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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 bones make up the acetabulum?
Nondominant temporal lobe
Granulosa cell tumor of the ovary
Reye syndrome
Pubis - ilium - and ischium

2. If a patient with a cerebellar lesion has nystagmus - which way is the fast component directed - toward or away from the lesion?
Birds
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
Sarcoplasmic reticulum
The fast component is directed toward the affected side of a cerebellar lesion.

3. What two monosaccharides are produced when lactose is hydrolyzed?
Bipolar disorder (manic - depressive disorder)
Affinity
Galactose and glucose
Uracil

4. What two stress hormones are under the permissive action of cortisol?
prognostic predictors
Glucagon and epinephrine
Excretion is greater than filtration for net secretion to occur.
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.

5. What form of endocarditis do patients with SLE commonly encounter?
Libman - Sacks endocarditis
Aspartate and carbomoyl PO4
Lower lobe
Hemorrhagic exudates

6. Name the RNA subtype based on the following: x Found only in the nucleus of eukaryotes and functions to remove introns from mRNA
snRNA
Type II hypersensitivity (cytotoxic)
4 years old
The folding of an AA chain

7. What are the five effects of insulin on fat metabolism?
Stable
VSD
Positive reinforcement
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation

8. What is the term for the number of Ag - binding sites on an Ig?
P = .05; P < .05 rejects the null hypothesis
Valence
Peutz - Jeghers syndrome
Alveolar dead space

9. What organelle is responsible for ribosomal RNA synthesis?
GLUT 2
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
Crigler - Najjar syndrome
Janeway lesions

10. What does prepubertal hypersecretion of growth hormone lead to?
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Yes - by three to four times. Having multiple sexual partners - being overweight - and pelvic pain and/or inflammatory disorders are also likely to be seen in sexually abused females.
Avidity (more than one binding site)
igantism

11. What is the term for the pH at which the structure carries no charge?
pI (isoelectric point)
After the latent period
Posterior
Confabulation; it is commonly seen in Korsakoff's syndrome.

12. How many strains of Pneumococcus capsular polysaccharides are present in the vaccine?
The vaccine contains 23 capsular polysaccharides.
Celiac sprue (gluten - sensitive enteropathy)
Left heart failure
Eosin

13. What enzyme is needed to activate the following reactions? - Trypsinogen to trypsin
None; they are not formed until a girl reaches puberty.
Enterokinase
Waterhouse - Friderichsen syndrome
At least 30% blast in the bone marrow

14. What phase of the cell cycle are the following antineoplastic agents specific for? - Vincristine
Chromomycosis
Estrogen use
Mitosis
Corticospinal tract

15. What water - soluble vitamin deficiency results in pellagra?
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
ASA
Silicosis - Coal worker's pneumoconiosis is synonymous with black lung disease - an upper lobe occupational disorder
Niacin (B3)

16. Starry sky appearance of macrophages is pathognomonic of what lymphoma?
Embolic
The myotatic reflex is responsible for the tension present in all resting muscle.
Burkitt lymphoma
Hypocalcemia and hypophosphatemia

17. Name the MCC of death - In neonates
Femoral nerve
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
Neonatal respiratory distress syndrome (NRDS)
The left gastric - splenic - and common hepatic arteries

18. What enzyme is needed to activate the following reactions? - Procarboxypeptidase to carboxypeptidase
Aspartic acid and glutamic acid
Trypsin
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.
Bacillus cereus

19. What component of the ETC is inhibited by the following? - Antimycin A
Cytochrome b/c1
Semicircular duct
80S ribosomes (because they are eukaryotic)
Dissociation

20. Is the AD or AR form of osteopetrosis malignant?
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
The AR form is malignant and AD is benign.
Pneumocystis carinii
Decreases

21. What vitamin deficiency may result in sideroblastic anemia?
Vitamin B6
At birth (reflex)
pH of 2 and 9
Radial nerve and the profunda brachii artery

22. What protein is required by prokaryotic RNA polymerases to initiate transcription at the promoter region of DNA?
Complex I
Sigma factor
Lactulose
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice

23. With an increase in arterial systolic pressure - what happens to x Vessel compliance?
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
Decreases
Folic acid deficiency
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane

24. What mineral is required for cross - linking of collagen molecules into fibrils?
Atrial contraction Atrial - Contraction - Venous
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
mRNA
Gilbert's syndrome

25. What type of hypersensitivity is a T cell - mediated response to Ags that are not activated by Ab or complement?
Acute glomerulonephritis
The conversion of tyrosine to dopamine in the cytoplasm
Constriction of afferent arteriole
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)

26. IgE- mediated mast cell release - C3a and C5a - and IL-1 all trigger the release of what vasoactive amine?
Androgens are 19- carbon steroids.
Gaucher disease
Histamine
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.

27. The faster the ___________ - the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).
Adrenarche
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Small cell cancer of the lung
Rate of absorption

28. What hematological malignancy is particularly likely to affect patients with Down syndrome?
All (nearly 15-20 times the normal risk)
The conversion of tyrosine to dopamine in the cytoplasm
Coxsackie B
Postinfectious GN

29. What GI pathology is associated with a positive string sign - an increase in the number of bloody stools - RLQ pain - skip lesions - terminal ileum most commonly affected - occurrence in women more than men - and an increased thickness of the bowel?
Resistance of the system increases. (Remember - when resistors are connected in a series - the total of the resistance is the sum of the individual resistances.)
Erythema multiforme
Gabapentin
Crohn disease

30. What oxygen - dependent killing enzyme requires hydrogen peroxide and halide (Cl -) to produce hypochlorous acid?
Buffers (remember that buffers are best when they are used in a pH range near its pK)
Myeloperoxidase
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Posterior

31. What cell transports IgA - is secreted by plasma cells - and is in Peyer's patches to the gastrointestinal lumen?
G1 phase; G2 and S phase are diploid (2N).
No - unsaturated fatty acids have double bonds.
Chromosome 12
M- cells

32. What is the only glycosaminoglycan (GAG) that binds to the linker portion of the proteoglycan?
Hyaluronic acid (all sulfates bind to the core protein)
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember - it may be negative in the first week of the illness - so retest if you have a high index of suspicion.)
Leiomyoma (fibroids)
Prolyl and lysyl hydroxylases

33. What two AAs do not have more than one codon?
Alcoholism
Methionine (start) and tryptophan are the only two AAs with only one codon.
Budd - Chiari syndrome
They innervate skeletal muscle.

34. What Brodmann area is associated with x Primary auditory cortex?
Areas 41 and 42
A low - resistance system is formed by resistors added in parallel.
Areas 44 and 45
The larger the volume of distribution - the lower the plasma concentration of a drug.

35. 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
Gain of isotonic fluid (isotonic saline)
The aorta
Heroin
The conus medullaris terminates at the level of the second lumbar vertebra.

36. Name the most common type or cause - Infantile diarrhea
Nasopharynx
ICF volume decreases when there is an increase in osmolarity and vice versa.
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
Rotavirus

37. Which drug is used to treat respiratory depression associated with an overdose of opioids?
The muscle's ATPase activity
Naloxone or naltrexone
Waldenstr
The tsetse fly

38. What two factors result in the apex of the lung being hypoperfused?
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.
Propranolol
Enkephalin
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.

39. What are the four signs of acute inflammation?
Methicillin
Metronidazole
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
CMV - Toxoplasma gondii - and Listeria

40. What is the most common one? - Complication of PDA
Subacute bacterial endocarditis
Hypervariable region (three per light chain; three per heavy chain)
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.

41. What antiepileptic agent has SIADH as a side effect?
Mercury
Shortens
Carbamazepine
Muscle glycogen phosphorylase

42. What is the term for a deficiency or absence of sexual fantasies or desires?
Nodes of Ranvier
Hypoactive sexual desire disorder
There would be two Fab and Fc regions.
Tylosis

43. What vitamin requires IF for absorption?
Escherichia coli
As sample size increases - the lower the chance of error.
Type IV hypersensitivity (cell - mediated)
Cyanocobalamin (B12)

44. What is the epithelial lining of the prostatic portion of the urethra?
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.
1. Streptomycin 2. Gentamicin 3. Tobramycin
Riboflavin (B2)
CN IX

45. 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?
Lente or NPH insulin (neutral protamine Hagedorn insulin)
IgA nephropathy (Berger disease)
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
C5- C8 deficiency

46. What are the four components of the basement membrane?
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.
Fungi
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.

47. What are the four capsular polysaccharides used in the Neisseria meningitides vaccine?
Wiskott - Aldrich syndrome
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result) - these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease - when obstructive symptoms begin to occur.
Thioridazine
Y - W-135 - and C and A capsular polysaccharides

48. What organism is associated with the following types of diarrhea? Watery diarrhea from beef - poultry - or gravies
DNA polymerase -?
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA
Copper deficiency
Clostridium perfringens

49. What structure or structures cross the diaphragm at x T8 level?
Fibrocystic change of the breast
14 days in most women (Remember - the luteal phase is always constant.)
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.

50. What happens to the lung if the intrapleural pressure exceeds lung recoil?
Measles (rubeola)
Superior
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
The lung will expand; also the opposite is true.