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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 is the term for cestode - encysted larvae found in intermediate hosts?
Prostatic carcinoma
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
Cysticerci
Achalasia

2. What Ig prevents bacterial adherence to mucosal surfaces?
IgA
Phenylephrine
Flocculonodular lobe (one of my favorite words in all of medicine!)
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)

3. What myeloid disorder is characterized by increased hematocrit - blood viscosity - basophils - and eosinophils; intense pruritus; and gastric ulcers due to histamine release from basophils - increased LAP - and plethora?
The vagina
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.
Adenocarcinoma (30% to 35%)
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)

4. What is the term for gastric ulcers associated with increased intracranial pressure?

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5. Name the most common type or cause - Infection in a patient on a ventilator
Pseudomonas aeruginosa
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
Iodine - resulting in congenital hypothyroidism
Flutamide

6. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
The T- test (used when comparing two groups)
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
catalase - negative
Meckel diverticulum

7. What lysosomal enzyme is deficient in x Tay- Sachs disease?
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma
Staphylococcus
Roth spots
Hexosaminidase A

8. What subtype of schizophrenia is characterized by x Stuporous mute echopraxia and automatic obedience - waxy flexibility with rigidity of posture?
Berger disease (IgA nephropathy)
Catatonic schizophrenia
Penicillin V
Pirenzepine

9. What results when the maxillary prominence fails to fuse with the medial nasal prominence?
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Adenocarcinoma (because of Barrett esophagus)
Cleft lip
IF and GTP (eIF for eukaryotes)

10. What vessels in the systemic circulation have the greatest and slowest velocity?
The aorta has the greatest velocity and the capillaries have the slowest velocity.
Rhombencephalon
Hypotonia (rag doll appearance)
Goodpasture disease

11. What is the term for any stimulus that increases the probability of a response happening?
Reinforcement
Being a female physician increases the risk of suicide nearly four times the general population.
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
Increased androgen secretion at puberty drives the increased GH secretion.

12. Name the most common type or cause - Nonorganic pneumoconiosis
ACTH
Asbestosis
No CHO - AA - ketones - or peptides are left in the tubular lumen.
2 NADPHs per acetyl CoA

13. What chronic systemic inflammatory disease commonly seen in women aged 20 to 50 is a progressive - symmetric arthritis affecting the hands - wrists - knees - and ankles that improves with increased activity?
Pasteurella multocida
Rheumatoid arthritis
1. Posterior auricular vein 2. Posterior division of the retromandibular vein
Gubernaculum

14. Name the following descriptions associated with bacterial endocarditis: x Painless hyperemic lesions on the palms and soles
Eosinophil
Janeway lesions
Histoplasma capsulatum
REM sleep. Remember - awake brain in a sleeping body.

15. What area of the female reproductive tract is lined by stratified squamous epithelium rich in |glycogen?
Transverse abdominis
The vagina
Amiloride
Hypercortisolism (Cushing syndrome)

16. At What age do children begin to understand the irreversibility of death?
Day 14
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
At 8 to 9 years of age. Prior to this age they view death as a form of punishment.
Gabapentin

17. The faster the ___________ - the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).
Coronary circulation
Calcitriol
PGI2
Rate of absorption

18. What AD disease is associated with chromosome 4p; does not present until the person is in his or her 30s; and involves atrophy of the caudate nucleus - dilatation of the lateral and third ventricles - and signs of extrapyramidal lesions?
Lung cancer
Vitreous humor
Carbamazepine
Huntington disease

19. A tropical fish enthusiast has granulomatous lesions and cellulitis; What is the most likely offending organism?
EBV
Left abducens nucleus or right cerebral cortex
Mycobacterium marinum
CN IX - X - and XI; sigmoid sinus

20. What enzyme of the purine salvage pathway is deficient in the following? - Selective T- cell immunodeficiency
It is rare with normal grief; however - it is relatively common in depression
Chromosome 20q (deficiency in adenosine deaminase)
Purine nucleoside phosphorylase
VSD

21. What is the term for a deficiency or absence of sexual fantasies or desires?
Hypoactive sexual desire disorder
Posterior cruciate ligament
Internal abdominal oblique
IgA

22. What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
The rate of infusion
Anopheles mosquito
Primary sclerosing cholangitis
Membranoproliferative glomerulonephritis (MGN)

23. What is the most common one? - Tumor in men aged 15 to 35
Menstruation
Escherichia coli
Testicular tumors
Duodenal atresia

24. What are the three branches of the celiac trunk?
Zoophilia
Areas 44 and 45
The left gastric - splenic - and common hepatic arteries
Agranulocytosis; approximately 2% develop this side effect.

25. What is the binding site for RNA polymerase?
Vitamin B12 deficiency and folate deficiency
M3 (promyelocytic leukemia)
The promoter indicates where transcription will begin.
Pygmalion effect (experimenter expectancy). This can be eliminated with double - blind studies.

26. Ensures emancipation.
Eosinophil
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Streptokinase
Pregnancy

27. What is the region of an axon where no myelin is found?
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
Primary hyperaldosteronism (Conn syndrome)
Thyroid gland
Nodes of Ranvier

28. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Ventral root?
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
It forms a germinal tube at 37
LH
Motor

29. What is the major difference between the veins in the face and the veins in the rest of the body?
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.
There are no valves and no smooth muscle in the walls of the veins in the face.
Terbinafine
Hepatoma and nonseminomatous testicular germ cell tumors

30. What vitamin deficiency produces angular stomatitis - glossitis - and cheilosis?
Riboflavin (B2) deficiency
Chromosome 15 - 17
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
Azithromycin

31. Is splenomegaly more commonly associated with intravascular or extravascular hemolysis?
Positive
Superior Oblique (CN IV) (LR6 SO4)3
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.
Coombs test

32. Where is ADH synthesized?
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
C5- C9
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.

33. What is the longest and most convoluted segment of the nephron?
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.
PCT
B lymphocyte
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.

34. During puberty - What is the main drive for the increased GH secretion?
LTB4
Resistance increases as resistors are added to the circuit.
Mycoplasma pneumoniae
Increased androgen secretion at puberty drives the increased GH secretion.

35. Name three opsonins.
Preload. It is the load on a muscle Prior to contraction.
Fc portion of IgG - C3b - and mannose - binding proteins
IgA - IgD - IgE - IgG - and IgM
Hypothyroidism. (TSH levels must be monitored.)

36. What vascular tumor associated with von Hippel - Lindau syndrome involves the cerebellum - brainstem - spinal cord - and retina?
Hemangioblastoma
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Psoriasis - ankylosing spondylitis - inflammatory bowel disease - and Reiter's syndrome
Multiple myeloma

37. What enzyme is inhibited by sulfonamides?
Dihydropteroate synthetase
Posterior
Embolism
Vibrio cholera

38. Name the B- cell CD marker: x Receptor for EBV
Mesangial macrophages
CD21; it is a complement receptor for cleaved C3
Alcoholic cirrhosis
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.

39. Name the area of the cerebral cortex with the function described: x Important for REM sleep; origin of NE pathway
Yolk sac tumor
Pons
McArdle's syndrome
Glucose and galactose

40. What is the most common one? - Primary tumor metastasis to the bone
Class IV
Taenia solium
Breast
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.

41. What are the two factors that affect alveolar PCO2 levels?
Metabolic rate and alveolar ventilation (main factor)
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
The greater the cell diameter - the greater the conduction velocity.
EF- G of the 50S subunit

42. Name the compartment of the mediastinum associated with the following thoracic structures: SVC
Surface tension; in the alveoli - it is a force that acts to collapse the lung.
Superior and middle
Mikulicz syndrome
Ribavirin

43. What is the drug of choice for early Parkinson's disease?
Superior
Muscle spindles
Selegiline
Undoing

44. What level of mental retardation is characterized by x Can work in sheltered workshops and learn simple tasks but need supervision?
Chromosome 19
Stretch receptors prevent overdistension of the lungs during inspiration.
Moderate (35-49)
Average

45. What is the term for transverse bands on the fingernails seen in patients with chronic arsenic poisoning?
BPH
Mees lines
Erythromycin
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)

46. What organ must metastasize for carcinoid heart disease to occur?
ATP production
Liver
Metronidazole
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

47. What is the term to describe inability to recall the past and possible assumption of a completely new identity?
LGB (think EYES)
Serocystadenocarcinoma
Dissociative fugue. (Patients are unaware of memory loss.)
Variola (smallpox)

48. Which macrolide is used in the treatment of gastroparesis?
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
Erythromycin
Lipoid nephrosis

49. What adrenal enzyme deficiency results in hypertension - hypernatremia - increased ECF volume - and decreased adrenal androgen production?
Cerebral aqueduct
17- alpha - Hydroxylase deficiency
Mitosis
Hepatitis A

50. With an increase in arterial systolic pressure - what happens to x Stroke volume?
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
Increases
Pernicious anemia
Churg - Strauss syndrome