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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 associated chromosomal translocation - Acute promyelocytic leukemia (M3)
Chromosome 15 - 17
Pseudomonas aeruginosa
Latency stage (6-12 years)
PCT

2. What vessels have the largest total cross - sectional area in systemic circulation?
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Hypotonic - because NaCl is reabsorbed in the salivary ducts
Capillaries
GnRH

3. What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Clostridium perfrigens
They innervate LMNs.
Smooth muscle
Thoracic splanchnic fibers

4. Are white rami preganglionic or postganglionic fibers?
Tensor tympani
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)
Secondary hypoparathyroidism (vitamin D toxicity)

5. What water - associated organism is a weakly stained gram - negative rod that requires cysteine and iron for growth?
Aminoglycosides
Legionella (think air conditioners)
Salmonella
Type II hypersensitivity reaction

6. With What three enzymes is thiamin pyrophosphate (TPP) associated?
Omphalocele and gastroschisis
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 -
Enteroendocrine (EE) cells; they also secrete secretin.
Melasma

7. What is the neurotransmitter at the d - receptor?
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.
Enkephalin
Thoracic and sacral
Short - chain fatty acids

8. What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls?
Acute pyelonephritis
Valine
Fungi
Bronchioloalveolar carcinoma

9. What is the name of the major chemotactic agent released from x Neutrophils?
Major
Blood clots
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
Leukotriene B4 (LTB4)

10. What is the term for repetitive actions blocking recurring bad thoughts?
Transudative; exudative has the opposite values and has an elevated cellular content.
Posterior cricoarytenoid muscles
Atrial contraction Atrial - Contraction - Venous
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.

11. What enzyme of the TCA cycle catalyzes the production of the following: x NADH (hint: 3 enzymes)
Masochism
Basophilic stippling
Clostridium perfringens
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase

12. What three structures increase the surface area of the GI tract?
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.

13. What condition results in the following CSF results? - Opening pressure 100 mm H2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17
Estriol
Viral meningitis
7 years old
Transverse abdominis

14. What a2- antagonist is used to treat impotence and postural hypotension?
Urogenital sinus
Alcohol. Nearly 10% of adults have a problem with alcohol.
Midazolam
Yohimbine

15. What is the only fatty acid that is gluconeogenic?
Axis IV
Propionic acid
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
Immature B cells

16. What is the karyotype in Turner syndrome?
HBcAb IgM
Renshaw neuron
Ketoconazole
45XO

17. What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
Astrocytoma
Vanillylmandelic acid (VMA)
Conus arteriosus of the right ventricle and right and left auricles

18. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Ventral rami?
Both
Pseudomonas aeruginosa
Idiotypes
EBV

19. What triggers phase 0 of the action potential in a ventricular pacemaker cell?
IF and GTP (eIF for eukaryotes)
Calcium influx secondary to slow channel opening
FSH
Ethyl alcohol

20. What CNs are responsible for the sensor and motor components of the light reflex?
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Acute toxic or viral nephrosis
Listeria monocytogenes
Hepadnavirus

21. What thyroid enzyme is needed for oxidation of I- to I'?
Eaton - Lambert syndrome
Osteoclasts
Scleroderma
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell

22. What component of an ECG is associated with the following? - Ventricular repolarization
Flea - bitten kidney (can also be seen in pyelonephritis)
Medial medullary syndrome
Chromomycosis
T wave

23. What is the most common one? - Site for an ectopic abdominal pregnancy
Marfan syndrome
Chromosome 5 - 21
The rectouterine pouch (of Douglas)
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.

24. What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated?
Glossopharyngeal nerve
2 and 5HT3 receptors
Good Samaritan Law. (Physicians are not required to stop and help.)
Methylation of bacterial DNA

25. What must be supplemented in patients with medium - chain acyl CoA dehydrogenase (MCAD) deficiency?
Picornaviridae
Vibrio parahaemolyticus
Short - chain fatty acids
Ulnar nerve

26. What is the most common one? - Form of muscular dystrophy
Duchenne muscular dystrophy
Phosphofructokinase -1 and costs 1 ATP
Hemangioblastoma
Streptococcus pneumoniae

27. What Brodmann area is associated with x Primary auditory cortex?
G-6- PD deficiency
Areas 41 and 42
EBV
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.

28. What seronegative spondyloarthropathy is seen in HLA- B27- positive young men - involves the sacroiliac joints - has no subcutaneous nodules - and has a bamboo spine appearance on radiograph?
1. Cough 2. Coryza 3. Conjunctivitis
A right CN V lesion results in weakened muscles of mastication - and the jaw deviates to the right.
Axis IV
Ankylosing spondylitis

29. What is the effect of LH on the production of adrenal androgens?
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
Chorda tympani of CN VII
RBCs
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.

30. What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
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
CN IV
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
Operant conditioning (reinforcement is after a response)

31. The closure of what valve indicates the beginning of the isovolumetric relaxation phase of the cardiac cycle?
Peau d'orange
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
Prostatic carcinoma
ELISA. It detects anti - p24 IgG.

32. What subset of T cells recognizes the MHC class I Ags?
Class 1 (1A - 1B - and 1C)
CD8+ T cells (cytotoxic) Remember - 8
Marijuana
Neuroblastoma

33. What gram - positive spore - forming anaerobic rod blocks the release of ACh at the NMJ - resulting in reversible flaccid paralysis?
Middle cerebral artery
Clostridium botulinum
They block the midcycle surge of LH.
Merkel cells (Merkel's tactile cells)

34. What three organs are responsible for peripheral conversion of T4 to T3?

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35. What thyroid abnormality has the following? - TRH increased - TSH increased - T4 decreased
Erythema multiforme
Primary hypothyroidism (Low T4 has a decreased negative feedback loop - resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release - respectively.)
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Breast cancer

36. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
Hemangioblastoma
Clonidine
Mees lines

37. Which type of cerebral herniation is associated with CN III palsy?
Coronavirus
Filovirus
Both
Transtentorial (uncal)

38. From What aortic arch are the following structures derived?
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.
Lateral part of the hemispheres
Maxillary artery
wave

39. Name the eukaryotic DNA polymerase based on the following information: x Synthesizes the lagging strand during replication
DNA polymerase - a
Stroke volume
Target cell
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon

40. What are the five tissues in which glucose uptake is insulin independent?
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
Squamous cell carcinoma
Invariant chain
Major

41. Bence - Jones proteinuria
Multiple myeloma
Arthroconidia with hyphae
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Medial nuclear group (limbic system)

42. What gluconeogenic enzyme is absent in muscle - accounting for its inability to use glycogen as a source for blood glucose?
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.
Glucose -6- phosphatase
Niclosamide
Pancreatic delta - cell tumors inhibit CCK secretion

43. Which PG is associated with maintaining a PDA?
Klinefelter syndrome
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Plasma cell
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.

44. What adenocarcinoma presents with elevated levels of acid phosphatase - dihydrotestosterone - PSA - and bone pain?
Interval scale (a ruler - for example)
Prostatic carcinoma
ELISA test
Omega -3; linoleic is omega -6

45. What glial cell is derived from mesoderm and acts as a scavenger - cleaning up cellular debris after injury?
Microglia (Microglia and mesoderm both begin with M)
Medullary carcinoma of the thyroid
Renal plasma flow (decrease flow - increase FF)
Hemiballismus

46. What hypothalamic nucleus is responsible for the production of ADH?
Tetracycline
Axillary nerve and posterior humeral artery
1. Iliocostalis 2. Longissimus 3. Spinalis ('I Love Science' muscles)
Supraoptic nuclei; lesions here result in diabetes insipidus.

47. What is the term for the same results achieved again on testing a subject a second or third time?
Test - retest reliability
Legionella
Uroporphyrinogen I synthetase
Lateral cricoarytenoid muscles

48. What form of endocarditis do patients with SLE commonly encounter?
ACh - histamine - and gastrin
Libman - Sacks endocarditis
Spermatogonia (type B)
Osler nodes

49. What is the valence of an Ig molecule equal to?
Standardized rate
Bronchial asthma (eosinophil membranes)
Hepatitis C
The number of Ags that the Ab can bind

50. Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
Embolic
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.
alpha - Motor neurons innervate extrafusal muscle fibers (a motor unit) - whereas gamma - motor neurons innervate intrafusal muscle fibers.
Mycobacterium marinum