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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. Why is hypothyroidism associated with night blindness?
Dimercaprol - penicillamine
Minimal change disease
Hyaluronic acid (all sulfates bind to the core protein)
Thyroid hormones are necessary for conversion of carotene to vitamin A.

2. What hypothalamic nucleus is responsible for the production of ADH?
Supraoptic nuclei; lesions here result in diabetes insipidus.
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
Henoch - Sch
Separation anxiety

3. Name the most common type or cause - Hematuria
Edrophonium
Adult T- cell leukemia
Infection
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion

4. 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
Bacteria
Cancer of the lung - stomach - colon - and breast
IgG

5. What size ribosomes do fungi have?
80S ribosomes (because they are eukaryotic)
Week four - and they remain dormant there until puberty.
For males - HTN; for females - pregnancy.
hyperventilation

6. What artery travels with the following veins? - Small cardiac vein
There is a difference; it takes about 7 to 8 half - lives to reach mathematical steady state and 4 to 5 half - lives to reach clinical steady state.
Right coronary artery
14 days in most women (Remember - the luteal phase is always constant.)
Ureaplasma urealyticum

7. What are the adult remnants of the following structures? - Foramen ovale
An elevated serum osteocalcin level
Fusobacterium
Herpes virus I and II
Fossa ovale

8. Where do adult tapeworms develop - in the intermediate or definitive host?
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
Diethylcarbamazine
Pneumococcus
Buffers (remember that buffers are best when they are used in a pH range near its pK)

9. What chromosome is associated with the AR form of SCID?
Extracellular
Chromosome 20q (deficiency in adenosine deaminase)
Burkitt lymphoma
Flea - bitten kidney (can also be seen in pyelonephritis)

10. What scale has a true zero point - graded into equal increments - and also orders them?
Ratio scale
Eisenmenger syndrome - which can also occur with any left - to - right shunt
Amantadine
Bronchial asthma (whorled mucous plugs)

11. T3 increases bone ossification through synergistic effect with what hormone?
Stapes artery
GH
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Hepatitis A

12. What is the most common one? - Type of hernia seen in males more than 50 years old
The poly(A) site on the DNA
Direct; in males less than 50 years old indirect hernias are the most common type.
a - Blockers (- zosins)
Major

13. What is the most common condition leading to an intracerebral bleed?
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.
Naloxone - naltrexone
HTN
Anterior nuclear group (Papez circuit of the limbic system)

14. What type of Ag do B cells recognize?
Gardner syndrome
Chloramphenicol
LH
Free - unprocessed Ag

15. What is the start codon - and What does it code for in eukaryotes? Prokaryotes?
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.
Subthreshold potential
CN III and IV
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.

16. What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels?
Adenosine (it is an excellent agent to use in emergencies because its half - life is 30 seconds)
Gastric ulcer
Cyanocobalamin (B12)
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels

17. What respiratory center in the rostral pons has an inhibitory affect on the apneustic center?
Diabetes mellitus
Pneumotaxic center (short - fast breaths)
Adenosine deaminase
Glycine/arginine

18. What is the amount in liters and percent body weight for the following compartments? - Total body water
Mast cells
Trichophyton
42 L - 67% of body weight
Sphingomyelinase

19. At what vertebral levels does the aortic arch begin and end?
Fo/F1 complex
Id (pleasure principle)
It both begins and ends at T4 (sternal angle [of Louis]).
Renin

20. Name the most common type or cause - Cellular injury
Stratum corneum (keratinized)
31 pairs
Hypoxia
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.

21. What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy?
Osteosarcoma
Celecoxib
Topoisomerase I (Relaxase)
Hematoxylin

22. What artificial sweetener must patients with PKU avoid?
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Alcohol abuse
Streptomycin
Aspartame

23. What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
Prophase of meiosis I (between 12th and 22nd week in utero)
Large intestine. Water is passively removed from the lumen.

24. Name the muscle type based on the histological features: x Actin and myosin in sarcomeres; striated; uninuclear; gap junctions; troponin:calcium binding complex; T tubules and SR forming dyadic contacts; voltage - gated calcium channels
Intellectualization
Breast and lung cancer - respectively.
Cardiac muscle
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.

25. What CNs arise from x The pons?
Formal operations (> 12 years)
CN V - VI - VII - and VIII
Cohort studies determine incidence and causality - not prevalence.
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.

26. Panic attacks can be induced by __________ or carbon dioxide.
hyperventilation
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
Diazoxide
Proencephalon

27. What reticular nuclei synthesize serotonin from L- tryptophan and plays a role in mood - aggression - and inducing sleep?
Vibrio parahaemolyticus
Cholera toxin
The raphe nuclei
Nigrostriatal pathways (basal ganglia)

28. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Agraphia - acalculia - finger agnosia - right - left disorientation

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29. What AA has a pKa of 13?
Pyrantel pamoate
Arginine
Oligodendroglioma
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA

30. What is the name of the tremor that occurs during movements and is absent while the person is at rest?
Histamine
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e. - pill rolling) is seen in basal ganglia lesions.
Interferons

31. What malignant neoplasm of the bone has a soap bubble appearance on radiograph?
Giant cell bone tumor (osteoclastoma)
Second M PITS for pharyngeal pouch derivatives
Glucuronidation
IgE

32. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x cyclin D
The AR form is malignant and AD is benign.
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.
Graves disease
Mantle cell lymphoma

33. What type of skin carcinoma occurring on sun - exposed sites has a low level of metastasis?
Bacillus cereus
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
Squamous cell carcinoma
Niemann - Pick and Tay- Sachs diseases

34. What three cephalosporins can produce disulfiram - like reactions?
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.
Propofol
Crigler - Najjar syndrome

35. What type of test asks a patient to draw a scene - attempting to find out the individual's unconscious perceptions in his or her life?
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.
Because it is the largest vessel and has the highest velocity in systemic circulation
C1 through C4
Obturator nerve

36. In an adult - Where does the spinal cord terminate and What is it called?
Minor
Triazolam
Duodenal atresia
The conus medullaris terminates at the level of the second lumbar vertebra.

37. What are the four most common causes of femoral head necrosis?
S phase
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
Fc portion of IgG - C3b - and mannose - binding proteins
HHV 8

38. What is the most common sexual assault?
Pituitary hypogonadism
Pedophilia
For males - HTN; for females - pregnancy.
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)

39. What is the term for the pH range where the dissociation of H+ occurs?
Ketoconazole
Turner syndrome
pK (think of it as where half is base and half is acid)
Aminophylline

40. What three things are needed to produce a double bond in a fatty acid chain in the endoplasmic reticulum?
NADPH - O2 - and cytochrome b5
Herpes I
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)
enveloped

41. What general pattern of sleep is described by slowing of EEG rhythms (high voltage and slower synchronization) - muscle contractions - and lack of eye movement or mental activity?
NREM sleep. Remember awake body - sleeping brain
Paneth cells
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.
Leukemias

42. What is the MCC of viral conjunctivitis?
Adenovirus
Rifampin
Glioblastoma multiforme
Atrial contraction Atrial - Contraction - Venous

43. What is the most common STD?
HPV
Cystic fibrosis
Birds
Anterior compartment of the thigh - femoral nerve

44. 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?
Arch of the aorta and right subclavian artery
1. Protest 2. Despair 3. Detachment
Mentally disabled
reflexes

45. Which subtype of AML is most commonly associated with Auer rods?
M3 (promyelocytic leukemia)
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.
Chromosome 15

46. What phase of Food and Drug Administration approval tests x The protocol and dose levels in a small group of patient volunteers?
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
Phase II
Invariant chain
Edward syndrome (trisomy 18)

47. What muscles in the hand adduct the fingers?
CD4+T cells
Pituitary hypogonadism
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself

48. What is the most common one? - Malignant carcinoma of the ovaries
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Primary sclerosing cholangitis
Increased androgen secretion at puberty drives the increased GH secretion.
Cystadenocarcinoma

49. What negative sense RNA virus is associated with cough - coryza - and conjunctivitis with photophobia?
Kupffer cells
Prolactin
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
Measles (rubeola)

50. What gram - positive spore - forming anaerobic rod blocks the release of ACh at the NMJ - resulting in reversible flaccid paralysis?
Clostridium botulinum
Breast and lung cancer - respectively.
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
von Hippel - Lindau syndrome