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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 enzyme for the oxidative reaction in glycolysis?
Langerhans cells
MGN
Right - sided
Glyceraldehyde dehydrogenase

2. The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?
Alternative hypothesis (What is left after the null has been defined)
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
Four high energy bonds - two from ATP in AA activation and two from GTP
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.

3. In What three areas of the body are sympathetics the predominant tone?
Accidents
1. Sweat glands 2. Arterioles 3. Veins
Amyotrophic lateral sclerosis (Lou Gehrig's disease) is a LMN lesion at the level of the lesion and UMN lesion below the level of the lesion.
Atrial contraction Atrial - Contraction - Venous

4. What happens to the following during skeletal muscle contraction? - Actin and myosin lengths
No change in length
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
Osteogenesis imperfecta
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.

5. Regarding neuroleptics - What is the relationship between potency and anticholinergic side effects?
Pregnancy
Antithyroglobulin and antimicrosomal Abs
Niclosamide
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.

6. Name the eukaryotic DNA polymerase based on the following information: x Replicates mitochondrial DNA
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
Housemaid's knee
DNA polymerase -?
von Hippel - Lindau syndrome

7. Name the most common cause - Insomnia
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
Polycystic ovary disease (Stein - Leventhal syndrome)
Priapism
Depression

8. From What embryonic structure are the following structures derived? - The right and left ventricles
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
Primitive ventricle
X- linked dominant

9. What are the four ways to increase TPR?
Scleroderma
total body water
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels
Cryptococcus

10. What growth factors are chondrogenic - working on the epiphyseal end plates of bone?
Posterior cricoarytenoid muscles
Somatomedins (IGF-1)
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
CN VI - VII - and VIII

11. Name the structure that enters or exits the following foramina: x Hypoglossal canal
CN XII
Hepatitis A (infectious)
Vimentin
Necator americanus is treated with mebendazole and iron therapy.

12. What small gram - positive - non - spore - forming rod is a facultative intracellular parasite that grows in the cold and is associated with unpasteurized milk products?
Preganglionic sympathetic neurons
Accommodation
In the first and second bronchi
Listeria monocytogenes

13. What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
Four
Beta- Hydroxybutyrate
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
Heroin

14. What is the only DNA virus that does not replicate its DNA in the nucleus of the host cell?
The time it takes ACh to diffuse to the postjunctional membrane
Poxvirus replicates its DNA in the cytoplasm.
Cilia
Buerger disease (thromboangiitis obliterans)

15. What AA is a precursor of the following substances? - NAD
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase
Tryptophan
Dihydropteroate synthetase
Oxytocin

16. Failure to accurately recall the past leads to what form of bias?
Recall bias. These problems arise in retrospective studies.
Eosin
Positive sense RNA means it can serve as mRNA and therefore has 5'-3' polarity
Streptococcus pneumoniae

17. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Diencephalon
Patau syndrome (trisomy 13)
Size
Proencephalon
Valproic acid

18. What Beta2- agonist is used as a prophylactic agent in the treatment of asthma?
The tsetse fly
Salmeterol
Osteosarcoma
Guanethidine and bretylium

19. What type of potential is characterized as graded - decremental - and exhibiting summation?
Dyslexia
Hapten; if it is coupled with a carrier - it may become immunogenic.
They are preganglionic sympathetic axons. They are white because they are myelinated.
Subthreshold potential

20. What enzyme is deficient in acute intermittent porphyria?
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
Uroporphyrinogen I synthetase
Hirschsprung disease (aganglionic megacolon)
Pseudomonas aeruginosa

21. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Agraphia - acalculia - finger agnosia - right - left disorientation

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22. Name the most common one - Chromosomal disorder involving sex chromosomes
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
Klinefelter syndrome
IgG
Hemophilia B

23. What is the term for the difference between the highest and the lowest score in a population?
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.
Range
Polyarteritis nodosa
Glutamine and aspartate

24. What is the most common one? - Esophageal carcinoma
Squamous cell carcinoma
Gastric carcinoma
Cohort studies determine incidence and causality - not prevalence.
Palms - up before palms - down maneuvers

25. What type of correlation is defined as x Two variables with no linear relation to one another?
Specific rate (e.g. - men aged 55-60)
Regression
Benign nevus (mole)
Zero correlation

26. What are the three posttranscriptional modifications?

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27. When does most REM sleep occur - in the first or second half of sleep?
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
Reovirus
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.
Vibrio cholera

28. Which hepatitis B serology markers
Pantothenic acid
HBcAb IgM - HBV- DNA - HBeAg - HBsAg
Plasmodium falciparum
Yellow fever (flavivirus)

29. Name the DNA virus x Linear dsDNA; enveloped; virion - associated polymerases; replicates in the cytoplasm :
Sinus venosus
Poxvirus
Prolactinoma
Squamous cell carcinoma

30. Which type of hepatitis is a picornavirus?
Hepatitis A (infectious)
Stage fright (discrete performance anxiety)
Candida albicans
Mycobacterium leprae

31. What is the second cell involved in the immune response?
Hypersegmented neutrophils
The CD4 T cell; the APC is the first cell in the immune response.
Risperidone
Deferoxamine - penicillamine

32. How are resistance and length related regarding flow?
Naloxone - naltrexone
Diffuse proliferative GN
HTLV-1
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.

33. What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
Asbestosis
Tetracycline
Klinefelter syndrome
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)

34. What is the term for gastric ulcers associated with severely burned or traumatic patients?
Kayser - Fleischer ring
Sensory
The dentate nucleus
Curling ulcers (think curling iron = burn)

35. What is your diagnosis of a young - thin asymptomatic female with a midsystolic click on cardiac auscultation?
Both
Mitral valve prolapse
Alcoholism
Being a white male

36. Name the following descriptions associated with bacterial endocarditis: x Retinal emboli
Cirrhosis
Roth spots
Methylation of bacterial DNA
Aldehyde dehydrogenase

37. What phase of Interphase is haploid (N)?
G1 phase; G2 and S phase are diploid (2N).
Phase 4
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
Calcarine sulcus

38. What hormone excess brings about abnormal glucose tolerance testing - impaired cardiac function - decreased body fat - increased body protein - prognathism - coarse facial features - and enlargements of the hands and feet?
Increased secretion of GH postpuberty leading to acromegaly.
Stable
NREM sleep. Night terrors are dreams that we are unable to recall.
overall dopamine activity

39. What nucleus - found in the intermediate zone of the spinal cord - sends unconscious proprioception to the cerebellum?

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40. What syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use?
Eaton - Lambert syndrome
GnRH pulsatile infusion
Glanzmann syndrome
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)

41. The first area to be oxygenated in the liver.
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
The portal tract of the liver lobule
Papule
S phase

42. What is the essential reservoir host for Toxoplasma gondii?
The cat
Dorsal prefrontal cortex
Adenocarcinoma (30% to 35%)
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.

43. Name the compartment of the lower extremity and the nerve based on its movements - Plantar flex the foot - flex the toes - and invert the foot
Vesicular stomatitis virus
Red muscle
Cardiac muscle
Posterior compartment of the leg - tibial nerve

44. Name the DNA virus: x ssDNA; naked; icosahedral; replicates in the nucleus
Parvovirus
N- Acetylcysteine
HMG- CoA reductase
Salmeterol

45. What is the term for the negative resting membrane potential becoming more negative?
Hyperpolarization (i.e. - K+ influx)
Purulent exudates
Type I pneumocytes
Somatoform pain disorder

46. Regarding the Lac operon - for What do the following genes code? - A gene
a -1 - 6 transferase
Thiogalactoside transacetylase
Azathioprine
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle

47. What is the only class of diuretics to retain Cl - used in the short - term treatment of glaucoma and of acute mountain sickness?
Acetazolamide
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Hepatitis B and hepatitis C
Liver

48. What term describes the reflex that increases the curvature of the lens - allowing near vision?
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.
Paramesonephric ducts
RSV
Accommodation

49. Which antihistamine is one of the DOCs for treatment of vertigo?
Incidence rate
Mean corpuscular volume (MCV)
Topoisomerase I (Relaxase)
Meclizine

50. Name the ventricular muscle membrane channel: x Closed at rest; depolarization causes channels to open slowly
Schistosoma haematobium
Voltage - gated calcium channel
Norm reference (i.e. - 75% of the students in the class will pass)
Theca cell