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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 precipitation of calcium phosphate in dying or necrotic tissue?
Middle
Dystrophic calcification
RU 486
Primary hypogonadism (postmenopausal women)

2. When a person goes from supine to standing - what happens to the following? - Dependent venous pressure
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Left atrium and tip of the right atrium
Clostridium botulinum
Serocystadenoma

3. 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?
Bacteria
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs - TCADs - dextromethorphan - and meperidine. Treat it with cyproheptadine.
Reiter syndrome
Acting out

4. What is the order of fuel use in a prolonged fast?
Muscle spindles
Stratum spinosum
Lung and bronchus cancer
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat

5. What form of alcohol causes blindness?
refractory sexual periods
Methanol (wood alcohol)
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Stable

6. What embryonic structure forms the adult female structures? - Gartner's duct
Native Americans
Vitamin B6
Mesonephric duct
Filovirus

7. In a parallel circuit - what happens to resistance when a resistor is added in parallel
Resistance decreases as resistors are added in parallel.
SER
Afterload
Chief cells

8. What virus is associated with progressive multifocal leukoencephalopathy?
Rhombencephalon
Secondary lysosome (think of the primary as inactive and secondary as active)
Enkephalins
JC virus

9. Name the most common cause - Infectious pancreatitis
relaxation
Mumps
Peyer's patch
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.

10. What is the first epidermal layer without organelles and nuclei
Saccule and utricle
Kinesins. Dynein generates retrograde transportation of information.
Stratum lucidum
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord

11. What is the most widely used class of antidepressants?
Site 4
SSRIs
Chi - square (when you are in doubt and have nominal data - use chi - square)
PPRF

12. Name the stages of sleep with these EEG patterns: x Alpha waves
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
HBc Ab
Myasthenia gravis
Being awake

13. Is GH considered a gluconeogenic hormone?
Coagulative
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.
Yes - it decreases fat and muscle uptake of glucose - thereby increasing blood glucose levels.
Janeway lesions

14. What IL is essential for lymphoid cell development?
Standardized rate
IL-7 (A 7 upside down is an L; L is for Lymphoid)
In the medulla; all the other structures are cortical.
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.

15. What papillae are responsible for sweet taste?
Skin - liver - and kidneys
Test - retest reliability
Yolk sac tumor
Circumvallate papillae

16. In regard to motor development during infancy - choose the motor response that happens first - Radial or ulnar progression
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Ulnar to radial progression
Klebsiella pneumoniae
Lethal dose for 50% of drug takers (median lethal dose)

17. Which encapsulated fungus is found in soil enriched with pigeon droppings?
IQ
Concentration gradient
antiemetic
Cryptococcus neoformans

18. From Where is the energy for gluconeogenesis derived?
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age
Beta- Oxidation of fatty acids
SITS
hnRNA

19. Name the most common type - Specific phobia
Middle
Primary Hemochromatosis
Public speaking (Remember: stage fright)
Aschoff bodies of rheumatic fever

20. What are the two most common chains of the TCR?
Somatomedins (IGF-1)
Mitral insufficiency
a - and Beta- chains are on most T cells.
MEN I (or Wermer syndrome)

21. Are the following major or minor Jones criteria of rheumatic fever? - Fever
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
Concentration force and electrical force
Palms - up before palms - down maneuvers
Minor

22. What is the most common one? - Germ cell tumor in men
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
7 to 14 days
Seminoma
Chromosome 9 - 22 (Philadelphia chromosome)

23. What cell surface marker is found on blood B cells?
CD19
The sensory limb is via CN IX - and the motor limb is from CN X.
Pulmonary infections
TCA cycle.

24. What happens to plasma concentration of a drug if there is a large volume of distribution?
Benign nevus (mole)
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
The larger the volume of distribution - the lower the plasma concentration of a drug.
Bunyavirus

25. What is the major muscle used in the relaxed state of expiration?
Venlafaxine. (It also has a mild dopaminergic effect.)
Phase I
CN VI - VII - and VIII
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.

26. What is the most serious form of tinea capitis - which results in permanent hair loss and is highly contagious?
Middle
Tinea favosa (favus)
Stage fright (discrete performance anxiety)
VSD - RVH - overriding aorta - and pulmonary stenosis

27. Is most of the coronary artery blood flow during systole or diastole?
Pseudomonas aeruginosa
HBcAb and HBeAb. You see the antibodies c and e.
They prevent mast cell degranulation.
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.

28. When is the surface tension the greatest in the respiratory cycle?
Massive influx of calcium
Bernard - Soulier syndrome
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Vibrio cholera

29. What is the DOC for the following protozoal infections? - Amebiasis
Superior and posterior
Metronidazole
Magnesium
Bronchioloalveolar carcinoma

30. Name four chemotactic factors for neutrophils.
CD40 ligand
16S subunit
Primary hypoaldosteronism (Addison's disease)
N- formyl - methionine LTB4 C5a IL-8

31. What enzyme is deficient in congenital erythropoietic porphyria?
Ligamentum venosum
Lead
Uroporphyrinogen III cosynthase
The conus medullaris terminates at the level of the second lumbar vertebra.

32. What type of random controlled test is least subjective to bias?
Double - blind study. It is the most scientifically rigorous study known.
Functional residual capacity (FRC)
Granulosa cell
Churg - Strauss syndrome

33. What is the leading cause of primary hyperparathyroidism?
Arterioles have the largest drop - whereas the vena cava has the smallest pressure drop in systemic circulation.
Chief cell adenoma (80%)
Budd - Chiari syndrome
Mallory- Weiss syndrome

34. What mineral deficiency involves blood vessel fragility?
Lung cancer
Seminoma
Copper deficiency
Ostium secundum defects

35. What CN is associated with the x Sixth pharyngeal arch?
Metformin
CN X
ATP production
Ewing's sarcoma

36. What is the most likely causative organism for a patient with folliculitis after spending time in a hot tub?
Mitral valve stenosis
Systemic lupus erythematosus
Pseudomonas aeruginosa
Carbonic anhydrase

37. What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?
Extinction
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Afterload
Acid is needed for the activation of pepsin and therefore needed for protein digestion.

38. What area of the female reproductive tract is lined by stratified squamous epithelium rich in |glycogen?
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
Dissociative fugue. (Patients are unaware of memory loss.)
The vagina
BPH

39. Name the type of necrosis - Seen as dead tissue with liquefactive necrosis?
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.
Duodenum
Liquefaction necrosis
Huntington disease

40. What form of bias is due to false estimates of survival rates?

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41. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Osteoblasts
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
C2 deficiency
Necrotizing enterocolitis
Listeria

42. What is the name of the hypothesis you are trying to prove?
Oxygen
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death
Chromosome 22q
Alternative hypothesis (What is left after the null has been defined)

43. Name the most common type - Phobia
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
The respiratory system
Stage fright (discrete performance anxiety)
Impaired ejaculation

44. What autoimmune syndrome is characterized by keratoconjunctivitis - corneal ulcers - xerostomia - and an increased risk of high - grade B- cell lymphomas? What two Ab tests are used in making the diagnosis?
Proencephalon
Sj
Rochalimaea quintana (now called Bartonella quintana)
Sphingomyelinase

45. What family do the following viruses belong to? - Hantavirus
Tibial nerve
McArdle's syndrome
Bunyavirus
Carbidopa and benserazide

46. What topoisomerase makes ssDNA cuts - requires no ATP - relaxes supercoils - and acts as the swivel in front of the replication fork?
Topoisomerase I (Relaxase)
Major
Streptococcus agalactiae and Escherichia coli
Parasympathetic

47. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Spinal nerve?
Repaglinide
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.
Both
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.

48. In what disease do you see horseshoe kidneys - rockerbottom feet - low - set ears - micrognathia - and mental retardation?
Phosphorylation of mannose residues
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
Edward syndrome (trisomy 18)
Propionibacterium acnes

49. What is the term for a delay in the onset of normal IgG synthesis seen in the fifth to sixth month of life?
The interposed nucleus
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
Vitamin B12 deficiency and folate deficiency
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.

50. What cell of the duodenum contains high concentrations of lysozymes and has phagocytic activity?
Meningomyelocele All except occulta cause elevated - fetoprotein levels.
HHV 6
Repolarization is from base to apex and from epicardium to endocardium.
Paneth cells