolar pressure equals zero - there is no airflow.
Dimercaprol - penicillamine
Extracellular
Eisenmenger's syndrome

11. What prion - associated CNS pathology produces rapidly progressive dementia with myoclonus - involuntary movements - and death within 6 to 12 months?
unprocessed Ags
HBcAb IgG and HBsAb IgG
presence of PMNs
Creutzfeldt - Jakob disease

12. Name the most common type or cause - Breast lump in females
Coxsackie B
Metastatic carcinoma
Fibrocystic change of the breast
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.

13. What diseases are associated with the HLA- B27 allele

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14. Name the DNA virus: x Circular dsDNA; naked; icosahedral; replicates in the nucleus
Hapten (not immunogenic)
Papovavirus
Fibroadenoma
Echinococcus multilocularis

15. What apoprotein on HDL activates lecithin - cholesterol acyltransferase (LCAT)?
apo A-1
Ulcerative colitis
G0 phase
Seasonal affective disorder (treat with bright light therapy)

16. What AA undergoes N- glycosylation?
Mitral valve prolapse
Asparagine
The greater the cell diameter - the greater the conduction velocity.
Magnesium ammonium phosphate (struvite)

17. Name the type of necrosis - Due to lipase activity and has a chalky white appearance
Transverse abdominis
ICF volume decreases when there is an increase in osmolarity and vice versa.
Fat necrosis
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.

18. What type of muscle is characterized by no myoglobin - anaerobic glycolysis - high ATPase activity - and large muscle mass?
Transferrin
White muscle; short term too
Courvoisier's law
The conversion of CHO to pregnenolone via the enzyme desmolase

19. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ decreased - Pi decreased
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
Major
S phase
Postductal coarctation of the aorta (adult)

20. What is the most common chromosomal abnormality associated with CLL?
Histoplasma capsulatum
Testicular feminization syndrome (Dude looks like a lady!)
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)
Physiologic dead space is the total dead space of the respiratory system.

21. Can incidence - prevalence - and cause and effect be assessed in x Cross - sectional studies?
Cardiac muscle
RES(Reticular endothelial system)
CN VII and VIII
Cross - sectional studies determine prevalence - not incidence or cause and effect.

22. Where is tropocollagen aggregated to form a collagen fibril?
Outside the cell
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Hemophilia B
Gastrinoma

23. What substance is used to test platelets' response in patients with von Willebrand disease?
Melanoma
HBsAg (incubation period)
Ristocetin
Monocytosis

24. What are the three components to the asthma triad?
Nasal polyps - rhinitis - and aspirin hypersensitivity
Hemorrhagic exudates
Calcitriol
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.

25. What is the term for an increase in the number of cells in a tissue?
Hyperplasia
Pompe's disease
Transcription (C comes before L in the alphabet - and transCription comes before transLation)
There would be two Fab and Fc regions.

26. What is the most common one? - Sites for abdominal aorta aneurysm
Kidney
Proencephalon diencephalon derivative
Between the renal arteries and at the bifurcation of the abdominal aorta
Arch of the aorta and right subclavian artery

27. Which class of antiarrhythmics are calcium channel blockers?
Obese patients
Autoimmune thrombocytopenia purpura
Class IV
Salpingitis

28. What is the term for a deficiency or absence of sexual fantasies or desires?
Medial pontine syndrome
G0 phase
Temporal arteritis (giant cell arteritis)
Hypoactive sexual desire disorder

29. What seronegative spondyloarthropathy is seen in HLA- B27- positive young females and presents with the triad of conjunctivitis - urethritis - and arthritis affecting the knees and ankles?
Pelvic splanchnics (They all begin with P.)
gp120
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Reiter syndrome

30. What is the only Rickettsia that is stable in the environment?
Occipital lobe
Coxiella burnetii
Waldeyer's ring
Wilson disease

31. What is characterized by an intense inflammatory reaction - an increase in the amounts of granulation tissue and wound contraction by myofibroblasts?
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Healing by secondary intention
Arch of the aorta
Alzheimer disease

32. What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
X- linked dominant
External abdominal oblique
Waldenstr

33. What receptor is in the smooth muscle cells of the small bronchi - is stimulated during inflation - and inhibits inspiration?
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Stretch receptors prevent overdistension of the lungs during inspiration.
Takayasu arteritis (medium - size to large vessels)
Stibogluconate

34. How many codons code for AAs? How many for termination of translation?
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.

35. Is a brush border enzyme.
Mean corpuscular hemoglobin (MCH)
4 years old
Enterokinase
Clearance

36. What is the only specific Ag - presenting cell?
Subclavian vein
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
B cells; macrophages and dendritic cells are nonspecific.
Cardiac output

37. Which cestode infection results in alveolar hydatid cyst disease?
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
naked viruses
DNA polymerase I
Echinococcus multilocularis

38. What type of hernia is described as passing through the deep lateral ring of the inguinal canal?

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39. What are the two broad - spectrum penicillins?
Clostridium perfrigens
ELISA test
Smoking
Ampicillin and amoxicillin

40. Both submandibular and sublingual glands are innervated by CN VII (facial) and produce mucous and serous secretions. Which one mainly produces serous secretions?
Methanol (wood alcohol)
Schistosoma haematobium
Potency
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.

41. What are the adult remnants of the following structures? - Ductus arteriosus
Fc portion of IgG - C3b - and mannose - binding proteins
PALS
Ligamentum arteriosum
Alternative hypothesis (What is left after the null has been defined)

42. What is used as an index of the number of functioning carriers for a substance in active reabsorption in the kidney?
Venous pressure above the heart is subatmospheric - so a puncture there has the potential to introduce air into the system.
CML
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
Pulmonary alveolar macrophages

43. What enzyme is deficient in congenital erythropoietic porphyria?
Dependent
Uroporphyrinogen III cosynthase
Acanthosis nigricans
Streptococcus viridans

44. What enzyme catalyzes the rate - limiting step of the urea cycle?
Carbamoyl phosphate synthetase I
Lactose must be present and glucose must be absent
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.

45. What two Beta- blockers decrease serum lipids?
Idiotypes
prognostic predictors
Yes
Acebutolol and Pindolol

46. What vessels carry deoxygenated blood into the lungs from the right ventricle?
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Bacillus cereus

47. What condition results in the following CSF results? - Opening pressure 450 mm H2O; 5 WBCs (90% lymphocytes); normal glucose and protein levels
Brain abscess
Clozapine
Selegiline
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.

48. What coronary artery vasculitis is seen in Japanese infants and children less than 4 years old with acute febrile illness - conjunctivitis - maculopapular rash - and lymphadenopathy?
Ipsilateral loss below the level of the lesion
1 day prior to ovulation
Kawasaki disease
Isotonic contraction

49. What are the two MCC of acute epididymitis in males? - Less than 35 years old
Riedel thyroiditis
Neisseria gonorrhoeae and Chlamydia trachomatis
Confabulation; it is commonly seen in Korsakoff's syndrome.
Hepatoma and nonseminomatous testicular germ cell tumors

50. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Months to years after transplantation; gradual onset of HTN - oliguria - and azotemia; seen as intimal fibrosis of the blood vessels and in
Area 17
Mean corpuscular volume (MCV)
Chronic rejection
Excess estradiol in the blood