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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 lung measurement based on the following descriptions: x The maximal volume inspired from FRC
Cricothyroid muscles
Inspiratory capacity
Cytochrome c
Medial meniscus

2. What is the legal age to be deemed competent to make decisions?
Aspartate and carbomoyl PO4
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Liver
18 years old (except if emancipated)

3. Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
Phase 4
Macrophages
Right atrium
Blocking

4. What is the drug of choice in the treatment of the lepra reaction?
Beryllium
Clofazimine
Primary intention
Osteopetrosis (Albers - Sch

5. RBCs in the urine
Motor nucleus of CN V
Mast cells
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
Bladder carcinoma

6. What condition is manifested by bilateral sarcoidosis of the parotid glands - submaxillary gland - and submandibular gland with posterior uveal tract involvement?
Mikulicz syndrome
Leptospira
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
Streptococcus viridans

7. Is ulcerative colitis or Crohn disease more commonly associated with primary sclerosing cholangitis?
EF-2 and GTP
Profound (I.Q. range < 20)
An elevated serum osteocalcin level
Ulcerative colitis

8. What is the formula to calculate IQ?
Chlamydia trachomatis
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age
Zanamivir and oseltamivir
Water soluble

9. Name the most common cause - Croup
Medial nuclear group (limbic system)
Parainfluenza virus
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Thymidylate synthetase

10. What are the two hepatitis viruses that can be chronic and can lead eventually to hepatocellular carcinoma?
Interval scale (a ruler - for example)
Missense
Reovirus
Hepatitis B and hepatitis C

11. What endotoxin receptor is the best marker for macrophages?
Leukotriene B4 (LTB4)
CD14
secondary immune response
Pimozide

12. What Ig is the major protective factor in colostrum?
IgA
More than 75% of the vessel
The Purkinje cell
Triazolam

13. Which sedative - hypnotic is contraindicated for patients taking warfarin?
CN XII
Paranoid schizophrenia
Trypsin
Chloral hydrate

14. Is irreversible
Metformin
Ag - Ab binding
External abdominal oblique
Upper outer quadrant (left more than right)

15. What tick is the vector for babesiosis?
Ixodes (also the vector for Lyme disease)
Priapism
Impaired ejaculation
Motor aspect

16. Replacing normal affect with 'brain power'
Cerebral aqueduct
Intellectualization
Cilia
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.

17. What signals are used to direct an enzyme to a lysosome?
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
competency
Ferrochelatase
Phosphorylation of mannose residues

18. What histone binds two nucleosomes together?
Foramen of Winslow
To provide attachment between contiguous cells and to maintain a semipermeable barrier
Beta- Endorphin
H1 histones

19. What excitatory fibers arise from the inferior olivary nuclei on the contralateral side of the body?
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern - my senior resident asked me this question more times than I would like to remember.)
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia

20. How does sympathetic stimulation to the skin result in decreased blood flow and decreased blood volume? (Hint: what vessels are stimulated - and how?)
The increased H+ moves intracellularly and is buffered by K+ leaving the cells - resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis - even though the serum
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.
They innervate skeletal muscle.
Seminoma

21. Where does Beta - oxidation of very long chain fatty acids begin?
Ketamine
Estrogen
Diffuse proliferative GN
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.

22. What mineral is required for cross - linking of collagen molecules into fibrils?
Carbidopa and benserazide
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
Red pulp (Remember - Red pulp and RBCs begin with R.)
Mild (50-70)

23. What are the two ways to leave the prevalence pot?
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
Dimercaprol - D- penicillamine
Recovery and death
Doxycycline and minocycline

24. What is the only dsRNA virus?
Reovirus
Sigma factor
Flumazenil
Amanita phalloides

25. Aschoff bodies
Afterload
Ampulla of the fallopian tube
Rheumatic fever
Bisphosphonates

26. What is the most common site for an aneurysm in cerebral circulation?
Mitosis
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia
Iatrogenesis
Superior and posterior

27. What is the tetrad of tetralogy of Fallot?
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Abs to HBsAg
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
wave

28. What pancreatic islet cell secretes somatostatin?
The poly(A) site on the DNA
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.
Right vagus innervates the SA node and the left vagus innervates the AV node
Mitochondria

29. What is the name for the following RBC indices? - Average Hgb concentration/given volume of packed RBCs
Epinephrine
Osteosarcoma
Verbigeration
Mean corpuscular hemoglobin concentration (MCHC)

30. What is the name of inflammation of the prepatellar bursa?

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31. What type of questions should you begin with when a patient seeks your medical opinion?
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.
Bitemporal heteronymous hemianopsia
Rotavirus
Posterior compartment of the leg - tibial nerve

32. What disorder is described as having x Conscious symptoms with unconscious motivation?
Finasteride
Factitious disorder
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Zonula occludens (tight junctions)

33. How many carbons do androgens have?
Mild (50-70)
Plasmodium falciparum
Aldolase B deficiencies are treated by eliminating fructose from the diet.
Androgens are 19- carbon steroids.

34. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x c - myc
Phase 4; NE increases the slope of the prepotential - allowing threshold to be reached sooner - and increases the rate of firing.
Osteitis fibrosa cystica (von Recklinghausen disease)
Stimulus control
Burkitt lymphoma

35. What glycolytic enzyme has a high Vmax - high Km - and low affinity for glucose?
Glucokinase
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
X- linked recessive
Alcohol. Nearly 10% of adults have a problem with alcohol.

36. What is the most common primary diagnosis resulting in an office visit for males? For females?
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.
Raynaud's phenomenon
CD19
For males - HTN; for females - pregnancy.

37. What is the most common one? - Renal calculus type
Calcium oxylate
Latissimus dorsi
eIF-2 in the P site
TXA2

38. Name the associated chromosome - Patau syndrome
Osteogenesis imperfecta
Serratus anterior
Corticospinal tract
Chromosome 13

39. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ increased - Pi decreased
Primary hyperparathyroidism
Gap junctions
Uric acid
Oblique fissure

40. Close before the valves on the left side of the heart.
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
Right - sided valves
Duchenne muscular dystrophy
Lesser curvature of the antrum of the stomach

41. Which direction is air flowing when the intra - alveolar pressure is zero?
Third M PITS for pharyngeal pouch derivatives
Takayasu arteritis (medium - size to large vessels)
Beta- Galactosidase
When the intra - alveolar pressure equals zero - there is no airflow.

42. What is the relationship between chance of error and x Standard deviation?
As the standard deviation increases - the greater the chance of error.
Ataxia - telangiectasia
Duodenum
Osteocyte

43. What frontal lobe cortex is associated with organizing and planning the intellectual and emotional aspect of behavior?
Prefrontal cortex; it is in front of the premotor area.
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.
Vesicle (e.g. - poison ivy)
Rheumatoid arthritis

44. What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
Syphilitic
Ventral posteromedial nucleus
Kidney

45. What do the following values indicate? - ED50
The stapedius muscle
Effective dose for 50% of drug takers (median effective dose)
Tensor tympani
LDL

46. What is the primary method of nonverbal communication of emotional states?
Expiratory reserve volume (ERV)
Facial expression (the second is vocal intonation)
Arginine
Potency

47. What capsular serotype is associated with Escherichia coli - induced meningitis?
Rho-immunoglobin
K1 capsule
Reverse transcriptase
CN III and IV

48. Which subset of MEN syndrome is associated with the following? - Medullary carcinoma of the thyroid - pheochromocytoma - and mucocutaneous neuromas
Substance P. (Opioids relieve pain in part by blocking substance P.)
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.
Dihydrofolate reductase
MEN III (or IIb)

49. What statistical test compares the means of many groups (>2) of a single nominal variable by using an interval variable?
Sexual aversion disorder
One - way ANOVA
Thermogenic
C5a

50. Which bacteria are associated with the following pigment production? - Pyocyanin (blue - green)
Brucella
Pseudomonas aeruginosa
Chloramphenicol
Streptolysin O

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USMLE Step 1 Prep

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