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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 preganglionic sympathetic fibers are responsible for innervating the smooth muscle and glands of the pelvis and the hindgut?
Hereditary spherocytosis
The tsetse fly
Lumbar splanchnics
Insulin

2. What percentage of cardiac output flows through the pulmonary circuit?
Capillaries
Stimulus control
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
C3a - C4a - C5a

3. Will a patient with a unilateral lesion in the cerebellum fall toward or away from the affected side?
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Kupffer cells
Rectum

4. Name the most common type or cause - Urethritis in a young - newly sexually active individual
Hydralazine
Succinyl CoA
Staphylococcus saprophyticus
Flea - bitten kidney (can also be seen in pyelonephritis)

5. Do the following structures pick up stain from hematoxylin or eosin? - Bacteria
Itraconazole
Hematoxylin
Relative refractory period
Topoisomerase I (Relaxase)

6. What encephalopathy causes ocular palsies - confusion - and gait abnormalities related to a lesion in the mammillary bodies and/or the dorsomedial nuclei of the thalamus?

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7. Name the structure that enters or exits the following foramina: x Foramen rotundum
CN V2
Nodular sclerosis
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
Blood

8. Results in vitamin B12 malabsorption.
Idiotypes
Pancreatic insufficiency
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
Transverse abdominis

9. Which Streptococcus pyogenes toxin is immunogenic?
Dopamine antagonists
Superior and posterior
total body water
Streptolysin O

10. What myeloid disorder is characterized by dry bone marrow aspirations - splenomegaly - leukoerythroblastosis - teardrop RBCs - and hyperuricemia due to increased cell turnover?
Myelofibrosis with myeloid metaplasia
Purine nucleoside phosphorylase
G0 phase
Housemaid's knee

11. What is the most common one? - Cardiac anomaly in Turner syndrome
Yolk sac tumor
Coarctation of the aorta
Increase the concentration of enzymes
Stratum corneum (keratinized)

12. What portion of the pericardium adheres to the tunica adventitia of the great vessels?
Fibrous pericardium
Separation anxiety
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Mantle cell lymphoma

13. Name the associated chromosome - Neurofibromatosis type 1
Chromosome 17
Hemostasis
Encapsulated bacteria
Type III hypersensitivity (immune complex)

14. What malignant tumor of the skin is associated with Birbeck granules?
CN IX - X - and XI; sigmoid sinus
G0 phase
Voyeurism
Histiocytosis X

15. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH decreased - Ca2+ increased - Pi increased
Pneumocystis carinii
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
The reduviid bug
Secondary hypoparathyroidism (vitamin D toxicity)

16. What bursa is inflamed in clergyman's knee?
The aorta has the greatest velocity and the capillaries have the slowest velocity.
Infrapatellar bursa
Lente insulin and either NPH or protamine zinc insulin (PZI)
The urea cycle

17. Circulating levels of what hormone in men is responsible for the negative feedback loop to the hypothalamus and the anterior pituitary gland regulating the release of LH?
Myasthenia gravis
Testosterone
Depolarization (i.e. - Na+ influx)
Blood

18. Which medication requires an acidic gastric pH for activation to form a protective gel - like coating over ulcers and GI epithelium?
G0 phase
Magnesium
Ipsilateral loss at and below the level of the lesion
Sucralfate

19. What skin type on the palms and soles is characterized by the absence of hair follicles and presence of stratum lucidum?
Thick skin
G-6- PD deficiency
Parallel circuit
epithelial lining

20. Under resting conditions - What is the main determinant of cerebral blood flow?
Plasmodium falciparum
Antigenic determinant (epitope)
Arterial PCO2 levels are proportional to cerebral blood flow.
Type II

21. What AA is substituted for glutamic acid at position 6 on the Beta - chain in patients with sickle cell anemia?
Temporal arteritis (giant cell arteritis)
Medial nuclear group (limbic system)
Vesicle (e.g. - poison ivy)
Valine

22. What are the three components of amyloid?
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
Left atrial myxoma
REM latency; normally it is about 90 minutes.
Digoxin is renally eliminated; digitoxin is hepatically eliminated.

23. What is the only pharyngeal muscle not innervated by CN X?
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
Skeletal muscle
Chi - square.
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.

24. Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
The stapedius muscle
Neuroblastoma
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.

25. What is the term for an increase in the number of cells in a tissue?
Waterhouse - Friderichsen syndrome
Superior and posterior
Area 17
Hyperplasia

26. What is the term for taking an mRNA molecule and arranging the AA sequence forming a protein?
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
Amiloride
G0 phase
Translation

27. What are the three rules of clonal selection?
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
Vitamin B 6 (pyridoxine)
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
Multiple sclerosis

28. What is the name of the B cell - rich area of the spleen?
catalase - negative
Visceral pleura
Primary follicle (in the white pulp)
Class II

29. By removing Na+ from the renal tubule and pumping it back into the ECF compartment - What does aldosterone do to the body's acid - base stores?
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.
LH
Glanzmann syndrome
Onion skinning

30. What is the most common one? - Malignant tumor of the esophagus
Middle
HGPRT
Phase 1
Squamous cell carcinoma

31. What is the vector for Chagas disease?
Primary hyperparathyroidism
The reduviid bug
Alveoli; they are part of the respiratory portion.
Clofazimine

32. What organism would you suspect in a patient with diarrhea after eating rice?
Hypoparathyroidism
Undoing
Bacillus cereus
Membrane conductance (think conductance = channels open)

33. Which leukotriene is chemotactic for neutrophils?
Cingulate gyrus herniation (subfalcine)
LTB4
4.7 L - 5% of body weight
Rhombencephalon

34. What is the label given to an individual whose IQ is x 130
Very superior (<2.5% of the population)
Urachus
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Cryptococcus neoformans

35. In What area of the GI tract does iron get absorbed?
Duodenum
CN IX - X - and XI; sigmoid sinus
Goodpasture syndrome
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.

36. Increases the risk of developing squamous cell carcinoma of the penis.
Spironolactone
Macula densa
NH4+(ammonium)
HPV infection

37. What is the MCC of death in black males aged 15 to 24?
Homocysteine methyl transferase
Hepatitis D
Osteogenesis imperfecta
Homicide. It is also the leading cause of death in black females aged 15 to 24.

38. Is nystagmus defined by the fast or slow component?
Waldenstr
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm
Free ionized Ca2+
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.

39. Name the aphasia based on these characteristics: x Both Broca's and Wernicke's areas damaged by lesion in the presylvian speech area; trouble repeating statements; poor comprehension with telegraphic speech
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
Global aphasia
Lung and bronchus cancer
Hereditary spherocytosis

40. What two Ags must be positive for a patient to have chronic active hepatitis?
Voltage - gated potassium channels
Relative refractory period
Kidney
HBsAg and HBeAg

41. All streptococci are...
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
catalase - negative
Streptococcus viridans
REM sleep. Nightmares are frightening dreams that we recall.

42. Which shuttle is used to bring fatty acyl CoA from the cytoplasm for ketogenesis?
Ipsilateral flaccid paralysis
Carnitine acyl CoA transferase II
Cryptococcus neoformans
Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.

43. What are the three signs of morphine overdose?
HMP shunt
Pinpoint pupils - decreased respiratory rate - and coma
Dimercaprol - D- penicillamine
The Purkinje cell

44. What herpes virus is associated with Kaposi sarcoma?
Coronavirus
HHV 8
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
Teeth grinding is associated with stage 2 sleep.

45. Name the type of necrosis - Histologically resembles fibrin
Negative
Th2
RSV
Fibrinoid necrosis

46. Reinke crystals
LH
Sertoli cell
Trypsin
Leydig cell tumor

47. Name the MCC - Pneumonia in a patient with atypical bird exposure and hepatitis
Chromosome 19
S2 - S3 - S4
Chromosome 15 - 17
Chlamydia psittaci

48. Name the ocular lesion; be specific - Left optic nerve lesion
Aspiration
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.
Left eye anopsia (left nasal and temporal hemianopsia)
Fixation (arrested development)

49. What nerve and artery could be affected in a humeral neck fracture?
Hurler syndrome and Hunter syndrome - respectively
Axillary nerve and posterior humeral artery
Peutz - Jeghers syndrome
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.

50. Name the antidote - Iron
Dimercaprol - penicillamine
Deferoxamine - penicillamine
Arboviruses (bunyavirus - flavivirus - and togavirus)
Enterococcus faecalis