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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. Which anticonvulsant causes gingival hyperplasia?
Priapism
Duodenal atresia
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Insulinoma

2. Pseudopalisades
Glioblastoma multiforme
Obsessive - compulsive
Primary hyperparathyroidism
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe

3. What disorder is due to a 5-- reductase deficiency - resulting in testicular tissue and stunted male external genitalia?
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
Skeletal muscles
Thiazide diuretics
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.

4. What is released from the mitochondria to trigger apoptosis?
Mallory- Weiss syndrome
Streptococcus pneumoniae
Cytochrome c
catalase - negative

5. What are the rules of 2 for Meckel diverticulum?
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors
positive correlation
T3 increases both heart rate and cardiac output by increasing the number of Beta - receptors and their sensitivity to catecholamines.

6. What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
Trypanosoma cruzi
Excision endonuclease - which removes thiamine dimers from DNA
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)

7. What are the primary neurotransmitters at the following sites? - Postganglionic sympathetic neurons
G2 phase (gap 2)
Spironolactone
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
NE

8. What form of endocarditis do patients with SLE commonly encounter?
Anhedonia
Libman - Sacks endocarditis
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)

9. Which shuttle is used to bring fatty acyl CoA from the cytoplasm for ketogenesis?
Silent
Carnitine acyl CoA transferase II
It is rare with normal grief; however - it is relatively common in depression
0.21; it is a fancy way of saying 21% of the air is O2.

10. Which class of antihypertensives produces angioedema - hyperkalemia - and a dry cough?
ACE inhibitors (the - pril agents)
The rectouterine pouch (of Douglas)
Chlamydia psittaci
Rapid efflux of potassium

11. What small gram - negative aerobic rod requires Regan - Lowe or Bordet - Gengou medium for growth?
3 years old
Bordetella pertussis
catalase - negative
Ea (activation energy)

12. What is the name of the process that ensures that each B cell produces only one heavy- chain variable domain and one light chain?
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
CN III
Salmonella
7

13. What is an elevated - fluid - filled cavity between skin layers up to 0.5 cm?
Vesicle (e.g. - poison ivy)
secondary immune response
Alanine and glutamine
Plummer - Vinson syndrome

14. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF normal - capillary pressure ?
Constriction of afferent arteriole
Copper
Rhabdovirus
Supraspinatus and infraspinatus

15. What is the only sphingolipid that contains choline and PO4?
Sphingomyelin (lecithin also - but it is not a sphingolipid)
Chorda tympani of CN VII
CD16 and CD56
Chromomycosis

16. What is the respiratory compensation mechanism for metabolic alkalosis?
Bile salts are actively reabsorbed in the distal ileum.
Ulcerative colitis
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+

17. What myeloid disorder is characterized by increased hematocrit - blood viscosity - basophils - and eosinophils; intense pruritus; and gastric ulcers due to histamine release from basophils - increased LAP - and plethora?
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)
Medial pontine syndrome
Prevalence increases. (Incidence does not change.)
Kl

18. Name the lung measurement based on the following descriptions: x Amount of air in the lungs after maximal inspiration
Linoleic acid and linolenic acid
Chlamydia
Total lung capacity (TLC)
Insulinoma

19. At what vertebral level does the trachea bifurcate?
Ergotamines
Hapten (not immunogenic)
Liver
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).

20. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Placental alkaline phosphatase
Intercellular adhesion molecule (ICAM) 1
Affinity
reflexes
Seminoma

21. Avidin decreases the absorption of what vitamin?
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
Biotin. Avidin is found in raw egg whites.
Splenic flexure
Increase the concentration of enzymes

22. What protein prevents ssDNA from reannealing during DNA replication?
Type III hypersensitivity (immune complex)
Accidents
REM latency; normally it is about 90 minutes.
Single - strand DNA binding protein

23. What thyroid enzyme is needed for oxidation of I- to I'?
Dimercaprol
Kidney
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.

24. What toxin ADP- ribosylates via Gi to increase cAMP?
Fading
Calcarine sulcus
Bacillus cereus
Pertussis toxin

25. What is the effect of insulin on intracellular K+ stores?
Osteosarcoma
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
PGD2 - PGE2 - and PGF 2
Rho (D) immune globulin (RhoGAM) - an anti - RhD IgG antibody - prevents generation of RhD- specific memory B cells in the mother.

26. Myelin is produced by which cells in the PNS? In the CNS?
Hypotonia (rag doll appearance)
Onset of bleeding
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
It forms a germinal tube at 37

27. Is spousal abuse a mandatory reportable offense?
Streptolysin O
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
Confidence interval. It is a way of admitting estimation for the population.

28. What are the two absolute requirements for the cytochrome P450 enzyme system?
Chief cells
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
Positive correlation
NADPH and molecular O 2

29. In which region of the lung are 75% of the pulmonary infarcts seen?
almitate
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
Right - sided valves
Lower lobe

30. What three factors increase simple diffusion?
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
Monosodium urate crystals
1. Cough 2. Coryza 3. Conjunctivitis
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane

31. What is the term for the external urethra opening onto the dorsal surface of the penis?
Stable
Frontal lobe syndrome (lesion in the prefrontal cortex)
Epispadia
INF- gamma

32. What is the only glycosaminoglycan (GAG) that binds to the linker portion of the proteoglycan?
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.
Unconjugated (indirect)
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Hyaluronic acid (all sulfates bind to the core protein)

33. What CNs are affected if there is a lesion in x The upper medulla?
Bcl -2
CN IX - X - and XII
HBcAb IgM - HBV- DNA - HBeAg - HBsAg
It increases REM and total sleep time.

34. What is the only important physiological signal regulating the release of PTH?
Sheehan syndrome
Low interstitial free Ca2+ concentrations
Fibrocystic change of the breast
Pernicious anemia

35. What protein carries free fatty acids to the liver?
Hyperpolarization (i.e. - K+ influx)
Latissimus dorsi
Albumin
Stratum granulosum

36. Name the form of spina bifida - Defect in the vertebral arch
None; they are the storage sites for ADH and oxytocin.
Sphingomyelin (lecithin also - but it is not a sphingolipid)
Total ventilation (minute ventilation or minute volume)
Occulta All except occulta cause elevated - fetoprotein levels.

37. What type of scheduled reinforcement states that after a desired response - the reinforcement is given x Varying in time?
Snails
Variable interval
Strongyloides stercoralis is treated with thiabendazole.
Adenosine (it is an excellent agent to use in emergencies because its half - life is 30 seconds)

38. Name the aphasia based on these characteristics: x Both Broca's and Wernicke's areas damaged by lesion in the presylvian speech area; trouble repeating statements; poor comprehension with telegraphic speech
Global aphasia
Tetralogy of Fallot
Cytochrome a/a3
1. Streptomycin 2. Gentamicin 3. Tobramycin

39. What is the term for a delay in the onset of normal IgG synthesis seen in the fifth to sixth month of life?
Gerstmann's syndrome; spoken language is usually understood.
Urogenital folds
Labile
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.

40. What is the most common form of elderly abuse?
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
Osteosarcoma
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%.
RU 486

41. What ocular muscle x Abducts the eyeball and is involved in horizontal conjugate gaze?
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis - or IHSS)
Lateral rectus (CN VI) (LR6 SO4)3
Somatomedins
Euchromatin - the dark stuff in the nucleus on an electron microscope image.

42. Name the associated chromosome - Cri - du - chat
Isograft
Chromosome 5p
School phobia
HHV 6

43. If the ratio of a substance's filtrate and plasma concentrations are equal - What is that substance's affect on the kidney?
Methylphenidate (Ritalin)
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
Transient ischemic attack
Duodenum

44. What urinary metabolite is elevated in pheochromocytoma?
Malignancy
Vanillylmandelic acid (VMA)
Mean
VIPoma

45. What is a sign of a Sertoli cell tumor in a man?
Staphylococcus aureus
Excess estradiol in the blood
Graves disease
Neisseria meningitides

46. What abdominal muscle runs in a posteroinferior direction - splits to contribute to the rectus sheath - contributes to the formation of the conjoint tendon - and in men gives rise to the middle spermatic fascia and the cremasteric muscle of the sperm
CN VII and VIII
Autosomal recessive
Internal abdominal oblique
Persistent truncus arteriosus

47. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x L- myc
Creatinine
Pheochromocytoma
Small cell cancer of the lung
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.

48. What subset of CD4 helper T- cell function is helping the development of CD8 T cells?
Mast cells
Fanconi - like syndrome
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
Fentanyl

49. What is the label given to an individual whose IQ is x 90 to 109
Average
Arginine
Agglutination test
Small to medium - sized cerebral vessels

50. What is the most common one? - Primary malignant tumor in the liver
Uracil
Proencephalon diencephalon derivative
CML and All
Hepatocellular carcinoma