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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. Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it?
Chromosome 19
More Ab is produced in less time in a secondary immune response (shorter lag period).
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)

2. What form of depression is due to abnormal metabolism of melatonin?
Seasonal affective disorder (treat with bright light therapy)
Gastric ulcer
Serum 25- hydroxy- vitamin D (25- OH- D)
Because it is the largest vessel and has the highest velocity in systemic circulation

3. What IL is essential for lymphoid cell development?
Premature ejaculation
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
IL-7 (A 7 upside down is an L; L is for Lymphoid)

4. Name the antimicrobial agent whose major side effect is listed - Altered folate metabolism
Transient ischemic attack
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
Trimethoprim
hnRNA

5. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Myelencephalon
Argyll Robertson pupils
Rhombencephalon
Fungi
Anemia of chronic disease

6. What AA is a precursor of the following substances? - Histamine
Histidine
Skin - liver - and kidneys
Incidence rate
Mumps

7. Name the most common type or cause - Nonorganic pneumoconiosis
Lisch nodules
Asbestosis
PRPP aminotransferase
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).

8. What component of the ETC is inhibited by the following? - Antimycin A
Cytochrome b/c1
SITS
LH
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)

9. DNA replication occurs During what phase of the cell cycle?
S phase
after abortion
Thymidylate synthase
Posterior

10. Name the structure that enters or exits the following foramina: x Optic canal
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
The limbic system
CN II and ophthalmic artery
CN XI - vertebral arteries

11. What is the term for the first 3 to 5 days of the female reproductive cycle?
Menses. (Ovulation occurs 14 days before the beginning of menses.)
Medial meniscus
Residual volume (RV)
Decreases

12. What segments of the lumbosacral plexus form the following nerves? - Femoral nerve
>5 mm
Pons
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.

13. What is the term to describe basophils that have left the bloodstream and entered a tissue?
Mast cells
Paramesonephric ducts
Waldeyer's ring
Fossa ovale

14. What malignant neoplasm of the bone is associated with Homer - Wright pseudorosettes; onion skinning of the periosteum on radiographs of the femur - pelvis - and tibia; and chromosome 11;22 translocation?

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15. Does the left or right vagus nerve innervate the SA node?
Coronary circulation
Conus arteriosus of the right ventricle and right and left auricles
Right vagus innervates the SA node and the left vagus innervates the AV node
Chromosome 19

16. Name the most common type or cause - Cushing syndrome
Pituitary adenoma
Gain of hypotonic fluid (water intoxication or hypotonic saline)
Virchow triad - associated with the formation of a thrombus.
Nystagmus and ataxia

17. What type of GN - associated with celiac disease and dermatitis herpetiformis - has mesangial deposits of IgA - C3 - properdin - IgG - and IgM?
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Berger disease (IgA nephropathy)
Vitelline fistula
Dynorphin

18. What is the drug of choice for steroid - induced osteoporosis?
Alendronate
Head of the pancreas
Agranulocytosis; approximately 2% develop this side effect.
IDL

19. What fungus is characterized by hypopigmented spots on the thorax - spaghetti - and - meatball KOH staining - and pityriasis or tinea versicolor?
Malassezia furfur (treat with selenium sulfide)
Negative predictive value
Marfan syndrome
CD4+T cells

20. What is the term to describe jumping from one topic to the next without any connection?
HPV
Ticlopidine or clopidogrel
Loose association
GLUT 2

21. Have catalase.
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Wilms tumor
Diazepam is longest acting and midazolam is shortest acting.
Streptococci

22. What is the most common one? - Cardiac anomaly in children
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.
Gluteus maximus
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
PDA

23. Name the most common type or cause - Breast lump in females
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Fibrocystic change of the breast
Coombs test
7 to 14 days

24. What aneurysm of the circle of Willis is associated with polycystic kidney disease?
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
The DCML system. (Remember - everything but pain and temperature.)
Ovarian cancer
Berry aneurysm

25. What muscle type is characterized by low ATPase activity - aerobic metabolism - myoglobin - association with endurance - and small muscle mass?
Bulbus cordis
Opposite the second upper molar tooth
They are in ganglia in the PNS.
Red muscle

26. Where does CHO digestion begin?
Facial expression (the second is vocal intonation)
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+
In the mouth with salivary a - amylase (ptyalin)
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries

27. What is the name of the tumor when gastric carcinoma spreads to the ovaries?
Ventral anterior nucleus
CN III
Krukenberg tumor
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)

28. At the D2A receptor have the capacity to induce pseudoparkinsonism.
Pyelonephritis
Odds ratio. (Case control studies deal with prevalence.)
Dopamine antagonists
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.

29. What genetic defect is characterized by coarse facial features - gingival hyperplasia - macroglossia - psychomotor and growth retardation - club foot - claw hand - cardiorespiratory failure - and death in the first decade of life?
Pergolide
Compliance (think of it as distensibility)
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
Wilson disease

30. After fertilization - what cells of the corpus luteum x Secrete progesterone?
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
Pseudomembranous colitis
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
Site 4

31. What is the size of a positive PPD test for the following? (Reactive) x Recent immigrant from India
>10 mm
Raynaud's phenomenon
Early collecting duct
Moderate (35-49)

32. What are the eight liver - specific enzymes?
Arterioles
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Cytochrome a/a3

33. What type II hypersensitivity disorder is defined as x Autoantibodies directed against RBC Ag I?
Autoimmune hemolytic anemia
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
Polycystic kidney disease of childhood
Type 2

34. What transports iron in the blood?
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
Transferrin
Rabies
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)

35. What disorder is characterized by an alternating pattern of depressed mood with periods of hypomania for more than 2 years?
Lymphoblastic lymphoma
Subacute bacterial endocarditis
Testicular feminization syndrome (Dude looks like a lady!)
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.

36. What segments of the lumbosacral plexus form the following nerves? - Obturator nerve
The conversion of tyrosine to dopamine in the cytoplasm
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.
Sertoli cell

37. 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.
Negative
Foramen of Winslow
Marfan syndrome
Conjugated (direct) hyperbilirubinemia

38. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Benzenes
The inner membrane of the mitochondria (cristae)
Leiomyoma
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
Leukemias

39. What are the five terminal branches of the facial nerve?
Desipramine
Osteoporosis
PGE (along with low oxygen tension)
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)

40. What phase of the cell cycle are the following antineoplastic agents specific for? - Nitrosoureas
Tip of the left ventricle
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
Antidigoxin Fab fragments
G0 phase

41. By What age should children be able to draw the following figures? - Cross
Myasthenia gravis
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember - it may be negative in the first week of the illness - so retest if you have a high index of suspicion.)
4 years old
epithelial lining

42. What drug is used to differentiate a cholinergic crisis from myasthenia gravis?
Ampulla of the fallopian tube
Edrophonium
Borderline
Malpighian layer (made up of the stratum basale and stratum spinosum)

43. 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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44. What fissure of the cerebral cortex runs perpendicular to the lateral fissure and separates the frontal and the parietal lobes?
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP
Central sulcus (sulcus of Rolando)
Achalasia
GP120

45. What is the label given to an individual whose IQ is x 110 to 119
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
X- linked recessive
Schistocytes
High average

46. What is the most common one? - Type of ASD
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III) - B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.
Vibrio parahaemolyticus
Ostium secundum defects
Chromosome 22q

47. What vessel is lacerated in an epidural hematoma?
Cushing's ulcers
Raynaud's phenomenon
Middle meningeal artery
Pneumocystis carinii

48. What virus is associated with body cavity large B- cell lymphomas?
HHV-8
Metastatic calcification
absorption
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -

49. Name the most common type or cause - Meningitis in renal transplantation patients
Listeria monocytogenes
Huntington disease
Hepatitis E
HPV serotypes 16 - 18 - 31 - and 33

50. What chromosome is mutant in patients with cystic fibrosis?
Hematoxylin
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Basophilic stippling
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia