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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 disease arises from the adrenal medulla - displaces and crosses the midline - metastasizes early - is the most common solid tumor - and is seen in the 2- to 4-year - old age group?
Because they do not block D2A receptors - they are antagonists of 5HT2 receptors.
Pseudomonas sp.
Neuroblastoma
1. Big 2. Bilateral 3. Berry aneurysm

2. Is the carotid sinus sensitive to pressure or oxygen?

3. Where is most of the body's Ca2+ stored?
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting).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
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Apoptosis (Remember - there is a lack of inflammatory response.)
Doxacurium

4. From what pharyngeal pouch is the following structure derived? - Palatine tonsil
Labile
Second M PITS for pharyngeal pouch derivatives
Type II hypersensitivity (cytotoxic)
GERD

5. Name the thalamic nucleus based on its input and output - Input from inferior colliculus; output to primary auditory cortex
MGB (think EARS)
Ungated potassium channel
G0 phase
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.

6. Name the most common type or cause - Erysipelas
Anterior hypothalamic zone; lesions here result in hyperthermia.
Breast
Papillary carcinoma
Streptococcus pyogenes

7. The clearance of what substance is the gold standard of renal plasma flow?
Labile
Regression
Para - aminohippurate (PAH)
Sphingomyelin

8. Name the cluster C personality disorder: x Sensitive to criticism - shy - anxious; socially isolated but yearns to be in the crowd
Reverse transcription
Vibrio parahaemolyticus
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns
Avoidant

9. What hormone level peaks 1 day before the surge of LH and FSH in the female cycle?
Streptococcus viridans
NREM sleep. Night terrors are dreams that we are unable to recall.
Deferoxamine - penicillamine
Estradiol

10. Name the compartment of the lower extremity and the nerve based on its movements - Dorsiflex the foot - extend the toes - and invert the foot
Anterior compartment of the leg - deep peroneal nerve
a - Methyldopa (Guanabenz or clonidine is also used.)
Measurement bias
Dimercaprol - penicillamine

11. What nerve supplies general sensation to the anterior two - thirds of the tongue?
Calcarine sulcus
Lingual nerve of CN V3
1. VSD 2. ASD 3. PDA
Oxytocin

12. What is the most common precipitin test used in clinical medicine?
Ipsilateral flaccid paralysis
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
Radial Immuno Diffusion (RID) for Ig levels.
Dystrophic calcification

13. Which macrolide is given as 1200 mg/week for the prophylaxis of Mycobacterium avium intracellulare complex?
The lateral vestibular nucleus
Potter facies
Azithromycin
Projective test. Most tests with a wide range of possibilities for the answers are projective.

14. Name the most common type or cause - Viral pneumonia leading to death
They are in ganglia in the PNS.
Helicobacter pylori - Which is also associated with an increased risk of gastric carcinoma
RSV
The affinity of the drug for its receptor

15. What three major cell lines participate in the acquired immune system?
T cells - B cells - and macrophages
Urogenital folds
C1 through C4
Schizotypal

16. What thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 decreased
Ampulla
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
Eosin
CN VII and VIII

17. Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
No - therapeutic indices can tell which drug is safer - not more toxic.
An internal elastic lamina
Phase 4
Phase I

18. What drug blocks intragranular uptake of NE?
Reserpine
Chronic end - stage renal disease
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.
Mild (50-70)

19. What is the term for a unit of DNA that encodes a particular protein or RNA molecule?
Mallory- Weiss syndrome
A gene (a rather simple definition but accurate)
The parasympathetic nervous system
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.

20. What is the name of demyelination of the corticospinal tract and the dorsal column in the spinal cord due most commonly to a vitamin B12 deficiency?
Emphysematous bleb
After the latent period
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Ewing's sarcoma

21. What substance is used to test platelets' response in patients with von Willebrand disease?
Herpesvirus
Ischemic
Ristocetin
Venlafaxine. (It also has a mild dopaminergic effect.)

22. What is the MCC of the following meningitides? - In patients who have AIDS or are immunocompromised
Cryptococcus
Prevalence rate
Mesencephalic nucleus
Type IV collagen

23. What mineral deficiency involves blood vessel fragility?
Raynaud's phenomenon
Rho-immunoglobin
cDNA - when it is made from mRNA
Copper deficiency

24. In regards to solute concentration - how does water flow?
ater flows from a low - solute to high - solute concentrations.
IgG
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
Stroke volume

25. What is the term for involuntary constriction of the outer third of the vagina to prevent penile penetration?
Mast cells
Vaginismus; it is the female counterpart of premature ejaculation.
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.
Ethyl alcohol

26. What two vitamins are inactivated when they come in contact with acetaldehyde?
Affinity decreases; they are inversely proportional.
H 2
PGE 1 - PGI 2 (most potent) - and TXA 2
Thiamine and folate

27. What hormone - produced by Sertoli cells - if absent would result in the formation of internal female structures?
Raynaud's phenomenon
IF
Parietal cells (Remember - they secrete HCl - too.)
Utricle and saccule

28. What vitamin is a component of the coenzyme thiamine pyrophosphate (TPP)?
Ketoconazole
Thymine (B1)
Day 14
Chromosome 5

29. What are the pharmacologic effects seen sexually with x Dopamine agonists?
Thiazide diuretics
VSD
Turner syndrome
Increased erection and libido

30. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Midbrain
1. Short attention span 2. Impulsivity 3. Hyperactivity
Urinary 17- OH steroids
Primitive atrium
Mesencephalon

31. What is the only DNA virus that has the reverse transcriptase enzyme?
IgG
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
Phase 1
Hepadnavirus

32. In What type of circuit is the total resistance always less than that of the individual resistors?
They are in the grey matter of the CNS.
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors
Reverse transcription
Parallel circuit

33. Name these cluster A personality disorders: x Odd - strange; has magical thinking; socially isolated - paranoid - lacks close friends; has incongruous affect
Uroporphyrinogen III cosynthase
Schizotypal
Gastric cancer
Hematoxylin

34. What three organs are responsible for peripheral conversion of T4 to T3?

35. What hypothalamic nucleus is responsible for the production of ADH?
Supraoptic nuclei; lesions here result in diabetes insipidus.
enveloped
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
The vestibulo - ocular reflex

36. Which hepatitis virus is in the Picornaviridae family?
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.
Hepatitis A
A positive PPD skin test
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.

37. What glycoprotein allows platelets to adhere to von Willebrand factor?
Metaplasia (usually to a more protective cell type)
GP Ib
Type II hypersensitivity reaction
Membrane conductance (think conductance = channels open)

38. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Metencephalon
Rhombencephalon
Minor
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
The energy of activation

39. What sex cell tumor causes precocious puberty - masculinization - gynecomastia in adults - and crystalloids of Reinke?
Spironolactone
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.
Chromophobe adenoma
Leydig cell tumor

40. What is the DOC for the following protozoal infections? - Giardiasis
Major basic protein
Metronidazole
HGPRT
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III) - B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.

41. What disorder is associated with decreased platelet count - prolonged PT and PTT - decreased fibrinogen - and increased fibrin split products (D- dimers)?
Transcription factor IID
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.
There would be a Fab' region; thus - it would still be able to participate in precipitation and agglutination.
Disseminated intravascular coagulation (DIC)

42. Name the most common type or cause - Acute renal failure in the United States
Profound (I.Q. range < 20)
Graves disease
Acute tubular necrosis
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.

43. What subset of T cells recognizes the MHC class I Ags?
CD8+ T cells (cytotoxic) Remember - 8
Onion skinning
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
Copper deficiency

44. What respiratory center in the caudal pons is the center for rhythm promoting prolonged inspirations?
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
Apneustic center (deep breathing place)
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Cefamandole - cefoperazone - and moxalactam

45. What type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea?
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
Hgb F
Excision endonuclease - which removes thiamine dimers from DNA
Labile

46. Name the Hgb - O2 binding site based on the following information: x Greatest affinity of the three remaining sites for attachment; requires PO2 levels of 26 mm Hg to remain attached
Secondary lysosome (think of the primary as inactive and secondary as active)
Area 4
Catatonic schizophrenia
Site 2

47. What nerve is associated with the following functions? - Innervation of the flexor carpi ulnaris - flexor digiti profundus (pinky and ring fingers) - and the intrinsic muscles of the hand
Follicular lymphoma
Basal cell carcinoma
Juxtaglomerular (JG) cell
Ulnar nerve

48. What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?
Syringomyelia
Venlafaxine. (It also has a mild dopaminergic effect.)
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
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.

49. A 30-year - old woman goes to your office with bilateral multiple breast nodules that vary with menstruation and have cyclical pain and engorgement. What is your diagnosis?
Osteosarcoma
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Hot pink with PAS and grey to black with silver stain

50. What is the term for the negative resting membrane potential moving toward threshold?
Depolarization (i.e. - Na+ influx)
Confabulation; it is commonly seen in Korsakoff's syndrome.
Cancer
Liver