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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 syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use?
Eaton - Lambert syndrome
Naloxone or naltrexone
Insulinoma
1. The child poses an imminent danger to self or others. 2. The child is unable to self - care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety e

2. Acts as the vertebral body of C1 allowing lateral rotation of the head. The first cervical vertebra has no vertebral body.
Somatization disorder
All (nearly 15-20 times the normal risk)
The odontoid process of C2
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.

3. What is the triad of Reiter syndrome?

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4. Name the MCC - Aspiration pneumonia in an alcoholic
Periaortic lymph nodes
Chromosome 6
Klebsiella pneumoniae
Hemophilia B

5. What is the most common form of inherited dwarfism?
Amantadine
Isotypes
Achondroplasia
Mitochondria

6. What is the term for the difference between the highest and the lowest score in a population?
Range
Meckel diverticulum
In the medulla; all the other structures are cortical.
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III) - B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.

7. Name the most common cause - Chronic pancreatitis
Chromosome 3p
G-6- PD deficiency
Alcohol abuse
Excess estradiol in the blood

8. Which three organisms cause heterophilic negative mononucleosis?
CMV - Toxoplasma gondii - and Listeria
M3 (promyelocytic leukemia)
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.
Nasopharynx

9. If you double the infusion rate of a drug - how long will it take to reach steady state?
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Area 17
positive correlation
Histidine - because of the imidazole ring found in the R group - is basic.

10. Which muscle of the eye is under sympathetic control?
Dilator pupillae muscle
Juxtaglomerular (JG) cell
Probenecid
Mees lines

11. Is an anti - HAV IgG Ab associated with immunization or recent infection?
Conus arteriosus of the right ventricle and right and left auricles
Glutamine
Premature ejaculation
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.

12. Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
Labile
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
IgG

13. Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?
Verbigeration
The JG cells
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.
Follicular phase

14. What Ig is associated with ADCC for parasites?
IgE
PALS (Parietolateral lymphocytic sheath)
Creatinine
Pseudogout

15. Name the lipoprotein based on the following characteristics - apo E - apo C- II - apoB-48
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
Chylomicrons
From age 5 onward IQ stabilizes.
Left homonymous hemianopsia

16. What tumor is seen in the 2- to 4-year - old age group; does not cross the midline; has immature glomeruli - tubules - and stroma; and metastasizes late to the lungs?
The interposed nucleus
Salmonella
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.)
Wilms tumor

17. What specifies how accurately the sample values and the true values of the population lie within a given range?
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
Selenium (Se)
Confidence interval. It is a way of admitting estimation for the population.
Galactitol

18. What is the most common form of non - Hodgkin lymphoma in the United States?
The stapedius muscle
Follicular lymphoma
Vitamin D3
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)

19. What is the largest muscle in the body?
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
Coagulative
Cryptococcus
Gluteus maximus

20. Name the lipoprotein based on the following characteristics - apo E - apo B-100 - apo C- II
VLDL
Compliance (think of it as distensibility)
Clozapine
Vitamin B6

21. Indicates the patient has active pulmonary disease.
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
A positive PPD skin test
Unstable (crescendo) angina
Apneustic center (deep breathing place)

22. Name the most common one - Chromosomal disorder involving sex chromosomes
Central sulcus (sulcus of Rolando)
The Purkinje cell
Klinefelter syndrome
Dorsal motor nucleus of CN X

23. Under resting conditions - What is the main determinant of cerebral blood flow?
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
Arterial PCO2 levels are proportional to cerebral blood flow.
0.2

24. What is the only pharyngeal muscle not innervated by CN X?
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
Pneumotaxic center (short - fast breaths)
Global aphasia
Orbitomedial frontal lobe

25. What area of the hypothalamus is responsible for recognizing an increase in body temperature and mediates the response to dissipate heat?
Metronidazole
Anterior hypothalamic zone; lesions here result in hyperthermia.
As the name indicates - there is no change in volume but there is an increase in pressure.
They innervate LMNs.

26. Which phenotype of osteogenesis imperfecta is incompatible with life?
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
Rifampin
The energy of activation
Type II

27. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Polycyclic aromatic hydrocarbons
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
There would be a Fab' region; thus - it would still be able to participate in precipitation and agglutination.
Bronchogenic carcinoma
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.

28. In which quadrant is breast cancer most commonly found?
Vitamin A
Upper outer quadrant (left more than right)
gp120
Ewing's sarcoma

29. What Beta2- agonist is used as a prophylactic agent in the treatment of asthma?
G1 phase (gap 1)
Salmeterol
LTC4 and LTD4
Low interstitial free Ca2+ concentrations

30. Name the DNA virus: x Linear dsDNA; naked; replicates in the nucleus
Adenovirus
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.

31. Name the compartment of the mediastinum associated with the following thoracic structures: Esophagus
Superior and posterior
Eaton - Lambert syndrome
Nystagmus and ataxia
Rhombencephalon

32. What basic reflex regulates muscle tone by contracting muscles in response to stretch of that muscle?
1. Propranolol 2. Timolol 3. Carteolol
The myotatic reflex is responsible for the tension present in all resting muscle.
Areas 5 and 7
50% - with 50% of them having the child

33. What complement factor or factors are associated with x Anaphylaxis?
LTC4 - LTD4 - and LTE4
C3a - C4a - C5a
Hot pink with PAS and grey to black with silver stain
Hypertrophic scar

34. What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue?
Arch of the aorta
Tip of the loop of Henle (1200 mOsm/L)
Metastatic calcification
Thymine (B1)

35. What complement factor deficiency leads to x Increased susceptibility to pyogenic infections?
No change in length
5- hydroxyindoleacetic acid (5- HIAA)
C3 deficiency
Toxic or viral hepatitis

36. Name the lipoprotein based on the following characteristics - apo E
Albinism
Catechol - O- methyl transferase (COMT)
Taenia solium
IDL

37. What are the four exceptions to requirements for informed consent?
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
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
These are the gross pathologic changes associated with Alzheimer's disease.
Immature B cells

38. In biostatistics - What are the three criteria required to increase power?
ALA dehydrogenase and ferrochelatase
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.)
1. Large sample size 2. Large effect size 3. Type I error is greater
Hexosaminidase A

39. Name the ocular lesion; be specific - Left Meyer's loop lesion of the optic radiations.
Left homonymous hemianopsia
LDL
Maxillary artery
Right coronary artery

40. What form of hormone is described as having membrane - bound receptors that are stored in vesicles - using second messengers - and having its activity determined by free hormone levels.
Water - soluble hormones are considered fast - acting hormones.
IgA
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.
Carbonic anhydrase

41. What wave is the cause of the following venous pulse deflections? - The contraction of the right atrium
Staphylococcus aureus
wave
Parasympathetic
The resistance increases 16- fold.

42. Are contraindicated in patients with SCID.
Live vaccines
Campylobacter jejuni
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)
Aspiration

43. What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.
Oxytocin
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
Cryptococcus neoformans

44. The proportion of truly diseased persons in the screened population who are identified as diseased refers to?
Neuroblastoma
Variola virus (Smallpox)
Diphenhydramine
Sensitivity (it deals with the sick)

45. What is the name of demyelination of the corticospinal tract and the dorsal column in the spinal cord due most commonly to a vitamin B12 deficiency?
Dominant parietal lobe (Gerstmann's syndrome)
Wegener granulomatosis
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Sideroblastic anemia

46. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
Medullary carcinoma of the thyroid
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
Beta- Blockers
rRNA

47. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Eye
Low molecular weight heparin (LMWH)
Secondary hypercortisolism (pituitary)
Proencephalon diencephalon derivative
First - pass metabolism and acid lability

48. What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
Operant conditioning (reinforcement is after a response)
Shigella
Negative
Conversion disorder

49. Name the phase of the eukaryotic cell cycle: x Period of DNA replication (preparing for mitosis)
S phase
Herpes I
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis

50. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Astrocytoma
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
Ipsilateral loss below the level of the lesion