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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 embryonic structure forms the adult female structures? - Gartner's duct
Log - kill hypothesis (follows first order kinetics)
Separation anxiety
Mesonephric duct
Legionella (think air conditioners)

2. To What is the diffusion rate indirectly proportional?
CN VII
Insulinoma
Amiloride
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.

3. Which three aminoglycosides have vestibular toxicity?
Terbinafine
Increased leukocyte alkaline phosphatase (LAP)
Cystic fibrosis
1. Streptomycin 2. Gentamicin 3. Tobramycin

4. In the window phase of a hepatitis B infection - which Abs do you see?
CSF
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Friedreich ataxia
HBcAb and HBeAb. You see the antibodies c and e.

5. Describe the organism based on the following information: x Beta - hemolytic Streptococcus sensitive to bacitracin
Streptococcus pyogenes
CD15 and CD30
At the end of the PCT 25% of the original volume is left
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma

6. What are the three rules governing a secondary immune response?
1. Streptomycin 2. Gentamicin 3. Tobramycin
Squamous cell carcinoma
transcription
1. Covalent bonding between the hapten and carrier 2. B- cell exposure to hapten twice 3. T- cell exposure to carrier twice

7. What glial cell is derived from mesoderm and acts as a scavenger - cleaning up cellular debris after injury?
Hepatic adenomas
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
HGPRT
Microglia (Microglia and mesoderm both begin with M)

8. What is the term for an abnormal amount of collagen type III that produces a large bulging scar - seen primarily in blacks?
Leydig cell tumor
Keloid
Glycerol kinase
Papillary carcinoma

9. What is the MCC of the following meningitides? - In neonates to 3 months of age
Streptococcus agalactiae and Escherichia coli
The conversion of CHO to pregnenolone via the enzyme desmolase
All
Bisphosphonates

10. From what pharyngeal pouch is the following structure derived? - Palatine tonsil
Bainbridge reflex
Second M PITS for pharyngeal pouch derivatives
Rapidly progressive glomerulonephritis (RPGN)
Friedreich ataxia

11. What nerve roots constitute the cervical plexus?
CHF
C1 through C4
Accommodation
Negative

12. What organism is associated with the following types of diarrhea? Diarrhea associated with raw or undercooked shellfish
Meningococcus (Gonococcus does not)
Staphylococcus aureus
Vibrio parahaemolyticus
Tylosis

13. What neurotransmitter inhibits the optic nerve bipolar cell and shuts off in response to light?
Kayser - Fleischer ring
Myasthenia gravis
Glutamate
14 L - 33% of body weight

14. What virus is associated with Guarnieri bodies?
Variola virus (Smallpox)
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
Areas 41 and 42
Truncus arteriosus

15. Name the product or products of arachidonic acid: x Vasodilation - bronchospasm - and increased vascular permeability
Shine - Dalgarno sequence
LTC4 - LTD4 - and LTE4
GnRH pulsatile infusion
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.

16. What hormone is necessary for normal GH secretion?
Ureaplasma urealyticum
Asbestosis and silicosis
AT II
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.

17. What is the term for the inherent ability to induce a specific immune response?
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
Alcohol consumption
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Nicotinic acid - because its side effects include hyperuricemia and exacerbation of ulcers.

18. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Placental alkaline phosphatase
Multiple myeloma
IgA - IgD - IgE - IgG - and IgM
Seminoma
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.

19. What operant conditioning therapy or modification is described as x Stopping the reinforcement that is leading to an undesired behavior?
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
Extinction
Native Americans
They block the midcycle surge of LH.

20. What is the respiratory compensation mechanism for metabolic alkalosis?
Impotence
Crohn disease
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR

21. What is the bone marrow maturation time for a phagocytic cell?
14 days
1. Sleep paralysis 2. Hypnagogic hallucinations (while falling asleep) 3. Sleep attacks with excessive daytime sleepiness 4. Cataplexy (pathognomonic) Narcolepsy is a disorder of REM sleep - with REM occurring within 10 minutes of sleep.
Red pulp (Remember - Red pulp and RBCs begin with R.)
2 ATPs by oxidative phosphorylation

22. Homer - Wright rosettes
Glucosyl cerebroside
Minor
Neuroblastoma
Rhombencephalon

23. What happens to the following during skeletal muscle contraction? - I band
Clostridium botulinum
Shortens
Glutamate dehydrogenase
Midazolam

24. Name the antidote - Anticholinergics
Pertussis toxin
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
Physostigmine

25. What four factors affect diffusion rate?
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
Haemophilus influenzae type B
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
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

26. In MHC class II molecules - what chain blocks access to the peptide - binding groove during transportation within the cell - ensuring that the MHC class II- peptide complex is transported to the surface?
Enterohemorhagic Escherichia coli
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
Phase I
GABA and glutamic acid

27. What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs?
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
Pseudogout
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
Auspitz sign

28. What three carcinomas are associated with EBV?

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29. What capsular serotype is associated with Escherichia coli - induced meningitis?
0157:H7
Parkinson's disease
T9
K1 capsule

30. In What area of the GI tract does iron get absorbed?
Sensory
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
Duodenum
Patent urachus

31. What inflammatory bowel disorder is continuous - with extensive ulcerations and pseudopolyps - and is associated with HLA- B27?
Albendazole
Giardia lamblia (treat with metronidazole)
Ulcerative colitis
Vaginismus; it is the female counterpart of premature ejaculation.

32. What is the only factor of enzyme kinetics that the enzyme affects?
Ea (activation energy)
Lysine and tyrosine
2 and 5HT3 receptors
Chromosome 1

33. What is the size of a positive PPD test for the following? (Reactive) x Posttransplantation patient taking immunosuppressive agents
Expressive aphasia
>5 mm
Middle meningeal artery
Down syndrome (trisomy 21)

34. What happens to intracellular volume when there is an increase in osmolarity?
ICF volume decreases when there is an increase in osmolarity and vice versa.
unprocessed Ags
Kidney
Chloramphenicol

35. How many ATPs are produced from cytoplasmic NADH oxidation using the glycerol phosphate shuttle?
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
Zafirlukast
Nimodipine
2 ATPs by oxidative phosphorylation

36. What is the only 17- hydroxysteroid with hormonal activity?
Cortisol - a 21- carbon steroid - has a - OH group at position 17.
Astrocytes
Right ventricle
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.

37. What is the term for increased iron deposition resulting in micronodular cirrhosis - CHF - diabetes - and bronzing of the skin?
Interferons
Hemochromatosis
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
PKU

38. Name the most common cause - Infectious pancreatitis
Cortisol
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
Mumps
C1 inhibitor (C1- INH)

39. What axis I disorder is characterized by pronoun reversal - preference for inanimate objects - obliviousness to the external environment - lack of separation anxiety - and abnormalities in language development?
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.
Primary hypothyroidism (Low T4 has a decreased negative feedback loop - resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release - respectively.)
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
18 years old (except if emancipated)

40. What are the five Ig isotypes?
Kupffer cells
IgA - IgD - IgE - IgG - and IgM
Avidity. There is a positive correlation between valence numbers and avidity.
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.

41. What aspects of sleep are affected during benzodiazepine use?
Schwannoma
Skeletal muscle
Granulosa cell
REM and stage 4 sleep; they decrease.

42. What Brodmann area is associated with x Primary visual cortex?
Adipose tissue
Gilbert's syndrome
Area 17
Ribavirin

43. What antiarrhythmic agent is the DOC for treating and diagnosing paroxysmal supraventricular tachycardia (PSVT) and AV nodal arrhythmias?
Adenosine (it is an excellent agent to use in emergencies because its half - life is 30 seconds)
Klatskin tumor
All
Hydatidiform mole

44. What do the following values indicate? - ED50
Hyperkalemia
NE - via its vasoconstrictive action on blood vessels
Effective dose for 50% of drug takers (median effective dose)
Superior rectus (CN III) (LR6 SO4)3

45. What chromosome is autism linked to?
Tylosis
Chromosome 15
Trapezius and sternocleidomastoid
Aspartame

46. Name the four ventral mesentery derivatives.
Testicular lymphoma
Axon hillock
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Tinea favosa (favus)

47. What small - to medium - sized vasculitis is seen in a 35-year - old man who is a heavy smoker presenting with claudication symptoms in the upper and lower extremities?
C5- C8 deficiency
Buerger disease (thromboangiitis obliterans)
Porcelain gallbladder
No CHO - AA - ketones - or peptides are left in the tubular lumen.

48. Name the Hgb - O2 binding site based on the following information: x Remains attached under most physiologic conditions
M- cells
Glioblastoma multiforme
Site 1
Hypocalcemia and hypophosphatemia

49. By What age should children be able to draw the following figures? - Square
Chromosome 5
Femoral hernias
The inner membrane of the mitochondria (cristae)
5 years old

50. What area of the hypothalamus is the feeding center?
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
Adrenal medulla
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)