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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 is the most common one? - Cardiac anomaly in children
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
PDA
Trazodone
Clonidine

2. What disorder is associated with decreased platelet count - prolonged PT and PTT - decreased fibrinogen - and increased fibrin split products (D- dimers)?
HBeAg
MI
Disseminated intravascular coagulation (DIC)
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.

3. What artery supplies the right atrium - right ventricle - sinoatrial and atrioventricular nodes?
Estrogen
Right coronary artery
Conidia
Hepatitis B

4. At what vertebral levels does the aortic arch begin and end?
2 - 4- Dinitrophenol
G-6- PD deficiency
It both begins and ends at T4 (sternal angle [of Louis]).
Smooth muscle

5. What cytokine do Th1 cells secrete to inhibit Th2 cell function?
INF- gamma
Staphylococcus aureus (but they are more prone to salmonella infections)
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
ELISA. It detects anti - p24 IgG.

6. What cell type is commonly elevated in asthma?
Dihydrofolate reductase
Eosinophil
Clostridium perfringens
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.

7. What potentially lethal side effect of clozapine should be monitored with frequent blood drawing?
Vitamin K
Epidermophyton
Agranulocytosis; approximately 2% develop this side effect.
Para - aminohippurate (PAH)

8. What happens to diastolic and systolic intervals with an increase in sympathetic activity?
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
CN III - VII - IX - and X
False - negative rate
Interferons

9. What disorder causes joint stiffness that worsens with repetitive motion - crepitus - effusions - and swelling and commonly affects the knees - hips - and spine?
Lead
Nephrotoxic oxylate stones
Osteoarthritis
Chloramphenicol

10. In what form is excess folate stored in the body?
Area 4
Multiple myeloma
When the intra - alveolar pressure equals zero - there is no airflow.
N-5- methyl THF

11. Name the most common type or cause - Restrictive cardiomyopathy
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Trimethoprim/sulfamethoxazole (TMP- SMX)
Hypertrophy
Amyloidosis

12. What is the term for the load on a muscle in the relaxed state?
Appendix (second is terminal ileum)
Chloral hydrate
Scleroderma
Preload. It is the load on a muscle Prior to contraction.

13. What disease is X- linked recessive - is associated with eczema thrombocytopenia and an increased chance of developing recurrent infections - involves a decrease in serum IgM and in the T cell - dependent paracortical areas of the lymph nodes - and m
Mesothelioma and bronchogenic carcinoma
Yolk sac tumor
Ribonucleotide reductase
Wiskott - Aldrich syndrome

14. Councilman bodies
Mean corpuscular hemoglobin concentration (MCHC)
Toxic or viral hepatitis
HIV
Copper deficiency

15. What enzyme catalyzes the rate - limiting step in fatty acid synthesis?
>5 mm
Acetyl CoA carboxylase
Stimulus control
Liquefaction necrosis

16. What antitubercular agent causes loss of red - green visual discrimination?
Ethambutol
Antisocial
Hemangioma (benign)
Keloid

17. What type of scale is graded into equal increments - showing not only any difference but how much?
Trapezius and sternocleidomastoid
Interval scale (a ruler - for example)
CMV - Toxoplasma gondii - and Listeria
McArdle's syndrome

18. What pneumoconiosis is associated with exposure to the following occupations or materials? - Shipyards - brake linings - insulation - and old building construction
Thymus - independent Ags
Asbestosis
For males it's prostate cancer - and for females it's breast cancer.
Toxoplasma gondii

19. Name the type of exudate - given the following examples - Meningococcal infection
Purulent exudates
Pituitary hypogonadism
Thymus gland. (Thymus gland is essential for T cell maturation.)
Insulinoma

20. How many ATPs per glucose are produced by pyruvate dehydrogenase?
M- cells
VSD - RVH - overriding aorta - and pulmonary stenosis
Plummer - Vinson syndrome
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)

21. What enzyme of cholesterol synthesis is inhibited by the statins?
HMG- CoA reductase
Staphylococcus
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.
Glioblastoma multiforme

22. Patients with ___________ have no Barr bodies.
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
Courvoisier's law
Kawasaki disease
Turner syndrome

23. Name the area of the cerebral cortex with the function described: x Intellectual processing of sensory information - with the left (dominant) processing verbal information - the right processing visual - spatial orientation
Permanent
Parietal lobe
Ipsilateral loss at and below the level of the lesion
Atropine - 2- PAM (pralidoxime)

24. Why is the apex of the lung hypoventilated when a person is standing upright?
Phallus
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
Posterior hypothalamic zones; lesions here result in poikilothermy (environmental control of one's body temperature).
Fibrocystic change of the breast

25. What is the site of action of the following? - Aldosterone antagonists
Distal convoluted tubules
Adult polycystic kidney disease
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
The urea cycle

26. Which virus is treated with the monoclonal antibody palivizumab?
Stable
X- linked dominant
Heroin
RSV

27. What are the three causes of transudate?
0.2
Deferoxamine - penicillamine
CHF - cirrhosis - and nephrosis
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)

28. What is the origin of the polyuria if a patient is dehydrated and electrolyte depleted?
Acanthosis nigricans
Brain abscess
Anterior tibial artery
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.

29. What are the five branches of the superior mesenteric artery?
Apneustic center (deep breathing place)
Duodenum
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Internal carotid artery

30. What renal side effect is commonly seen in patients taking lithium?
Neuroblastoma
Pyloric stenosis
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
Cestodes

31. What foci of fibrinoid necrosis are surrounded by lymphocytes and macrophages throughout all the layers of the heart?
Free ionized Ca2+
Antisocial
Hepatitis C
Aschoff bodies of rheumatic fever

32. What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?
G-6- PD
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.
Boutonni
IgA

33. What is the second leading cause of death in children aged 1 to 14 in the United States?
Cancer
CML and All
Roth spots - and they are seen in bacterial endocarditis.
Meningomyelocele All except occulta cause elevated - fetoprotein levels.

34. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Small prokaryotic cells; no histones; 70S ribosomes; no sterols in cell membrane; peptidoglycans in cell wall; replicate by binary fission
Stable
The bifurcation of the abdominal aorta
Bacteria
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.

35. What area of the limbic system is responsible for attaching emotional significance to a stimulus?
Proencephalon diencephalon derivative
Glioblastoma multiforme
Hypoxia
Amygdala; it helps imprint an emotional response in memory.

36. What area of the small intestine is characterized by Peyer's patches?
Metanephros
Chronic alcoholic
The gut rotates clockwise around the superior mesenteric artery.
Ileum

37. What type of test asks a patient to draw a scene - attempting to find out the individual's unconscious perceptions in his or her life?
Utricle and saccule
Blastoconidia
Enterokinase
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.

38. How many ATPs are hydrolyzed every time a skeletal muscle cross - bridge completes a single cycle?
NADPH oxidase
One - and it provides the energy for mechanical contraction.
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.
Folic acid

39. What a1- agonist is used to treat paroxysmal atrial tachycardia with hypotension?
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Pyrantel pamoate
ACh
Metaraminol (a1 - Beta1 )

40. What is the MCC of cancer mortality in males and females?
Lateral rectus (CN VI) (LR6 SO4)3
Healing by secondary intention
Lung cancer
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma

41. Name the type of mutation: x The deletion or addition of a base
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Type III hypersensitivity (immune complex)
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
Frameshift

42. Describe What type of fluid is either gained or lost with the following changes in body hydration for the ECF volume - ICF volume - and body osmolarity - respectively: x ECF - increase; ICF - decrease; body - increase
Flutamide
Chromosome 22q
Gain of hypertonic fluid (mannitol or hypertonic saline)
Carbidopa and benserazide

43. What abdominal muscle runs horizontally - contributes to the posterior rectus sheath - and contributes to form the conjoint tendon?
Transverse abdominis
No CHO - AA - ketones - or peptides are left in the tubular lumen.
Propofol
Arginine

44. What is the only way to increase O2 delivery in the coronary circulation?
Proencephalon diencephalon derivative
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
Protease - integrase - and reverse transcriptase
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.

45. Name the type of hypersensitivity reaction based on the following properties - Reaction - mediated by sensitized T- cells
Type IV hypersensitivity (cell - mediated)
Areas 18 and 19
Psoriasis - ankylosing spondylitis - inflammatory bowel disease - and Reiter's syndrome
Selegiline

46. What family do the following viruses belong to? - Measles
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
Celecoxib
Ileum
Paramyxovirus

47. What mineral deficiency in children is associated with poor growth and impaired sexual development?
Obese patients
Homocysteine methyl transferase
Zinc (Zn) deficiency
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.

48. What is the only site in the body that uses M1 receptors?
Shortens
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
The stomach

49. What is the most common form of elderly abuse?
4.7 L - 5% of body weight
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
Lente insulin and either NPH or protamine zinc insulin (PZI)

50. Is jugular venous distention a presentation of isolated left or right heart failure?
PR interval
Hypoparathyroidism
Right - sided
Stroke volume

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USMLE Step 1 Prep

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