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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 wave is the cause of the following venous pulse deflections? - The rise in right atrial pressure secondary to blood filling and terminating when the tricuspid valves opens
Paracortex
M3 (promyelocytic leukemia)
Sj
V wave

2. What family do the following viruses belong to? - RSV
Labetalol
Paramyxovirus
Thymus - independent Ags
Lipid - soluble hormones are considered slow - acting hormones.

3. Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD?
Cyanocobalamin (B12)
Actually - yes. You should encourage your patient to try other forms of medicine as long as they are not contraindicated with the patient's preexisting illness. You must be able to accept the health beliefs of your patients - even if you don't agree.
Nicotinic acid - because its side effects include hyperuricemia and exacerbation of ulcers.
The lung will expand; also the opposite is true.

4. What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
M 2
Parkinson disease
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.
Renshaw neuron

5. What organ is responsible for the elimination of excess nitrogen from the body?
Dilation of efferent arteriole
Endometriosis
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Reticulocyte

6. What vessels in the systemic circulation have the greatest and slowest velocity?
Large segment deletions
Streptococci
Separation anxiety
The aorta has the greatest velocity and the capillaries have the slowest velocity.

7. Which gram - negative diplococcus ferments maltose?
Meningococcus (Gonococcus does not)
CN IX
The entire tubule barring the thick ascending limb
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)

8. What is the triad of NPH?
Mitochondria
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Severe (range 20-34)

9. What is the most common one? - Tumor arising within the bone
Ultraviolet B (UVB) sunlight
Progressive multifocal leukoencephalopathy
Multiple myeloma
TCR

10. What hormone causes contractions of smooth muscle - regulates interdigestive motility - and prepares the intestine for the next meal?
Rathke's pouch; they can result in compression of the optic chiasm.
Motilin
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.
Coronary circulation

11. If no fertilization occurs - How many days after ovulation does the corpus luteum begin to degenerate?
12 days after ovulation
Anterior hypothalamic zone; lesions here result in hyperthermia.
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
0157:H7

12. What is the greatest component of lung recoil?
Surface tension; in the alveoli - it is a force that acts to collapse the lung.
AT II
CN III - IV - and VI
There are no valves and no smooth muscle in the walls of the veins in the face.

13. What does prepubertal hypersecretion of growth hormone lead to?
Cricothyroid muscles
igantism
Hirschsprung disease (aganglionic megacolon)
Necrotizing enterocolitis

14. What nonmotile gram - negative - non - lactose - fermenting facultative anaerobic rod uses the human colon as its only reservoir and is transmitted by fecal - oral spread?
Shigella
Streptomycin
0.2
Alanine cycle

15. A suspected dermatophyte infection is stained with KOH. What spore type do you expect to see?
Carbonic anhydrase
Arthroconidia with hyphae
Mean corpuscular volume (MCV)
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon

16. What type of mortality rate is defined as the number of deaths x In the population?
Crude mortality rate
Aschoff bodies of rheumatic fever
Duodenal atresia
Axis III

17. Where does most circulating plasma epinephrine originate?
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Takayasu arteritis (medium - size to large vessels)
Rhabdovirus
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)

18. Name the most common type or cause - Subacute bacterial endocarditis
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
Ratio scale
Streptococcus viridans
3 months of symptoms in 2 consecutive years

19. What three structures are in contact with the left colic flexure? With the right colic flexure?
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
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.)
Lithium
Cryptococcus neoformans

20. What intrauterine deficiency leads to failure to thrive - mental retardation - motor incoordination - and stunted growth?
Pimozide
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.
3'-5' direction - synthesizing RNA in the 5'-3' direction
Iodine - resulting in congenital hypothyroidism

21. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Diencephalon
extrapyramidal dysfunction
Transposons
Proencephalon
Invariant chain

22. In What three areas of the body are sympathetics the predominant tone?
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
1. Sweat glands 2. Arterioles 3. Veins
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
CD40

23. What are the two MCC of acute epididymitis in males? - Less than 35 years old
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
CSF
H 1
Neisseria gonorrhoeae and Chlamydia trachomatis

24. Which muscles of the eye are under parasympathetic control?
Constrictor pupillae and ciliary muscles
Cori cycle
The conus medullaris terminates at the level of the second lumbar vertebra.
a -1 - 6 transferase

25. Name three purine bases that are not found in nucleic acids.
Tetralogy of Fallot
Constriction of afferent arteriole
Vibrio parahaemolyticus
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.

26. How many kilocalories per gram are produced from the degradation of fat? CHO? Protein?
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
Hepatitis B and hepatitis C
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)
Dapsone

27. What type of spore is asexual and formed of hyphae?
Left ventricle and tip of right ventricle
Hapten; if it is coupled with a carrier - it may become immunogenic.
Ea (activation energy)
Conidia

28. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CA-19.9 and CEA
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
Pancreatic cancer
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Galactoside permease

29. What is the most common one? - Proliferative abnormality of an internal organ
BPH
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Herpes I
It both begins and ends at T4 (sternal angle [of Louis]).

30. What protein catalyzes the formation of the last PDE bond between the Okazaki fragments to produce a continuous strand?
DNA ligase
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
BPH
Sorbitol (resulting in cataracts)

31. Bence - Jones proteinuria
Amantadine
GP Ib
Multiple myeloma
IgA nephropathy (Berger disease)

32. What IL is important in myeloid cell development?
Low interstitial free Ca2+ concentrations
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.
IL-3 (3 face down is an M)
Osteogenesis imperfecta

33. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Asbestos
GnRH
Parietal cells (Remember - they secrete HCl - too.)
Measles (rubeola)
Mesothelioma and bronchogenic carcinoma

34. What is the term for the same results achieved again on testing a subject a second or third time?
Arthroconidia with hyphae
Clonorchis sinensis
Test - retest reliability
Palindrome

35. Name the lung measurement based on the following descriptions: x Volume in the lungs at the end of passive expiration
Hypotonia (rag doll appearance)
Functional residual capacity (FRC)
Median nerve lesion
Lysine and tyrosine

36. What embryonic structure forms the adult male structure? - Testes - seminiferous tubules - and rete testes
Iodine - resulting in congenital hypothyroidism
1. Propranolol 2. Timolol 3. Carteolol
Eisenmenger syndrome - which can also occur with any left - to - right shunt
Gonads

37. What type of estrogen is produced in peripheral tissues from androgens?
C5a
Estrone
PALS (Parietolateral lymphocytic sheath)
More Ab is produced in less time in a secondary immune response (shorter lag period).

38. Can advance directives be oral?
Schistosoma haematobium
Choriocarcinomas and trophoblastic tumors
Candida albicans
Yes

39. What is the term for a reversible change in one cell type to another?
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
CML
Metaplasia (usually to a more protective cell type)

40. Damage to what nerve will give you winged scapula?
RU 486
Urachus
Protease - integrase - and reverse transcriptase
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.

41. What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
Skin - liver - and kidneys
Potency
Arch of the aorta and right subclavian artery

42. Aroused EEG pattern (fast low voltage and desynchronization) - saccadic eye movements - ability to dream - and sexual arousal are all associated with what general pattern of sleep?
Vitamin K
P = .05; P < .05 rejects the null hypothesis
REM sleep. Remember - awake brain in a sleeping body.
Neuroblastoma

43. What is the term for osteophyte formation at the proximal interphalangeal (PIP) joints in osteoarthritis? In the distal interphalangeal (DIP) joints?
Malignant mesothelioma
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
Subclavian vein
1. Protest 2. Despair 3. Detachment

44. What disorder causes joint stiffness that worsens with repetitive motion - crepitus - effusions - and swelling and commonly affects the knees - hips - and spine?
As the name indicates - there is no change in volume but there is an increase in pressure.
Tay- Sachs disease
Smooth muscle
Osteoarthritis

45. With a decrease in arterial diastolic pressure - what happens to x Heart rate?
Primary hypogonadism (postmenopausal women)
Ferrochelatase
Decreases
Obese patients

46. Which bacteria are associated with the following pigment production? - Red pigmentation
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.
Serratia
H1 histones
C3 deficiency

47. What is the most common one? - Solid tumor in the body
Nephroblastoma
The conus medullaris terminates at the level of the second lumbar vertebra.
Sphingomyelin
Left homonymous hemianopsia

48. What is the only muscle of the soft palate that is innervated by CN V3?
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
Clonidine
A transport maximum (Tm) system
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.

49. What judgment states that the decision - by rights of autonomy and privacy - belongs to the patient - but if the patient is incompetent to decide - the medical decision is based on subjective wishes?
Substituted judgment. It is made by the person who best knows the patient - not the closest relative.
Ungated channels
Pantothenic acid
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia

50. What is the ratio of T4:T3 secretion from the thyroid gland?
The greater the cell diameter - the greater the conduction velocity.
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
9.3 L - 15% of body weight
F- Met - Peptides