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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. 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: no change; body: no change
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
Keloid
Gain of isotonic fluid (isotonic saline)

2. What lysosomal enzyme is deficient in x Niemann - Pick disease?
Sphingomyelinase
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)
Volume of distribution is decreased when a large percentage of drug is protein bound.
Ulnar to radial progression

3. What three steps of the TCA cycle generate NADH?
Filiform papillae
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
Toxic or viral hepatitis
Prostatic carcinoma

4. What embryonic structure forms the adult female structures? - Uterine tube - uterus - cervix - and upper third of the vagina
The AR form is malignant and AD is benign.
Diazoxide
Taenia saginata
Paramesonephric ducts

5. What branch off the vertebral artery supplies x The ventrolateral two - thirds of the cervical spinal cord and the ventrolateral part of the medulla?
Ixodes (also the vector for Lyme disease)
Subthreshold potential
Microcytotoxic assay
Anterior spinal artery

6. What part of a neuron receives information?
Dendrites receive information - whereas axons send information.
Isolation of affect
Voltage - gated calcium channel
Postinfectious GN

7. Are the following responses associated with histamines H1 or H2 receptor activation? - Pain and pruritus
Fibroadenoma
Campylobacter jejuni
Spleen
H 1

8. What acid - base disturbance is produced from vomiting?
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)
Scrofula
Microglia (Microglia and mesoderm both begin with M)
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.

9. A 30-year - old woman goes to your office with bilateral multiple breast nodules that vary with menstruation and have cyclical pain and engorgement. What is your diagnosis?
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Vitamin E
C5b - C9
Coma - convulsions - and cardiotoxicity

10. What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
Primary hypercortisolism
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
External 3' - 5' PDE bonds
Porcelain gallbladder

11. Protein production - bile secretion - detoxification - conjugation - and lipid storage.
Log - kill hypothesis (follows first order kinetics)
Atropine with pralidoxime
Functions of hepatocytes
NE

12. Is used to detect Abs in a patient?
Testicular lymphoma
Massive influx of calcium
Direct fluorescent Ab test
Vmax

13. Goodpasture Ag is a component of What type of collagen?
Type IV collagen
Subacute bacterial endocarditis
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
DNA polymerase - a

14. What is the longest and most convoluted segment of the nephron?
Hepatitis A (infectious)
PCT
Pneumococcus (Streptococcus pneumoniae)
B lymphocyte

15. Name the most common cause - Chronic pancreatitis
Resistance decreases as resistors are added in parallel.
Alcohol abuse
Down syndrome (trisomy 21)
Epinephrine

16. What is the only excitatory neuron in the cerebellar cortex - and What is its neurotransmitter?
RNA polymerase I
Takayasu arteritis (medium - size to large vessels)
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
Stapes artery

17. Which diuretic is used as an adrenal steroid antagonist?
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
ELISA screens and Western blot confirms the diagnosis.
Spironolactone
Four high energy bonds - two from ATP in AA activation and two from GTP

18. What primary acid - base disturbance is caused by a loss in fixed acid forcing the reaction to shift to the right - thereby increasing HCO3- levels?
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)
Primary hyperparathyroidism
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
Functions of hepatocytes

19. What diagnosis ensues from finding well - demarcated erythematous plaques with silvery scales on the knees - elbows - and scalp along with nail bed pitting and discoloration?
Mesocortical area
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
Psoriasis
Hydroxyproline (breakdown product of collagen)

20. What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficile - ischemia - Staphylococcus - Shigella - or Candida infection?
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
School phobia
Paramesonephric ducts
Pseudomembranous colitis

21. What is the most common one? - Benign GI tumor
Leiomyoma
Major
Pontocerebellar angle syndrome
The vagina

22. What cells of the retina sees in color and needs bright light to be activated?
Thymus - independent Ags
IgM
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.
Cones (C for color and cones)

23. Under normal conditions - What is the main factor that determines GFR?
The T- test (used when comparing two groups)
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Acute rejection

24. What dementia is associated with dilated ventricles with diffuse cortical atrophy - decreased parietal lobe blood flow - and a decrease in choline acetyl transferase activity?

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25. Which macrolide is given as 1200 mg/week for the prophylaxis of Mycobacterium avium intracellulare complex?
Permanent
Azithromycin
Carnitine acyltransferase I
Hepatitis D

26. What thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 decreased
Virchow triad - associated with the formation of a thrombus.
Menses
Hyperkalemia
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)

27. Why is there an increase in prolactin if the hypothalamic - pituitary axis was severed?
Plummer - Vinson syndrome
Ligament teres
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed - thereby increasing the secretion of prolactin.
Th1; they are also responsible for delayed - type hypersensitivity (type IV)

28. What embryonic structure forms the adult male structure? - Testes - seminiferous tubules - and rete testes
Hypoparathyroidism
Aminoglycosides
Gonads
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.

29. What T cell deficiency syndrome is associated with facial anomalies - hypoparathyroidism - thymic hypoplasia - and recurrent viral and fungal infections?
Gastric carcinoma
Janeway lesions
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
Acetyl CoA and propionyl CoA (in odd chain fatty acids)

30. What two Abs are used to diagnose Hashimoto's thyroiditis?
McArdle's syndrome
Aedes (the same for yellow fever)
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Antithyroglobulin and antimicrosomal Abs

31. What two sugars can be used to produce cerebrosides?
Glucose and galactose
The zygote divides mitotically; only germ cells divide meiotically.
Magnesium
Crude mortality rate

32. What structure or structures cross the diaphragm at x T8 level?
Variable ratio If it is based on time - it is an interval - and if it is based on the number of responses - it is a ratio.
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
Purulent exudates

33. What vitamin is a cofactor of aromatic amino acid decarboxylase and decreases the efficacy of L- dopa if used concomitantly?
Niacin (B3)
Hypertension
Phosphorylation of mannose residues
Vitamin B 6 (pyridoxine)

34. What hormones are produced in the median eminence region of the hypothalamus and the posterior pituitary gland?
None; they are the storage sites for ADH and oxytocin.
Seminoma
Thiamine
Postductal coarctation of the aorta (adult)

35. What herpes virus is associated with Kaposi sarcoma?
HHV 8
Cushing's ulcers
Plummer - Vinson syndrome
LH

36. What is the term for the negative resting membrane potential moving toward threshold?
Reliability (think of it as 'nice grouping' or 'precise')
Osteoclasts
Right coronary artery
Depolarization (i.e. - Na+ influx)

37. Males are more likely to develop _______ than females.
Femoral hernias
Breast and lung cancer - respectively.
Pseudomonas sp.
Hydatidiform mole

38. What CN nucleus receives auditory information from both ears via the cochlear nuclei?
Superior olivary nucleus
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.

39. What three muscles constitute the pes anserinus?
Tryptophan
Superior
1. Sartorius 2. Gracilis 3. Semitendinous
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.

40. What is the only Ig that crosses the placenta?
IgG
IGF-1
Voltage - gated channel
CN V

41. Name the cluster C personality disorder: x Gets others to assume responsibility - is subordinate - and is fearful of being alone and caring for self
G-6- PD deficiency
Dependent
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
Lactulose

42. What segment of the gastrointestinal tract lacks villi - has crypts - and actively transports sodium out of its lumen?
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
Constipation and miosis
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Large intestine. Water is passively removed from the lumen.

43. The first area to be oxygenated in the liver.
The portal tract of the liver lobule
Guanethidine and bretylium
Transferrin
Stage 2 - which accounts for approximately 45% of total sleep time - with REM occupying 20%.

44. What AR disorder is seen by age 1 to 2 with recurrent sinopulmonary infections - uncoordinated muscle movements - and dilation of the blood vessels?
Primary biliary cirrhosis
Topoisomerase I (Relaxase)
Ataxia - telangiectasia
Constipation and miosis

45. What percent of unwed mothers are teenagers?
50% - with 50% of them having the child
Appendix (second is terminal ileum)
hCG can be detected in the blood by day 8 and in the urine by day 10.
Conus arteriosus of the right ventricle and right and left auricles

46. What are the first signs of phenobarbital overdose?
The energy of activation (Ea)
Nystagmus and ataxia
Papillary carcinoma
Onset of bleeding

47. Where is the lesion that produces these symptoms when a patient is asked to look to the left? - Left eye can't look to the left
Left abducens nerve
Aged adult
Fragile X syndrome
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.

48. When is the surface tension the greatest in the respiratory cycle?
Bronchogenic carcinoma
Toxoplasmosis
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Pantothenic acid

49. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - aggression - inability to learn new material - and memory problems
greater
Leydig cell tumor
They are in the grey matter of the CNS.
Limbic system

50. Regarding skeletal muscle mechanics - What is the relationship between velocity and afterload?
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
Alveolar macrophages
Poxvirus