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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. How can a deficiency in adenosine deaminase be a bone marrow suppressor?
It causes a buildup of dATP - which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate - a precursor of DNA - resulting in overall bone marrow suppression.
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
d - ALA synthase
3 months of symptoms in 2 consecutive years

2. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x c - myc
Churg - Strauss syndrome
Duodenal ulcers (4 times as common as gastric)
Urachus
Burkitt lymphoma

3. What percentage of children born to HIV- positive mothers will test positive for HIV at birth?
100% - with about 20% remaining positive after 1 year
Affinity
Shifts it to the right
Edward syndrome (trisomy 18)

4. Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it?
Chromosome 19
Glioblastoma multiforme
Staphylococcus aureus
Mitral valve prolapse

5. At high doses aspirin has ________ properties.
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
Coronary circulation
Uricosuric
Leydig cell tumor

6. Name four major risk factors for atherosclerosis.
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.
Fixed interval
Achondroplasia
Pregnancy

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

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8. What is the name of the T cell - rich area of the spleen?
Gastric carcinoma
Being single
Risk factors for breast cancer
PALS (Parietolateral lymphocytic sheath)

9. What bronchogenic carcinoma is associated with an elevated level of Ca2+ - involves keratin pearls - occurs in men more than women - is associated with smoking - occurs in the major bronchi - and is seen in the central areas of the lung?
Herpes virus
Hepatitis E
Production of oxygen free radicals
Squamous cell carcinoma

10. What is the most common one? - Site of Crohn disease
Fc portion of IgG - C3b - and mannose - binding proteins
Cerebral aqueduct
Gout
Terminal ileum

11. What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
Hemolytic uremic syndrome
GP120
Second M PITS for pharyngeal pouch derivatives
Mixed (both cholesterol and calcium)

12. Name the most common type or cause - Acute renal failure in the United States
gamma and delta chains
Krukenberg tumor
Nephrotoxicity
Acute tubular necrosis

13. Name the associated chromosome - Cri - du - chat
Enterococcus faecalis
Chromosome 7
B cells; macrophages and dendritic cells are nonspecific.
Chromosome 5p

14. What is the most common one? - Cardiac anomaly in children
The anterior nucleus of the thalamus
Leiomyoma
The fast component is directed toward the affected side of a cerebellar lesion.
PDA

15. How many carbons do androgens have?
Glycogen synthase
Dysplasia
Arnold - Chiari malformation type 2
Androgens are 19- carbon steroids.

16. What is the term to describe the limited portion of an Ag that is recognized by an Ab?
Measurement bias
Antigenic determinant (epitope)
McArdle's syndrome
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.

17. What segment of the small intestine is associated with Brunner's glands?
Tetralogy of Fallot
Duodenum
Stranger anxiety
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is

18. In the water deprivation test - does a patient with reduced urine flow have primary polydipsia or diabetes insipidus?
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Ganciclovir
Pituitary adenoma

19. What is the most common chromosomal disorder?
Down syndrome
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.
Amyl nitrate - sodium nitrate - or sodium thiosulfate
Third week

20. Name the ocular lesion; be specific - Left Meyer's loop lesion of the optic radiations.
Nystagmus and ataxia
Postinfectious GN
Left homonymous hemianopsia
Hepatoma and nonseminomatous testicular germ cell tumors

21. Is filtration greater than or less than excretion for net reabsorption to occur?
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Lead
Filtration is greater than excretion for net reabsorption to occur.
Alcohol and its related problems cost the country approximately $100 billion a year.

22. Name the MCC of death - In diabetic individuals
MI
Right medial longitudinal fasciculus
Hepatitis C
Increased GABA levels decrease the likelihood of learned helplessness.

23. What is the drug of choice in the treatment of the lepra reaction?
Phase 0
Ependymoma
Clofazimine
Superior and posterior

24. Are the following responses associated with histamines H1 or H2 receptor activation? - Pain and pruritus
The basilar artery is formed at the pontomedullary junction.
Vancomycin
H 1
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)

25. What part of the heart forms x Diaphragmatic wall?
More than 75% of the vessel
Decreases
Left ventricle and tip of right ventricle
Proencephalon

26. Where is the action potential generated on a neuron?
Axon hillock
Axillary nerve and posterior humeral artery
Carbidopa and benserazide
Childhood

27. What CN nucleus receives auditory information from both ears via the cochlear nuclei?
Small cell carcinoma (oat cell)
Superior olivary nucleus
Stretch receptors prevent overdistension of the lungs during inspiration.
Type II

28. Name the most common type or cause - Pyogenic osteomyelitis
Staphylococcus aureus
The AR form is malignant and AD is benign.
One - way ANOVA
Acute rejection

29. Why does carbon monoxide diffusion in the lung (DLCO) decrease in emphysema and fibrosis but increase during exercise?
Dimorphic
Pyruvate carboxylase
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
Stapedius muscle

30. What syndrome is associated with the following brainstem lesions? - Occlusion of the PICA - resulting in ipsilateral limb ataxia - ipsilateral facial pain and temperature loss - contralateral pain and body temperature loss - ipsilateral Horner's synd

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31. What is the name of the exotoxin Shigella dysenteriae produces - which interferes with the 60S ribosomal subunit and results in eukaryotic protein synthesis inhibition?
Eisenmenger syndrome - which can also occur with any left - to - right shunt
G0 phase
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)
Pedophilia

32. What is the MCC of the following endocarditis scenarios? - Following biliary infections
Enterococcus faecalis
Molindone
Membrane conductance (think conductance = channels open)
Area 22 and occasionally 39 and 40

33. What GnRH analog is used as a repository form of treatment in prostatic cancer?
Snails
When it crosses the teres major
Leuprolide
Schizotypal

34. What area of the brain acts as the center for ipsilateral horizontal gaze?
PPRF
Methicillin
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm
Caseous necrosis

35. At the apex of the lung - What is the baseline intrapleural pressure - and what force does it exert on the alveoli?
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.
Listeria monocytogenes
Body dysmorphic disorder
Osteitis fibrosa cystica (von Recklinghausen disease)

36. Aroused EEG pattern (fast low voltage and desynchronization) - saccadic eye movements - ability to dream - and sexual arousal are all associated with what general pattern of sleep?
Takayasu arteritis (medium - size to large vessels)
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
REM sleep. Remember - awake brain in a sleeping body.
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma

37. In which quadrant is breast cancer most commonly found?
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.
Upper outer quadrant (left more than right)
Clostridium botulinum
Parvovirus B 19

38. What cell type is commonly elevated in asthma?
Eosinophil
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol
Intrapleural pressure decreases (becomes more negative).
Uroporphyrinogen I synthetase

39. Why is there an increase in FF if the GFR is decreased under sympathetic stimulation?
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
Mitral valve prolapse
Transcription factor IID

40. A Japanese man has weight loss - anorexia - early satiety - epigastric abdominal pain - and a palpable left supraclavicular lymph node. On endoscopy you find a large - irregular ulcer with elevated margins on the lesser curvature of the stomach. What
Gastric carcinoma
Sinus venosus
Shigella
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.

41. Has analgesic and antipyretic activities but lacks anti - inflammatory effects.
At the end of the PCT 25% of the original volume is left
Posterior
Both Neisseria and Moraxella are gram - negative cocci.
Acetaminophen

42. What is the term for the external urethra opening onto the dorsal surface of the penis?
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.
Kinesins. Dynein generates retrograde transportation of information.
Epispadia
Atrial filling (venous filling) Atrial - Contraction - Venous

43. What two veins form the portal vein?
Ribonucleotide reductase
Thyroid gland
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
Dyslexia

44. What syndrome is characterized by sweating - insomnia - nausea - diarrhea - cramps - delirium - and general restlessness secondary to MAOI and SSRI in combination?
Primary hypoparathyroidism
Fixed ratio (rewards set behaviors)
Ergosterol
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.

45. What operant conditioning therapy or modification is described as x Reinforcing successive attempts that lead to the desired goal (gradual improvement)?
Clonidine
The Beta- subunit; remember - the a - subunit is nonspecific.
Shaping (successive approximation)
B cells; macrophages and dendritic cells are nonspecific.

46. What test is used to screen for HIV?
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.
ELISA. It detects anti - p24 IgG.
Astrocytes
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.

47. What somatoform disorder is described as x La belle indiff
It decreases insulin secretion.
The inner membrane of the mitochondria (cristae)
Conversion disorder
Nitrates

48. Blue sclera is seen In what hereditary bone disorder?
Hepatitis B
The rate of Beta- oxidation
Osteogenesis imperfecta
Abs to HBsAg

49. What diagnosis ensues from finding well - demarcated erythematous plaques with silvery scales on the knees - elbows - and scalp along with nail bed pitting and discoloration?
Liver
von Hippel - Lindau syndrome
Mycobacterium leprae
Psoriasis

50. What is the most common form of dementia?

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