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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 the four exceptions to requirements for informed consent?
Bcl -2
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
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
Exposure

2. What artery travels with the following veins? - Small cardiac vein
Teratoma
The surface of the medulla
Right coronary artery
60%

3. Name the antimicrobial agent whose major side effect is listed - Grey baby syndrome
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
IL-4
Chloramphenicol

4. What enzyme of the TCA cycle catalyzes the production of the following: x GTP
Ulcerative colitis
NREM sleep. Remember awake body - sleeping brain
Succinyl CoA synthetase
Herpesvirus

5. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Vinyl chloride
EF- Tu or EF- ts and GTP
Angiosarcoma of the liver
GABA and glutamic acid
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.

6. Name the MCC - Pneumonia in a patient with atypical bird exposure and hepatitis
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.
Hepatic glycogen phosphorylase
Chlamydia psittaci

7. Name the thalamic nucleus based on its input and output - Input from the optic tract; output projects to the primary visual cortex of the occipital lobe
LGB (think EYES)
Prinzmetal variant angina
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts
C3b

8. What term describes the reflex that increases the curvature of the lens - allowing near vision?
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
Upper outer quadrant (left more than right)
Ergotamines
Accommodation

9. RBCs in the urine
Bladder carcinoma
Vibrio parahaemolyticus
Varicella virus and influenza virus
Fossa ovale

10. What component of the trigeminal nuclei x Receives sensory input (all but pain and temperature) from the face - scalp - dura - and the oral and nasal cavities?
Histidine
Spinal trigeminal nucleus
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Anemia of chronic disease

11. Regarding muscle mechanics - How is passive tension produced?
Somatization disorder
It is produced by the preload on the muscle prior to contraction.
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
Hepatitis B and hepatitis C

12. What disease arises from the adrenal medulla - displaces and crosses the midline - metastasizes early - is the most common solid tumor - and is seen in the 2- to 4-year - old age group?
gp120
Cytosine
Smoking
Neuroblastoma

13. What are the three Beta - lactamase inhibitors?
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
Disorganized schizophrenia
Minoxidil (orally and topically - respectively!)

14. What stage of male development is characterized by the following LH and testosterone levels? - Both LH and testosterone levels drop and remain low.
Hypertension
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.
Childhood
Heroin

15. What thyroid carcinoma is associated with radiation exposure - psammoma bodies - and Orphan Annie eye nuclei?
The left gastric - splenic - and common hepatic arteries
Papillary carcinoma of the thyroid
Ischemia
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.

16. Where is tropocollagen aggregated to form a collagen fibril?
Outside the cell
Down syndrome
4.7 L - 5% of body weight
Head of the pancreas

17. What adult structures are derived from preotic somites?
Muscles of the internal eye
Sucralfate
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
CD19

18. Stimulate hair cells at the base of the cochlea.
Prodrugs
Poxvirus
PGE2 and PGF2a
High - frequency sound waves

19. What wave is the cause of the following venous pulse deflections? - The contraction of the right atrium
Sideroblastic anemia
Tryptophan
wave
Anorgasmia. (The overall prevalence is 30%.)

20. Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery?
Histidine
Class 1 (1A - 1B - and 1C)
Axillary nerve and posterior humeral artery
Propofol

21. In What trimester is the fetus most vulnerable to congenital rubella syndrome?
The first trimester
Roth spots - and they are seen in bacterial endocarditis.
Bile salts are actively reabsorbed in the distal ileum.
Hematoxylin

22. What enzyme system is the most common form of phase II biotransformation?
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get
Displacement
Glucuronidation

23. Influx of what ion is associated with irreversible cell injury?
FSH
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
Massive influx of calcium
Glucuronidation

24. What naturally occurring substances mimic the effects of opioids?
Enkephalins
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
Folate deficiency (very common in the elderly)
The basilar artery is formed at the pontomedullary junction.

25. What determines the rate of a reaction?
Homocysteine methyl transferase
Direct pathway; a good example is Parkinson's disease.
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
The energy of activation (Ea)

26. Where is most of the body's Ca2+ stored?
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Janeway lesions
Buerger disease (thromboangiitis obliterans)
Constrictor pupillae and ciliary muscles

27. Which thalamic nucleus receives auditory input from the inferior colliculus?
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
MGB
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)

28. What is the name of inflammation of the prepatellar bursa?

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29. What is the term to describe the soft - flabby feel and diminished reflexes seen in patients with acute cerebellar injury to the deep cerebellar nuclei?
Osteoblasts (Remember - they modulate the function of osteoclasts.)
Ventral lateral nucleus
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
Hypotonia (rag doll appearance)

30. Name the stages of sleep with these EEG patterns: x Disappearance of alpha waves - appearance of theta waves
For males - HTN; for females - pregnancy.
Stage 1
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons
Treacher Collins syndrome

31. What is the most common one? - Benign breast tumor in females less than 35 years old
O2 has a higher driving force but is only one - twenty- fourth as soluble as CO2. CO 2 has a very small partial pressure difference across the alveolar membrane (47-40 = 7 mmHg) - but it is extremely soluble and therefore diffuses readily across the
Fibroadenoma
Repaglinide
Silicosis - Coal worker's pneumoconiosis is synonymous with black lung disease - an upper lobe occupational disorder

32. Eating fava beans can produce the Mediterranean type of what deficiency?
G-6- PD deficiency
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
Lysine and tyrosine
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm

33. What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100 - 00); decreased LAP levels; and nonspecific symptoms of fatigue - malaise - weight loss - and anorexia?
CML
NREM sleep. Night terrors are dreams that we are unable to recall.
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Clearance

34. What is the most serious form of tinea capitis - which results in permanent hair loss and is highly contagious?
Levator palpebrae superioris
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Tinea favosa (favus)

35. Do the following structures pick up stain from hematoxylin or eosin? - Bacteria
Hematoxylin
M3 (promyelocytic leukemia)
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
Giardia lamblia (treat with metronidazole)

36. What is the DOC for trigeminal neuralgia?
50% - with 50% of them having the child
Dimercaprol - penicillamine
First - order elimination
Carbamazepine

37. How many pairs of spinal nerves are associated with x Coccygeal vertebrae?
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum
Osteoclasts
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
No change in length

38. What hormone is necessary for normal GH secretion?
Naloxone - naltrexone
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)

39. What are the first signs of overdose from phenobarbitals?
A low - resistance system is formed by resistors added in parallel.
Hepatitis A (infectious)
Nystagmus and ataxia
Homocysteine methyl transferase

40. What are the eight liver - specific enzymes?
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.)
a - Blockers (- zosins)
Minor
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase

41. What rate is indicated by 1- specificity?
LC4 - LD4 - and LE 4
Aldolase B deficiencies are treated by eliminating fructose from the diet.
PGD2 - PGE2 - and PGF 2
False - positive rate

42. What are the rules of 10 regarding pheochromocytoma?
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland
Voyeurism
The vermis
It increases Ca2+ excretion from the kidney and increases bone mineralization.

43. What cell's axons are the only ones that leave the cerebellar cortex?
CD4+T cells
Lispro insulin
Cystadenocarcinoma
The Purkinje cell

44. What phase of the cell cycle are the following antineoplastic agents specific for? - Dacarbazine
Ischemic heart disease (MIs)
G0 phase
emancipates
Orotic acid (purine metabolism)

45. What nerve and artery could be affected in a midshaft humeral fracture?
Radial nerve and the profunda brachii artery
D- Penicillamine
Granulosa cells
Resistance decreases as resistors are added in parallel.

46. The duodenal - jejunal flexure is suspended from the posterior abdominal wall by what?
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Specificity (it deals with the healthy)
Borrelia recurrentis
Ligament of Treitz

47. What component of the vascular system is most sensitive to the effects of calcium channel blockers?
Ankylosing spondylitis
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
Achondroplasia
Arterioles

48. Name the lung measurement based on the following descriptions: x Volume in the lungs at the end of passive expiration
At least 5 lobes
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
Functional residual capacity (FRC)

49. How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle?
An increase in serum glucose levels
Chromosome 4p
3 ATPs by oxidative phosphorylation
Dimercaprol - D- penicillamine

50. What is the term for conversion of a dsDNA molecule to the base sequence of an ssRNA molecule?
Transcription (C comes before L in the alphabet - and transCription comes before transLation)
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Extrahepatic biliary atresia
CD19