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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 disease involves microcephaly - mental retardation - cleft lip or palate - and dextrocardia?
Kimmelstiel - Wilson disease
Patau syndrome (trisomy 13)
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)

2. In MHC class II molecules - what chain blocks access to the peptide - binding groove during transportation within the cell - ensuring that the MHC class II- peptide complex is transported to the surface?
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
VLDL
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
A low - resistance system is formed by resistors added in parallel.

3. Are the following responses associated with histamines H1 or H2 receptor activation? - Edema
Ependymal cells
Spearman correlation
H 1
RNA polymerase I

4. Are salivary secretions hypertonic - hypotonic - or isotonic?
Turner syndrome
Hypotonic - because NaCl is reabsorbed in the salivary ducts
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
Membrane conductance (think conductance = channels open)

5. Is irreversible
Ag - Ab binding
Corynebacterium diphtheriae
Ovulation
Familial hypercholesterolemia

6. What Ig mediates ADCC via K cells - opsonizes - and is the Ig of the secondary immune response?
Bridging veins draining into the sagittal sinus
IgG
IF and GTP (eIF for eukaryotes)
Tetracycline

7. Name the end product or products: x Fatty acid synthesis
Narcissistic
Monocytosis
almitate
Right medial longitudinal fasciculus

8. Name the antidote - Benzodiazepines
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
Flumazenil
Menses

9. What are the two reasons for megaloblastic anemia with elevated MCV?
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
Vitamin B12 deficiency and folate deficiency
C3 deficiency
6 years old

10. What benign bone tumor is associated with Gardner syndrome?
Internal 3' - 5' PDE bonds
Osteoma
Public speaking (Remember: stage fright)
ELISA screens and Western blot confirms the diagnosis.

11. What is the renal compensation mechanism for alkalosis?
Abs to HBsAg
Scleroderma
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+

12. What is the period between going to bed and falling asleep called?
Thiabendazole
The urea cycle
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
Sleep latency

13. What chromosome is associated with the AR form of SCID?
Varicella virus and influenza virus
All
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)
Chromosome 20q (deficiency in adenosine deaminase)

14. What two ligaments of the uterus are remnants of the gubernaculum?
HBc Ab
Round and ovarian ligaments
Erythema marginatum
Linoleic acid and linolenic acid

15. Can incidence - prevalence - and cause and effect be assessed in x Cross - sectional studies?
Cilia
prior to birthThe foramen ovale closes just...
Cross - sectional studies determine prevalence - not incidence or cause and effect.
RSV

16. What enzyme is deficient in hereditary protoporphyria?
The rate of infusion
Ferrochelatase
Accessory nucleus
4 years old

17. What cells of the epidermis carry the pigment melanin?
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
Transcription (C comes before L in the alphabet - and transCription comes before transLation)
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.

18. What is the vector of African sleeping sickness?
The tsetse fly
Being a female physician increases the risk of suicide nearly four times the general population.
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
Functional residual capacity (FRC)

19. What type of scale is graded into equal increments - showing not only any difference but how much?
Early collecting duct
Adenovirus
Interval scale (a ruler - for example)
Yes

20. Which organism causes trench fever?
Melasma
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
Sigmoid colon
Rochalimaea quintana (now called Bartonella quintana)

21. What embryonic structure forms the following adult structures? - Collecting ducts - calyces - renal pelvis - and ureter
Alzheimer disease
Medial meniscus
Mesonephric duct (ureteric bud)
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.

22. Is a membranous septal defect more commonly interventricular or interatrial?
Escherichia coli
Ovarian cancer
PR interval
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.

23. What type of Ag do T cells recognize?
Processed antigenic peptides bound in the groove of the MHC molecule
Bacterial meningitis
Disseminated intravascular coagulation (DIC)
Ipsilateral loss below the level of the lesion

24. What is the term for the appearance of the kidney in malignant hypertension (it has petechiae on its surface)?
Flea - bitten kidney (can also be seen in pyelonephritis)
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
G1 phase (gap 1)
Gaucher disease

25. What type of foods should patients taking MAOIs avoid? Why?
The larger the volume of distribution - the lower the plasma concentration of a drug.
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
Major
Phase 0

26. What is the only antifungal agent to penetrate CSF?
Glycogen synthase
Major
Fluconazole
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.

27. What urinary metabolite is elevated in pheochromocytoma?
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.
Leiomyoma (fibroids)
Cleft lip
Vanillylmandelic acid (VMA)

28. A patient goes to the ER with abdominal cramps - vomiting - diarrhea - and sweating less than 24 hours after eating potato salad at a picnic; What is the most likely responsible organism?
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
Staphylococcus aureus
Air flows into the respiratory system.
The reduviid bug

29. Induces the cytochrome P-450 enzymes.
Ethyl alcohol
Estrone
Glucagon
Inspiratory reserve volume (IRV)

30. What size ribosomes do fungi have?
Pyrantel pamoate
Achondroplasia
80S ribosomes (because they are eukaryotic)
The sensory limb is via CN IX - and the motor limb is from CN X.

31. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Dorsal rami?
Both
Proximal tubule
Graves disease
The vestibulo - ocular reflex

32. What is the name for failed recanalization of the duodenum resulting in polyhydramnios - bile - containing vomitus - and a distended stomach?
Mean corpuscular volume (MCV)
Pseudomembranous exudates
Duodenal atresia
Parvovirus B-19

33. What body fluid preferentially breaks down esters?
Muscle glycogen phosphorylase
Avoidant
Blood
IgA nephropathy (Berger disease)

34. From What aortic arch are the following structures derived?
Cardiac muscle
Klatskin tumor
Site 1
Stapes artery

35. What organ is responsible for the elimination of excess nitrogen from the body?
Lateral pontine syndrome
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Moderate (35-49)
The kidneys excrete the excess nitrogen from the body as urea in the urine.

36. What segment of the nephron has the highest concentration of inulin? Lowest concentration of inulin?

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37. How can a deficiency in adenosine deaminase be a bone marrow suppressor?
Primary follicle (in the white pulp)
It causes a buildup of dATP - which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate - a precursor of DNA - resulting in overall bone marrow suppression.
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Gardner syndrome

38. What percentage of children born to HIV- positive mothers will test positive for HIV at birth?
Vesicle (e.g. - poison ivy)
CD40
100% - with about 20% remaining positive after 1 year
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.

39. T cells can recognize - bind - and internalize...
unprocessed Ags
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Ag - Ab binding
Spironolactone

40. A schizophrenic patient who is taking haloperidol is brought to your ER with muscle rigidity - a temperature of 104
hyperventilation
Heroin
Acute rejection
Neuroleptic malignant syndrome is a potentially life - threatening condition Which is treated with symptomatic support - bromocriptine - and dantrolene.

41. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral hemispheres
Ventricular contraction Atrial - Contraction - Venous
Sublimation
Proencephalon
Heart disease

42. RBC casts in the urine
Hepatitis A
Leiomyoma
Acute glomerulonephritis
Paneth cells

43. Name the product or products of arachidonic acid: x Vasoconstriction and platelet aggregation produced by platelets
Red blood cell distribution width index (RDW)
TXA2
Autoimmune thrombocytopenia purpura
Extinction

44. What maintains the osmotic gradient that is critical to the concentrating ability of the kidney?
The venae recta maintain the gradient via countercurrent flow.
Menstruation
Libman - Sacks endocarditis
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)

45. What cell surface marker is found on blood B cells?
CD19
Glucose -6- phosphatase
Humerus with ulna (major) and radius (minor)
Pheochromocytoma

46. What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated?
Estrone
2 and 5HT3 receptors
>10 mm
Guanethidine and bretylium

47. What negative sense RNA virus is associated with cough - coryza - and conjunctivitis with photophobia?
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma
Tropomyosin
50% - with 50% of them having the child
Measles (rubeola)

48. What two drugs - when mixed - can lead to malignant hyperthermia?
Major
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Succinylcholine and halothane (Treatment is with dantrolene.)
HBcAb IgM

49. Multiple pregnancies - early age of intercourse - multiple sexual partners - OCP use - smoking - HIV - and STDs.
Area 17
Risk factors for cervical cancer
Acetyl CoA - FADH2 - and NADH
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.

50. Name the MCC of death - In diabetic individuals
MI
Rhombencephalon
Thrush
Allograft