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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 paraphilia is defined as x Combining sex with urination?
CN II and ophthalmic artery
Urophilia
Unconjugated (indirect)
Middle meningeal artery

2. What signals are used to direct an enzyme to a lysosome?
Priapism
Hypothyroidism. (TSH levels must be monitored.)
Phosphorylation of mannose residues
Melanoma - cancer of the stomach and bladder

3. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Spinal nerve?
Both
Plasmodium falciparum
Central. Remember - there is a deficiency in ADH production in the central form.
Rhabdomyoma

4. What is the tetrad of tetralogy of Fallot?
Salmonella typhi
refuse
VSD - RVH - overriding aorta - and pulmonary stenosis
In the JG cells of the kidney

5. From what pharyngeal pouch is the following structure derived? - Inferior parathyroid gland and thymus
Chromosome 15q
Third M PITS for pharyngeal pouch derivatives
Arnold - Chiari malformation type 2
Mitochondrial inheritance

6. What embryonic structure forms the adult female structures? - Labia majora
Chronic rejection
Free form determines hormone activity and is responsible for the negative feedback loop.
Renal circulation
Labioscrotal swelling

7. What three vitamin deficiencies are associated with homocystinemia?
Folate - vitamin B12 - and vitamin B6
Arginine
Cervical neoplasia
Decreases

8. Name the most common type or cause - Sinusitis and otitis media in children
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
Probenecid
Pneumococcus
cDNA - when it is made from mRNA

9. Describe What type of fluid is either gained or lost with the following changes in body hydration for the ECF volume - ICF volume - and body osmolarity - respectively: x ECF - increase; ICF - increase; body - decrease
Sarcoplasmic reticulum
Superior
Pulmonary shunt (i.e. - pulmonary embolism)
Gain of hypotonic fluid (water intoxication or hypotonic saline)

10. What is the enzyme for the oxidative reaction in glycolysis?
Glyceraldehyde dehydrogenase
Low interstitial free Ca2+ concentrations
Yolk sac tumor
Proencephalon

11. What oral hypoglycemic agent stimulates pancreatic Beta- cell release of insulin and is given just prior to meals because of its short half - life?
G0 phase
Repaglinide
Cytochrome c
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma

12. What mast cell mediator is a chemotactic agent?
Pneumothorax
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.
Western blot
Eosinophil chemotactic factor A

13. Can advance directives be oral?
Excess lead
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Methylphenidate (Ritalin)
Yes

14. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x Ki - ras and erb -2
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Swan - neck deformities
Lung cancer
Placental alkaline phosphatase

15. What lymphoid organ has the following characteristics: outer and inner cortical areas - encapsulation - germinal centers - and high endothelial venules?
Null hypothesis (what you hope to disprove)
Lymph nodes
pI (isoelectric point)
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.

16. What Freudian psyche component is described as x The conscience - morals - beliefs (middle of the road)?
Atracurium
Wernicke's aphasia
Superego
Glucokinase

17. What thyroid enzyme is needed for oxidation of I- to I'?
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell
Vibrio cholera
In the mouth with salivary a - amylase (ptyalin)
Right coronary artery

18. What organ functions to keep blood glucose levels normal through both well - fed and fasting states and produces ketones in response to increased fatty acid oxidation?
Liver
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.
C1 inhibitor (C1- INH)
Schizoid

19. What organism is associated with the following types of diarrhea? Watery diarrhea from beef - poultry - or gravies
Clostridium perfringens
Between the renal arteries and at the bifurcation of the abdominal aorta
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting). The needle is part of the blood - drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in th
Class II

20. What facultative intracellular fungus is associated with hepatosplenomegaly?
Live vaccines
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Superior and middle
Streptococcus agalactiae (Group B Streptococcus - or GBS)

21. Name the ocular lesion; be specific - A right LGB lesion (in the thalamus)
Eosinophilic exudates
Left homonymous hemianopsia
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.
The left gastric - splenic - and common hepatic arteries

22. What is the term for the point on a scale that divides the population into two equal parts?
IF-2 of the 30S subunit
Syphilitic
Median (think of it as the halfway point)
Atrial filling (venous filling) Atrial - Contraction - Venous

23. Which direction is air flowing when the intra - alveolar pressure is zero?
Non - Hodgkin lymphoma
When the intra - alveolar pressure equals zero - there is no airflow.
IgM
Methicillin

24. Name the area of the cerebral cortex with the function described: x Recall of objects - distances - and scenes; visual input processed here
Occipital lobe
Catatonic schizophrenia
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Agglutination test

25. What cells of the kidney are extravascular chemoreceptors for decreased Na+ - Cl - - and NaCl?
Cleft lip
Macula densa
Urogenital sinus
Superior

26. What vascular pathology is associated with HTN in the upper extremities - hypotension in the lower extremities - and a radial - femoral delay?
H 1
Postductal coarctation of the aorta (adult)
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.
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.

27. What antitubercular agent requires vitamin B6 supplementation?
Hemophilia B
Isoniazid
Standardized rate
Fat necrosis

28. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Naphthylamine
Bladder cancer
Oxazepam - temazepam - and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation - not via the cytochrome p450 system.
Chromosome 5p
Clavicle - acromion - and glenoid fossa of the scapula and the humerus

29. What is the most common one? - Form of vasculitis
Temporal arteritis
Chemotaxis
Repolarization is from base to apex and from epicardium to endocardium.
Initiate and manage gross skeletal muscle movement control

30. What is the most common STD?
ALA dehydrogenase and ferrochelatase
HPV
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
Vitamin C

31. What type of bias is it when the sample population is not a true representative of the population?
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
Selection bias
Corynebacterium diphtheriae
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.

32. Name the product or products of arachidonic acid: x Pain and fever
PGE2
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
Merkel cells (Merkel's tactile cells)

33. What does Candida albicans do that distinguishes it from other fungi?
Phase 4; NE increases the slope of the prepotential - allowing threshold to be reached sooner - and increases the rate of firing.
Dilation of afferent arteriole
EBV
It forms a germinal tube at 37

34. Does subatmospheric pressure act to expand or collapse the lung?
Middle meningeal artery
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.
PDA
Ankylosing spondylitis

35. What is the most common one? - Viral cause of myocarditis
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
None; they are the storage sites for ADH and oxytocin.
Coxsackie B
Affinity (one of each)

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

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37. What is the DOC for the treatment of the late phase response in an asthmatic attack?
Corticosteroid
Midazolam
Arch of the aorta and right subclavian artery
Hydatidiform mole

38. Name the muscle type based on these descriptions: x Continuous involuntary contraction - uninuclear striated branched fibers - actin and myosin overlapping for banding pattern - dyadic T tubules - intercalated discs - troponin and desmin as a Z disc
Cardiac muscle
In men it is prostate cancer - and in women it is breast cancer.
Posterior compartment of the leg - tibial nerve
Cohort studies determine incidence and causality - not prevalence.

39. What lipoprotein is formed if an IDL particle acquires cholesterol from a HDL particle?
LDL
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Middle cerebral artery
CD28

40. Thin extremities - fat collection on the upper back and abdomen - hypertension - hypokalemic alkalosis - acne - hirsutism - wide purple striae - osteoporosis - hyperlipidemia - hyperglycemia with insulin resistance - and protein depletion are all cha
Serocystadenocarcinoma
Punishment
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
Hypercortisolism (Cushing syndrome)

41. What is the titratable acid form of H+ in the urine?
hnRNA
MEN II and III syndromes
H2PO4- (dihydrogen phosphate)
PGD2 - PGE2 - and PGF 2

42. Is excretion greater than or less than filtration for net secretion to occur?
Utricle and saccule
Excretion is greater than filtration for net secretion to occur.
alpha - Cells; glucagon has stimulatory effects on - cells and inhibitory effects on - cells.
Capillaries

43. A 20-year - old woman who was recently diagnosed with a sexually transmitted disease goes to the ER with a tender - painful - swollen - and erythematous knee (monoarticular). What organism is the likely culprit?
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
H 2
Middle meningeal artery

44. Name the MCC - Epiglottitis in an unvaccinated child
Haemophilus influenzae type B
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
The tsetse fly

45. What form of oxidation takes place with the addition of a water molecule and breakage of bonds?
Hydrolysis
Yes. The only civil liberty they lose is the freedom to come and go as they please.
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
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

46. What three AAs are used to synthesize the purine ring?
1. Glycine 2. Aspartate 3. Glutamine
Anxiety disorders; for men it is substance abuse.
Naloxone - naltrexone
Lewy bodies

47. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Eukaryotic cell - 15 to 25 microns - 80S ribosomes - no cell walls - replicates via cytokinesis with mitosis and meiosis
Adulthood
Parasites
Dimercaprol
HDL

48. Does light or darkness regulate the pineal gland?
Hemochromatosis
Melanoma - cancer of the stomach and bladder
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.
Third week

49. When does most REM sleep occur - in the first or second half of sleep?
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
CN I - II - III - VI - and XII Add 1 + 1 = 2 - 1 + 2 = 3 - 1 + 2 + 3 = 6 - 1 + 2 + 3 + 6 = 12
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
As sample size increases - the lower the chance of error.

50. What branch of the immune system is acquired in response to an Ag?
Androgens are 19- carbon steroids.
Phenytoin
Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.
The tsetse fly