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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 area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Euphoria - delusions - thought disorders - Wernicke's aphasia - auditory hallucinations (Hint: the lesion is in the left hemisph
Hirschsprung disease
Trapezius and sternocleidomastoid
Dominant temporal lobe
Being a female physician increases the risk of suicide nearly four times the general population.

2. Name the type of exudate - given the following examples - Parasitic infection
Zollinger - Ellison syndrome
Chromosome 19
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
Eosinophilic exudates

3. What is the size of a positive PPD test for the following? (Reactive) x Recent immigrant from India
>10 mm
C5b - C9
Theca cell
Hypertrophy

4. What are the two side effects of opioids to which the user will not develop tolerance?
Riedel thyroiditis
Toxic or viral hepatitis
Aspartate and carbomoyl PO4
Constipation and miosis

5. What portion of the intervertebral disk is a remnant of the notochord?
Lateral rectus (CN VI) (LR6 SO4)3
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
Nucleus pulposus
Rho-immunoglobin

6. What is the term for the external urethra opening onto the ventral surface of the penis?
Specificity (it deals with the healthy)
Hypospadia
Ergotamines
CSF

7. What Ig activates the alternate pathway - neutralizes bacterial endotoxins and viruses - and prevents bacterial adherence?
Pontocerebellar angle syndrome
The lateral vestibular nucleus
IgA
Xanthine oxidase

8. What is the term for neurologic signs consistent with a cerebrovascular accident but lasting 24 hours with full recovery?
CN I
Transient ischemic attack
Acetaldehyde dehydrogenase
Accuracy (think of it as all the trues - because they are the ones correctly identified)

9. What condition results in the following CSF results? - Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
Osteosarcoma
Nodes of Ranvier
Bacterial meningitis
Oxazepam - temazepam - and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation - not via the cytochrome p450 system.

10. What carpal bone is most commonly fractured? Dislocated?
Yes - it decreases fat and muscle uptake of glucose - thereby increasing blood glucose levels.
Shortens
ACE inhibitors (the - pril agents)
The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated.

11. Why is the apex of the lung hypoventilated when a person is standing upright?
PGD2 - PGE2 - and PGF 2
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
The bifurcation of the abdominal aorta
Herpesvirus

12. What happens to flow and pressure in capillaries with arteriolar dilation? Arteriolar constriction?
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
Diffuse proliferative GN
Liver (hepatocytes)
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.

13. What type of cerebral bleed is due to a rupture of a berry aneurysm in the circle of Willis?
G-6- PD
Acute glomerulonephritis
Fever - night sweats - and hemoptysis
Subarachnoid hematoma

14. What syndrome is characterized by dynein arm abnormality resulting in chronic sinusitis - recurrent pulmonary infections - and infertility?

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15. Is ACh associated with bronchoconstriction or bronchodilation?
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Fc portion of IgG - C3b - and mannose - binding proteins
Atrial contraction Atrial - Contraction - Venous
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)

16. What adrenal enzyme deficiency results in hypertension - hypernatremia - increased ECF volume - and decreased adrenal androgen production?
Lateral collateral ligament
17- alpha - Hydroxylase deficiency
Osteitis fibrosa cystica (von Recklinghausen disease)
Edrophonium

17. What component of the ANS is responsible for dilation of the blood vessels in the erectile tissue of the penis - resulting in an erection?
Dilator pupillae muscle
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
Crohn disease
Parasympathetics (parasympathetics point - sympathetics shoot)

18. What is the respiratory compensation mechanism for metabolic acidosis?
Hyperventilation - which decreases CO2 - shifting the reaction to the left and decreasing H+
HBcAb IgM
Pterygopalatine ganglion (I remember this as the only ganglion left.)
Subarachnoid hemorrhage

19. From the fourth month of fetal life to term - what secretes the progesterone and estrogen to maintains the uterus?
Water - soluble hormones are considered fast - acting hormones.
Fossa ovale
H 2
The placenta

20. Do the following structures pick up stain from hematoxylin or eosin? - Nuclei
Aortic insufficiency
Hematoxylin
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa

21. What fungus is characterized by India ink staining of the CSF that produces colorless cells with a halo on a black background?
Isoniazid
Pedophilia
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
Cryptococcus neoformans

22. Which hepatitis B Ab indicates low transmissibility?
Profound (I.Q. range < 20)
Flocculonodular lobe (one of my favorite words in all of medicine!)
HBeAb
Nicotinic acid - because its side effects include hyperuricemia and exacerbation of ulcers.

23. In a negatively skewed curve is the mean greater than the mode?
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
Albendazole
The fast component is directed toward the affected side of a cerebellar lesion.
Hereditary spherocytosis

24. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CA-19.9 and CEA
Iodine (I)
PGE (along with low oxygen tension)
Pancreatic cancer
Head of the pancreas

25. What AA is a precursor of the following substances? - Serotonin
More Ab is produced in less time in a secondary immune response (shorter lag period).
Superior and posterior
Cystadenoma
Tryptophan

26. Serum concentration of what substance is used as a clinical measure of a patient's GFR?
Metanephros
robenecid - a uricosuric agent
P24
Creatinine

27. Measles - mumps - varicella zoster - and Francisella tularensis.
G0 phase
Are live attenuated vaccines available in the United States
Mycobacterium leprae
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)

28. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Renshaw neuron
Kawasaki disease
The cat
Clonidine

29. What is the term for the round intracytoplasmic eosinophilic inclusions containing ?- synuclein found in the dopaminergic neurons of the substantia nigra?
Left ventricle and tip of right ventricle
Tetralogy of Fallot
Lewy bodies
Increase (5- HT and dopamine levels do the same)

30. Which class of antiarrhythmics are Beta- blockers?
Surface tension; in the alveoli - it is a force that acts to collapse the lung.
cDNA - when it is made from mRNA
Class II
CMV retinitis and HSV-2

31. Name these narcissistic defense mechanisms: x Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.
A positive PPD skin test
GLUT 4
Splitting
Rhinoviruses for summer and fall; coronaviruses for winter and spring

32. What mineral - via excessive depositions in the liver - causes hemochromatosis?
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.
Enkephalins
Iron (Fe)
Pneumococcus

33. What hematologic agent is used in the treatment of intermittent claudication because it decreases blood viscosity and increases RBC membrane flexibility and stability?
The cat
0157:H7
Pentoxifylline
Schwannoma

34. Name the antidote - Opioids
Paramesonephric ducts
Naloxone - naltrexone
Caseous necrosis
The poly(A) site on the DNA

35. What cytoplasmic organelle carries the enzymes for elongation and desaturation of fatty acyl CoA?
Cytochrome a/a3
Valine
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.
SER

36. What viruses are associated with Cowdry type A intranuclear inclusions?
Rectum
Herpes virus I and II
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
11- Beta - Hydroxylase deficiency results in excess production of 11- deoxycorticosterone - a weak mineralocorticoid. It increases BP - Na+ - and ECF volume along with production of adrenal androgens.

37. What stage of male development is characterized by the following LH and testosterone levels? - Decreased testosterone production is accompanied by an increase in LH production.
Biotin. Avidin is found in raw egg whites.
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
G2 phase (gap 2)
Aged adult

38. What two CNs are responsible for the carotid body and sinus reflexes?
Direct; in males less than 50 years old indirect hernias are the most common type.
CN IX and X
pI (isoelectric point)
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.

39. What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
Aromatase
Gonococcus
Adrenarche

40. What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb - containing area?
Target cell
Histidine
Null hypothesis (what you hope to disprove)
C1 inhibitor (C1- INH)

41. What five factors promote turbulent flow?
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
Gluteus maximus
The energy of activation
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.

42. What cell of the male reproductive system produces testosterone?
Inspiratory reserve volume (IRV)
Bordetella pertussis
GP120
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)

43. What is the MCC of death in black males aged 15 to 24?
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.
Mannitol
Homicide. It is also the leading cause of death in black females aged 15 to 24.
Flumazenil

44. Name the type of mutation: x New codon specifies for the same AA
Silent
Cyanocobalamin (B12)
The stapedius muscle
Riboflavin (B2)

45. Name these mature defense mechanisms: x Forgetting on purpose (so you can actually remember it)
Mesencephalic nucleus
Suppression
Norm reference (i.e. - 75% of the students in the class will pass)
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.

46. Are the following major or minor Jones criteria of rheumatic fever? - Migratory polyarthritis
Ferritin
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
Left ventricle and auricle of left atrium
Major

47. Is the hydrophobic or hydrophilic end of the phospholipids of the cell membrane facing the aqueous environment?
Massive influx of calcium
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
Basal cell carcinoma
Sarcoplasmic reticulum

48. Name the neurotransmitter at the neuromuscular junctions for all of the voluntary muscles in the body.
Thymic epithelial cells - dendritic cells - and macrophages
Positive
Filtration; if hydrostatic pressure is less than oncotic pressure - reabsorption is promoted.
ACh; think about the ANS.

49. What is the most stressful event as determined by the Holmes and Rahe scale?
Rabies
Recovery and death
The death of a spouse. The higher the score - the greater the risk of developing an illness in the next 6 months.
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero - order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than i

50. What vessels carry deoxygenated blood into the lungs from the right ventricle?
TCA cycle.
Catatonic schizophrenia
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood
Oligodendroglioma