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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 foramen must be traversed for entry into the lesser peritoneal sac?
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.
Correlation. No - correlation does not imply causation.
Foramen of Winslow
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.

2. What factors are needed for translocation in eukaryotes?
There are no valves and no smooth muscle in the walls of the veins in the face.
Proteus
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
EF-2 and GTP

3. Do the following structures pick up stain from hematoxylin or eosin? - Nucleoli
Hematoxylin
Musculocutaneous nerve
Dihydrofolate reductase
Lesser curvature of the antrum of the stomach

4. What is the most common one? - Vasculitis
Temporal arteritis
ater flows from a low - solute to high - solute concentrations.
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
Adenocarcinoma

5. Where is most of the airway resistance in the respiratory system?
In the first and second bronchi
Urogenital sinus
Swan - neck deformities
Stages 3 and 4 (NREM)

6. What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
G-6- PD deficiency; pyruvate kinase deficiency is second.
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)
Bunyavirus
Duodenal ulcer

7. What is the term for the round intracytoplasmic eosinophilic inclusions containing ?- synuclein found in the dopaminergic neurons of the substantia nigra?
Exhibitionism
Lewy bodies
Streptococcus viridans
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.

8. What glycogen storage disease is due to the following enzyme deficiencies? - Lysosomal glucosidase (acid maltase)

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9. What causes slow writhing movements (athetosis)?
Cushing's ulcers
Mild (50-70)
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
Lisch nodules

10. What is the order of fuel use in a prolonged fast?
Zero - order elimination
Mitochondria - linked disorders are always inherited from the mother.
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
Translation

11. What bones make up the acetabulum?
Metronidazole
Schistosoma haematobium
1. VSD 2. ASD 3. PDA
Pubis - ilium - and ischium

12. What is the label given to an individual whose IQ is x 90 to 109
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Herpes virus I and II
Average

13. What is the male - to - female ratio for committing suicide?
Epinephrine
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
No - therapeutic indices can tell which drug is safer - not more toxic.
Pimozide

14. What breast pathology involves malignant cells with halos invading the epidermis of the skin?
Pyloric stenosis
Paget disease of the breast
CD8
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.

15. What cell membrane structure increases the surface area of a cell and has actin randomly assorted within its structure?
HBsAg and HBeAg
Menses
Erythromycin
Microvillus

16. What small gram - negative facultative intracellular rod is transmitted to human host by Dermacentor tick bite?
Francisella tularensis
Middle
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
Para - aminohippurate (PAH)

17. Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
Embolic
12 to 16 weeks (in response to mother's face)
Brucella
nef and tat genes

18. Name these immature defense mechanisms: x Psychic feelings converted to physical symptoms
Red blood cell distribution width index (RDW)
Borderline
Internal carotid artery
Somatization

19. What T- cell surface projection recognizes and reacts to foreign Ags (presented by APCs)?
Dysplasia
TCR
Tetanospasmin (also called tetanus toxin)
Inspiratory capacity

20. Name the RNA subtype based on the following: x Only type of RNA that is translated
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
Labioscrotal swelling
mRNA
Panacinar

21. How many bronchopulmonary segments are on the right lung? Left lung?
Tidal volume (VT)
There are 10 bronchopulmonary segments on the right and 8 on the left.
Medial collateral ligament
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+

22. What tetracycline is associated with hepatotoxicity?
Positive reinforcement
RNA polymerase II
Chlortetracycline
Serocystadenocarcinoma

23. Has a sodium - conserving action in the distal colon.
Phase II
Aldosterone
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)
Ligamentum venosum

24. What three Beta- blockers are used in the treatment of glaucoma?
Small cell carcinoma (oat cell)
The hallmarks of LMN lesion injury are absent or decreased reflexes - muscle fasciculations - decreased muscle tone - and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget - LMN lesions are ipsilateral at the level of the
Antithyroglobulin and antimicrosomal Abs
1. Propranolol 2. Timolol 3. Carteolol

25. What is the drug of choice for early Parkinson's disease?
TB meningitis
Selegiline
Kupffer cells
Hematoxylin

26. What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
Medullary carcinoma of the thyroid
Fitz - Hugh - Curtis syndrome
Trapezius and sternocleidomastoid

27. What is the primary screening test used to detect HIV- infected individuals? Confirmatory test?
Left homonymous hemianopsia
Oxytocin
Coagulative
ELISA is used as a screening test because it is very sensitive; Western blot is used as a confirmatory test because it detects antibodies (protein) to the HIV virus.

28. What embryonic structure forms the adult female structures? - Gartner's duct
Mesonephric duct
Type II pneumocytes
Osteoblast (Remember - blasts make - clasts take)
Teratoma

29. Where in the spinal cord are the presynaptic opioid receptors?
In the dorsal horn of the spinal cord on the primary afferent neurons
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
Kidney
Carbonic anhydrase

30. Anatomical and alveolar dead spaces together constitute what space?
Endometrial cancer
Moving objects - along with large bright objects with curves and complex designs.
Physiologic dead space is the total dead space of the respiratory system.
Gubernaculum

31. 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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32. Name the most common type - Learning disability
CD8+ T cells
Dyslexia
Escherichia coli
Oxytocin

33. What is the name of the postganglionic parasympathetic ganglion that innervates x The submandibular and sublingual glands?
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
Hypochondriasis (they will begin with 'I think I have...')
Semicircular canal

34. What is the term for pupils that react normally to accommodation but have bilateral loss of constriction in response to light?
Argyll Robertson pupils
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
Generalized anxiety disorder
Site 1

35. What glycolytic enzyme has a high Vmax - high Km - and low affinity for glucose?
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
Treacher Collins syndrome
Glucokinase
Chronic rejection

36. What is the most important determinant of drug potency?
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
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
The affinity of the drug for its receptor
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.

37. What two post - transcriptional enzymes in collagen synthesis require ascorbic acid to function properly?
EBV
Pyridoxine (B6)
Stage 2 - which accounts for approximately 45% of total sleep time - with REM occupying 20%.
Prolyl and lysyl hydroxylases

38. What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN - hypokalemia - and low rennin levels?
Hypertrophic scar
Conn syndrome (primary hyperaldosteronism)
Reverse transcription
Fluconazole

39. What is the main type of cell involved in cellular immunity?
The stapedius muscle
Tyramine
The muscle's ATPase activity
T lymphocyte

40. What GI pathology is associated with a positive string sign - an increase in the number of bloody stools - RLQ pain - skip lesions - terminal ileum most commonly affected - occurrence in women more than men - and an increased thickness of the bowel?
Asbestosis and silicosis
Posterior
Helicobacter pylori
Crohn disease

41. What is the most common one? - Form of muscular dystrophy
Molluscum contagiosum
Cystadenocarcinoma
Pancreatic insufficiency
Duchenne muscular dystrophy

42. What body fluid preferentially breaks down esters?
CLL (B- cell origin)
Blood
ACL
Chemotaxis

43. What two factors determine the clearance of a substance?
Primary intention
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.
Progestins
Plasma concentration and excretion rate

44. A marfanoid patient presents with tearing retrosternal chest pain radiating to her back. What is your first diagnosis?
Sublimation
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.
Oxytocin

45. What is the most common one? - Pituitary adenoma
Variable ratio If it is based on time - it is an interval - and if it is based on the number of responses - it is a ratio.
After the eclipse period
Live vaccines
Prolactinoma

46. Notching of the ribs - seen on chest radiograph in patients with postductal coarctation of the aorta - is due to collateralization of What arteries?
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
PGI2
IgG
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)

47. What CNs are affected if there is a lesion in x The upper medulla?
Chlamydia
Gonads
CN IX - X - and XII
Alzheimer disease

48. Name the most common type or cause - UTIs
The carotid sinus is a pressure - sensitive (low) receptor - while the carotid body is an oxygen - sensitive (low) receptor. (Remember 'Sinus Pressure').
Escherichia coli
Endocardial cushion defect
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.

49. What is the stimulus for the classical pathway activation?
None; they are the storage sites for ADH and oxytocin.
Ischemic
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
Cholera toxin

50. Initiates rhythmic contractions associated with labor.
P = .05; P < .05 rejects the null hypothesis
Middle
Melanoma - cancer of the stomach and bladder
Oxytocin