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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 are the two reasons for megaloblastic anemia with elevated MCV?
Burkitt lymphoma
Flucytosine
Aldosterone
Vitamin B12 deficiency and folate deficiency

2. What enzyme of the purine salvage pathway is deficient in the following? - Selective T- cell immunodeficiency
Anterior nuclear group (Papez circuit of the limbic system)
H 1
Clostridium perfrigens
Purine nucleoside phosphorylase

3. What is the only pharyngeal muscle not innervated by CN X?
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
Anterior compartment of the thigh - femoral nerve
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.

4. What has proved to be the best way to extinguish enuresis?
Homogentisic oxidase
PGE2 and PGF2a
Parasites
Bell pad

5. What three bacteria are positive to quellung reactive test?
Hyperplasia
Lateral pontine syndrome
Ligamentum arteriosum
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae

6. What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells - not a fixed number?
Chromosome 19
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.
Translation
Log - kill hypothesis (follows first order kinetics)

7. What hormone is characterized by the following renal effects? - Calcium reabsorption - phosphate excretion
alpha - Motor neurons innervate extrafusal muscle fibers (a motor unit) - whereas gamma - motor neurons innervate intrafusal muscle fibers.
Motilin
PTH
Berylliosis

8. Name the DNA virus x Linear dsDNA; enveloped; virion - associated polymerases; replicates in the cytoplasm :
wave
Poxvirus
Exposure
Third week

9. What embryonic structure forms the adult female structures? - Glans clitoris - corpus cavernosus - and spongiosum
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
Creutzfeldt - Jakob disease
Phallus
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)

10. What is the term to describe a man who has x Never been able to achieve an erection?
Mesocortical area
Allotypes
Biotin - ATP - and CO2
Primary erectile disorder

11. What are the three characteristics of autoregulation?
eEF-1
Malignant mesothelioma
Ego syntonic
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes

12. Which type of hepatitis can cause hepatocellular carcinoma?
Histamine
Malassezia furfur (treat with selenium sulfide)
Total lung capacity (TLC)
Hepatitis B

13. What antimuscarinic is used as an inhalant for asthma?
Ipratropium
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.
ACh
Familial hypercholesterolemia

14. What are the pharmacologic effects seen sexually with x Beta- Blockers?
Impotence
Masochism
Streptococcus viridans
Multiple myeloma

15. What muscles make up the rotator cuff?
Proton pump inhibitors
By causing rebound insomnia and decrease in REM sleep
Red pulp (Remember - Red pulp and RBCs begin with R.)
SITS

16. What three substances stimulate glycogenolysis?
Minimal change disease
Thymus gland. (Thymus gland is essential for T cell maturation.)
Autosomal dominant
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon

17. What syndrome is associated with the following brainstem lesions? - AICA or superior cerebellar artery occlusion - resulting in ipsilateral limb ataxia - ipsilateral facial pain and temperature loss - contralateral loss of pain and temperature to the
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
Myelofibrosis with myeloid metaplasia
Staphylococcus aureus
Lateral pontine syndrome

18. What cell of the male reproductive system produces testosterone?
Physostigmine
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
Iron deficiency anemia

19. What condition results from a deficiency in the enzyme hexosaminidase A?
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
Yolk sac tumor
Tay- Sachs disease
Foramen of Winslow

20. What syndrome results if the enzyme ?-1- iduronidase is deficient? L- iduronate sulfatase deficiency?
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
Nystagmus and ataxia
Transudative; exudative has the opposite values and has an elevated cellular content.
Hurler syndrome and Hunter syndrome - respectively

21. Starry sky appearance of macrophages is pathognomonic of what lymphoma?
Burkitt lymphoma
Conidia
Melanosis coli
Ovarian cancer

22. What inflammatory bowel disorder is continuous - with extensive ulcerations and pseudopolyps - and is associated with HLA- B27?
Medial midbrain (Weber's) syndrome
Ulcerative colitis
<2
Protamine sulfate

23. What hormone is activated in adipose tissue when blood glucose levels decrease?
Chromosome 3p
Hormone - sensitive lipase
As the standard deviation increases - the greater the chance of error.
Diphyllobothrium latum

24. Name the most common type or cause - Right heart failure
CN XII
GABA and glutamic acid
Left heart failure
Frotteurism

25. What drug is being given to HIV- positive mothers during labor and to the children after birth to decrease the risk of mother - to - child HIV transmission?
Klinefelter syndrome
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.
Bacillus cereus
Escherichia coli

26. What is the term for any stimulus that increases the probability of a response happening?
G0 phase
Niemann - Pick and Tay- Sachs diseases
Reinforcement
Anterior compartment of the leg - deep peroneal nerve

27. What purine base is contained in inosine monophosphate?
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
Primary hypothyroidism (Low T4 has a decreased negative feedback loop - resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release - respectively.)

28. Name the Plasmodium species based on the following information: Persistent hypnozoite liver stage with relapses; blood smear shows amoeboid trophozoites; 48- hour fever spike pattern; the most prevalent form worldwide
Mitral insufficiency
ALA dehydrogenase and ferrochelatase
The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated.
Plasmodium vivax

29. Name the valve abnormality based on the following criteria: x Systolic murmur - increased preload and afterload - decreased aortic pulse pressure and coronary blood flow
Aortic stenosis
Crossover study
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
Catechol - O- methyl transferase (COMT)

30. Name the ventricular muscle membrane channel: x Open at rest; depolarization is stimulus to close; begin to reopen during the plateau phase and during repolarization
Water soluble
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Voltage - gated potassium channels
Down syndrome (trisomy 21)

31. What causes slow writhing movements (athetosis)?
Histiocytosis X
Negative
Lipoid nephrosis
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)

32. What is the MCC of the following meningitides? - In those 12 months to 6 years of age
Glossopharyngeal nerve
Haemophilus influenzae type B
Puberty
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)

33. What are effects of PTH in the kidney?
Eosinophil chemotactic factor A
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Yersinia pestis
Topoisomerase I (Relaxase)

34. Name the Hgb - O2 binding site based on the following information: x Requires a PO2 level of 40 mm Hg to remain attached
Hypervariable region (three per light chain; three per heavy chain)
Site 3
Gain of hypertonic fluid (mannitol or hypertonic saline)
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.

35. Name the phase of the eukaryotic cell cycle: x Period of DNA replication (preparing for mitosis)
Pseudomembranous colitis
S phase
Lesser curvature of the antrum of the stomach
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.

36. What form of anxiety - appearing at 6 months - peaking at 8 months - and disappearing by 1 year of age - is seen in the presence of unfamiliar people?
hCS and serum estriol - which are produced by the fetal liver and placenta - respectively - are used as estimates of fetal well - being.
Stranger anxiety
The fast component is directed toward the affected side of a cerebellar lesion.
Medial meniscus

37. What is the leading cause of school dropout?
Pregnancy
Amyotrophic lateral sclerosis (Lou Gehrig's disease) is a LMN lesion at the level of the lesion and UMN lesion below the level of the lesion.
Antigenic determinant (epitope)
presence of PMNs

38. Name the associated chromosome - VON Hippel - Lindau disease
Insulin
Chromosome 3p
Granulosa/thecal cell tumor of the ovary
Prader - Willi syndrome and Angelman syndrome - respectively

39. What is the rate - limiting step of the following? - Cholesterol synthesis
Leukemias
It is rare with normal grief; however - it is relatively common in depression
HMG CoA reductase
Malignancy

40. What is the name of the pathway that produces leukotrienes?
Lipoxygenase pathway - from arachidonic acid
12 days after ovulation
Unipolar disorder (major depression)
Malignancy

41. Has no underlying pathology.

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42. Where are the preganglionic neuron cell bodies - the CNS or the PNS?
Anterior wall of the first part of the duodenum
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
They are in the grey matter of the CNS.
Early distal tubule

43. What is the term for squamous to columnar metaplasia of the distal esophagus secondary to chronic inflammation?
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Lateral pontine syndrome
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.
Tetralogy of Fallot

44. What DNA viral disease is associated with aplastic crisis in patients with sickle cell anemia?
Parvovirus B-19
None; they are the storage sites for ADH and oxytocin.
Enkephalins
NE

45. What antitubercular agent requires vitamin B6 supplementation?
IL-7 (A 7 upside down is an L; L is for Lymphoid)
Buffers (remember that buffers are best when they are used in a pH range near its pK)
C5b - C9
Isoniazid

46. Name the B- cell CD marker: x Required for class switching signals from T cells
Erythromycin
Muscle glycogen phosphorylase
CD40
Iatrogenesis

47. Does the heart rate determine the diastolic or systolic interval?
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
Glucose
Kl
Constrictor pupillae and ciliary muscles

48. What statistical method do you use when analyzing x Cross - sectional studies?
Magnesium ammonium phosphate (struvite)
Alveoli; they are part of the respiratory portion.
Chlamydia psittaci
Chi - square.

49. What does the tunica intima of arteries have that veins do not?
CN IX - X - and XI; sigmoid sinus
Both Neisseria and Moraxella are gram - negative cocci.
An internal elastic lamina
Sympathetic chain ganglion

50. What law was adopted to shield physicians from liability when helping at the scene of an accident?
Subclavian vein
Good Samaritan Law. (Physicians are not required to stop and help.)
Superior and middle
emancipates