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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. What is the term for a unit of DNA that encodes a particular protein or RNA molecule?
Kayser - Fleischer ring
A gene (a rather simple definition but accurate)
Direct; in males less than 50 years old indirect hernias are the most common type.
P1 protein

2. What component of the cardiovascular system has the largest blood volume? Second largest blood volume?
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Cori cycle
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
The systemic veins have the largest blood volume - and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.

3. A chronic alcohol abuser goes to the ER with weakness - a sore - beefy red tongue - loss of vibration and position sense - arm and leg dystaxia - elevated levels of methylmalonic acid in the urine - and anemia with an MCV above 105 fL. What is your d
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
Tetralogy of Fallot
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working - you will see an increased reticulocyte count on the peripheral smear in about 5 days.
Male pseudohermaphrodite (dude looks like a lady!)

4. What happens to total and alveolar ventilation with x Increased rate of breathing?
As the name indicates - there is no change in volume but there is an increase in pressure.
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).
Volvulus
Proteus

5. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Medical or physical ailments?
Anaerobes
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
There are 10 bronchopulmonary segments on the right and 8 on the left.
Axis III

6. What is the term for the strength of the association between Ag and an Ab?
NE
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
CN IX
Affinity (one of each)

7. Name the area of the cerebral cortex with the function described: x Speech; critical for personality - concentration - initiating and stopping tasks (do one thing and begin a new without completion of the first) - abstract thought - and memory and hi
Burkitt lymphoma
Small cell cancer of the lung
Adult T- cell leukemia
Frontal lobe

8. What happens to the Ab specificity when class switching occurs in mature B cells?
Mode
Glutamine
As the isotype is switched - the Ab specificity does not change because it does not affect the variable chains.
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.

9. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Kidney
Stable
Short - chain fatty acids
Eosin
LTC4 and LTD4

10. What is the term for diffusion of water across a semipermeable or selectively permeable membrane?
Dihydrofolate reductase
Resistance decreases as resistors are added in parallel.
Melanoma - cancer of the stomach and bladder
Osmosis; water will diffuse from higher to lower water concentrations.

11. What is the second leading cause of cancer deaths in males? In females?

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12. What type of random controlled test is least subjective to bias?
Tolcapone and entacapone
Double - blind study. It is the most scientifically rigorous study known.
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
During stage 3 and 4 (remember - it is called deep sleep.)

13. What three factors increase simple diffusion?
Superficial spreading melanoma
The energy of activation (Ea)
Pinpoint pupils - decreased respiratory rate - and coma
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane

14. In What area of the brain can an excess of dopamine lead to psychotic symptoms?
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Chief cells
Mesocortical area

15. What is the most common one? - Site for atherosclerotic plaques in the abdominal aorta
The bifurcation of the abdominal aorta
Endometrial cancer
Impaired ejaculation
At the end of the PCT 25% of the original volume is left

16. What fat - soluble vitamin is connected to selenium metabolism?
IgM
Vitamin E
Dystrophic calcification
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling

17. Is suicidal ideation a component of normal grief?
Dihydropteroate synthetase
Acetyl CoA (pyruvate to acetyl CoA)
It is rare with normal grief; however - it is relatively common in depression
Tetracycline

18. What P value defines whether the hull hypothesis should or should not be rejected?
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.
Alternative hypothesis (What is left after the null has been defined)
Dilation of efferent arteriole
P = .05; P < .05 rejects the null hypothesis

19. What enzyme is essential for the conversion of CO2 to HCO3-?
LTC4 and LTD4
Carbonic anhydrase
Lateral cricoarytenoid muscles
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)

20. Name at least three bacteria that use capsules to prevent immediate destruction from the host's defense system.
Chromosome 15 - 17
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Cerebellum
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus

21. What part of the ANS is affected in the biofeedback model of operant conditioning?
Galactoside permease
The biofeedback model is based on the parasympathetic nervous system.
Increased GABA levels decrease the likelihood of learned helplessness.
Indirect or unconjugated

22. What is the anatomic positioning of the right and left gastric nerve plexus of the esophagus as they pass through the diaphragm?
SER
Menses. (Ovulation occurs 14 days before the beginning of menses.)
Translation
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)

23. What muscle of the middle ear is innervated by CN VII?
The stapedius muscle
Bernard - Soulier syndrome
Voltage - gated calcium channel
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.

24. What small gram - negative aerobic rod requires Regan - Lowe or Bordet - Gengou medium for growth?
Akathisia
4.7 L - 5% of body weight
Bordetella pertussis
Hepatitis B

25. Name the most common type or cause - Meningitis in adults
Chromosome 6
Marfan syndrome
ACL
Pneumococcus

26. What type of spore is defined as an asexual budding daughter yeast cell?
Blastoconidia
4.7 L - 5% of body weight
V wave
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)

27. What type of resistance system - high or low - is formed when resistors are added in a series?
Semicircular canal
MstII; changing codon 6 (from A to T) destroys the restriction site.
A high - resistance system is formed when resistors are added in a series.
Avidity (more than one binding site)

28. What is the major cell membrane sterol found in fungi?
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
The affinity of the drug for its receptor
Th2 cells
Ergosterol

29. Ensures emancipation.
Pregnancy
Chromosome 1
Hapten (not immunogenic)
Serum 25- hydroxy- vitamin D (25- OH- D)

30. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Myelencephalon
CHF
Rhombencephalon
Ipsilateral loss at and below the level of the lesion
Deficiency in surfactant

31. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
rRNA
Tamoxifen
Epinephrine
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.

32. The lack of dopamine production in the substantia nigra leads to the ______________ - characteristically seen in patients with Parkinson's disease.
Affinity decreases; they are inversely proportional.
Ampicillin and amoxicillin
Area 8
extrapyramidal dysfunction

33. Codman triangle on radiograph
Acute toxic or viral nephrosis
Osteosarcoma
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.

34. What rate is indicated by 1- sensitivity?
Hepatocellular carcinoma
relaxation
False - negative rate
Goodpasture syndrome

35. What are the three Bs of adult polycystic kidneys?
Chloramphenicol
Chromosome 21
1. Big 2. Bilateral 3. Berry aneurysm
The cat

36. What is the most common one? - Pancreatic islet cell tumor
IgA
Procainamide
The subclavian artery
Insulinoma

37. How many pairs of spinal nerves are associated with x Coccygeal vertebrae?
Arch of the aorta and right subclavian artery
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.

38. When does the primitive gut herniate out of the embryo? When does it go back into the embryo?
Being single
Aspartame
Neisseria gonorrhoeae and Chlamydia trachomatis
6 weeks 10 weeks

39. Homer - Wright rosettes
Neuroblastoma
Dimercaprol - D- penicillamine
Cocaine
Ipratropium

40. A suspected dermatophyte infection is stained with KOH. What spore type do you expect to see?
Teeth grinding is associated with stage 2 sleep.
Glanzmann syndrome
Bladder cancer
Arthroconidia with hyphae

41. What pathology is associated with podagra - tophi in the ear - and PMNs with monosodium urate crystals?
The stapedius muscle
IgA
Chromosome 4p
Gout

42. Can parents withhold treatment from their children?
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.
Sphingomyelin (lecithin also - but it is not a sphingolipid)
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
Amphotericin B

43. Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
M 2
Rhombencephalon
Metaraminol (a1 - Beta1 )
Antimicrobial agents

44. After traveling in a plane across the Atlantic Ocean - an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose?
NADPH oxidase
Flea - bitten kidney (can also be seen in pyelonephritis)
Since they are independent events - their probabilities would be multiplied.
Pulmonary embolism due to a DVT; this is not absolute but a classic description.

45. What test is used to detect anti - RBC Abs seen in hemolytic anemia?
Concrete operations (6-12 years)
Coombs test
Brain abscess
Obsessive - compulsive

46. What are the three effects of insulin on protein metabolism?
Cerebellum
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
Affinity (one of each)
Streptolysin O

47. Why are clozapine and olanzapine unlikely to result in EPS effects?
Because they do not block D2A receptors - they are antagonists of 5HT2 receptors.
RSV
Right ventricle
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.

48. To what viral family does the polio virus belong?
Hyperventilation - which decreases CO2 - shifting the reaction to the left and decreasing H+
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
Picornaviridae
hnRNA

49. What is the name of the B cell - rich area in the lymph node?
Primary follicle of the cortex
Clear cell
Uracil
Transference. When it is from the physician to the patient it is called countertransference.

50. At What age does a child develop x Exogenous smile?
M- cells
8 weeks (response to a face)
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
Autoimmune hemolytic anemia