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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 nerve and artery could be affected in a humeral neck fracture?
Hgb F
Arsenic
Axillary nerve and posterior humeral artery
Intrapleural pressure decreases (becomes more negative).

2. Which type of hepatitis can cause hepatocellular carcinoma?
Hepatitis B
Primary follicle of the cortex
Gradient - time system
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.

3. What is the only Rickettsia that is stable in the environment?
C1 esterase inhibitor (C1INH)
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
Coxiella burnetii
Pneumococcus

4. Which gram - negative diplococcus grows on chocolate agar? Thayer - Martin medium?
Histidine - because of the imidazole ring found in the R group - is basic.
Yohimbine
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.
1. VSD 2. ASD 3. PDA

5. What is the name for the following RBC indices? - Average Hgb concentration/given volume of packed RBCs
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Mean corpuscular hemoglobin concentration (MCHC)
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.

6. What complement factor or factors are associated with x Chemotaxis?
C5a
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
Variola virus (Smallpox)
Microglia

7. What is the most common one? - Malignant tumor in the bone of teenagers
ICF volume decreases when there is an increase in osmolarity and vice versa.
Coagulative necrosis
Onion skinning
Osteosarcoma

8. How does cell diameter affect the conduction velocity of an action potential?
Axis V
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
ELISA. It detects anti - p24 IgG.
The greater the cell diameter - the greater the conduction velocity.

9. All primary oocytes in females are formed By What age?
Cystic fibrosis
They are all formed by the fifth month of fetal life.
Lead
Acarbose

10. What lysosomal enzyme is deficient in x Tay- Sachs disease?
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
Hexosaminidase A

11. How many high - energy bonds are used to activate an AA?
Hepatoma and nonseminomatous testicular germ cell tumors
Ulnar to radial progression
2 ATPs - via the amino acyl tRNA synthase enzyme
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.)

12. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x sis
Red blood cell distribution width index (RDW)
Vitamin C
Astrocytoma
Clavicle - acromion - and glenoid fossa of the scapula and the humerus

13. A clear - hypertonic solution with higher concentrations of K + and HCO3- - than the serum.
Renin secretion
Postinfectious GN
Class 1 (1A - 1B - and 1C)
CSF

14. What cell in the heart has the highest rate of automaticity?
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)
SA node; it is the reason it is the primary pacemaker of the heart.
Site 3
Mantle cell lymphoma

15. If the AV difference is positive - is the substance extracted or produced by the organ?
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.
Phase I
Validity (remember - reliability is necessary but not the only thing needed for validity)
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)

16. 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?
HIV
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Immature B cells
CN X

17. What motile - gram - negative spiral bacillus with flagella is oxidase positive - urease positive - and associated with gastritis - peptic ulcer disease - and stomach cancer?
well - fed and fasting
Prostatic carcinoma
Helicobacter pylori
Bitemporal heteronymous hemianopsia

18. What encephalitis is associated with the JC virus?
Progressive multifocal leukoencephalopathy
Pantothenic acid
Enteroendocrine (EE) cells; they also secrete secretin.
Glanzmann syndrome

19. What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
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
Phase 0
Decreasing potassium conductance - which results in increased excitability
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.

20. Increases the risk of developing squamous cell carcinoma of the penis.
HBeAb
Trimethoprim/sulfamethoxazole (TMP- SMX)
Type I hypersensitivity (anaphylactic)
HPV infection

21. At the end of each round of Beta- oxidation - What is released?
Fovea
Acetyl CoA - FADH2 - and NADH
Succinyl CoA
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.

22. What bacterium is a gram - negative - oxidase - positive aerobic rod that produces a grapelike odor and pyocyanin pigmentation?
Paranoid schizophrenia
Glucose and galactose
Coarctation of the aorta
Pseudomonas aeruginosa

23. Name the ventricular muscle membrane channel: x Closed at rest; depolarization causes channels to open quickly; will not respond to a second stimulus until cell is repolarized.
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
Tryptophan
Voltage - gated sodium channel
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.

24. What is the name of the tumor when gastric carcinoma spreads to the ovaries?
VLDLs
Common and internal carotid arteries
Krukenberg tumor
Raloxifene

25. In high altitudes - What is the main drive for ventilation?
Astrocytes
Alveolar macrophages
Gonads
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.

26. What is the most common one? - Acquired GI emergency of infancy
Free - unprocessed Ag
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
Testicular lymphoma
Necrotizing enterocolitis

27. Is Dubin - Johnson or Rotor syndrome associated with black pigmentation of the liver?
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
Psoriasis
Corynebacterium diphtheriae
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid

28. How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle?
Dorsal prefrontal cortex
Gaucher disease
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
3 ATPs by oxidative phosphorylation

29. Name the form of spina bifida - Meninges project through a vertebral defect
Meningocele All except occulta cause elevated - fetoprotein levels.
a - and Beta- chains are on most T cells.
Elevated ASO titers and serum complement levels
G0 phase

30. What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Alcohol. Nearly 10% of adults have a problem with alcohol.
Thoracic splanchnic fibers
The parasympathetic nervous system
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus

31. What is the name of the spinal cord passing within the subarachnoid space and forming the spinal nerves that exit the lumbar and sacral foramina?
Cauda equina
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve
Paramyxovirus
Confounding bias

32. What is the label given to an individual whose IQ is 70 to 79
Down syndrome (it is slightly more common than fragile X syndrome.)
HPV serotypes 1 and 4
Borderline
A gene (a rather simple definition but accurate)

33. Name the lipoprotein based on the following characteristics - apo E
>5 mm
Hirschsprung's disease (colonic gangliosus)
Selegiline
IDL

34. What is the term for pelvic inflammatory disease of the fallopian tubes?
Rhombencephalon
None; they are the storage sites for ADH and oxytocin.
Salpingitis
2 and 5HT3 receptors

35. What type of mortality rate is defined as the number of deaths x From a specific cause per all deaths?
Coagulative
Negative reinforcement
Membranoproliferative glomerulonephritis (MGN)
Proportionate mortality rate

36. What is the term for the dementia characterized by decremental or patchy deterioration in cognitive function due to a cerebrovascular accident?
Production of oxygen free radicals
Middle
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
Enterohepatic cycling

37. What is the most important stimulus for the secretion of insulin?
An increase in serum glucose levels
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.
Rheumatoid arthritis
Reiter syndrome

38. What is the most common one? - Cardiac anomaly in Turner syndrome
REM
Adulthood
Disseminated intravascular coagulation (DIC)
Coarctation of the aorta

39. What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
hCG
Kimmelstiel - Wilson disease
Spironolactone (binds to aldosterone receptors)
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)

40. How long is the transit time through the large intestine?
3 to 4 days
Metastatic
Insulinoma
Carbamazepine

41. Name the B- cell CD marker: x Receptor for EBV
Macula densa
Medial collateral ligament
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
CD21; it is a complement receptor for cleaved C3

42. Bloody tap on lumbar puncture
Subarachnoid hemorrhage
Type IV collagen
Glucuronidation
Resorb CSF into the blood

43. What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1?
Sensory
Opposite the second upper molar tooth
Androgen - binding protein
Lisch nodules

44. What are the pharmacologic effects seen sexually with x Beta- Blockers?
Both Neisseria and Moraxella are gram - negative cocci.
Impotence
Chromosome 5p
HDL

45. What two AAs have a pKa of 10?
Valine
Where the cell bodies for the DCML and spinothalamic sensory systems are...
Lysine and tyrosine
pK (think of it as where half is base and half is acid)

46. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
CN III
rRNA
Early distal tubule
Norm reference (i.e. - 75% of the students in the class will pass)

47. What enzyme of the purine salvage pathway is deficient in the following? - Selective T- cell immunodeficiency
Purine nucleoside phosphorylase
Common peroneal nerve
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)

48. What phase of the female reproductive cycle is 14 days long?
Cones (C for color and cones)
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies

49. What benign bone tumor is associated with Gardner syndrome?
Ticlopidine or clopidogrel
Osteoma
The sandfly
It is produced by the preload on the muscle prior to contraction.

50. What cells of the epidermis - derived from the neural crest - act as mechanoreceptors?

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