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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. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Pancreas
Stable
H2PO4- (dihydrogen phosphate)
Lateral part of the hemispheres
unprocessed Ags

2. What metal poisoning produces microcytic anemia with basophilic stippling?
Moving objects - along with large bright objects with curves and complex designs.
Lead poisoning
M
Rhinovirus and hepatitis A virus

3. What glycoprotein in the HIV virus attaches to CD4?
Desipramine
GP120
C1 inhibitor (C1- INH)
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse

4. What is the term for the load on a muscle in the relaxed state?
Preload. It is the load on a muscle Prior to contraction.
HMG CoA synthase
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Streptococcus agalactiae

5. What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex- mediated; and is seen as lumpy- bumpy subepithelial deposits?
G2 phase
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Postinfectious GN
HPV serotypes 1 and 4

6. What is the central issue regarding the Roe vs. Wade decision (legalization of abortion)?
Trimethoprim
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
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.
C5- C9

7. What are the three most common sites for left - sided heart embolisms to metastasize?
Punishment
Serratus anterior
transcription
Brain - spleen - and kidney

8. What are the nonoxidative enzymes of the HMP shunt? Are the reactions they catalyze reversible or irreversible?
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.
Thrombocytopenia - eczema - and immunodeficiency is the triad of this X- linked recessive disorder.
Transketolase and transaldolase. The reactions they catalyze are reversible.
Selenium (Se)

9. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Telencephalon
Rate of absorption
Proencephalon
Intrapleural pressure decreases (becomes more negative).
Affinity

10. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Months to years after transplantation; gradual onset of HTN - oliguria - and azotemia; seen as intimal fibrosis of the blood vessels and in
Epinephrine
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Chronic rejection
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.

11. What branch off the vertebral artery supplies x The ventrolateral two - thirds of the cervical spinal cord and the ventrolateral part of the medulla?
Alcoholism
Anterior spinal artery
eIF-2 in the P site
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)

12. What prevents the down - regulation of the receptors on the gonadotrophs of the anterior pituitary gland?
Thioridazine
Peutz - Jeghers syndrome
The pulsatile release of GnRH
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)

13. Name the type of necrosis - Soft - friable - cottage - cheese appearing; characteristically seen in TB
Caseous necrosis
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone - whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
Corynebacterium diphtheriae
Factors II - VII - IX - and X and proteins C and S.

14. What oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis?
Metformin
Plummer - Vinson syndrome
IL-8 (IL-1 and TNF- gamma also)
Compliance (think of it as distensibility)

15. Could an overdose with either zolpidem or zaleplon be reversed with flumazenil?
T wave
Yes - because they both activate the BZ1- receptors - which can be reversed by flumazenil.
Albendazole
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)

16. What part of the heart forms x Anterior wall?
Osteocyte
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
Right ventricle

17. What stage of male development is characterized by the following LH and testosterone levels? - LH secretion drives testosterone production - with both levels paralleling each other.
Female pseudohermaphrodite
The cat
Hapten (not immunogenic)
Adulthood

18. What vitamin is necessary for the transfer of one amino group from a carbon skeleton to another?
Absolutely not! Answer any question you are asked.
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.
Diffuse proliferative GN

19. Name the phase of the eukaryotic cell cycle: x Period of cellular growth (translation and transcription) after DNA synthesis
Because it is the largest vessel and has the highest velocity in systemic circulation
5' deiodinase
G2 phase (gap 2)
Epinephrine

20. What is the most common one? - Primary CNS tumor in adults
Glioblastoma multiforme
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Atropine with pralidoxime
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.

21. Which phenotype of osteogenesis imperfecta is incompatible with life?
0.21; it is a fancy way of saying 21% of the air is O2.
Potter facies
Type II
Riboflavin (B2)

22. What enzyme catalyzes the rate - limiting step in heme synthesis?
d - ALA synthase
No. It is abnormal only if it interferes with normal sexual or occupational function.
Axis II
Valine

23. All of the hormones in the hypothalamus and anterior pituitary gland are...
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
3' end. Phosphate (PO4) is at the 5' end.
Unstable (crescendo) angina
Water soluble

24. With What two pathologies is a honeycomb lung associated?
Leydig cell tumor
Aldehyde dehydrogenase
Hepatitis A
Asbestosis and silicosis

25. What is used as an index for both adrenal and testicular androgens?
Urinary 17- ketosteroids
Estradiol
Superficial spreading melanoma
Estrone

26. What disease is associated with the HLA- DR2 and HLA- DR3 alleles
Systemic lupus erythematosus
Phase II
Dysmetria; this is seen in a finger - to - nose test.
Left coronary artery

27. Which of the following
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
Stereocilia
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)

28. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x CDK4
Size
5' deiodinase
Inulin
Melanoma

29. Name the type of hypersensitivity reaction based on the following properties - Reaction - mediated by sensitized T- cells
Type IV hypersensitivity (cell - mediated)
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
Omega -3 fatty acids
Intrinsic factor (IF)

30. What organism is associated with megaloblastic anemia?
Action potential
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
Endometriosis
Diphyllobothrium latum

31. What is the most common one? - Acquired GI emergency of infancy
Necrotizing enterocolitis
Neisseria gonorrhoeae
Subthreshold potential
Hepatic adenomas

32. Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD?
Cones (C for color and cones)
Hepadnavirus
Alzheimer disease
Nicotinic acid - because its side effects include hyperuricemia and exacerbation of ulcers.

33. Name the most common cause - Hospitalization in children younger than 1 year of age
Stage 2 - which accounts for approximately 45% of total sleep time - with REM occupying 20%.
Impaired ejaculation
RSV
Anopheles mosquito

34. What prokaryotic positioning enzyme in translation is blocked by the following? - Tetracycline
Fat necrosis
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts
EF- Tu and EF- Ts of the 30S ribosomal subunit
Depolarization (i.e. - Na+ influx)

35. What causes slow writhing movements (athetosis)?
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
Myasthenia gravis
Atropine and 2- PAM (pralidoxime)
Acid is needed for the activation of pepsin and therefore needed for protein digestion.

36. What thyroid enzyme is needed for oxidation of I- to I'?
Cytochrome a/a3
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
HBcAb IgG and HBsAb IgG
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell

37. Which drugs bind to the 30S ribosomal subunit and interfere with the initiation complex - causing a misreading of mRNA?
Pneumococcus
Anterior compartment of the leg - deep peroneal nerve
Aminoglycosides
Histrionic

38. The clearance of what substance is the gold standard of GFR?
Wiskott - Aldrich syndrome
Visceral pleura
Inulin
Dilation of afferent arteriole

39. What three cephalosporins are eliminated via biliary mechanisms?
Median (think of it as the halfway point)
Acarbose
Ampicillin and amoxicillin
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone

40. What direction does RNA polymerase move along the template strand of DNA during transcription?

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41. Name the most common type or cause - Cushing syndrome
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Ventral posterolateral nucleus
Pituitary adenoma
Wernicke's aphasia

42. What molecule that is needed to trigger T cell activation is noncovalently linked to TCR?
A transport maximum (Tm) system
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
Brucella
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)

43. If the occurrence of one event had nothing to do with the occurrence of another event - How do you combine their probabilities?
Sertoli cell
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
Since they are independent events - their probabilities would be multiplied.
HBcAb IgG and HBsAb IgG

44. Name the antidote - Atropine
Erythromycin
Physostigmine
Vesicle (e.g. - poison ivy)
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.

45. Are the following conditions associated with a negative or positive nitrogen balance? - Pregnancy
Deltoid
Fibrocystic change of the breast
Positive
Superior

46. What prokaryotic positioning enzyme in translation is blocked by the following? - Streptomycin
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
HBsAb IgG
IF-2 of the 30S subunit
Pneumococcus

47. What size ribosomes do fungi have?
Dilation of afferent arteriole
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
After the latent period
80S ribosomes (because they are eukaryotic)

48. In an adrenergic nerve terminal - Where is dopamine converted to NE? By what enzyme?
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Papillary carcinoma of the thyroid
Alcohol consumption
Metronidazole

49. What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100 - 00); decreased LAP levels; and nonspecific symptoms of fatigue - malaise - weight loss - and anorexia?
CML
Intermediate part of the hemispheres
Risk factors for breast cancer
Maxillary division of CN V and glossopharyngeal nerves

50. What encapsulated group of nerve endings seen at the muscle - tendon junction responds to an increase in tension generated in that muscle? (This is dropping a box that is too heavy to carry.)
Urogenital folds
Transvestite fetishism
Streptococcus agalactiae
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.