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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. Have analgesic - antipyretic - anti - inflammatory - and antiplatelet activities.
Large segment deletions
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
NSAIDs
IgA

2. What encapsulated lymphoid organ is characterized by presence of Hassall's corpuscles - and absence of germinal centers and B cells?
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
Thymus gland. (Thymus gland is essential for T cell maturation.)
Reiter syndrome
PR interval

3. What rare form of dementia is associated with personality changes and affects the frontal and temporal lobes?

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4. What is the effect of insulin on intracellular K+ stores?
Rheumatoid arthritis
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
Estrogen
Quaternary structure

5. What hormone - stimulated by epinephrine - results in an increase in lipolysis?
Superficial spreading melanoma
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
Meningocele All except occulta cause elevated - fetoprotein levels.

6. What is the second leading cause of death in the United States?
Uric acid
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
Cancer
Somatic motor neurons

7. What CN carries preganglionic parasympathetic fibers that innervate the viscera of the neck - thorax - foregut - and midgut?
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.)
Leydig cell tumor
Bacteria
Ulcerative colitis

8. What four branches of the brachial plexus arise prior to the first rib?
2 ATPs - via the amino acyl tRNA synthase enzyme
REM latency; normally it is about 90 minutes.
Parvovirus (it is the only ssDNA virus)
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius

9. What are the two leading causes of cancer - related death in women?
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone - whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
Preductal (infantile)
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Breast and lung cancer - respectively.

10. Name the phase of the ventricular muscle action potential based on the following information: x Slow channels open - allowing calcium influx; voltage - gated potassium channels closed; potassium efflux through ungated channels; plateau stage
Valproic acid
Conjugated (direct) hyperbilirubinemia
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Phase 2

11. What syndrome is associated with the following brainstem lesions? - Contralateral corticospinal and medial lemniscus tract deficits and an ipsilatera medial strabismus secondary to a lesion in CN VI
Medial pontine syndrome
Schistosoma have separate males and females.
Nocardia asteroides
Hematoxylin

12. What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
Unconjugated (indirect)
Phenytoin
Berger disease (IgA nephropathy)
Fentanyl

13. T3 increases bone ossification through synergistic effect with what hormone?
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
HTN
GH
Streptococcus pneumoniae

14. In a ventricular pacemaker cell - what phase of the action potential is affected by ACh?
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
antiemetic
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance - taking longer to reach threshold and slowing the rate of firing.

15. What form of estrogen is of placental origin?
Estriol
Leptospira
Hepatitis B
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade

16. What are the five effects of insulin on fat metabolism?
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
Hyperplasia
Right vagus innervates the SA node and the left vagus innervates the AV node
Negative correlation

17. What microaerophile is a motile gram - negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)?
Enterokinase
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Rhombencephalon
Campylobacter jejuni

18. Name the macrophage based on its location: x Connective tissue macrophages
Increase (5- HT and dopamine levels do the same)
Isocitrate dehydrogenase
Histiocytes
It both begins and ends at T4 (sternal angle [of Louis]).

19. What is the name of the T cell - rich area of the lymph node?
Glioblastoma multiforme
Meningococcus (Gonococcus does not)
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
Paracortex

20. What is the most superficial layer of the epidermis?
Stratum corneum (keratinized)
Ampulla of the fallopian tube
Middle
Beta- Galactosidase

21. Is a nicotinic receptor agonist.
Obesity - DM - HTN - multiparity - early menarche - and late menopause
Lithium
Succinylcholine
Streptococcus pneumoniae

22. What nerves carry the sensory and motor components of the blink reflex?
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.
Superior
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
Adenosine deaminase

23. What part of a neuron receives information?
Dendrites receive information - whereas axons send information.
Coagulative necrosis
Gain of isotonic fluid (isotonic saline)
Anhedonia

24. What gluconeogenic enzyme is absent in muscle - accounting for its inability to use glycogen as a source for blood glucose?
Cancer
Hemiazygous vein
Procainamide
Glucose -6- phosphatase

25. What hormone is characterized by the following renal effects? - Calcium reabsorption - phosphate reabsorption
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Trypsin
Vitamin D3
Primitive atrium

26. If the AV difference is positive - is the substance extracted or produced by the organ?
Type II
Staphylococcus aureus
Ipsilateral flaccid paralysis
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.

27. Heinz bodies
G-6- PD deficiency
Allopurinol
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.

28. What is the name of the postganglionic parasympathetic ganglion that innervates x The parotid gland?
The otic ganglion. (These fibers are carried in CN IX. Remember it like this: the - oti - is in both otic ganglion and parotid gland.)
No. Prions are infectious proteins - so antibiotics are useless.
Tensor tympani
Axon hillock

29. What mosquito is the vector for dengue fever?
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
Aedes (the same for yellow fever)
Efficacy
The right gonadal vein drains into the inferior vena cava directly - and the left gonadal vein drains into the left renal vein.

30. What is the term for the pH range where the dissociation of H+ occurs?
pK (think of it as where half is base and half is acid)
Methylene blue
Penicillin G (benzylpenicillin)
Parvovirus (it is the only ssDNA virus)

31. Can parents withhold treatment from their children?
Porcelain gallbladder
Type IV collagen
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.
Primary hypocortisolism (Addison's disease)

32. What three steps of the TCA cycle generate NADH?
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
Translation
PALS

33. Name the most common type or cause - Liver transplantation in adults
Range
Alcoholic cirrhosis
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
QRS complex

34. Which way will the O2 dissociation curve shift with the addition of 2 - 3- bisphosphoglycerate (2 - 3- BPG) to adult hemoglobin (Hgb)?
Herpes I
Shifts it to the right
CD14
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.

35. What is the triad of Reiter syndrome?

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36. In a diabetic patient - to What does aldose reductase convert glucose?
HBcAb IgG and HBsAb IgG
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
Paranoid
Sorbitol (resulting in cataracts)

37. What are the most common causes of osteomyelitis x In drug addicts?
Ego
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
Adenocarcinoma (because of Barrett esophagus)
Pseudomonas

38. During puberty - What is the main drive for the increased GH secretion?
Obturator nerve
Increased androgen secretion at puberty drives the increased GH secretion.
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
Neonatal respiratory distress syndrome (NRDS)

39. What test is used to detect anti - RBC Abs seen in hemolytic anemia?
Hirschsprung's disease (colonic gangliosus)
Vimentin
The poly(A) site on the DNA
Coombs test

40. What two factors result in the base of the lung being hyperperfused?
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
Gonads
Buffers (remember that buffers are best when they are used in a pH range near its pK)
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.

41. Name the most common type or cause - Nephritic syndrome in adults
MGN
LTC4 and LTD4
Brain abscess
Anterior nuclear group (Papez circuit of the limbic system)

42. How many ATPs per glucose are generated from glycolysis in RBCs?
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Variola virus (Smallpox)
C5a
2 ATPs - because RBCs use only anaerobic metabolism.

43. What type of crystals are associated with gout?
Proportionate mortality rate
Chromosome 4p
Sinus venosus
Monosodium urate crystals

44. What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
Berger disease (IgA nephropathy)
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
Systemic lupus erythematosus
Propofol

45. What lipoprotein is formed if an IDL particle acquires cholesterol from a HDL particle?
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern - my senior resident asked me this question more times than I would like to remember.)
A gene (a rather simple definition but accurate)
LDL

46. What type of skin carcinoma occurring on sun - exposed sites has a low level of metastasis?
Vesicular stomatitis virus
Squamous cell carcinoma
Scleroderma
Desipramine

47. What is defined as a general estimate of the functional capacities of a human?
Poxvirus
IQ
Hepatitis E (enteric)
Dimercaprol - penicillamine

48. Name the type of graft described by these transplants: x From one species to another
Bulla
Xenograft
Wilms tumor
Prader - Willi syndrome and Angelman syndrome - respectively

49. What enzyme is needed to activate the following reactions? - Chymotrypsinogen to chymotrypsin
Umbilical vein and ductus venosus (80%)
CLL (B- cell origin)
Ligamentum venosum
Trypsin

50. What statistical test - using nominal data only - checks whether two variables are independent events?
Embolism
Chi - square (when you are in doubt and have nominal data - use chi - square)
Anterior compartment of the leg - deep peroneal nerve
nef and tat genes