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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. Name the correct artery - The right recurrent laryngeal nerve passes around it.
Right brachiocephalic artery
Primary follicle of the cortex
Glioblastoma multiforme
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.

2. What statistical method do you use when analyzing x Case control studies?
Diazoxide
Odds ratio. (Case control studies deal with prevalence.)
Ewing's sarcoma
Anatomical dead space - which ends at the level of the terminal bronchioles.

3. Regarding neuroleptics - What is the relationship between potency and anticholinergic side effects?
One - and it provides the energy for mechanical contraction.
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
Seasonal affective disorder (treat with bright light therapy)
Neisseria meningitides

4. Has proteolytic metabolic effects.
Ovarian fibroma
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Epinephrine
HPV

5. What is the term for the number of new events occurring in a population divided by the population at risk?
Neuroleptic malignant syndrome is a potentially life - threatening condition Which is treated with symptomatic support - bromocriptine - and dantrolene.
Incidence rate
GP Ib
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.

6. What purine base is contained in inosine monophosphate?
Schistocytes
Ribavirin
positive correlation
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)

7. What is the term for white retinal spots surrounded by hemorrhage? In what condition are they seen?
hCG can be detected in the blood by day 8 and in the urine by day 10.
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
Roth spots - and they are seen in bacterial endocarditis.

8. In the classical conditioning model - when a behavior is learned - what must occur to break the probability that a response will happen?
Left atrium and tip of the right atrium
Chromosome 19
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.

9. Of what serotonin receptor is sumatriptan an agonist?
Deltoid
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
5HT1D
Finasteride

10. Based on operant conditioning - What type of reinforcement is described when x Removing a stimulus stops a behavior?
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.
Extinction
Patau syndrome (trisomy 13)
Both

11. Do you monitor heparin's therapeutic levels by PT or PTT?
Homocysteine methyl transferase and methylmalonyl CoA transferase
Deficiency in surfactant
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
Correlation. No - correlation does not imply causation.

12. What regulates the rate of ketone body formation?
The rate of Beta- oxidation
Gout
IgA
Burkitt lymphoma

13. Why is the apex of the lung hypoventilated when a person is standing upright?
Tidal volume (VT)
Fibrinoid necrosis
When it crosses the teres major
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.

14. What is the most common primary malignant tumor in bone?
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.
Afterload
Osteosarcoma
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.

15. What is the term for headaches - inability to concentrate - sleep disturbances; avoidance of associated stimuli; reliving events as dreams or flashbacks following a psychologically stressful event beyond the normal range of expectation?
HMG CoA reductase
Are live attenuated vaccines available in the United States
Acute glomerulonephritis
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)

16. What neuronal cell bodies are contained in the intermediate zone of the spinal cord? (T1- L2)
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.
Site 3
Eaton - Lambert syndrome
Preganglionic sympathetic neurons

17. What cells are atypical on a peripheral blood smear in heterophil - positive mononucleosis?
Plasmodium vivax
Vitamin D
T cells - not B cells
Hypervariable region (three per light chain; three per heavy chain)

18. Which antimicrobial class may cause tooth enamel dysplasia and decreased bone growth in children?
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Streptokinase
Tetracycline
Lisch nodules

19. What are effects of PTH in the kidney?
Acetyl CoA carboxylase
Pasteurella multocida
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Negative

20. Name the MCC of death - In SLE
Ego dystonic
IL-4 - IL-10 - and IL-13
IgM
Renal failure

21. What MHC class of antigens do all nucleated cells carry on their surface membranes?
Rhinovirus and hepatitis A virus
Paneth cells
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
MHC class I antigens; they are also found on the surface of platelets.

22. What is the most common one? - Testicular tumor in infants and children
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
T lymphocyte
Yolk sac tumor
Type II pneumocytes

23. What right - to - left shunt occurs when the aorta opens into the right ventricle and the pulmonary trunk opens into the left ventricle?
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Liver (hepatocytes)
HHV 8
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.

24. What diseases are associated with the HLA- B27 allele

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25. What small - facultative gram - negative intracellular rod's transmission is associated with unpasteurized dairy products and undulant fever?
Toxic dose for 50% of drug takers (median toxic dose)
Left ventricle and auricle of left atrium
Brucella
Porcelain gallbladder

26. Why does carbon monoxide diffusion in the lung (DLCO) decrease in emphysema and fibrosis but increase during exercise?
Ketoconazole
Tensor tympani
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is

27. How early can a pregnancy be detected by hCG assays in the blood? In urine?
refuse
Adenocarcinoma of the cervix
Proud flesh
hCG can be detected in the blood by day 8 and in the urine by day 10.

28. What syndrome is rheumatoid arthritis with pneumoconiosis?
Hepatitis D
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
Caplan syndrome
Utricle and saccule

29. Is digoxin or digitoxin renally eliminated?
Fibroadenoma
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
Ristocetin
Amyloidosis

30. Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid?
Semicircular duct
Doxycycline
Chlortetracycline
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino

31. What area of the brain acts as the center for contralateral horizontal gaze?
HPV serotypes 1 and 4
Frontal eye field (Brodmann area 8)
Isoniazid
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.

32. How many mature sperm are produced by one type B spermatogonium?
Cori cycle
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.
The splenic vein
Four

33. What are the five Ig isotypes?
Substituted judgment. It is made by the person who best knows the patient - not the closest relative.
Pseudogout
Lithium
IgA - IgD - IgE - IgG - and IgM

34. Name the type of exudate - given the following examples - Uremic pericarditis
Fibrinous exudates
Viral meningitis
NREM sleep. Night terrors are dreams that we are unable to recall.
Spermatogonia (type A)

35. What urinary metabolite is elevated in pheochromocytoma?
Area 22 and occasionally 39 and 40
Vanillylmandelic acid (VMA)
PCR
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe

36. Regarding the Lac operon - for What do the following genes code? - I gene
Succinyl CoA
Chromosome 11 - 22
Third M PITS for pharyngeal pouch derivatives
Lac repressor protein

37. Name the type of graft described by these transplants: x From one site to another on the same person
Autograft
Aminophylline
Goodpasture syndrome
Uroporphyrinogen - I synthase

38. What is the most common disease or infection reported to the CDC?
Transudative; exudative has the opposite values and has an elevated cellular content.
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)
PGE2 and PGF2a
Internal abdominal oblique

39. What is the major ketone body produced during alcoholic ketoacidosis?
Salpingitis
Beta- Hydroxybutyrate
Benign nevus (mole)
Squamous cell carcinoma

40. What are the five terminal branches of the facial nerve?
Gubernaculum
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)
Lethal dose for 50% of drug takers (median lethal dose)
Sensitivity (it deals with the sick)

41. What enzyme is deficient in the following glycogen storage disease? - Hers' disease
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
Being a female physician increases the risk of suicide nearly four times the general population.
Hepatic glycogen phosphorylase
CD8+ T cells

42. What CNs are affected if there is a lesion in x The upper medulla?
Adenovirus
Muscle glycogen phosphorylase
CN IX - X - and XII
Eosinophilic exudates

43. A complete opposite expression of your inward feeling (e.g. - arguing all the time with someone you are attracted to when your feelings are not known)
Cohort studies determine incidence and causality - not prevalence.
Reaction formation
Porcelain gallbladder
Diabetes mellitus

44. Is encapsulated.
Renal plasma flow (decrease flow - increase FF)
Gonococcus
Dilation of efferent arteriole
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.

45. Where is lithium metabolized and excreted?

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46. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Benzenes
Affinity
Leukemias
Glycerol kinase
Chlamydia trachomatis

47. What is the term for a large - immature RBC that is spherical - blue - and without a nucleus?
Reticulocyte
Poliomyelitis; it is a bilateral LMN lesion.
Dependent
Fibrinous exudates

48. What is the most common one? - Location of a gastric ulcer
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.
Inferior rectus (CN III) (LR6 SO4)3
M12 strains
Lesser curvature of the antrum of the stomach

49. How many covalent bonds per purine - pyrimidine base pairing are broken during denaturation of dsDNA?
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.
Stable
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.

50. Abs to what hepatitis B Ag provide immunity?
Formation of an identity through issues of independence and rebellion; they define who they are.
Minoxidil (orally and topically - respectively!)
Abs to HBsAg
Parasympathetics (parasympathetics point - sympathetics shoot)