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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. Name the antidote - Acetaminophen
Bactericidal
Mesencephalon
N- Acetylcysteine
Glioblastoma multiforme

2. What type of jaundice is seen in Dubin - Johnson syndrome?
Conjugated (direct) hyperbilirubinemia - a transport defect
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
All
Galactose and glucose

3. What form of hemophilia is X- linked recessive and due to a deficiency in factor VIII?
Hemophilia A
The pH of CSF is 7.33 - acidotic.
Doxycycline and minocycline
5' deiodinase

4. In what stage of sleep is GH secreted?
Stages 3 and 4 (NREM)
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
CN I - II - III - VI - and XII Add 1 + 1 = 2 - 1 + 2 = 3 - 1 + 2 + 3 = 6 - 1 + 2 + 3 + 6 = 12
Congenital heart disease

5. What seven structures are found in more than one mediastinum?
ELISA test
Remember the mnemonic PAM SMIDT P - (hyper) Parathyroid/ Paget disease A - Addison's disease M - Milk - alkali syndrome/metastatic cancer S - Sarcoidosis M - Multiple myeloma I - Immobilization/idiopathic D - Vitamin D intoxication T - Tumors
Nucleus pulposus
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve

6. You would not prescribe __________ for a patient with gout who is an overexcretor of uric acid.
Huntington's chorea. (Death in 15-20 years - often via suicide.)
Probenecid
Adenovirus
Chromosome 13

7. What ocular ganglion is affected if the pupil on the affected side sluggishly responds to light with normal accommodation?
Cystadenocarcinoma
Ciliary ganglion producing a tonic pupil
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.
Clostridium perfringens

8. In prokaryotes - What is the term for a set of structural genes that code for a select group of proteins and the regulatory elements required for the expression of such gene?
Operon
Ipratropium
Deferoxamine - penicillamine
Lispro insulin

9. What are the two functions of the thymus in T- cell differentiation?
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
Ganciclovir
Metronidazole

10. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Months to years after transplantation; gradual onset of HTN - oliguria - and azotemia; seen as intimal fibrosis of the blood vessels and in
Farnesyl pyrophosphate (FPP)
Areas 1 - 2 - and 3
Pons
Chronic rejection

11. What three chemical agents are associated with angiosarcomas of the liver?
Arsenic - thorotrast - and vinyl chloride
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
Albinism

12. What is the primary target for the action of glucagon?
Liver (hepatocytes)
Test - retest reliability
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.
Lipoid nephrosis

13. Name the lung measurement based on the following descriptions: x The amount of air that enters or leaves the lung system in a single breath
Acute pyelonephritis
Pedophilia
Tidal volume (VT)
Obturator nerve

14. What three lung measurements must be calculated because they cannot be measured by simple spirometry?
Invariant chain
Serous exudates
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern - my senior resident asked me this question more times than I would like to remember.)

15. Which hepatitis B serology markers
HBcAb IgG - HBV- DNA - HBeAg - HBsAg
First - pass metabolism and acid lability
CN IX and X
Estrone

16. What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
Streptomycin
Yolk sac tumor
Boutonni

17. What is the term for the proportion of a drug that reaches systemic circulation?
hCG can be detected in the blood by day 8 and in the urine by day 10.
HBsAg (incubation period)
Normal values
Bioavailability

18. What structure of a protein describes the interaction among subunits?
Quaternary structure
Churg - Strauss syndrome
Staphylococcus aureus
CN V2

19. To What is the diffusion rate indirectly proportional?
Serratus anterior
IF and GTP (eIF for eukaryotes)
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Ulnar to radial progression

20. The inferior mesenteric artery drains into it.
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
Salmeterol
2 - 4- Dinitrophenol
The splenic vein

21. What slow - growing CNS tumor in 30- to 50-year - old patients with a long history of seizures has fried egg cellular appearance in a network of chicken wire?
Oligodendroglioma
Posterior interventricular artery
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Parasympathetics (parasympathetics point - sympathetics shoot)

22. If a virus has positive sense RNA - can it be used as mRNA or is a template needed?
Teeth grinding is associated with stage 2 sleep.
Chylomicrons
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.
CSF

23. What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs?
Auspitz sign
Osteoblasts (Remember - they modulate the function of osteoclasts.)
Rotavirus
IF

24. Does REM deprivation interfere with performance on simple tasks?
The odontoid process of C2
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Smoking
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)

25. What is the term for RBCs with smooth undulations on the surface of their membrane - commonly seen in uremia?
Burr cells (echinocytes)
Where the cell bodies for the DCML and spinothalamic sensory systems are...
Yolk sac tumor
Retinoblastoma

26. Where does the synthesis of ACh occur?
Venlafaxine. (It also has a mild dopaminergic effect.)
Excess estradiol in the blood
Duodenal atresia
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.

27. Name the most common type or cause - Pyogenic osteomyelitis
Histamine
Nigrostriatal pathways (basal ganglia)
Staphylococcus aureus
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids

28. What tetracycline is associated with hepatotoxicity?
Eosin
Proud flesh
Chlortetracycline
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.

29. What factors are needed for elongation in eukaryotes?
Sertoli cell
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.
Carbamoyl phosphate synthetase I
EF-1 and GTP

30. What thyroid enzyme is needed for oxidation of I- to I'?
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
almitate
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell

31. What is the DOC for the following protozoal infections? - Pneumocystis carinii pneumonia
Eosin
The Beta -2- microglobin. It is the separately encoded Beta - chain for class I Ags.
Trimethoprim/sulfamethoxazole (TMP- SMX)
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans

32. In a ventricular pacemaker cell - what phase of the action potential is affected by ACh?
Sheehan syndrome
Saltatory conduction
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance - taking longer to reach threshold and slowing the rate of firing.

33. Name the GLUT transporter based on the following: x Found in most tissues - including brain and RBCs
Glutamine and aspartate
Chromosome 15
GLUT 3 and 4
Yes - because they both activate the BZ1- receptors - which can be reversed by flumazenil.

34. Which two cephalosporins cross the blood - brain barrier?
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Size
Hypoxia
Cefuroxime and cefaclor

35. Name the compartment of the mediastinum associated with the following thoracic structures: Ascending aorta
S phase
Middle
Glanzmann syndrome
The energy of activation (Ea)

36. Results in vitamin B12 malabsorption.
Ulnar and radial arteries (ulnar is the main supplier)
Pancreatic insufficiency
Transvestite fetishism
Pentoxifylline

37. What condition results in the following CSF results? - Opening pressure 250 mm H2O; WBCs 250 (90% lymphocytes); glucose 35; protein 100
TB meningitis
CN XI - vertebral arteries
Staphylococcus aureus
Fructose -1 - 6- bisphosphatase

38. What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament
Wilms tumor
CD3
Fentanyl

39. What is the name of a thin brown ring around the outer edge of the cornea - seen in Wilson's disease?
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
DiGeorge syndrome
Kayser - Fleischer ring
Ticlopidine or clopidogrel

40. Name the most common type or cause - Neonatal septicemia and meningitis
Streptococcus agalactiae (Group B Streptococcus - or GBS)
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs - TCADs - dextromethorphan - and meperidine. Treat it with cyproheptadine.
Basophilic stippling
Schwannoma

41. Name the type of exudate - given the following examples - Diphtheria infection
Pseudomembranous exudates
Melanosis coli
Adenosine deaminase
Clarke's nucleus

42. At what point does the axillary artery become the brachial artery?
Cancer
When it crosses the teres major
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 -
Ipratropium

43. When do hCG concentrations peak in pregnancy?
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
Pedophilia
Myasthenia gravis
In the first 3 months

44. What is the DOC for CMV retinitis?
G2 phase
Nitrates
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.
Ganciclovir

45. Name the phase of the eukaryotic cell cycle: x Period of DNA replication (preparing for mitosis)
Prodrugs
S phase
Albinism
2.0 or greater

46. What AA is the major carrier of nitrogen byproducts from most tissues in the body?
HPV serotypes 16 - 18 - 31 - and 33
Glutamine
Specific rate (e.g. - men aged 55-60)
0.2

47. Regarding the Lac operon - for What do the following genes code? - Z gene
Dissociation
Heart disease
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
Beta- Galactosidase

48. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - aggression - inability to learn new material - and memory problems
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Flumazenil
Limbic system
More Ab is produced in less time in a secondary immune response (shorter lag period).

49. What childhood pathology involves anterior bowing of the tibia - epiphyseal enlargements - and costochondral widening - with the endochondral bones being affected?
Rickets
For males - HTN; for females - pregnancy.
pI (isoelectric point)
Coprophilia

50. In a negatively skewed curve is the mean greater than the mode?
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Multiple myeloma
Cytochrome c
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.