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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. Which class of antiarrhythmics are potassium channel blockers?
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
Bender Visual Motor Gestalt Test
Pyloric stenosis
Class III

2. What is the only muscle of the soft palate that is innervated by CN V3?
Both Neisseria and Moraxella are gram - negative cocci.
Crossover study
Flumazenil
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.

3. What reflex - seen in lesions of the corticospinal tract - is an extension of the great toe with fanning the of remaining toes?
TB meningitis
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse - hyperreflexia - spastic paralysis - increased muscle tone - and weakness are commonly seen in UMN lesions.
Combined metabolic and respiratory acidosis
Small to medium - sized cerebral vessels

4. Name at least three bacteria that use capsules to prevent immediate destruction from the host's defense system.
Succinate dehydrogenase
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
Amiloride

5. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
With arteriolar constriction both the flow and pressure downstream decrease.
Trazodone
Residual volume
Contralateral loss below and bilateral loss at the level of the lesion

6. What is the most important stimulus for the secretion of insulin?
An increase in serum glucose levels
Dependent
Blastomyces dermatitidis
Abs to HBsAg

7. What is the name of the B cell that secretes Ig?
Pneumococcus
Trimethoprim/sulfamethoxazole (TMP- SMX)
Plasma cell (mature B lymphocyte)
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.

8. What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
embranoproliferative glomerulonephritis (MPGN)
Terbinafine
Autosomal dominant
HIV

9. Is seen in TB.
Monocytosis
Propranolol
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
>10 mm

10. What intermediate of cholesterol synthesis anchors proteins in the membranes and forms CoA?
Pedophilia
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
More than 75% of the vessel
Farnesyl pyrophosphate (FPP)

11. What disorder leads to IgG autoantibodies to the TSH receptor?
Myasthenia gravis
Lipoprotein lipase
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Graves disease

12. What is the most common one? - Malignant tumor in women
Breast
Duchenne muscular dystrophy
G0 phase
Dopamine

13. What CNs are affected if there is a lesion in x Pontomedullary junction?
CN VI - VII - and VIII
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Cystadenoma
Humor

14. What is the most common one? - Thyroid cancer
Papillary carcinoma
snRNA
Bipolar disorder (manic - depressive disorder)
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. What two enzymes of heme synthesis are inhibited by lead?
Pregnancy
Prevalence increases. (Incidence does not change.)
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
ALA dehydrogenase and ferrochelatase

16. In what stage of sleep is it easiest to arouse a sleeping individual?
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Luteal phase
During REM sleep
Chromosome 5p

17. What is the term for RBCs with smooth undulations on the surface of their membrane - commonly seen in uremia?
Burr cells (echinocytes)
More than 75% of the vessel
Areas 18 and 19
Iodine (I)

18. What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?
Parvovirus
Separation anxiety
>15 mm
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.

19. With which pituitary adenoma is an elevated somatomedin C level associated?
Labile
Escherichia coli
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
GH- producing adenoma

20. At the level of rib 6 - the internal thoracic artery divides into What two arteries?
Cardiac muscle
Musculophrenic and superior epigastric arteries
8 to 25 hours
von Gierke's disease

21. How many pairs of spinal nerves are associated with x Cervical vertebrae?
GnRH constant infusion
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
relaxation
LH

22. What are the pharmacologic effects seen sexually with x Dopamine agonists?
Choriocarcinoma
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
Increased erection and libido
Strongyloides stercoralis is treated with thiabendazole.

23. What type of cell surface projection lies on the lateral surface of cells closest to the apex and acts to seal off the outside environment from the rest of the body?
gram positive
MstII; changing codon 6 (from A to T) destroys the restriction site.
Zonula occludens (tight junctions)
Huntington disease

24. What type of membrane is characterized as being permeable to water only?
Prinzmetal variant angina
Huntington's chorea. (Death in 15-20 years - often via suicide.)
Osteoblast (Remember - blasts make - clasts take)
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.

25. Ophthalmic artery is a branch of What artery?
Glucagon and epinephrine
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Granulosa cells
Internal carotid artery

26. What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur - humerus - and tibia?
Caisson disease
Inferior rectus (CN III) (LR6 SO4)3
Schistosoma have separate males and females.
Cancer

27. What phase of the cell cycle are the following antineoplastic agents specific for? - 6- Mercaptopurine
Suprachiasmatic nucleus
Granulosa cell
Scrotal cancer - due to the high exposure to polycyclic aromatic hydrocarbons
S phase

28. What form of bias occurs when the experimenter's expectation inadvertently is expressed to the subjects - producing the desired effects? How can it be eliminated?
Type IV collagen
Respiratory depression
epithelial lining
Pygmalion effect (experimenter expectancy). This can be eliminated with double - blind studies.

29. What are the three mechanisms of action for atrial natriuretic peptide's diuretic and natriuretic affects?
Pirenzepine
Fc portion of IgG - C3b - and mannose - binding proteins
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.

30. Bence - Jones proteinuria
Monosodium urate crystals
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
Multiple myeloma
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)

31. Leading to gallstones and steatorrhea.
Proencephalon diencephalon derivative
Water soluble
1. Skin 2. Liver 3. Kidney
Pancreatic delta - cell tumors inhibit CCK secretion

32. With a decrease in arterial diastolic pressure - what happens to x Heart rate?
Western blot
Middle meningeal artery
Middle
Decreases

33. What generate anterograde transport of information in a neuron?
Kinesins. Dynein generates retrograde transportation of information.
Spleen
HPV
The hallmarks of LMN lesion injury are absent or decreased reflexes - muscle fasciculations - decreased muscle tone - and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget - LMN lesions are ipsilateral at the level of the

34. Name the most common type or cause - Rectal bleeding
Stretch receptors prevent overdistension of the lungs during inspiration.
Burkitt lymphoma
Diverticulosis
CD28

35. What is the only CN to arise from the dorsal surface of the midbrain?
Actually - yes. You should encourage your patient to try other forms of medicine as long as they are not contraindicated with the patient's preexisting illness. You must be able to accept the health beliefs of your patients - even if you don't agree.
Major
CN IV
Schwannoma

36. How many major and/or minor Jones criteria are required for the diagnosis of rheumatic fever?
Afterload
Pontocerebellar angle syndrome
Staphylococcus
Two major or one major and two minor

37. What artificial sweetener must patients with PKU avoid?
Aspartame
Ventricular fibrillation (V fib)
Direct; in males less than 50 years old indirect hernias are the most common type.
Primary hypogonadism (postmenopausal women)

38. What is the term for the dementia characterized by decremental or patchy deterioration in cognitive function due to a cerebrovascular accident?
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
LTB4
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
Celiac sprue (gluten - sensitive enteropathy)

39. Name the lung measurement based on the following descriptions: x Amount of air in the lungs after maximal expiration
Residual volume (RV)
The aorta
Coxsackie B
Ligamentum venosum

40. At which three sites in the body is T4 converted to T3?

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41. What form of immunity is responsible for removal of intracellular infections?
Cell - mediated immunity
Megaloblasts
Amnesia. (The person is aware of the memory loss.)
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.

42. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 23/2n
Subacute bacterial endocarditis
Secondary spermatocyte
Mentally disabled
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve

43. Schiller - Duval bodies
Shaping (successive approximation)
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Yolk sac tumor

44. What mast cell mediator is a chemotactic agent?
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
HMP shunt
Roth spots - and they are seen in bacterial endocarditis.
Eosinophil chemotactic factor A

45. What are the most common causes of osteomyelitis x Overall?
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.
Class IV
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
Staphylococcus aureus

46. What two pituitary hormones are produced by acidophils?
Coxiella burnetii
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
GH and prolactin are produced by acidophils; all others are by basophils.
False - negative rate

47. What is the term for ascending bacterial infection of the renal pelvis - tubules - and interstitium causing costovertebral angle tenderness - fever - chills - dysuria - frequency - and urgency?
Seminoma
Mercury
Pyelonephritis
Hemostasis

48. How does ventricular depolarization take place - base to apex or vice versa?
Listeria
Depolarization is from apex to base and from endocardium to epicardium.
Minimal change disease
Filtration is greater than excretion for net reabsorption to occur.

49. What disease is described by the following characteristics: multiple motor and vocal tics - average age of onset 7 - a M:F ratio of 3:1 - and association with increased levels of dopamine?

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50. What nerve supplies taste sensation to the anterior two - thirds of the tongue?
Zonula occludens (tight junctions)
A transport maximum (Tm) system
Chorda tympani of CN VII
Ego syntonic