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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 failure of the testes to descend into the scrotum?
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
Stapes artery
CN VII

2. Name the stages of sleep with these EEG patterns: x Delta waves
Chromosome 20q (deficiency in adenosine deaminase)
Stage 3 and 4
Hydatidiform mole
Follicular lymphoma

3. What is the site of action of cholera toxin?
Proencephalon diencephalon derivative
Phototherapy
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.
Red muscle

4. What is the name for the following RBC indices? - The coefficient of variation of the RBC volume
Zinc (Zn) deficiency
Convergence
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Red blood cell distribution width index (RDW)

5. What is the term for new made - up words?

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6. What is the term for formation of a stable fibrin - platelet plug to stop bleeding?
alpha2- Receptors
Hemostasis
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.
Pinpoint pupils - decreased respiratory rate - and coma

7. What operant conditioning therapy or modification is described as x Reinforcing successive attempts that lead to the desired goal (gradual improvement)?
Nystagmus and ataxia
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Shaping (successive approximation)
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.

8. What pituitary hormone is inhibited during sleep?
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Vimentin
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
Prinzmetal variant angina

9. What nerve is associated with the following functions? - Supinate the wrist - extend the wrist and digits - extend the shoulder and elbow
Radial nerve
Extinction
hnRNA
Chromosome 15

10. What are the most common causes of osteomyelitis x In neonates?
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.
Streptococcus agalactiae
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)
Rotavirus

11. Heinz bodies
Dominant temporal lobe
G-6- PD deficiency
Cytochrome c
DHEA (androgens) Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

12. Ophthalmic artery is a branch of What artery?
Secondary spermatocyte
RNA polymerase III
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
Internal carotid artery

13. What are the two precursors of heme?
apo B-48
Unconjugated free bilirubin
Glycine and succinyl - CoA
Nonsense

14. Name the thalamic nucleus based on its input and output - Input from the mammillary bodies via the mammillothalamic tract and the cingulated gyrus; output to the cingulated gyrus via the anterior limb of the internal capsule
Anterior nuclear group (Papez circuit of the limbic system)
Urachus
Gastric cancer
NREM sleep. Night terrors are dreams that we are unable to recall.

15. What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
Streptococcus viridans
Acetyl CoA carboxylase
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.

16. What adrenal enzyme deficiency results in hypertension - hypernatremia - and virilization?
11- Beta - Hydroxylase deficiency results in excess production of 11- deoxycorticosterone - a weak mineralocorticoid. It increases BP - Na+ - and ECF volume along with production of adrenal androgens.
Mitral valve stenosis
Bacteria
Serotonin

17. What is the name of the process that ensures that each B cell produces only one heavy- chain variable domain and one light chain?
Folate - vitamin B12 - and vitamin B6
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Azithromycin

18. What hormone is necessary for normal GH secretion?
Ribonucleotide reductase
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
Afterload

19. What is associated with prolonged lithium use?
Alveolar macrophages
Hypothyroidism. (TSH levels must be monitored.)
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.

20. Name the most common one - Chromosomal disorder
Introjection (a sports fan is a good example)
Down syndrome (trisomy 21)
Haemophilus influenzae type B
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.

21. What disorder is characterized by autoantibodies to IF?
Eosin
Gonads
Positive predictive value
Pernicious anemia

22. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Percentage of Na+ - Cl - - K+ left in the lumen
t the end of the PCT 25% of Na+ - Cl - - K+ is left
Clostridium perfringens
robenecid - a uricosuric agent
Medial compartment of the thigh - obturator nerve

23. What are the three platelet aggregating factors?
Plasma cell
Tyrosine
Melanoma - cancer of the stomach and bladder
1. ADP 2. PG 3. TXA2

24. What substrate is built up in Niemann - Pick disease?
Sphingomyelin
Fibrous pericardium
Biotin. Avidin is found in raw egg whites.
Bronchial asthma (eosinophil membranes)

25. Is an anti - HAV IgG Ab associated with immunization or recent infection?
Right coronary artery
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
almitate
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.

26. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Placental alkaline phosphatase
Negative
Seminoma
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Hypoactive sexual desire disorder

27. Name the cerebral vessel associated with the following vascular pathologies - Subdural hemorrhage
Pinpoint pupils - decreased respiratory rate - and coma
Wiskott - Aldrich syndrome
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm
Bridging veins draining into the sagittal sinus

28. What area of the lymph node contains germinal centers?
The outer cortex contains most of the germinal centers and therefore also most B cells.
Gardner syndrome
Hepatitis A
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)

29. Without ADH the collecting duct would be...
hyperventilation
Graves disease
impermeable to water
Stapedius muscle

30. What is the fastest - conducting fiber of the heart? Slowest conduction fiber in the heart?
Purkinje cell is the fastest - and the AV node is the slowest.
Superior and posterior
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.

31. What AD GI neoplasia produces multiple adenomatous polyps - osteomas - fibromas - and epidural inclusion cysts?
Streptococcus viridans
CN X
Generalized anxiety disorder
Gardner syndrome

32. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Clonidine
Ureaplasma urealyticum
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
Western blot

33. Name these immature defense mechanisms: x Returning to an earlier stage of development (e.g. - enuresis)
IgD; IgM is also correct.
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
Regression
Phase 0

34. What two AAs have a pKa of 4?
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
Agranulocytosis; approximately 2% develop this side effect.
Immature B cells
Aspartic acid and glutamic acid

35. On a graphical representation of filtration - reabsorption - and excretion - When does glucose first appear in the urine?
Serum 25- hydroxy- vitamin D (25- OH- D)
Acetoacetate - acetone - and Beta- hydroxybutyrate
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
Impaired ejaculation

36. What is the term for the difference between systolic and diastolic pressures?
Seminoma
Pulse pressure
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
The surface of the medulla

37. What is the treatment for nephrogenic diabetes insipidus induced by lithium?
Because they do not block D2A receptors - they are antagonists of 5HT2 receptors.
Creutzfeldt - Jakob's disease. Patients first develop vague somatic complaints and anxiety - rapidly followed by dysarthria - myoclonus - ataxia - and choreoathetosis.
Isovolumetric contraction
Amiloride

38. What is the name of the major chemotactic agent released from x Neutrophils?
Breast and lung cancer - respectively.
At least 5 lobes
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
Leukotriene B4 (LTB4)

39. What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
CML and All
Melanoma - cancer of the stomach and bladder
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.
Heroin

40. What is the drug of choice for steroid - induced osteoporosis?
In the first and second bronchi
Alendronate
Arsenic - thorotrast - and vinyl chloride
Gain of isotonic fluid (isotonic saline)

41. What disorder is described as having x Conscious symptoms with conscious motivation?
Malingering
Middle cerebral artery
Hepatic glycogen phosphorylase
Generalized anxiety disorder

42. How many days prior to ovulation does LH surge occur in the menstrual cycle?
Nodular sclerosis
1 day prior to ovulation
Adenocarcinoma (because of Barrett esophagus)
LH

43. What AA is the major carrier of nitrogen byproducts from most tissues in the body?
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.
Glutamine
Breast cancer

44. What is the most common one? - Location of a gastric ulcer
Acetyl CoA (pyruvate to acetyl CoA)
Flocculonodular lobe (one of my favorite words in all of medicine!)
Lesser curvature of the antrum of the stomach
Thymine

45. Match the pulmonary end capillary blood levels.
Site 2
The alveolar PO2 and PCO2 levels
Pyelonephritis
Decreases

46. What is the largest muscle in the body?
Gluteus maximus
Imipenem and meropenem
a -1 - 6 transferase
The death of a spouse. The higher the score - the greater the risk of developing an illness in the next 6 months.

47. What are the adult remnants of the following structures? - Right and left umbilical arteries
C- peptide levels
16S subunit
Medial umbilical ligaments
Kayser - Fleischer rings

48. What is the name of the benzodiazepine antagonist used in the treatment of an overdose?
Parvovirus (it is the only ssDNA virus)
5HT1D
Severe (range 20-34)
Flumazenil

49. Describe What type of fluid is either gained or lost with the following changes in body hydration for the ECF volume - ICF volume - and body osmolarity - respectively: x ECF - increase; ICF - decrease; body - increase
PKU
almitate
Being a female physician increases the risk of suicide nearly four times the general population.
Gain of hypertonic fluid (mannitol or hypertonic saline)

50. Where is the most frequent site of ectopic pregnancy?
Encapsulated bacteria
Arginine
Ampulla of the fallopian tube
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.

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USMLE Step 1 Prep

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