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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 are the four functions of saliva?
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
Th2 cells

2. What AA is substituted for glutamic acid at position 6 on the Beta - chain in patients with sickle cell anemia?
IgA nephropathy (Berger disease)
Mikulicz syndrome
Valine
Bactericidal

3. What is the term for inflamed - thickened skin on the breast with dimpling associated with cancer?

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4. What happens to plasma concentration of a drug if there is a large volume of distribution?
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
The larger the volume of distribution - the lower the plasma concentration of a drug.
Alveolar macrophages (dust cells)
Arterial PCO2 levels are proportional to cerebral blood flow.

5. The separation of 46 homologous chromosomes without splitting of the centromeres occurs During what phase of meiosis?
Meiosis I; disjunction with centromere splitting occurs during meiosis II.
Alzheimer disease
Positive
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.

6. Name the pattern of genetic transmission characterized thus: both M and F are affected; M may transmit to M; each generation has at least one affected parent; and one mutant allele may produce the disease.
Carbamoyl phosphate synthetase I
DiGeorge's syndrome
MGB (think EARS)
Autosomal dominant

7. What form of hormone is described as having membrane - bound receptors that are stored in vesicles - using second messengers - and having its activity determined by free hormone levels.
Conversion disorder
DiGeorge syndrome
CD28
Water - soluble hormones are considered fast - acting hormones.

8. What organism would you suspect in a patient with diarrhea after eating rice?
Rhinovirus and hepatitis A virus
Clozapine
Bacillus cereus
Megaloblasts

9. What type of pleura is adherent to the surface of the organ?
Sarcoplasmic reticulum
Visceral pleura
Chromosome 11 - 22
H 1

10. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Asbestos
Positive
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
Adult polycystic kidney disease
Mesothelioma and bronchogenic carcinoma

11. Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD?
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Nicotinic acid - because its side effects include hyperuricemia and exacerbation of ulcers.
1. ADP 2. PG 3. TXA2

12. What are the two side effects of opioids to which the user will not develop tolerance?
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.
Goodpasture disease
Adipose tissue
Constipation and miosis

13. What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels?
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
Biotin (only if eaten in large quantities)
TCR
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion

14. What is the signal to open the voltage - gated transmembrane potassium channels?
Ketoconazole
Lysine and arginine
RNA polymerase III
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.

15. Name the eukaryotic RNA polymerase based on the following: x Synthesizes hnRNA - mRNA - and snRNA
RNA polymerase II
CN III
Prokaryotes. Polycistronic and prokaryotes both start with P.
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.

16. What subtype of schizophrenia is characterized by x Stuporous mute echopraxia and automatic obedience - waxy flexibility with rigidity of posture?
Thyroid gland
The biofeedback model is based on the parasympathetic nervous system.
Bulla
Catatonic schizophrenia

17. Where is renin produced?
Saccule and utricle
C5a
Urogenital sinus
In the JG cells of the kidney

18. What are five clinical signs of portal HTN?
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Preload. It is the load on a muscle Prior to contraction.
Menses
Concentration gradient

19. Name the associated chromosome - Chronic lymphocytic leukemia (CLL)
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
Benign lentigo
Chromosome 12
The short arm of chromosome 6

20. Which laxative is used in the treatment of hepatic encephalopathy ?
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
Lactulose

21. What are the four segmented RNA viruses?
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
a - Blockers (- zosins)
Terminal ileum
Hormone - sensitive lipase

22. What disorder is associated with loss of polarity - anaplasia - pleomorphism - discohesiveness - increase in the nuclear:cytoplasmic ratio - hyperchromasia - and increase in the rate of mitosis?
Glioblastoma multiforme
The surface of the medulla
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.
Malignancy

23. What AD disease is associated with chromosome 4p; does not present until the person is in his or her 30s; and involves atrophy of the caudate nucleus - dilatation of the lateral and third ventricles - and signs of extrapyramidal lesions?
Huntington disease
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
They are in ganglia in the PNS.

24. Name the area of the cerebral cortex with the function described: x Speech; critical for personality - concentration - initiating and stopping tasks (do one thing and begin a new without completion of the first) - abstract thought - and memory and hi
Pregnancy
Frontal lobe
tRNA
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.

25. Do the following structures pick up stain from hematoxylin or eosin? - Calcium
Vitamin A is responsible for vision and epithelial health.
Both
Hematoxylin
Hgb F

26. What are the three effects of insulin on protein metabolism?
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
Because the large drop in TPR is accompanied by a large increase in cardiac output - resulting in a minimal change in BP.
Decrease (5- HT and dopamine levels do the same)

27. What right - to - left shunt occurs when the aorta opens into the right ventricle and the pulmonary trunk opens into the left ventricle?
Posterior hypothalamic zones; lesions here result in poikilothermy (environmental control of one's body temperature).
Pantothenic acid
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Conus arteriosus of the right ventricle and right and left auricles

28. Megaloblastic anemia and thrombocytopenia are signs of what vitamin deficiency?
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
Folic acid deficiency
Acetazolamide

29. How many ATPs are hydrolyzed every time a skeletal muscle cross - bridge completes a single cycle?
G0 phase
One - and it provides the energy for mechanical contraction.
Papillary carcinoma of the thyroid
N-5- methyl THF

30. What CNS tumor arises from Rathke's pouch?
IGF-1 (somatomedin C)
Craniopharyngioma
Pinpoint pupils - decreased respiratory rate - and coma
Complex 4

31. Close before the valves on the left side of the heart.
Right - sided valves
Arboviruses (bunyavirus - flavivirus - and togavirus)
Medullary carcinoma of the thyroid
Liver - kidney - and GI epithelium

32. Name the muscle type based on these descriptions: x Involuntary contraction - uninuclear nonstriated fibers - actin and myosin not forming banding pattern; lack of T tubules - gap junctions - and calmodulin.
Urogenital folds
Smooth muscle
Lewy bodies
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.

33. What is the only specific Ag - presenting cell?
Stable
Parallel circuit
5- hydroxyindoleacetic acid (5- HIAA)
B cells; macrophages and dendritic cells are nonspecific.

34. Which chromosome is associated with MHC genes?
Chromosome 6
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.
4 years old
LTB4

35. After fertilization - what cells of the corpus luteum x Secrete progesterone?
Incidence rate
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
Albumin
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.

36. What enzyme is inhibited by disulfiram?
Chronic end - stage renal disease
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.

37. What is the DOC for trigeminal neuralgia?
Carbamazepine
Direct pathway; a good example is Parkinson's disease.
HPVs 16 and 18
Riboflavin (B2)

38. Name the antidote - Nitrates
Negative
Methylene blue
Squamous cell carcinoma
Preoperational (2-6 years)

39. What wave is the cause of the following venous pulse deflections? - The bulging of the tricuspid valve into the right atrium
C wave
Graves disease
Chromosome 5 - 21
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

40. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Spinal nerve?
17- alpha - Hydroxylase deficiency
Both
G-6- PD deficiency
Test - retest reliability

41. What vitamin is a cofactor of aromatic amino acid decarboxylase and decreases the efficacy of L- dopa if used concomitantly?
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.
MGN
HIV
Vitamin B 6 (pyridoxine)

42. Which hepatitis virus is in the Picornaviridae family?
Chromosome 15 - 17
Hepatitis A
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
Healing by secondary intention

43. Name the antidote - Warfarin
Vitamin K
First - order elimination
Smoking
Glucose -6- phosphatase

44. What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
Adrenarche
Salmeterol
Kupffer cells
Corticosteroid

45. Name the ocular lesion; be specific - Left Meyer's loop lesion of the optic radiations.
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Left homonymous hemianopsia
Proximal tubule
Beta- Oxidation of fatty acids

46. Which acid - fast rod is an obligate intracellular parasite?
Mycobacterium leprae
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti - Ab
Both
90% as HCO3- - 5% as carbamino compounds - and 5% as dissolved CO2

47. What embryonic structure forms the following adult structures? - Nephrons - kidney
Metanephros
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Familial polyposis coli
Stapes artery

48. What disease involves microcephaly - mental retardation - cleft lip or palate - and dextrocardia?
NADPH and molecular O 2
Global aphasia
Ethambutol
Patau syndrome (trisomy 13)

49. The duodenal - jejunal flexure is suspended from the posterior abdominal wall by what?
Ligament of Treitz
Folate - vitamin B12 - and vitamin B6
Melanoma - cancer of the stomach and bladder
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.

50. What small - to medium - sized vasculitis is seen in a 35-year - old man who is a heavy smoker presenting with claudication symptoms in the upper and lower extremities?
Areas 44 and 45
Buerger disease (thromboangiitis obliterans)
Meckel diverticulum
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine