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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 a - blocking agent is used to treat refractory hypertension and baldness?
S phase
Minoxidil (orally and topically - respectively!)
ELISA. It detects anti - p24 IgG.
Axis III

2. Name the hypochromic microcytic anemia based on the following laboratory values - Increased iron - decreased TIBC - increased percent saturation - increased ferritin
Proximal to distal progression
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
Nystagmus and ataxia
Sideroblastic anemia

3. What facultative gram - negative anaerobic rod is motile - ferments lactose - and is the MCC of UTIs?
Escherichia coli
Janeway lesions
Anemia
Lateral collateral ligament

4. A migrating myoelectric complex is a propulsive movement of undigested material of undigested material from the stomach to the small intestine to the colon. During a fast - What is the time interval of its repeats?
Ependymoma
IgA
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
Ethyl alcohol

5. What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Paramesonephric ducts
Catalase - negative bacteria secrete H2O2 as a byproduct (remember - catalase breaks down H2O2) - allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase - positive bacterial infect
refuse

6. What is the term for transverse bands on the fingernails seen in patients with chronic arsenic poisoning?
Occipital lobe
IGF-1
Diacylglycerols and phosphatidic acid
Mees lines

7. Name the lipoprotein based on the following characteristics - apo B-100
LDL
Osmosis; water will diffuse from higher to lower water concentrations.
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
At least 5 lobes

8. What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
Poxvirus
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
Hepatitis E (enteric)
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.

9. What muscles in the hand adduct the fingers?
Encapsulated bacteria
CN IX
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
Urophilia

10. What encephalitis is associated with the JC virus?
Progressive multifocal leukoencephalopathy
HBsAg and HBeAg
HBeAb
Where the cell bodies for the DCML and spinothalamic sensory systems are...

11. What two factors influence low oral bioavailability?
First - pass metabolism and acid lability
IL-4
Procainamide
Zero - order elimination

12. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - aggression - inability to learn new material - and memory problems
Limbic system
Repolarization is from base to apex and from epicardium to endocardium.
Outside the cell
Phase I

13. What cycle is responsible for converting to glucose in the liver the lactate produced in the RBCs?
Cori cycle
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
Pseudomonas aeruginosa
The entire tubule barring the thick ascending limb

14. What phase of the female cycle occurs during days 1 to 15?
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
Alteplase
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
Follicular phase

15. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH decreased - Ca2+ decreased - Pi increased
They block the midcycle surge of LH.
The increased H+ moves intracellularly and is buffered by K+ leaving the cells - resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis - even though the serum
Cones (C for color and cones)
Primary hypoparathyroidism

16. What purine base is contained in inosine monophosphate?
VSD - RVH - overriding aorta - and pulmonary stenosis
Type IV hypersensitivity (cell - mediated)
Superior and posterior
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)

17. What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
Marrow failure - cancer - and leukemia
Histidine
Ethyl alcohol
Nodes of Ranvier

18. What is the most common one? - Primary malignant tumor of the female genital tract in the United States
Adenocarcinoma of the cervix
Parasympathetics (parasympathetics point - sympathetics shoot)
Iatrogenesis
Posterior

19. What is the pyrimidine intermediate that joins PRPP (5- Phosphoribosyl -1- Pyrophosphate)?
Cross - sectional studies determine prevalence - not incidence or cause and effect.
Orotic acid (purine metabolism)
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Increased leukocyte alkaline phosphatase (LAP)

20. Name the cluster C personality disorder: x Gets others to assume responsibility - is subordinate - and is fearful of being alone and caring for self
The fasciculus cuneatus
Dependent
Increased androgen secretion at puberty drives the increased GH secretion.
Ipratropium

21. What is the term for having fantasies or dressing in female clothes for sexual arousal by heterosexual men?
Menstruation
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
Transvestite fetishism
Mitochondria

22. What embryonic structure forms the adult female structures? - Gartner's duct
Mesonephric duct
Primary hyperparathyroidism
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci

23. Name the most common type or cause - Nonorganic pneumoconiosis
Preload. It is the load on a muscle Prior to contraction.
Asbestosis
For the USMLE Step 1 the answer is no - but if the information would do more harm than good - withhold. This is very rare but it does occur.
Antimicrobial agents

24. What is the term for an inhibited female orgasm?
Anorgasmia. (The overall prevalence is 30%.)
Neuroblastoma
The Purkinje cell
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.

25. In what form are triglycerides sent to adipose tissue from the liver?
LTB4
VLDLs
Topoisomerase I (Relaxase)
Cancer of the lung - stomach - colon - and breast

26. Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
Nephroblastoma
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
almitate
Undoing

27. 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
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.
Shine - Dalgarno sequence
Rho-immunoglobin
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.

28. Name the Hgb - O2 binding site based on the following information: x Least affinity for O2; requires the highest PO 2 levels for attachment (approx. 100 mm Hg)
Dopamine
Site 4
Mesocortical area
Macula densa

29. What type of Plasmodium affects x Only reticulocytes?
Voltage - gated sodium channel
Hemophilia A
Plasmodium vivax
The energy of activation

30. What embryonic structure forms the adult female structures? - Ovary - follicles - rete ovarii
Gonads
Contralateral loss below and bilateral loss at the level of the lesion
Libman - Sacks endocarditis
Mesencephalon

31. What is the name of the exotoxin Shigella dysenteriae produces - which interferes with the 60S ribosomal subunit and results in eukaryotic protein synthesis inhibition?
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
Carnitine acyl CoA transferase II
Yolk sac tumor
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)

32. Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?

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33. What small - facultative gram - negative intracellular rod's transmission is associated with unpasteurized dairy products and undulant fever?
Brucella
Mycoplasma pneumoniae
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)
ATP production

34. What is the longest and most convoluted segment of the nephron?
PCT
Positive predictive value
Cancer
Glycine and succinyl - CoA

35. What disease involves cold skin abscesses due to a defect in neutrophil chemotaxis and a serum IgE level higher than 2000?
Hepatitis A
CN V
Cancer
Job syndrome

36. By What age should children be able to draw the following figures? - Triangle
6 years old
Chlamydia trachomatis
gp120
Labioscrotal swelling

37. What microaerophile is a motile gram - negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)?
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
Gastric ulcer
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).
Campylobacter jejuni

38. What ocular ganglion is affected if the pupil on the affected side sluggishly responds to light with normal accommodation?
Nigrostriatal pathways (basal ganglia)
Alcohol and its related problems cost the country approximately $100 billion a year.
Type I hypersensitivity (anaphylactic)
Ciliary ganglion producing a tonic pupil

39. What type of spore is asexual and formed of hyphae?
Conidia
Hydralazine - isoniazid - and procainamide (HIP)
Listeria monocytogenes
Production of oxygen free radicals

40. What bones make up the acetabulum?
Pubis - ilium - and ischium
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
Familial hypercholesterolemia
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus

41. What is the most common one? - Type of PUD
Rotavirus
Mean corpuscular volume (MCV)
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
Duodenal ulcers (4 times as common as gastric)

42. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x Ki - ras
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.
Pancreas and colon
Lipoprotein lipase
Metformin

43. What artery supplies most of the lateral surfaces of the cerebral hemispheres?
Middle cerebral artery
Fibrocystic change of the breast
Chromosome 4p
Limbic system

44. What is the most common one? - Primary CNS tumor in adults
refuse
Flocculonodular lobe (one of my favorite words in all of medicine!)
Glioblastoma multiforme
Chemotaxis

45. On what chromosome is the adenomatous polyposis coli gene?
Malingering
Itraconazole
Hypochondriasis (they will begin with 'I think I have...')
Chromosome 5q21

46. What is the term for flattened nose - low - set ears - and recessed chin seen in patients with bilateral renal agenesis?
well - fed and fasting
Potter facies
Probenecid
Clavicle - acromion - and glenoid fossa of the scapula and the humerus

47. Which IL is associated with increases of IgG and IgE?
NADPH - O2 - and cytochrome b5
IL-4
Wiskott - Aldrich syndrome
Degenerates

48. What phase of the cell cycle are the following antineoplastic agents specific for? - Cisplatin
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
Cortisol - a 21- carbon steroid - has a - OH group at position 17.
Arginine
G0 phase

49. What paraphilia is defined as x Deriving sexual pleasure from watching others having sex - grooming - or undressing?
Anterior hypothalamic zone; lesions here result in hyperthermia.
Voyeurism
Area 6
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning

50. What are the three end products of amylase digestion?
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
Hyperpolarization (i.e. - K+ influx)
Arboviruses (bunyavirus - flavivirus - and togavirus)