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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 area of the brain acts as the center for contralateral horizontal gaze?
14 L - 33% of body weight
2 ATPs by oxidative phosphorylation
Ulcerative colitis
Frontal eye field (Brodmann area 8)

2. What is the signal to open the voltage - gated transmembrane sodium channels?
Decreases
Live vaccines
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
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.

3. What is the most common one? - Tumor of the female genitourinary tract
The optic disk is the blind spot.
Ewing's sarcoma
Leiomyoma
Duchenne muscular dystrophy

4. How far below ideal body weight are patients with anorexia nervosa?
Chromosome 12
At least 15%
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Chromosome 15 - 17

5. Patients with ___________ have no Barr bodies.
O2
Turner syndrome
Absolute refractory period is due to voltage inactivation of sodium channels.
Glycine/arginine

6. What CNs are affected if there is a lesion in x The upper pons?
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.)
CN V
Adenocarcinoma of the cervix
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

7. What is the MCC of the following endocarditis scenarios? - Non - IV drug user
Staphylococcus aureus
Meckel diverticulum
Primary biliary cirrhosis
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)

8. What are the four exceptions to requirements for informed consent?
Medullary carcinoma of the thyroid
IL-4
Negative
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency

9. What is the term for a direct connection between the intestine and the external environment through the umbilicus because the vitelline duct persists?
Aspiration
Vitelline fistula
Ascaris lumbricoides
Leydig cell tumor

10. What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?
PKU
Berry aneurysm in the circle of Willis
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
Patients with unilateral cerebellar lesions fall toward the side of the lesion.

11. Do alpha - or gamma - motor neurons innervate extrafusal muscle fibers?
alpha - Motor neurons innervate extrafusal muscle fibers (a motor unit) - whereas gamma - motor neurons innervate intrafusal muscle fibers.
Proximal tubule
Hepatitis C
Metaproterenol and albuterol

12. What embryonic structure forms the adult female structures? - Uterine tube - uterus - cervix - and upper third of the vagina
Breast cancer
Mentally disabled
Gastrinoma
Paramesonephric ducts

13. What drug causes a sixfold increase in schizophrenia - can impair motor activity - and can cause lung problems?
Marijuana
Thymine (B1)
The bifurcation of the abdominal aorta
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.

14. What type of jaundice is seen in Dubin - Johnson syndrome?
Conjugated (direct) hyperbilirubinemia - a transport defect
Burr cells (echinocytes)
Osteoporosis
Altruism

15. Name at least three bacteria that use capsules to prevent immediate destruction from the host's defense system.
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
HBcAb IgG and HBsAb IgG
Y - W-135 - and C and A capsular polysaccharides
Anaerobes

16. How many bronchopulmonary segments are on the right lung? Left lung?
PGI2
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
There are 10 bronchopulmonary segments on the right and 8 on the left.
X- linked dominant

17. Are contraindicated in patients with SCID.
Left atrium and tip of the right atrium
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
Live vaccines
CN II and ophthalmic artery

18. What is the end product of purine catabolism?
Leukemias
Stimulus control
Uric acid
CN IV

19. What is the most common one? - Benign breast tumor in females less than 35 years old
Fibroadenoma
Phase 3
7
False - positive rate

20. What Brodmann area is associated with x Primary motor cortex?
>10 mm
Area 4
Elongation factor - G and GTP
Prokaryotes. Polycistronic and prokaryotes both start with P.

21. Which trematode is associated with bladder carcinoma in Egypt and Africa?
Fragile X syndrome
Oxytocin
Schistosoma haematobium
Pedophilia

22. What chromosome is associated with the AR form of SCID?
Schwannoma
Benign nevus (mole)
Chromosome 20q (deficiency in adenosine deaminase)
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.

23. How does sympathetic stimulation to the skin result in decreased blood flow and decreased blood volume? (Hint: what vessels are stimulated - and how?)
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.
Common peroneal nerve
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
Mesencephalon

24. What is the reservoir for the togavirus?
Ribozymes
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.
Lesch - Nyhan syndrome
Birds

25. What stage of male development is characterized by the following LH and testosterone levels? - Decreased testosterone production is accompanied by an increase in LH production.
Periaortic lymph nodes
Aged adult
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
Two - way ANOVA. It allows the test to check several variables at the same time.

26. What is the relationship between preload and the passive tension in a muscle?
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
Hypersegmented neutrophils
Functions of hepatocytes

27. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
Schistosoma have separate males and females.
The T- test (used when comparing two groups)
Spironolactone (binds to aldosterone receptors)
Positive correlation

28. What phase of the cell cycle are the following antineoplastic agents specific for? - 6- Thioguanine
Maxillary artery
Left homonymous hemianopsia
S phase
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)

29. Name the most common type or cause - Restrictive cardiomyopathy
Escherichia coli
Amyloidosis
PGI2
Fluconazole

30. What two Beta2- agonists cause myometrial relaxation?
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Glucose
Thalassemia minor
Ritodrine and terbutaline

31. What is the titratable acid form of H+ in the urine?
H2PO4- (dihydrogen phosphate)
Griseofulvin
One - way ANOVA
Combined metabolic and respiratory acidosis

32. What are the three most common sites for left - sided heart embolisms to metastasize?
MEN I (or Wermer syndrome)
Myasthenia gravis
PALS
Brain - spleen - and kidney

33. What malignant tumor of the trophoblast causes high levels of hCG and may occur after a hydatidiform mole - abortion - or normal pregnancy?
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
Achalasia
Penicillin V
Lung cancer

34. What is the most common sexual assault?
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 -
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis - or IHSS)
Pedophilia
Riedel thyroiditis

35. Which thrombolytic agent - activated in the presence of fibrin - is manufactured by recombinant DNA process?
Alteplase
Hirschsprung disease
NE
Cryptococcus

36. Which three factors cause the release of epinephrine from the adrenal medulla?
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
Ventral posteromedial nucleus
LTB4

37. What fissure of the cerebral cortex separates the frontal and temporal lobes rostrally and partially separates the parietal and temporal lobes?
Coxsackie B
Lateral fissure (fissure of Sylvius)
<2
Cortisol - a 21- carbon steroid - has a - OH group at position 17.

38. Which of the following is not a risk factor for cholesterol gallstones: pregnancy - OCP use - female gender - hemolytic anemia - cirrhosis - and obesity? (May be more than one answer.)
Inferior Oblique (CN III) (LR6 SO4)3
pK (think of it as where half is base and half is acid)
Specific rate (e.g. - men aged 55-60)
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.

39. What percent of sexual abuse cases are committed by family members?
Breast cancer
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Alcoholics Anonymous

40. Name the associated chromosome - Cri - du - chat
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.
Stable angina
Chromosome 5p

41. Name the antidote - Lead
Phallus - urogenital folds - and labioscrotal swellings
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol
Spironolactone
Vitamin D3

42. Can incidence - prevalence - and cause and effect be assessed in x Cohort studies?
Beta- Endorphin
Hemorrhagic exudates
Cohort studies determine incidence and causality - not prevalence.
Duodenal ulcers (4 times as common as gastric)

43. Why are eukaryotes unable to perform transcription and translation at the same time like prokaryotes?
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Proximal tubule
None; it degenerates.

44. When a person goes from supine to standing - what happens to the following? - Dependent venous blood volume
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
3 ATPs by oxidative phosphorylation
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Follicular adenoma

45. Arrange the following layers in the correct sequence through which a needle must pass in a lumbar puncture - Skin x Subarachnoid space x Interspinous ligament x Dura mater x Deep fascia x Epidural space x Superficial fascia x Interlaminar space x Su
Bordetella pertussis
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
C2 deficiency

46. The separation of 46 homologous chromosomes without splitting of the centromeres occurs During what phase of meiosis?
IQ
Agglutination test
Meiosis I; disjunction with centromere splitting occurs during meiosis II.
Dystrophic calcification

47. What is the pentad of TTP?

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48. What type of damage to the kidneys is caused by drinking ethylene glycol (antifreeze)?
Oligodendroglioma
Beta2- Adrenergic agents
NE - via its vasoconstrictive action on blood vessels
Nephrotoxic oxylate stones

49. What family do the following viruses belong to? - Rabies
Copper (Cu+)
Rhabdovirus
Acute CO poisoning
Rapidly progressive glomerulonephritis (RPGN)

50. Name the associated chromosome - Marfan disease
Where the cell bodies for the DCML and spinothalamic sensory systems are...
Chromosome 15
C3a - C4a - and C5a
Progestin