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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 are five clinical signs of portal HTN?
Labioscrotal swelling
Eosinophils
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Cirrhosis

2. What AR disease involves a defect in AA 508 on chromosome 7 - causing a defect in Cl - transportation that leads to recurrent pulmonary infections and an increase in viscid mucoid secretions along with pancreatic insufficiencies?
MEN I (or Wermer syndrome)
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
Ethyl alcohol

3. What organ of the body has the smallest AV oxygen difference?
G-6- PD deficiency
Vitamin K
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.
Area 22 and occasionally 39 and 40

4. Insulin - induced hypoglycemia is the most reliable (by far not the safest) test For what hormone deficiency?
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
CN IX
GH deficiency

5. Is the carotid sinus sensitive to pressure or oxygen?

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6. As what compound do the carbons for fatty acid synthesis leave the mitochondria?
Hypertrophic scar
Rhinovirus
Citrate - via the citrate shuttle
Ciliary ganglion producing a tonic pupil

7. What rate removes any difference between two populations - based on a variable - to makes groups equal?
Standardized rate
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
The systemic veins have the largest blood volume - and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.
Alcohol. Nearly 10% of adults have a problem with alcohol.

8. What AA is broken down into N2O - causing an increase in cyclic guanosine monophosphate (cGMP) of smooth muscle - hence vasodilation?
Where the cell bodies for the DCML and spinothalamic sensory systems are...
Zona fasciculata and zona reticularis
Methionine (start) and tryptophan are the only two AAs with only one codon.
Arginine

9. What lymphoid organ has the following characteristics: outer and inner cortical areas - encapsulation - germinal centers - and high endothelial venules?
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Adenocarcinoma (30% to 35%)
Parvovirus (it is the only ssDNA virus)
Lymph nodes

10. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Eukaryotic cell - 15 to 25 microns - 80S ribosomes - no cell walls - replicates via cytokinesis with mitosis and meiosis
B- cell Ag receptors
Eosinophilic exudates
Parasites
Minor

11. What testicular tumor of infancy is characterized by elevated - fetoprotein levels and Schiller - Duval bodies?
Copper (Cu+)
Yolk sac tumor
Duodenal ulcer
The rate of infusion

12. Why is spermatogenesis decreased with anabolic steroid therapy?
naked viruses
presence of PMNs
Cocaine - induced coronary ischemia
Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone - produced by Leydig cells - is needed for spermatogenesis.

13. How many days prior to ovulation does LH surge occur in the menstrual cycle?
1 day prior to ovulation
1. Big 2. Bilateral 3. Berry aneurysm
IF-2 of the 30S subunit
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)

14. Which Streptococcus pyogenes toxin is immunogenic?
Severe combined immunodeficiency disease
Streptolysin O
1. Posterior auricular vein 2. Posterior division of the retromandibular vein
Broca's aphasia

15. What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
Homicide. It is also the leading cause of death in black females aged 15 to 24.
Trapezius and sternocleidomastoid
Primary sclerosing cholangitis
Lung cancer

16. What CNs arise from x The midbrain?
Preload. It is the load on a muscle Prior to contraction.
CN III and IV
Type III hypersensitivity (immune complex)
Escherichia coli and Pseudomonas sp.

17. What virus is associated with progressive multifocal leukoencephalopathy?
Pyelonephritis
Axis II
The affinity of the drug for its receptor
JC virus

18. Influx of what ion is associated with irreversible cell injury?
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
Elevated ASO titers and serum complement levels
Scavenger receptor (SR- B1)
Massive influx of calcium

19. What genus is known as the smallest free living bacteria? (hint: has no cell wall and has sterols in the membrane)
C3 - C4 - and C5 keep the diaphragm alive!
Mycoplasma
Facial expression (the second is vocal intonation)
Right - sided

20. What syndrome is characterized by bilateral medial temporal lobe lesion - placidity - hyperorality - hypersexuality - hyperreactivity to visual stimuli - and visual agnosia?
Kl
Superior and anterior
Because the large drop in TPR is accompanied by a large increase in cardiac output - resulting in a minimal change in BP.
Neuroblastoma

21. On what layer of the epidermis does all mitosis occur?
Malpighian layer (made up of the stratum basale and stratum spinosum)
HMG CoA reductase
Gaucher disease
Cones (C for color and cones)

22. What pharyngeal pouch and groove persist when a pharyngeal fistula is formed?
The second pharyngeal pouch and groove
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Chordae tendineae
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.

23. With what stage of sleep are nightmares associated?
Varicella virus and influenza virus
Stable angina
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
REM sleep. Nightmares are frightening dreams that we recall.

24. What is the name of the hypothesis you are trying to prove?
Alternative hypothesis (What is left after the null has been defined)
4 years old
Crohn disease
Pernicious anemia (secondary to a lack of vitamin B12 absorption)

25. Which cestode infection results in alveolar hydatid cyst disease?
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
Aspiration
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Echinococcus multilocularis

26. Is the bound form or free form of a lipid - soluble hormone responsible for the negative feedback activity?
Streptococcus pyogenes
First - pass metabolism and acid lability
Free form determines hormone activity and is responsible for the negative feedback loop.
PDA

27. What happens to the lung if the intrapleural pressure exceeds lung recoil?
The lung will expand; also the opposite is true.
Selective erectile disorder
Patau syndrome (trisomy 13)
Serratus anterior

28. What happens to intraventricular pressure and volume during isovolumetric contraction?
Pseudomembranous exudates
Aldolase B deficiencies are treated by eliminating fructose from the diet.
As the name indicates - there is no change in volume but there is an increase in pressure.
Androgens are 19- carbon steroids.

29. What subset of CD4 helper T cells stimulate B- cell division and differentiation?
LTC4 and LTD4
Clozapine
Th2
Interferons

30. What hereditary bone disorder is due to decreased osteoclast function - resulting in thick - sclerotic bones that fracture easily?
Osteopetrosis (Albers - Sch
Histamine
The basilar artery is formed at the pontomedullary junction.
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.

31. What vitamin deficiency is evidenced by poor wound healing - loose teeth - bleeding gums - petechiae - and ecchymosis?
Sideroblastic anemia
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors
Neuroblastoma

32. What bacterium is diagnosed using the Dieterle silver stain?
Legionella
Axillary nerve and posterior humeral artery
excites the neuron
ACL

33. What form of sunlight is the most carcinogenic?
Hexosaminidase A
Ultraviolet B (UVB) sunlight
Premature ejaculation
Cingulate gyrus herniation (subfalcine)

34. T cells can recognize - bind - and internalize...
unprocessed Ags
Chromosome 21
C3 - C4 - and C5 keep the diaphragm alive!
Fluconazole

35. What cycle is responsible for converting to glucose in the liver the lactate produced in the RBCs?
CD40
Stable
Fibroadenoma
Cori cycle

36. Name the GLUT transporter based on the following: x Found in most tissues - including brain and RBCs
GLUT 3 and 4
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
Superior olivary nucleus

37. What fungus is urease positive?
Postinfectious GN
Series circuit
Gerstmann's syndrome; spoken language is usually understood.
Cryptococcus

38. What two post - transcriptional enzymes in collagen synthesis require ascorbic acid to function properly?
G2 phase (gap 2)
Bell pad
Prolyl and lysyl hydroxylases
Direct fluorescent Ab test

39. 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?
>10 mm
Cauda equina
Methanol (wood alcohol)
Pulse pressure

40. What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
C3a - C4a - and C5a
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.
Isocitrate dehydrogenase
Listeria monocytogenes

41. Name the AD disease associated with chromosome 15 in which the patient has long extremities - lax joints - pigeon chest - and posterior mitral leaflet prolapse and is prone to developing dissecting aortic aneurysm.
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
Undoing
Marfan syndrome
Phallus - urogenital folds - and labioscrotal swellings

42. What is the most common one? - Location of a gastric ulcer
ELISA screens and Western blot confirms the diagnosis.
Magnesium ammonium phosphate (struvite)
Lesser curvature of the antrum of the stomach
Glycogen synthase

43. What do the risk factors late menopause - early menarche - obesity - nulliparity - excessive estrogen - genetic factor p53 - and brc - abl characterize?
Breast cancer
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade

44. What chamber of the eye lies between the iris and the lens?
Pseudogout
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Posterior chamber
Primary biliary cirrhosis

45. What organelles make ATP - have their own dsDNA - and can synthesize protein?
Mitochondria
Rotavirus
ASA (salicylate)
Insulin

46. Name the type of mutation: x The deletion or addition of a base
Frameshift
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
At least 30% blast in the bone marrow

47. What is the term for TB with the cervical lymph node involved?
Abs to HBsAg
Scrofula
Decreasing potassium conductance - which results in increased excitability
Aldehyde dehydrogenase

48. What basic reflex regulates muscle tone by contracting muscles in response to stretch of that muscle?
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
Proto - oncogenes
The myotatic reflex is responsible for the tension present in all resting muscle.
Transcription (C comes before L in the alphabet - and transCription comes before transLation)

49. What are the three components to the asthma triad?
Chloramphenicol
1. Short attention span 2. Impulsivity 3. Hyperactivity
Nasal polyps - rhinitis - and aspirin hypersensitivity
Lesch - Nyhan syndrome

50. What is the label given to an individual whose IQ is x 130
Arch of the aorta
Pons
Very superior (<2.5% of the population)
Herpes II