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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 acid - base disturbance occurs in colonic diarrhea
Methylene blue
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.
Eclipse period
Raloxifene

2. What embryonic structure forms the adult male structure? - Urinary bladder - urethra - prostate gland - bulbourethral gland
Hyperplasia
Urogenital sinus
Dilator pupillae muscle
Wiskott - Aldrich syndrome

3. What breast pathology involves malignant cells with halos invading the epidermis of the skin?
Paget disease of the breast
Hepatoma and nonseminomatous testicular germ cell tumors
Serocystadenoma
Affinity

4. Most sleep time is spent In what stage of sleep?
Chromosome 11 - 22
Reliability (think of it as 'nice grouping' or 'precise')
Stage 2 - which accounts for approximately 45% of total sleep time - with REM occupying 20%.
eEF-1

5. What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting - fissuring - and oozing?
Adenosine (it is an excellent agent to use in emergencies because its half - life is 30 seconds)
Parietal cells (Remember - they secrete HCl - too.)
Paget disease of the breast
Acanthosis nigricans

6. What is the MCC of the following meningitides? - In neonates to 3 months of age
At birth (reflex)
Streptococcus agalactiae and Escherichia coli
All are lactose fermenters except Yersinia and Proteus.
Chorda tympani of CN VII

7. What is the bioactive form of thyroid hormone?
Arcuate line
Chief cells
Proencephalon
T3

8. What component of the ANS is responsible for dilation of the blood vessels in the erectile tissue of the penis - resulting in an erection?
Translation
Parasympathetics (parasympathetics point - sympathetics shoot)
Vital capacity (VC)
Chromosome 21

9. What antiviral agent blocks the attachment and penetration of influenza A virus?
Short - chain fatty acids
42 L - 67% of body weight
Mitosis
Amantadine

10. From What aortic arch are the following structures derived?
Radial Immuno Diffusion (RID) for Ig levels.
Stapes artery
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.
Proportionate mortality rate

11. What is the most common one? - Site for atherosclerotic plaques in the abdominal aorta
Lentigo maligna melanoma
Pseudomembranous exudates
Preganglionic sympathetic neurons
The bifurcation of the abdominal aorta

12. Are contraindicated in patients who present to the hospital with CHF.
Zonula occludens (tight junctions)
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
Diazepam is longest acting and midazolam is shortest acting.
Beta- Blockers

13. Measles - mumps - varicella zoster - and Francisella tularensis.
A decrease in Ca2+ and an increase in PO4
Are live attenuated vaccines available in the United States
0157:H7
Right ventricle

14. What is the name of the postganglionic parasympathetic ganglion that innervates x The papillary sphincter and ciliary muscle of the eye?
The bifurcation of the abdominal aorta
Basal ganglia
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
Clostridium botulinum

15. What form of GN is characteristically associated with crescent formation?
Medial medullary syndrome
Methylphenidate (Ritalin)
Cilia
Rapidly progressive glomerulonephritis (RPGN)

16. What type of hormone is described as having intracellular receptors - being synthesized as needed - mostly bound to proteins - and having its activity determined by free hormone levels?
Lipid - soluble hormones are considered slow - acting hormones.
Depression
Normal values
1. Cough 2. Coryza 3. Conjunctivitis

17. What lysosomal enzyme is deficient in x Niemann - Pick disease?
Arterioles have the largest drop - whereas the vena cava has the smallest pressure drop in systemic circulation.
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
Sphingomyelinase
Catatonic schizophrenia

18. What is the term for new made - up words?

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19. When do hCG concentrations peak in pregnancy?
In the first 3 months
Nodular sclerosis
Nocardia asteroides
IQ

20. What neuronal cell bodies are contained in the intermediate zone of the spinal cord? (T1- L2)
Pompe's disease
Preganglionic sympathetic neurons
Ipsilateral loss at and below the level of the lesion
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)

21. What is a palpable - elevated solid mass up to 0.5 cm?
Dynorphin
8 weeks (response to a face)
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
Papule

22. Name the structure that enters or exits the following foramina: x Optic canal
CN II and ophthalmic artery
Loose association
Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle.
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent

23. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Fibroblasts
Seminoma
Stable
Vaginismus; it is the female counterpart of premature ejaculation.
Primary hypocortisolism (Addison's disease)

24. Regarding the Lac operon - for What do the following genes code? - I gene
Lac repressor protein
Selection bias
Without children (but don't think about this one for too long)
Umbilical vein and ductus venosus (80%)

25. What disease that involves mental retardation - flat face - muscle hypotonia - and a double - bubble sign on radiograph poses an increased risk of Alzheimer's disease and All?
Rathke's pouch; they can result in compression of the optic chiasm.
Regression
Minocycline
Down syndrome (trisomy 21)

26. What is the term for production of a DNA copy from an RNA molecule?
Odds ratio. (Case control studies deal with prevalence.)
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
Reverse transcription
Semicircular duct

27. Curschmann spirals
Prefrontal cortex; it is in front of the premotor area.
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
Bronchial asthma (whorled mucous plugs)
Postductal coarctation of the aorta (adult)

28. What are the three carboxylase enzymes that require biotin?
a - Blockers (- zosins)
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Tidal volume (VT)
Sinus venosus

29. What does failure of PaO2 to increase with supplemental O2 indicate?
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
1. Covalent bonding between the hapten and carrier 2. B- cell exposure to hapten twice 3. T- cell exposure to carrier twice
Pulmonary shunt (i.e. - pulmonary embolism)
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.

30. When is the first arrested stage of development in the female reproductive cycle?
Prophase of meiosis I (between 12th and 22nd week in utero)
HDL
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Macula densa

31. Which bacteria are associated with the following pigment production? - Red pigmentation
Bronchogenic carcinoma
Serratia
The stapedius muscle
Herpes virus

32. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF ? - capillary pressure ?
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
Dilation of efferent arteriole
GnRH constant infusion
2 ATPs - because RBCs use only anaerobic metabolism.

33. What three organs are necessary for the production of vitamin D3(cholecalciferol)?
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
Succinate dehydrogenase
Skin - liver - and kidneys
Biotin - ATP - and CO2

34. If a patient with a cerebellar lesion has nystagmus - which way is the fast component directed - toward or away from the lesion?
Staphylococcus saprophyticus
NADPH and molecular O 2
The fast component is directed toward the affected side of a cerebellar lesion.
Look for broken blood vessels in the baby's eyes.

35. What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
Lipoprotein lipase
Hypervariable region
Myasthenia gravis
Simon focus

36. Name these mature defense mechanisms: x Helping others without expecting any return
Chromosome 17
Ulcerative colitis
Altruism
Beryllium

37. What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?
Primary sclerosing cholangitis
During stage 3 and 4 (remember - it is called deep sleep.)
Duodenum
Excision endonuclease - which removes thiamine dimers from DNA

38. What triggers phase 4 of the action potential in a ventricular pacemaker cell?
Decreasing potassium conductance - which results in increased excitability
Mesolimbic system
Obturator nerve
M 2

39. With a decrease in arterial diastolic pressure - what happens to x TPR?
Decreases
Supraspinatus and infraspinatus
Astrocytoma
Motor nucleus of CN V

40. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CA-19.9 and CEA
Pancreatic cancer
Mesonephric duct
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.
Hypochondriasis (they will begin with 'I think I have...')

41. What transports iron in the blood?
IgA
2 ATPs by oxidative phosphorylation
Transferrin
Factors II - VII - IX - X - and proteins C and S

42. Name the type of necrosis - Histologically resembles fibrin
Craniopharyngioma
Budd - Chiari syndrome
Fibrinoid necrosis
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.

43. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x abl
Because it is the largest vessel and has the highest velocity in systemic circulation
Eisenmenger's syndrome
CML and All
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.

44. What is the most common one? - Type of hernia seen in males more than 50 years old
Posterior cruciate ligament
Middle meningeal artery
Direct; in males less than 50 years old indirect hernias are the most common type.
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)

45. Name the most common type or cause - Acute renal failure in the United States
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Acute tubular necrosis
Myeloperoxidase
Id

46. What AA has a pKa of 13?
S phase
Mees lines
Arginine
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)

47. How many pairs of spinal nerves are associated with x Sacral vertebrae?
Neutrophils - eosinophils - and basophils
Inspiratory capacity
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
A transport maximum (Tm) system

48. What is the rule of one - third regarding muscle type of the esophagus?
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
SA node; it is the reason it is the primary pacemaker of the heart.
Urogenital sinus
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle

49. What is the name of the benzodiazepine antagonist used in the treatment of an overdose?
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
Flumazenil
Acute glomerulonephritis
Diphenhydramine

50. What is the most common one? - Malignant thyroid tumor
Papillary carcinoma of the thyroid
The Fc region of IgG and C3b
Poxvirus
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.