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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 a complete aversion to all sexual contact?
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Sexual aversion disorder
Reovirus
Neutrophils - eosinophils - and basophils

2. What fungus is characterized by hypopigmented spots on the thorax - spaghetti - and - meatball KOH staining - and pityriasis or tinea versicolor?
Malassezia furfur (treat with selenium sulfide)
Null hypothesis (what you hope to disprove)
Dendrites receive information - whereas axons send information.
Haemophilus ducreyi

3. What enzyme is needed to activate the following reactions? - Procarboxypeptidase to carboxypeptidase
Stable
Methylation of bacterial DNA
Osteosarcoma
Trypsin

4. What muscle is the chief flexor of the hip?
Psoas major
Laminin
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
PICA

5. What is pumped from the lumen of the ascending loop of Henle to decrease the osmolarity?
Copper deficiency
Conidia
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
Complex I

6. What is the function of white rami communicantes?
In the medulla; all the other structures are cortical.
They are preganglionic sympathetic axons. They are white because they are myelinated.
Mesolimbic system
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)

7. What is the term to describe a man who has x Used to be able to achieve an erection but now cannot?
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
gp120
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
Glanzmann syndrome

8. Name the end product or products: x Fatty acid synthesis
It increases Ca2+ excretion from the kidney and increases bone mineralization.
almitate
LDL
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.

9. What a2- antagonist is used to treat impotence and postural hypotension?
Yohimbine
Ethyl alcohol
Osteosarcoma
Proencephalon diencephalon derivative

10. What five factors promote turbulent flow?
Alcohol abuse
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.
The Beta -2- microglobin. It is the separately encoded Beta - chain for class I Ags.
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice

11. What metal poisoning produces microcytic anemia with basophilic stippling?
Lead poisoning
Glycogen synthase
Ethyl alcohol
Small cell cancer of the lung

12. Can parents withhold treatment from their children?
Tensor tympani
IgM
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.
Four high energy bonds - two from ATP in AA activation and two from GTP

13. The fibers of nucleus gracilis and nucleus cuneatus cross at the medullary decussation and ascend contralateral to What thalamic relay nucleus?
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
Achalasia

14. Inhibits glucose uptake in skeletal muscle.
Concrete operations (6-12 years)
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
Staphylococcus saprophyticus
Cortisol

15. How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery?
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
Renal plasma flow (decrease flow - increase FF)
MGB
CD19

16. How many pairs of spinal nerves are associated with x Cervical vertebrae?
1. Liver 2. Muscle 3. Adipose tissue
Misoprostol
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Rifampin

17. What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
Amanita phalloides
Heroin
Hypervariable region (three per light chain; three per heavy chain)
Systematic desensitization

18. From What aortic arch are the following structures derived?
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
Common and internal carotid arteries
IgM

19. What type of saliva is produced under parasympathetic stimulation?
Rhinovirus and hepatitis A virus
Chromosome 12
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
Propofol

20. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CA-19.9 and CEA
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)
Pancreatic cancer
HBsAb IgG

21. When attempting to make up sleep - what stage of sleep is recovered?
Somatization
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.
Paramesonephric ducts

22. What MAOI does not cause a hypertensive crisis?
HPV serotypes 16 - 18 - 31 - and 33
Arginine
Selegiline
Duchenne muscular dystrophy

23. What is the term for hypoperfusion of an area involving only the inner layers?
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
Crude mortality rate
Mural infarct
TB meningitis

24. What artificial sweetener must patients with PKU avoid?
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
Aspartame
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Embolic

25. What is the term for the ability of a test to measure something consistently?

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26. What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
HIV
Northern blot
Copper
Fetal alcohol syndrome

27. Anhedonia - lack of motivation - feelings of worthlessness - decreased sex drive - insomnia - and recurrent thoughts for at least 2 weeks - representing a change from previous level of function - describes what disorder?
Eisenmenger syndrome - which can also occur with any left - to - right shunt
Unipolar disorder (major depression)
EBV
Sporozoites

28. Name the most common type or cause - Cystitis
Escherichia coli
Postinfectious GN
Streptokinase
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)

29. What is the most common organ involved in amyloidosis?
DNA polymerase - d
Primary follicle (in the white pulp)
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies
Kidney

30. What is the term for conversion of a dsDNA molecule to the base sequence of an ssRNA molecule?
Area 6
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.
Transcription (C comes before L in the alphabet - and transCription comes before transLation)
Coxiella burnetii

31. ______________ that slow bacterial growth are bactericidal.
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Antimicrobial agents
Empyema
Cryptococcus

32. What is the name of the major chemotactic agent released from x The blood serum? (Hint: it is a complement factor.)
C5a
Thyroarytenoid muscles
Streptococcus pyogenes
T cells - not B cells

33. Are modified skeletal muscle fibers. They are the sensory component of the stretch reflexes.
Muscle spindles
Median nerve
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.

34. A 30-year - old woman goes to your office with bilateral multiple breast nodules that vary with menstruation and have cyclical pain and engorgement. What is your diagnosis?
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Premature ejaculation
B- cell Ag receptors
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.

35. Auer rods
Minoxidil (orally and topically - respectively!)
Pneumothorax
AML- M3
With arteriolar constriction both the flow and pressure downstream decrease.

36. What area of the limbic system is responsible for attaching emotional significance to a stimulus?
8 weeks (response to a face)
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
Amygdala; it helps imprint an emotional response in memory.
Arginine

37. What is the vector for Leishmania infections?
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Osteoclasts
Measurement bias
The sandfly

38. What prion - associated CNS pathology produces rapidly progressive dementia with myoclonus - involuntary movements - and death within 6 to 12 months?
Pseudogout
Creutzfeldt - Jakob disease
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.

39. What syndrome is seen in iron - deficient middle - aged women with esophageal webs?
HIV and poxvirus
It both begins and ends at T4 (sternal angle [of Louis]).
greater
Plummer - Vinson syndrome

40. With What three enzymes is thiamin pyrophosphate (TPP) associated?
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Anterior compartment (it's the blood supply to the posterior compartment)
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 -
Nitrates

41. What is the MCC of the following endocarditis scenarios? - Post dental work
Borrelia recurrentis
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
Streptococcus viridans
Isocitrate dehydrogenase

42. What is found in the R group if the AA is acidic? Basic?
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
Propionic acid
Wernicke's aphasia
Ungated potassium channel

43. What determines the rate of a reaction?
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
Proencephalon
Four
The energy of activation (Ea)

44. What stage of sleep is associated with somnambulism?
Without children (but don't think about this one for too long)
Serocystadenocarcinoma
When it crosses the teres major
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.

45. What enzyme catalyzes the reversible oxidative deamination of glutamate and produces the TCA cycle intermediate a - ketoglutarate?
Ego syntonic
EF- G of the 50S subunit
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
Glutamate dehydrogenase

46. What is the neurotransmitter at the
Kartagener's syndrome (also known as immotile cilia syndrome) -------------------------------------------------------------------------------
Beta- Endorphin
Increased leukocyte alkaline phosphatase (LAP)
Blastoconidia

47. Name the muscle type based on the histological features: x Actin and myosin in sarcomeres; striated; uninuclear; gap junctions; troponin:calcium binding complex; T tubules and SR forming dyadic contacts; voltage - gated calcium channels
HBeAg
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
Cardiac muscle
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.

48. What chromosome 4 - AD disorder is a degeneration of GABA neurons in the striatum of the indirect pathway of the basal ganglia?

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49. What is the term for the rate measured for a subgroup of a population?
Myasthenia gravis
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Argyll Robertson pupils
Specific rate (e.g. - men aged 55-60)

50. What androgen receptor blocker is used in the treatment of prostatic cancer?
Cytochrome a/a3
Nystagmus and ataxia
Rochalimaea quintana (now called Bartonella quintana)
Flutamide

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USMLE Step 1 Prep

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