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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 pituitary hormone is inhibited during sleep?
Left atrium
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
Postinfectious GN
CN VII

2. How is sleep affected in a person with alcohol intoxication?
Yellow fever (flavivirus)
Decreased REM sleep and REM rebound during withdrawal
They are all formed by the fifth month of fetal life.
At birth (reflex)

3. What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway?
ASA
Gerstmann's syndrome; spoken language is usually understood.
Transketolase and transaldolase. The reactions they catalyze are reversible.
A high - resistance system is formed when resistors are added in a series.

4. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x erb -1
Squamous cell carcinoma of the lung
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Atropine - 2- PAM (pralidoxime)

5. A patient can ______ a feeding tube.
refuse
Ulnar and radial arteries (ulnar is the main supplier)
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.
As the name indicates - there is no change in volume but there is an increase in pressure.

6. What level of mental retardation is characterized by x Needing a highly structured environment with constant supervision?
Chromosome 5p
Thrombus
Profound (I.Q. range < 20)
G0 phase

7. What is the most common one? - Renal pathology in patients with SLE
Somatoform pain disorder
Diffuse proliferative GN
ACh
Metronidazole

8. During puberty - What is the main drive for the increased GH secretion?
Increased androgen secretion at puberty drives the increased GH secretion.
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Nissl substances; there is a great deal of RER in neuron cell bodies - indicating high protein synthesis.
eIF-2 in the P site

9. What is the most common one? - Site for carcinoid tumors
Appendix (second is terminal ileum)
IgG
Passive - aggressive
Afterload

10. Name the macrophages by location: x Liver
Kupffer cells
Bioavailability
Elongation factor - G and GTP
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.

11. Which PG is associated with maintaining a PDA?
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
Bernard - Soulier syndrome
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Chromosome 5

12. Increases the effect of digoxin.
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Superior and posterior
Hyperkalemia
Intermediate part of the hemispheres

13. What is the term to describe the inability to feel any pleasant emotions?
Posterior interventricular artery
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
3' end. Phosphate (PO4) is at the 5' end.
Anhedonia

14. What is the main inhibitor of pyruvate dehydrogenase?
Seminoma
Isovolumetric contraction
Acetyl CoA (pyruvate to acetyl CoA)
REM

15. In What trimester is the fetus most vulnerable to congenital rubella syndrome?
Semicircular duct
Conidia
The first trimester
Hemophilia B

16. Via what pathway is glycolysis increased after phagocytosis?
HMP shunt
Neuroblastoma
CD40
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)

17. What is the only fatty acid that is gluconeogenic?
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death
Lithium
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA
Propionic acid

18. Name the three ketone bodies.
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.
Breast and lung cancer - respectively.
CN II and ophthalmic artery
Acetoacetate - acetone - and Beta- hydroxybutyrate

19. What disease has IgG autoantibodies - occurs in women more than men - and includes exophthalmos - pretibial myxedema - nervousness - heart palpitations - and fatigue?
Nasopharynx
Posterior cricoarytenoid muscles
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
Graves disease

20. What is the largest organ in the body?
Vitamin C
Craniopharyngioma
Asbestosis
Integument (skin and its derivatives)

21. What factors are needed for translocation in eukaryotes?
EF-2 and GTP
Crohn disease
TCR
Doxycycline and minocycline

22. Name the structure that enters or exits the following foramina: x Foramen magnum
gamma and delta chains
CN XI - vertebral arteries
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
The conversion of tyrosine to dopamine in the cytoplasm

23. What is the most common opportunistic infection of the CNS in HIV?
The inner cortex (paracortex) contains the T cells - so it is considered the thymic - dependent area.
Toxoplasmosis
emancipates
Methionine (start) and tryptophan are the only two AAs with only one codon.

24. Name the product or products of arachidonic acid: x Vasodilation
Medial umbilical ligaments
PGD2 - PGE2 - and PGF 2
Chromium (Cr)
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.

25. What follicular cell possesses FSH receptors and converts androgens into estradiol?
Granulosa cells
Type III hypersensitivity (immune complex)
Osteosarcoma
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself

26. What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
Duodenal ulcer
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.
Yersinia pestis

27. What structure of the knee is described thus? - C- shaped shock absorber; aids in attachment of the tibia to the femur via the medial collateral ligament
Prader - Willi syndrome and Angelman syndrome - respectively
Medial meniscus
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.

28. What neurotransmitter is associated with sedation and weight gain?
Musculocutaneous nerve
Purkinje cell is the fastest - and the AV node is the slowest.
Rapidly progressive glomerulonephritis (RPGN)
Histamine

29. What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur - humerus - and tibia?
Caisson disease
Recall bias. These problems arise in retrospective studies.
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
Valine

30. What parasympathetic neurotransmitter of the GI tract stimulates the release of gastrin?

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31. Name the valve abnormality based on the following criteria: x Back - filling into the left atrium during systole; increased v - wave - preload - left atrial volume - and left ventricular filling
Ultralente
Mitral insufficiency
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes

32. What disease is produced by a deficiency in the enzyme tyrosinase?
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
Graves disease
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)
With arteriolar constriction both the flow and pressure downstream decrease.

33. Name the RNA subtype based on the following: x Found only in the nucleus of eukaryotes and functions to remove introns from mRNA
Copper (Cu+)
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
Mercury
snRNA

34. What three AAs are used to synthesize the purine ring?
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
1. Glycine 2. Aspartate 3. Glutamine
IL-5. It also stimulates eosinophil proliferation.
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T

35. Name the most common type or cause - Infantile diarrhea
Rotavirus
ll
Housemaid's knee
Voltage - gated calcium channel

36. What phase of the cell cycle are the following antineoplastic agents specific for? - Bleomycin
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
G2 phase
von Hippel - Lindau syndrome
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)

37. To what host cell receptor does the rabies virus attach?
Hemiballismus
ACh receptor
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva
Chromosome 15

38. Which immunoglobulin is secreted by the plasma cells in the gastrointestinal tract?
IgA
Chi - square.
Occipital lobe
Theca cell

39. What happens to the tonicity of the urine with increased ADH secretion?
Glutamate
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Ixodes (also the vector for Lyme disease)
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)

40. Name the MCC - Pneumonia in adults
Virchow triad - associated with the formation of a thrombus.
Subacute bacterial endocarditis
Streptococcus pneumoniae
Plasmin

41. What is the term for thickened - hyperpigmented skin in the axillae - groin - and skin folds associated with malignancies - obesity - and DM?
During stage 3 and 4 (remember - it is called deep sleep.)
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
Acanthosis nigricans
Beryllium

42. Where do the primordial germ cells arise?
Gubernaculum
X- linked recessive
unprocessed Ags
From the wall of the yolk sac

43. What is the term for the amount of blood expelled from the ventricle per beat?
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e. - pill rolling) is seen in basal ganglia lesions.
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
Superior
Stroke volume

44. What stage of male development is characterized by the following LH and testosterone levels? - LH pulsatile amplitude and levels increase - with increased testosterone production.
Polycystic ovary disease (Stein - Leventhal syndrome)
Negative correlation
Phase 1
Puberty

45. What muscle or muscles are innervated by the following nerves? - Suprascapular nerve
Propofol
PKU
Ulcerative colitis
Supraspinatus and infraspinatus

46. What primary acid - base disturbance is cause by a decrease in alveolar ventilation (increasing CO2 levels) resulting in the reaction shifting to the right and increasing H+ and HCO3- levels?
Constipation and miosis
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
Insulin increases intracellular K+ stores while decreasing serum K+ levels.

47. What is the most common one? - Organism associated with mastitis
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
Staphylococcus aureus
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.
IgG3

48. What is the term to describe how easily a vessel stretches?
Compliance (think of it as distensibility)
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
Glucocorticoids and amphetamines
Quinolones

49. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - poor grooming - poor ability to think abstractly - decreased drive - poor attention span (Hint: if the lesion is in the
Dorsal prefrontal cortex
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Transtentorial (uncal)
Osteogenesis imperfecta

50. Name the compartment of the mediastinum associated with the following thoracic structures: Phrenic nerve
Phase II
Decreases
Albendazole
Superior and middle