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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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 three organisms cause heterophilic negative mononucleosis?
Mitochondria
Pearson correlation
CMV - Toxoplasma gondii - and Listeria
Nodular sclerosis

2. What blotting technique uses the following for analysis? - Protein
Mural infarct
Levator palpebrae superioris
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
Western blot

3. What nucleus of the hypothalamus is the satiety center - regulating food intake?
Ventromedial nucleus; lesions here result in obesity.
Superior
Femoral nerve
They are in the grey matter of the CNS.

4. What is the T- cell area of the spleen?
PALS
Aortic stenosis
Tetracycline
Contralateral loss below and bilateral loss at the level of the lesion

5. Which form of emphysema is associated with an alpha1- antitrypsin deficiency?
ASA
Panacinar
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.

6. What nematode is known as threadworms? What is the treatment?
Microvillus
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Common peroneal nerve
Strongyloides stercoralis is treated with thiabendazole.

7. Ophthalmic artery is a branch of What artery?
Flocculonodular lobe (one of my favorite words in all of medicine!)
Follicular lymphoma
Negative
Internal carotid artery

8. What is the name of the force that develops in the wall of the lungs as they expand?
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
Large segment deletions
Ventromedial nucleus; lesions here result in obesity.
D- Penicillamine

9. A patient goes to the ER with signs and symptoms of biliary colic. Which opioid analgesic do you choose?
Adenine and guanine
Chromosome 5q21
Sciatic nerve
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.

10. What thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 increased
Combined metabolic and respiratory acidosis
17- alpha - Hydroxylase deficiency
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
Cholesterolosis

11. What organelle is responsible for ribosomal RNA synthesis?
Dimercaprol - D- penicillamine
gp120
Purine nucleoside phosphorylase
Nucleolus. Ribosomal assembly also takes place in the nucleolus.

12. What are the five branches of the posterior cord of the brachial plexus?
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Yes - by three to four times. Having multiple sexual partners - being overweight - and pelvic pain and/or inflammatory disorders are also likely to be seen in sexually abused females.
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis

13. What mineral deficiency involves blood vessel fragility?
Aminoglycosides
Plasma cell
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
Copper deficiency

14. Name the area of the cerebral cortex with the function described: x Intellectual processing of sensory information - with the left (dominant) processing verbal information - the right processing visual - spatial orientation
Gubernaculum
Parietal lobe
Squamous cell carcinoma
Voltage - gated potassium channels

15. Is the Lac operon activated or inactivated in the presence of both glucose and lactose?
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
Look for broken blood vessels in the baby's eyes.
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
Epstein - cardiac anomaly of the tricuspid valve

16. Name the associated chromosome - Down syndrome
Chromosome 21
Giant cell bone tumor (osteoclastoma)
Osteoblasts (Remember - they modulate the function of osteoclasts.)
Klinefelter syndrome

17. Name the hepatitis virus based on the following information - Small circular RNA virus with defective envelope
Hydralazine - isoniazid - and procainamide (HIP)
Lead poisoning
Toxoplasmosis
Hepatitis D

18. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH decreased - Ca2+ increased - Pi increased
Osteosarcoma
CN V3 and the lesser petrosal nerve
Secondary hypoparathyroidism (vitamin D toxicity)
Id (pleasure principle)

19. Name the three postganglionic sympathetic ganglia that receive input from thoracic splanchnics.

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20. What happens to affinity if you increase Km?
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
3 months of symptoms in 2 consecutive years
Integrase
Affinity decreases; they are inversely proportional.

21. What are the four ways to down - regulate the immune system?
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti - Ab
Shine - Dalgarno sequence
H 1

22. The faster the ___________ - the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).
Because creatinine is filtered and a small amount is secreted
Rate of absorption
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
Dimorphic

23. What thyroid abnormality has the following? - TRH increased - TSH increased - T4 decreased
Vital capacity (VC)
Pneumococcus (Streptococcus pneumoniae)
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.)
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney

24. 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?
Middle meningeal artery
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
Staphylococcus aureus
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.

25. What are the five effects of insulin on fat metabolism?
Burkitt lymphoma
Resistance decreases as resistors are added in parallel.
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
Spironolactone

26. How many mature sperm are produced by one type B spermatogonium?
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
Northern blot
McArdle's syndrome
Four

27. In regard to motor development during infancy - choose the motor response that happens first - Proximal or distal progression
Rhinovirus
Proximal to distal progression
premature ejaculation
Carbidopa and benserazide

28. Leading to gallstones and steatorrhea.
Unconjugated (indirect)
The alveolar PO2 and PCO2 levels
Pancreatic delta - cell tumors inhibit CCK secretion
Bipolar disorder (manic - depressive disorder)

29. Which protozoal parasitic vaginal infection produces a positive whiff test with KOH staining?
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.
Trichomonas vaginalis (treat with metronidazole)
Dihydrofolate reductase
Voyeurism

30. What thyroiditis presents as a tender - enlarged - firm thyroid gland - usually preceded by an upper respiratory viral illness?
Live vaccines
Increased secretion of GH postpuberty leading to acromegaly.
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.
de Quervain thyroiditis

31. Do the following structures pick up stain from hematoxylin or eosin? - Nucleoli
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Escherichia coli
Hematoxylin
Free - unprocessed Ag

32. What autoimmune syndrome is characterized by keratoconjunctivitis - corneal ulcers - xerostomia - and an increased risk of high - grade B- cell lymphomas? What two Ab tests are used in making the diagnosis?
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae
Sj
Aromatase
CD19

33. Ventral rami of what cervical nerves constitute the phrenic nerve?
First - order elimination
C3 - C4 - and C5 keep the diaphragm alive!
HBsAg as its envelope
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus

34. What Ig is associated with Ag recognition receptor on the surface of mature B cells?
IgD; IgM is also correct.
Increase (5- HT and dopamine levels do the same)
Nonsense
Isoniazid

35. What is the physiologic storage form of iron?
Target cell
Sheehan syndrome
Ferritin
give a warning

36. What are effects of PTH in the kidney?
Myeloschisis All except occulta cause elevated - fetoprotein levels.
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Cytochrome a/a3

37. By What age should children be able to draw the following figures? - Rectangle
Lactulose
Microglia
Pedophilia
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)

38. What enzyme catalyzes the rate - limiting step in gluconeogenesis?
Variola virus (Smallpox)
Clostridium botulinum
Id (pleasure principle)
Fructose -1 - 6- bisphosphatase

39. What two glycolytic enzymes catalyze the substrate - level phosphorylations?
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Toxic dose for 50% of drug takers (median toxic dose)
Insulinoma
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae

40. What chromosome 4 - AD disorder is a degeneration of GABA neurons in the striatum of the indirect pathway of the basal ganglia?

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41. Where are the postganglionic neuron cell bodies - the CNS or the PNS?
They are in ganglia in the PNS.
Bronchogenic carcinoma
Anterior compartment of the thigh - femoral nerve
Enterokinase

42. What syndrome causes inability to concentrate - easy distractibility - apathy - and regression to an infantile suckling or grasping reflex?
Hepatitis B
Third week
Frontal lobe syndrome (lesion in the prefrontal cortex)
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.

43. What two Ags must be positive for a patient to have chronic active hepatitis?
CD40
HBsAg and HBeAg
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
The larger the volume of distribution - the lower the plasma concentration of a drug.

44. What area of the hypothalamus is responsible for recognizing an increase in body temperature and mediates the response to dissipate heat?
Anterior hypothalamic zone; lesions here result in hyperthermia.
d - Tubocurarine
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
3' end. Phosphate (PO4) is at the 5' end.

45. What is the most common form of non - Hodgkin lymphoma in the United States?
Follicular lymphoma
Parallel circuit
Affinity
IgA

46. Are the following conditions associated with a negative or positive nitrogen balance? - Uncontrolled DM
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
Negative
Neisseria meningitides
Akathisia

47. What is the most common one? - Bone tumor
Metastatic
Progestin
Ventromedial nucleus; lesions here result in obesity.
Phallic stage (4-6 years)

48. What three carcinomas are associated with EBV?

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49. Name the associated chromosomal translocation - Adult familial polyposis
Ipratropium
Enterobius vermicularis; the treatment is albendazole.
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Chromosome 5 - 21

50. What testicular tumor of infancy is characterized by elevated - fetoprotein levels and Schiller - Duval bodies?
Yolk sac tumor
Mesonephric duct (ureteric bud)
Area 22 and occasionally 39 and 40
Propionic acid

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USMLE Step 1 Prep

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