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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 most common cause - Infectious pancreatitis
Orbitomedial frontal lobe
a - Methyldopa (Guanabenz or clonidine is also used.)
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
Mumps

2. What is the term for inflamed - thickened skin on the breast with dimpling associated with cancer?

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3. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ decreased - Pi decreased
Bulbus cordis
Depolarization (i.e. - Na+ influx)
The T- test (used when comparing two groups)
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)

4. Which class of antiarrhythmics blocks sodium channels?
Class 1 (1A - 1B - and 1C)
robenecid - a uricosuric agent
Rhombencephalon
Scavenger receptor (SR- B1)

5. What two AAs act as excitatory transmitters in the CNS - generating EPSPs?
CD4+ T cells (helper)
Passive - aggressive
Left homonymous hemianopsia
Glutamine and aspartate

6. What Hgb - derived endogenous pigment is found in areas of hemorrhage or bruises?
Physostigmine
Hemosiderin
gram positive
Calcium influx secondary to slow channel opening

7. What three criteria allow you to differentiate an ulcer from an erosion or carcinoma?
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Right brachiocephalic artery
Left atrium
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa

8. Name the most common type or cause - Hematuria
CN II and ophthalmic artery
Elongation factor - G and GTP
Infection
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

9. What Enterobacteriaceae are prone to produce osteomyelitis in sickle cell patients?
Preload. It is the load on a muscle Prior to contraction.
Succinate dehydrogenase
Salmonella
Chromosome 9 - 22 (Philadelphia chromosome)

10. What two cell lines of the immune system do not belong to the innate branch?
Lower lobe
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.
Because creatinine is filtered and a small amount is secreted
Alveoli; they are part of the respiratory portion.

11. What type of drug elimination is characterized by the following? - Elimination independent of plasma concentration; constant amount eliminated per unit time; no fixed half - life
Kupffer cells
Zero - order elimination
Primary follicle (in the white pulp)
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.

12. Which IL increases IgA synthesis?
X- linked dominant
IL-5. It also stimulates eosinophil proliferation.
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
Low molecular weight heparin (LMWH)

13. Name the hypochromic microcytic anemia based on the following laboratory values - Normal iron - TIBC - percent saturation - and ferritin
Pygmalion effect (experimenter expectancy). This can be eliminated with double - blind studies.
Thalassemia minor
Yohimbine
M

14. What nerves provide sensory innervation above the vocal cords? Below the vocal cords?
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
Ixodes (also the vector for Lyme disease)
HGPRT
Reject it

15. What toxicities are caused by the following agents? - Methoxyflurane
Th2 cells
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.
Nephrotoxicity
Pneumothorax

16. Name the hormone
Chi - square (when you are in doubt and have nominal data - use chi - square)
Internal abdominal oblique
Glucagon
HMG- CoA reductase

17. What personality disorder affects 75% of the prison population?
C3b
Antisocial personality
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
Transference. When it is from the physician to the patient it is called countertransference.

18. What fructose metabolism enzyme is deficient in patients with vomiting - apathy - diarrhea - jaundice - proximal renal tubular acidosis - hypoglycemia - and hyperuricemia?
Down syndrome
Bcl -2
Aldolase B deficiencies are treated by eliminating fructose from the diet.
Mumps and influenza virus

19. What is the name of the protein coat that surrounds the nuclear envelope?
CN IX - X - and XII
Vimentin
Bronchogenic carcinoma
MHC class I antigens; they are also found on the surface of platelets.

20. What gram - positive anaerobic rod with branching filaments is a component of the normal flora of the mouth and female genital tract and is responsible for draining abscesses with sulfur granules in the exudates?
Rhinovirus and hepatitis A virus
Secondary hypoparathyroidism (vitamin D toxicity)
Dependent
Actinomyces israelii

21. What is the greatest component of lung recoil?
The conversion of CHO to pregnenolone via the enzyme desmolase
14 days in most women (Remember - the luteal phase is always constant.)
H1 histones
Surface tension; in the alveoli - it is a force that acts to collapse the lung.

22. What is the most common one? - Benign tumor of the breast
Fibroadenoma
Chromosome 15 - 17
Dorsal motor nucleus of CN X
In the first 3 months

23. Inhibition of peripheral COMT - allowing increased CNS availability of L- dopa - is accomplished by What two agents?
CCK stimulates the pancreas to release amylase - lipase - and proteases for digestion.
Tolcapone and entacapone
Cestodes
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)

24. Name the thalamic nucleus based on its input and output - Input from the optic tract; output projects to the primary visual cortex of the occipital lobe
Rifampin
LGB (think EYES)
Medial nuclear group (limbic system)
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels

25. What is the only CN to arise from the dorsal surface of the midbrain?
Neisseria meningitidis
Cocaine - induced coronary ischemia
CN IV
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.

26. What hormone acts on Granulosa cells?
FSH
Fixation (arrested development)
Creutzfeldt - Jakob disease
Giardia lamblia (treat with metronidazole)

27. What is the name of a thin brown ring around the outer edge of the cornea - seen in Wilson's disease?
Simon focus
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum
Kayser - Fleischer ring
Flutamide

28. Increases the risk of developing ovarian cancer.
Estrogen use
Increase enzyme concentrations
Hyperplasia
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.

29. Name the most common cause - Insomnia
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Alzheimer disease
Dysplasia
Depression

30. What infection is associated with ring - enhancing lesions seen on computed tomography (CT) of the brain in an HIV- positive individual?
Anterior hypothalamic zone; lesions here result in hyperthermia.
a -1 - 6 transferase
Biofeedback
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)

31. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Personality and mental disorders?
HMP shunt
Axis II
Frotteurism
prior to birthThe foramen ovale closes just...

32. What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities - red cell aplasia - and muscle weakness?
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
5 years old
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
Myasthenia gravis

33. What is the drug of choice for treating Tourette syndrome?
Enkephalin
Pimozide
X- linked dominant
Voltage - gated calcium channel

34. What protein carries free fatty acids to the liver?
Biotin - ATP - and CO2
Constipation and miosis
Albumin
Hypnozoite

35. What form of angina is characterized by x Coronary artery luminal narrowing - symptom occurrence during exertion - ST segment depression on ECG?
Minimal change disease
Stable angina
Chloramphenicol
Rectum

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

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37. If a virus has positive sense RNA - can it be used as mRNA or is a template needed?
Teratoma (dermoid cyst)
Adipose tissue
Terminal bronchioles. (No gas exchange occurs here.)
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.

38. What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
Kimmelstiel - Wilson disease
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
Wernicke's aphasia

39. Name the area of the cerebral cortex with the function described: x Skill - based memory - verbal recall - balance - refined voluntary movements
Osteosarcoma
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.
Cerebellum
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.

40. What AA undergoes N- glycosylation?
Asparagine
Protamine sulfate
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
They are in ganglia in the PNS.

41. In what compartment of the thigh is the profundus femoris artery found?

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42. 1- a - Hydroxylase activity is increased in response to What two physiologic states? (hint: think of vitamin D activity)
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 -
The resistance will decrease one - sixteenth of the original resistance.
HPV
Hypocalcemia and hypophosphatemia

43. In eukaryotes - What transcription factor binds to the TATA box before RNA polymerase II can bind?
Major
Transcription factor IID
Patau syndrome (trisomy 13)
give a warning

44. Name the most common cause - A cold in the spring and fall
All
Rhinovirus
Farnesyl pyrophosphate (FPP)
Glutamate

45. How long after ovulation does fertilization occur?
Urogenital sinus
Avidity (more than one binding site)
8 to 25 hours
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)

46. What glycoprotein allows platelets to adhere to von Willebrand factor?
The muscle's ATPase activity
GP Ib
Melanocytes
Alzheimer disease

47. What are the top three causes of infant mortality?
REM sleep. Remember - awake brain in a sleeping body.
ICF volume decreases when there is an increase in osmolarity and vice versa.
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
Papillary carcinoma of the ovary

48. What is the most common primary diagnosis resulting in an office visit for males? For females?
Metronidazole
CN II and ophthalmic artery
Mannitol
For males - HTN; for females - pregnancy.

49. Senile plaques
Alzheimer disease
Superior Oblique (CN IV) (LR6 SO4)3
Social learning theory
Cricothyroid muscles

50. What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN - hypokalemia - and low rennin levels?
LH
Conn syndrome (primary hyperaldosteronism)
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
Sj