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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 ejaculation before or immediately after vaginal penetration on a regular basis?
Vitamin D
Purulent exudates
Premature ejaculation
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.

2. Leukopenia - neutropenia - and mental deterioration are signs of what mineral deficiency?
Positive predictive value
Copper
Protamine sulfate
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion

3. What type of erythema do you see in x Ulcerative colitis?
RSV
Erythema nodosum
Th2
Ulcerative colitis

4. What Brodmann area is associated with x Wernicke's area?
Enterokinase
Area 22 and occasionally 39 and 40
1. Glycine 2. Aspartate 3. Glutamine
Rho-immunoglobin

5. What is the term for the difference between systolic and diastolic pressures?
Pulse pressure
Constipation and miosis
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
Expiratory reserve volume (ERV)

6. Name the associated chromosome - VON Hippel - Lindau disease
Alcohol. Nearly 10% of adults have a problem with alcohol.
Sarcoplasmic reticulum
Hemophilia B
Chromosome 3p

7. Name the most common type or cause - Subacute bacterial endocarditis
Streptococcus viridans
Goodpasture syndrome
Somatoform disorder
Paget disease of the breast

8. What is the most common genetic deficiency resulting in hemolytic anemia?
rRNA
Nocardia asteroides
G-6- PD deficiency; pyruvate kinase deficiency is second.
Turcot syndrome

9. Are used in diagnosing CREST syndrome.
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.
Hypocalcemia and hypophosphatemia
An elevated serum osteocalcin level
Anticentromere Abs

10. How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery?
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.
Mees lines
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.
Pseudomonas aeruginosa

11. Name the antimicrobial agent whose major side effect is listed - Auditory toxicity
Sensory
Vancomycin
Neutropenia - splenomegaly - and rheumatoid arthritis
Left abducens nerve

12. What bacterium is a gram - negative - oxidase - positive aerobic rod that produces a grapelike odor and pyocyanin pigmentation?
1. Liver 2. Muscle 3. Adipose tissue
Pseudomonas aeruginosa
Labile
CML

13. What are the pharmacologic effects seen sexually with x Trazodone?
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Coxiella burnetii
Transvestite fetishism
Priapism

14. What eukaryotic translation enzyme is associated with the following: x Elongation
Superior
eEF-1
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.

15. If you double the infusion rate of a drug - how long will it take to reach steady state?
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
>15 mm
Third week; they are derived from the wall of the yolk sac.
Selegiline

16. Name the Hgb - O2 binding site based on the following information: x Requires a PO2 level of 40 mm Hg to remain attached
Rationalization
Fixed ratio (rewards set behaviors)
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
Site 3

17. What malignant bone tumor is associated with familial retinoblastoma?
Beta2- integrins
Diverticulosis
Avidity. There is a positive correlation between valence numbers and avidity.
Osteosarcoma

18. What is the most common cancer diagnosed in men? In women?
Schwannoma
In men it is prostate cancer - and in women it is breast cancer.
Copper
Lesch - Nyhan syndrome

19. What enzyme is deficient in the following glycogen storage disease? - Hers' disease
Specificity (it deals with the healthy)
Acetyl CoA - FADH2 - and NADH
Hepatic glycogen phosphorylase
Carbamazepine

20. With an increase in arterial systolic pressure - what happens to x Vessel compliance?
Decreases
Klinefelter syndrome
Polycystic ovaries
Peau d'orange

21. What class of antianginal activates the NO pathway to produce endothelial vasodilation?
Nitrates
5HT1D
Mycoplasma pneumoniae
Preoperational (2-6 years)

22. What is the name of inflammation of the prepatellar bursa?

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23. What forms of fatty acids are absorbed from the small intestine mucosa by simple diffusion?
Microcytotoxic assay
Short - chain fatty acids
Alendronate
Parvovirus B-19

24. What level of mental retardation is characterized by x Needing a highly structured environment with constant supervision?
Cones (C for color and cones)
Clindamycin
Profound (I.Q. range < 20)
Positive

25. Increases your risk of suicide.
Being single
Paneth cells
Duchenne muscular dystrophy
Sporozoites

26. Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium?
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)
Liver - kidney - and GI epithelium
Carbamazepine
The central vein of the liver lobule

27. What cytoplasmic organelle carries the enzymes for elongation and desaturation of fatty acyl CoA?
Erythema multiforme
Onset of bleeding
Series circuit
SER

28. What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
Clozapine
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Pseudomonas aeruginosa
Hepatitis A

29. What cystic swelling of the chorionic villi is the most common precursor of choriocarcinoma?
Thoracic splanchnic fibers
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Chromosome 19
Hydatidiform mole

30. What type of Ag do B cells recognize?
Free - unprocessed Ag
Western blot
Lateral cricoarytenoid muscles
Bacillus cereus

31. What cell in the heart has the highest rate of automaticity?
SA node; it is the reason it is the primary pacemaker of the heart.
Chromaffin cells (adrenal medulla)
Cystadenocarcinoma
S phase

32. Name the antimicrobial agent whose major side effect is listed - CN VIII damage (vestibulotoxic)
Cytochrome a/a3
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.
Aminoglycosides
Takayasu arteritis (medium - size to large vessels)

33. What cells are atypical on a peripheral blood smear in heterophil - positive mononucleosis?
Follicular lymphoma
Mycobacterium marinum
T cells - not B cells
Congenital heart disease

34. What are the pharmacologic effects seen sexually with x Neuroleptics?
Erectile dysfunction
G0 phase
The courts. These are legal - not medical terms.
Lac repressor protein

35. What hormone level peaks 1 day before the surge of LH and FSH in the female cycle?
Intraductal papilloma
Nonsense
Estradiol
Taenia saginata

36. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x cyclin D
Mantle cell lymphoma
Zinc (Zn) deficiency
Increase the concentration of enzymes
Erectile dysfunction

37. What is a plasma cell's life expectancy?
Rheumatoid arthritis
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
The splenic vein
7 to 14 days

38. What is the most serious form of tinea capitis - which results in permanent hair loss and is highly contagious?
Microcytotoxic assay
von Gierke's disease
Tinea favosa (favus)
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus

39. By What age should children be able to draw the following figures? - Cross
4 years old
eEF-1
Sertoli cell
Nephroblastoma

40. What atypical pneumonia can be diagnosed with elevated cold agglutinin titers?
Hereditary spherocytosis
Mycoplasma pneumoniae
Abs to HBsAg
Flumazenil

41. What is the term for the round intracytoplasmic eosinophilic inclusions containing ?- synuclein found in the dopaminergic neurons of the substantia nigra?
Lewy bodies
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
apo A-1
Cocaine

42. What is the term for the copper corneal deposits found in Wilson's disease?
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
REM sleep. Nightmares are frightening dreams that we recall.
In early- morning sleep - usually between the sixth and eighth hours
Kayser - Fleischer rings

43. Are the following conditions associated with a negative or positive nitrogen balance? - Recovery from injury
The first trimester
Edrophonium
Left homonymous hemianopsia
Positive

44. What three structures increase the surface area of the GI tract?
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
LGB (think EYES)
ELISA test
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)

45. Are the following parameters associated with an obstructive or restrictive lung disorder: decreased FEV1 - FVC - peak flow - and FEV1/FVC; increased TLC - FRC - and RV?
Hemiazygous vein
Gastric cancer
The lung will expand; also the opposite is true.
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.

46. What is the name of the postganglionic parasympathetic ganglion that innervates x The papillary sphincter and ciliary muscle of the eye?
Superior
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)

47. What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Lymph nodes
Risk factors for cervical cancer
Transitional cell carcinoma
Terbinafine

48. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH
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.
N-5- methyl THF
Squamous cell carcinoma
Pituitary hypogonadism

49. What direct - pathway basal ganglia disease is described by masklike facies - stooped posture - cogwheel rigidity - pill - rolling tremor at rest - and a gait characterized by shuffling and chasing the center of gravity?

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50. What two factors result in the base of the lung being hyperperfused?
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
Chlortetracycline
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Copper