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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. What enzyme catalyzes the covalent bonding of the AA's carboxyl group to the 3' end of tRNA?
Riboflavin (B2)
Inhibited orgasm
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.
Entamoeba histolytica (treat with metronidazole)

2. 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?
IgG4
Hyperplasia
C5b - C9
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)

3. What AD disease associated with chromosome 19 involves a defect in the LDL receptors that leads to skin and tendon xanthomas?
Southern blot
Carnitine acyltransferase I
Yolk sac tumor
Familial hypercholesterolemia

4. What are the four functions of SER?
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling
H1 histones
Alveolar macrophages (dust cells)
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.

5. What is the primary screening test used to detect HIV- infected individuals? Confirmatory test?
Cystadenocarcinoma
ELISA is used as a screening test because it is very sensitive; Western blot is used as a confirmatory test because it detects antibodies (protein) to the HIV virus.
Secondary hypoparathyroidism (vitamin D toxicity)
Mesencephalic nucleus

6. What is the name of the spinal cord passing within the subarachnoid space and forming the spinal nerves that exit the lumbar and sacral foramina?
Homicide. It is also the leading cause of death in black females aged 15 to 24.
Yes
Cryptococcus
Cauda equina

7. What is the first membrane - bound Ig on B cell membranes?
IgM; IgD follows shortly thereafter.
Squamous cell carcinoma
Free form determines hormone activity and is responsible for the negative feedback loop.
MGB

8. Name the RNA subtype based on the following: x Found only in the nucleus of eukaryotic cells and are precursors of mRNA
hnRNA
Placental alkaline phosphatase
Nimodipine
Paget disease of the breast

9. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
rRNA
Total lung capacity (TLC)
Duchenne muscular dystrophy
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.

10. Which class of antiarrhythmics are potassium channel blockers?
The limbic system
HGPRT
Class III
6 years old

11. What is the term for programmed cell death?
Celecoxib
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell
Seminoma
Apoptosis (Remember - there is a lack of inflammatory response.)

12. When a person goes from supine to standing - what happens to the following? - BP
No. Remember - tests do not diagnose - they confirm or refute your diagnosis. Also - diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI - elevated cardiac enzymes consistent with MI - and ST segment elevati
Carbamazepine
AML- M3
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------

13. What muscle or muscles are innervated by the following nerves? - Upper subscapularis nerve
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
Subscapularis
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
Afterload

14. What cytokine do CD4 T cells secrete to activate B cells when the specific peptide in the groove of the MHC II molecule interacts with the TCR?
Onset of bleeding
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.

15. Name the compartment of the mediastinum associated with the following thoracic structures: SVC
DNA polymerase I
Superior and middle
Microglia (Microglia and mesoderm both begin with M)
Alveoli; they are part of the respiratory portion.

16. Name the hypochromic microcytic anemia based on the following laboratory values - Decreased iron - TIBC - and percent saturation; increased ferritin
Melatonin - serotonin - and CCK
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.
Thymine
Anemia of chronic disease

17. What is the function of white rami communicantes?
They are preganglionic sympathetic axons. They are white because they are myelinated.
VSD
Scrotal cancer - due to the high exposure to polycyclic aromatic hydrocarbons
Flucytosine

18. How much dietary iodine is necessary to maintain normal thyroid hormone secretion?
Paranoid
MEN IIa (or Sipple syndrome)
Valence
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.

19. What drug - if given during pregnancy - would cause the uterus to exhibit signs of progesterone withdrawal and induce an abortion?
Cocaine
Western blot
RU 486
Squamous cell carcinoma

20. What cell surface modification of ependymal cells and respiratory epithelium has a 9 + 2 microtubular configuration and movement as its function?
transcription
Cilia
IL-4
Two - way ANOVA. It allows the test to check several variables at the same time.

21. With what stage of sleep is enuresis associated?
Squamous cell carcinoma
Permanent
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
Farnesyl pyrophosphate (FPP)

22. What cell of the duodenum secretes CCK?
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Enteroendocrine (EE) cells; they also secrete secretin.
Positive
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)

23. Name the aphasia based on these characteristics: x Nonfluent speech - telegraphic and ungrammatical; lesion in Brodmann's area 44; unimpaired comprehension

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24. Name the antidote - Warfarin
Juxtaglomerular (JG) cell
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
Pituitary adenoma
Vitamin K

25. What remains patent in a hydrocele of the testis - allowing peritoneal fluid to form into a cyst?
C3a - C4a - and C5a
The entire tubule barring the thick ascending limb
A patent processus vaginalis
Hepatitis B and hepatitis C

26. To differentiate central from nephrogenic diabetes insipidus - after an injection of ADH - which will show a decreased urine flow?
Central. Remember - there is a deficiency in ADH production in the central form.
Mebendazole
Dysplasia
Necrotizing enterocolitis

27. What projective test asks the patient to tell a story about What is going on in the pictures - evaluating the conflicts - drives - and emotions of the individual?
Finasteride
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.
TAT (Thematic apperception test)
Plasmodium falciparum

28. What skin condition is a localized proliferation of melanocytes presenting as small - oval - light brown macules?
Rathke's pouch; they can result in compression of the optic chiasm.
Boutonni
Benign lentigo
Low molecular weight heparin (LMWH)

29. What aphasia is seen as an inability to comprehend spoken language and speaking in a word salad?
Transcortical aphasia
Burr cells (echinocytes)
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.
Thrush

30. By What age should children be able to draw the following figures? - Cross
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
IgG
4 years old
Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone - produced by Leydig cells - is needed for spermatogenesis.

31. In a ventricular pacemaker cell - what phase of the action potential is affected by NE?
Major
Phase 4; NE increases the slope of the prepotential - allowing threshold to be reached sooner - and increases the rate of firing.
Fc portion of IgG - C3b - and mannose - binding proteins
Zinc (Zn) deficiency

32. How many months in How many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
Negative reinforcement
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.
3 months of symptoms in 2 consecutive years
Velocity is inversely related to cross - sectional area.

33. What apoprotein on HDL activates lecithin - cholesterol acyltransferase (LCAT)?
Kawasaki disease
apo A-1
MGN
Medullary carcinoma of the thyroid

34. What chromosome 4 - AD disorder is a degeneration of GABA neurons in the striatum of the indirect pathway of the basal ganglia?

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35. Clarke's nucleus is the second ascending sensory neuron of which spinocerebellar tract?
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)
Atropine with pralidoxime
For males - HTN; for females - pregnancy.

36. Name the most common type or cause - Breast lump in females
Spinothalamic tract (anterolateral system)
Fibrocystic change of the breast
A gene (a rather simple definition but accurate)
Neuroblastoma

37. What vitamin is needed for the production of heme?
Pyridoxine (B6)
Kayser - Fleischer rings
Stibogluconate
Clostridium perfringens

38. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CA-125
The small subunit (40S) binds first.
CD3
Acral - lentiginous melanoma
Ovarian cancer

39. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x N- myc
Neuroblastoma
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working - you will see an increased reticulocyte count on the peripheral smear in about 5 days.
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
Acid is needed for the activation of pepsin and therefore needed for protein digestion.

40. Name the most common type or cause - Cellular injury
Hypoxia
It increases Ca2+ excretion from the kidney and increases bone mineralization.
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
Ticlopidine or clopidogrel

41. What type of DNA library is made from the mRNA from a tissue expressing a particular gene?
Transcription (C comes before L in the alphabet - and transCription comes before transLation)
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.
Occipital lobe
Ligamentum venosum

42. What IL is important in myeloid cell development?
IL-3 (3 face down is an M)
Stable
Site 3
Osteitis fibrosa cystica (von Recklinghausen disease)

43. What is the first sign of megaloblastic anemia on a peripheral blood smear?
IL-3 (3 face down is an M)
Conjugated (direct) hyperbilirubinemia - a transport defect
Hypersegmented neutrophils
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.

44. What is the most common one? - Organism associated with mastitis
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Nitrofurantoin
Riedel thyroiditis
Staphylococcus aureus

45. There are no persistent infections with...
Zanamivir and oseltamivir
Disseminated intravascular coagulation (DIC)
naked viruses
Glucose -6- phosphatase

46. Near the end of pregnancy - what hormone's receptors increase in the myometrium because of elevated plasma estrogen levels?
Oxytocin
Turner syndrome
Chromosome 4p
HMG- CoA reductase

47. What antiviral agent is used to treat RSV - influenza A and B - Lassa fever - and hantavirus and as an adjunct to IFN- in hepatitis C?
Ribavirin
Broca's aphasia
Eosin
Chlamydia psittaci

48. What case is best known for use of the 'best interest standard'?

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49. The elimination of the unfertilized egg. In females - meiosis II is incomplete unless fertilization takes place.
Day 14
Metastatic calcification
Menses
Prolactinoma

50. From what pharyngeal pouch is the following structure derived? - Superior parathyroid gland and ultimobranchial body of the thyroid
Fourth M PITS for pharyngeal pouch derivatives
Listeria
Bile pigments and bile salts
Bile salts are actively reabsorbed in the distal ileum.

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USMLE Step 1 Prep

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