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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 is the major difference between the veins in the face and the veins in the rest of the body?
Gonococcus
Helicase (requires ATP for energy)
Huntington disease
There are no valves and no smooth muscle in the walls of the veins in the face.

2. Keratin pearls
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Primitive atrium
Squamous cell carcinoma
Processed antigenic peptides bound in the groove of the MHC molecule

3. What inhibitor of microtubule synthesis is the drug of choice for whipworm and pinworm?
Angiosarcoma of the liver
Minimal change disease
Popliteus
Mebendazole

4. What type of healing occurs in a clean surgical incision?
1. Tinea coli 2. Haustra 3. Epiploic appendages
Clostridium botulinum
Primary intention
Demeclocycline

5. What phase of Food and Drug Administration approval tests x The safety in healthy volunteers?
Malignant mesothelioma
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
Phase I
Subacute combined degeneration - Which is bilateral below the level of the lesion.

6. Pseudopalisades
Chief cells
Hepatitis A (infectious)
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
Glioblastoma multiforme

7. What are the three stages that children aged 7 months to 5 years go through when they are separated from a primary caregiver for a long time?
CD8
Succinate dehydrogenase
Serratia
1. Protest 2. Despair 3. Detachment

8. What happens to blood flow and pressure downstream with local arteriolar constriction?
Parasympathetic
With arteriolar constriction both the flow and pressure downstream decrease.
LDL
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)

9. Name the most common type or cause - Nephrotic syndrome in children
HPV serotypes 16 - 18 - 31 - and 33
Neisseria meningitides
Lipoid nephrosis
High average

10. What X- linked recessive immune disorder is characterized by recurrent infections - severe thrombocytopenia - and eczema?
Fourth M PITS for pharyngeal pouch derivatives
Hyaluronic acid (all sulfates bind to the core protein)
Wiskott - Aldrich syndrome
1. Propranolol 2. Timolol 3. Carteolol

11. What three circumstances allow a child to be committed to institutional care?

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12. What is the term for a large - immature RBC that is spherical - blue - and without a nucleus?
Extrahepatic biliary atresia
AML- M3
Carbonic anhydrase
Reticulocyte

13. What happens to the Ab specificity when class switching occurs in mature B cells?
Western blot
Multiple myeloma
HPV serotypes 16 - 18 - 31 - and 33
As the isotype is switched - the Ab specificity does not change because it does not affect the variable chains.

14. Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?
1. The child poses an imminent danger to self or others. 2. The child is unable to self - care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety e
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
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.
Rifampin

15. Name the most common type or cause - Meningitis in renal transplantation patients
hypophosphatemia
Listeria monocytogenes
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12
IgM; IgD follows shortly thereafter.

16. Name the T- cell CD marker: x Essential for Ab isotype switching (for B cell binding)
Dystrophic calcification
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
CD40 ligand

17. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - poor grooming - poor ability to think abstractly - decreased drive - poor attention span (Hint: if the lesion is in the
Farnesyl pyrophosphate (FPP)
Dorsal prefrontal cortex
Frotteurism
Preductal (infantile)

18. What is associated with prolonged lithium use?
Hypothyroidism. (TSH levels must be monitored.)
Factors II - VII - IX - and X and proteins C and S.
Metaplasia (usually to a more protective cell type)
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself

19. Is a side effect of cimetidine.
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
Gynecomastia
Right atrium
Cystadenocarcinoma

20. Does the heart rate determine the diastolic or systolic interval?
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
One day after the LH surge and 2 days after the estrogen peak.
Progressive multifocal leukoencephalopathy

21. What are the five pieces of information considered necessary for fully informed consent?

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22. What is a sign of a Sertoli cell tumor in a man?
Excess estradiol in the blood
Plasmin
Primary follicle (in the white pulp)
Hepatitis C

23. When is the first arrested stage of development in the female reproductive cycle?
Prophase of meiosis I (between 12th and 22nd week in utero)
1. Liver 2. Muscle 3. Adipose tissue
Avoidant
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.

24. What component of the ETC is inhibited by the following? - Rotenone
The affinity of the drug for its receptor
snRNA
Complex I
Mitochondria

25. Name the product or products of arachidonic acid: x Chemotactic for neutrophils
Sadism
LTB4
The pH of CSF is 7.33 - acidotic.
Skeletal muscle

26. What virus causes small pink benign wartlike tumors and is associated with HIV- positive patients?
Molluscum contagiosum
mRNA
The alveolar PO2 and PCO2 levels
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.

27. What Ig is associated with mucosal surfaces and external secretions?
Medulla blastoma
1. Tinea coli 2. Haustra 3. Epiploic appendages
Pirenzepine
IgA

28. What CN is associated with the sensory innervation of x Nasopharynx?
Infliximab
Nodular sclerosis
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Maxillary division of CN V and glossopharyngeal nerves

29. Name the most common cause - Hospitalization in children younger than 1 year of age
Candida
RSV
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
Varicocele

30. What cerebral lobes are most commonly affected in herpes encephalitis?
Posterior hypothalamic zones; lesions here result in poikilothermy (environmental control of one's body temperature).
Temporal lobes
Rapidly progressive glomerulonephritis (RPGN)
Gastric carcinoma

31. What component of the ANS - when stimulated - results in bronchoconstriction?
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.
0.2
Diazepam is longest acting and midazolam is shortest acting.
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.

32. Name the muscle type based on these descriptions: x Involuntary contraction - uninuclear nonstriated fibers - actin and myosin not forming banding pattern; lack of T tubules - gap junctions - and calmodulin.
Temporal lobe
Gastric carcinoma
Smooth muscle
Melatonin - serotonin - and CCK

33. What is the site of action of the following? - Aldosterone antagonists
Glutamate
Distal convoluted tubules
Cohort studies determine incidence and causality - not prevalence.
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.

34. Which region of the variable domain comprises the Ag - binding site of the Ab?
Interval scale (a ruler - for example)
Hypervariable region (three per light chain; three per heavy chain)
Libman - Sacks endocarditis
Severe (range 20-34)

35. What is the term for an increase in the number of cells in a tissue?
Hyperplasia
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
Oblique fissure
Doxacurium

36. What is the most common diagnosis made (or missed!) resulting in a malpractice suit?
Breast cancer
HMP shunt
Homocysteine methyl transferase and methylmalonyl CoA transferase
There would be two Fab and Fc regions.

37. What are the three anatomic characteristics that differentiate the large bowel from the small bowel and the rectum?
Eosinophil
GLUT 4
1. Tinea coli 2. Haustra 3. Epiploic appendages
Small cell carcinoma (oat cell)

38. What is the most abundant neuron in the cerebellum?
Streptomycin
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
hypophosphatemia

39. What is the name of the B cell - rich area of the spleen?
Primary follicle (in the white pulp)
1. Protest 2. Despair 3. Detachment
From age 5 onward IQ stabilizes.
Megaloblasts

40. What motile - gram - negative spiral bacillus with flagella is oxidase positive - urease positive - and associated with gastritis - peptic ulcer disease - and stomach cancer?
Helicobacter pylori
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
G-6- PD deficiency; pyruvate kinase deficiency is second.
Hyperplasia

41. What occurs when the lower esophageal sphincter fails to relax during swallowing due to abnormalities of the enteric nervous plexus?
Achalasia
Biotin (only if eaten in large quantities)
Staphylococcus aureus
Serum 25- hydroxy- vitamin D (25- OH- D)

42. What genus is known as the smallest free living bacteria? (hint: has no cell wall and has sterols in the membrane)
Mycoplasma
Helicase (requires ATP for energy)
Stratum lucidum
Fixed interval

43. Why is the base of the lung hyperventilated when a person is standing upright?
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.
hnRNA
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
Transposons

44. What are the four functions of saliva?
Residual volume (RV)
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Multiple sclerosis
Niemann - Pick disease

45. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Beta - hCG
Klebsiella pneumoniae
After the latent period
Gilbert's syndrome
Choriocarcinomas and trophoblastic tumors

46. What T cell deficiency syndrome is associated with facial anomalies - hypoparathyroidism - thymic hypoplasia - and recurrent viral and fungal infections?
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
Gametocytes
Embolic
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12

47. What is the fastest - conducting fiber of the heart? Slowest conduction fiber in the heart?
X- linked dominant
Agoraphobia. It also means having a sense of humiliation or hopelessness.
Purkinje cell is the fastest - and the AV node is the slowest.
Increased leukocyte alkaline phosphatase (LAP)

48. Does the direct or indirect basal ganglia pathway result in a decreased level of cortical excitation?
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Sideroblastic anemia
Magnesium
Area 8

49. What is found in the R group if the AA is acidic? Basic?
Left eye anopsia (left nasal and temporal hemianopsia)
Amiloride
Musculocutaneous nerve
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.

50. On the venous pressure curve - What do the following waves represent? - C wave?
Middle
Ventricular contraction Atrial - Contraction - Venous
Dihydrofolate reductase
GH deficiency