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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. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral aqueduct
Atropine and 2- PAM (pralidoxime)
Mesencephalon
CN III and IV
Magnesium

2. What is the term for the summation of mechanical stimuli due to the skeletal muscle contractile unit becoming saturated with calcium?
GnRH
Stage 2 - which accounts for approximately 45% of total sleep time - with REM occupying 20%.
Glucuronidation
Tetany

3. What is the most common one? - Cardiac anomaly in children
Enterobius vermicularis; the treatment is albendazole.
The Beta- subunit; remember - the a - subunit is nonspecific.
PDA
Bladder cancer

4. What eukaryotic translation enzyme is associated with the following: x Initiation
eIF-2 in the P site
Altruism
Osteosarcoma
Metastatic carcinomas

5. What CN is associated with the x Fifth pharyngeal arch?
Pyruvate carboxylase
Thioridazine
None; it degenerates.
The Beta- subunit; remember - the a - subunit is nonspecific.

6. During what stage of B- cell development is IgM first seen on the surface?
MstII; changing codon 6 (from A to T) destroys the restriction site.
Sigma factor
Immature B cells
Acetazolamide

7. What gene stimulates apoptosis when DNA repair is unable to be done?
p -53
MEN I (or Wermer syndrome)
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
The raphe nuclei

8. What benign cardiac tumor is associated with tuberous sclerosis?
All (nearly 15-20 times the normal risk)
Rhabdomyoma
Fo/F1 complex
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.

9. In What area of the brain can an excess of dopamine lead to psychotic symptoms?
Glutamine
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Mesocortical area
HPV

10. At What age does IQ stabilize?
From age 5 onward IQ stabilizes.
Purulent exudates
Shaping (successive approximation)
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.

11. What glycogen storage disease is due to the following enzyme deficiencies? - Muscle phosphorylase

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12. What type of personality test is the Rorschach inkblot test - objective or projective?
Benign nevus (mole)
Projective test. Most tests with a wide range of possibilities for the answers are projective.
The courts. These are legal - not medical terms.
Staphylococcus aureus

13. What GnRH analog is used as a repository form of treatment in prostatic cancer?
Leuprolide
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
X- linked recessive

14. What is the name of the urinary bladder where the ureters enter and the urethra exits?
CD8
The placenta
Marfan syndrome
Urinary trigone

15. In regards to solute concentration - how does water flow?
relaxation
Aspiration
ater flows from a low - solute to high - solute concentrations.
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.

16. What is the term for RBCs with smooth undulations on the surface of their membrane - commonly seen in uremia?
11- Beta - Hydroxylase deficiency results in excess production of 11- deoxycorticosterone - a weak mineralocorticoid. It increases BP - Na+ - and ECF volume along with production of adrenal androgens.
Malpighian layer (made up of the stratum basale and stratum spinosum)
Huntington's chorea. (Death in 15-20 years - often via suicide.)
Burr cells (echinocytes)

17. What is the triad of fat embolism?
Bronchioloalveolar carcinoma
McArdle's syndrome
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.

18. What is the term for a unit of DNA that encodes a particular protein or RNA molecule?
Crude mortality rate
A gene (a rather simple definition but accurate)
Four
Left eye anopsia (left nasal and temporal hemianopsia)

19. What female follicular cell is under LH stimulation and produces androgens from cholesterol?
Anxiety disorders; for men it is substance abuse.
Theca cell
Neisseria meningitides
Negative

20. Why is the clearance of creatinine always slightly greater than the clearance of inulin and GFR?
Osteoporosis
Infection
Rods
Because creatinine is filtered and a small amount is secreted

21. What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
Iodine - resulting in congenital hypothyroidism
2 ATPs by oxidative phosphorylation
EBV
Syphilitic

22. What disease is associated with the HLA- A3 allele
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
Primary Hemochromatosis
G-6- PD
Clostridium botulinum

23. What is the DOC for CMV retinitis?
Ganciclovir
Opposite the second upper molar tooth
RNA polymerase II
Red pulp (Remember - Red pulp and RBCs begin with R.)

24. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x N- myc
Diacylglycerols and phosphatidic acid
Acute cystitis
Neuroblastoma
The central vein of the liver lobule

25. Name one of the ADP receptor antagonists used in patients who are post - MI - have had TIAs - have unstable angina - and are allergic to ASA?
Ticlopidine or clopidogrel
Osteoma
PR interval
Phenytoin

26. What encapsulated lymphoid organ is characterized by presence of Hassall's corpuscles - and absence of germinal centers and B cells?
Neutrophils - eosinophils - and basophils
Cytochrome a/a3
Klinefelter syndrome
Thymus gland. (Thymus gland is essential for T cell maturation.)

27. What class of heparin is active against factor Xa and has no effect on PT or PTT?
Concentration gradient
Coccidioides immitis
Low molecular weight heparin (LMWH)
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)

28. What is the most common one? - Site of ulcerative colitis
Bender Visual Motor Gestalt Test
Rectum
M12 strains
Labile

29. What bonds are broken by endonucleases?

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30. What vitamin is a component of the coenzyme thiamine pyrophosphate (TPP)?
P24
Thymine (B1)
28 L - 40% of body weight
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)

31. Where are the enzymes for the ETC and oxidative phosphorylation found?
The outer cortex contains most of the germinal centers and therefore also most B cells.
Staphylococcus saprophyticus
The inner membrane of the mitochondria (cristae)
Gap junctions

32. Name these anxiety defense mechanisms: x Use of explanations to justify unacceptable behaviors.
Rationalization
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)
Coxiella burnetii
Invasive ductal carcinoma

33. What protein is required by prokaryotic RNA polymerases to initiate transcription at the promoter region of DNA?
Pantothenic acid
Sigma factor
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
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

34. Name the cluster B personality disorder: x Grandiose sense of self - importance; demands constant attention; fragile self - esteem; can be charismatic
Narcissistic
Ch
Neuroblastoma
Blocking

35. What CNS demyelinating disease is characterized by diplopia - ataxia - paresthesias - monocular blindness and weakness - or spastic paresis?
Constriction of efferent arteriole
1. Liver 2. Kidney 3. Pituitary gland (via 5'- deiodinase enzyme)
Collecting ducts - which make them readily permeable to water reabsorption.
Multiple sclerosis

36. Name the ventricular muscle membrane channel: x Open at rest; depolarization is stimulus to close; begin to reopen during the plateau phase and during repolarization
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Formation of an identity through issues of independence and rebellion; they define who they are.
Voltage - gated potassium channels
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase

37. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Ventral rami?
Both
Ribonucleotide reductase
Latissimus dorsi
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)

38. What projective test asks the patient to tell a story about What is going on in the pictures - evaluating the conflicts - drives - and emotions of the individual?
Transverse abdominis
Aspartate and carbomoyl PO4
TAT (Thematic apperception test)
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.

39. Although the CSF normally contains 0 to 4 lymphocytes or monocytes - the ___________ is always considered abnormal.
presence of PMNs
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
Clostridium botulinum
IgA nephropathy

40. What hormone has the following effects: chondrogenic in the epiphyseal end plates of bones; increases AA transport for protein synthesis; increases hydroxyproline (collagen); and increases chondroitin sulfate synthesis?
Gastrinoma
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Nocardia asteroides
Escherichia coli

41. What causes a skeletal muscle contraction to terminate?
Onset of bleeding
Posterior
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Rotavirus

42. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - poor grooming - poor ability to think abstractly - decreased drive - poor attention span (Hint: if the lesion is in the
Knee
Dorsal prefrontal cortex
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.
Carnitine acyl CoA transferase II

43. What type of hemostasis in an intravascular space consists of fibrin - platelets - RBCs - and WBCs?
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.
Thrombus
Schizoid
Inspiratory reserve volume (IRV)

44. Reinke crystals
Rhabdomyoma
Yohimbine
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
Leydig cell tumor

45. What are the four reasons for hypochromic microcytic anemia with a low MCV?
The lung will expand; also the opposite is true.
RES(Reticular endothelial system)
Eosin
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning

46. What vein drains the lower third of the thoracic wall?
Atrial filling (venous filling) Atrial - Contraction - Venous
Head of the pancreas
Hepatitis A (infectious)
Hemiazygous vein

47. What form of antimicrobial therapy is best for an immunocompromised patient?
Myeloperoxidase
Hepatitis C
Bactericidal
CN VII and VIII

48. What component of the basement membrane binds to collagen type IV and heparin sulfate and is a cell surface receptor?
Childhood
Third week
HBcAb and HBeAb. You see the antibodies c and e.
Laminin

49. What term is described as the prestretch on the ventricular muscle at the end of diastole?
Pedophilia
As the name indicates - there is no change in volume but there is an increase in pressure.
Preload (the load on the muscle in the relaxed state)
Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine.

50. Is excretion greater than or less than filtration for net secretion to occur?
Hypoxia
Excretion is greater than filtration for net secretion to occur.
The aorta has the greatest velocity and the capillaries have the slowest velocity.
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.