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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 is the DOC for the following protozoal infections? - Pneumocystis carinii pneumonia
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
Formation of an identity through issues of independence and rebellion; they define who they are.
Trimethoprim/sulfamethoxazole (TMP- SMX)
Copper

2. What is the most common one? - Type of PUD
Duodenal ulcers (4 times as common as gastric)
Entamoeba histolytica (treat with metronidazole)
Masochism
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.

3. What direct - pathway basal ganglia disease is described by masklike facies - stooped posture - cogwheel rigidity - pill - rolling tremor at rest - and a gait characterized by shuffling and chasing the center of gravity?

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4. What paraphilia is defined as x Deriving sexual pleasure from being abused or in pain?
12 to 16 weeks (in response to mother's face)
Adrenarche
Internal abdominal oblique
Masochism

5. What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
17- alpha - Hydroxylase deficiency
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Rhombencephalon
Intraductal papilloma

6. What embryonic structure forms the adult male structure? - Gubernaculum testes
Intellectualization
Biotin - ATP - and CO2
Gubernaculum
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).

7. Which IL increases IgA synthesis?
IL-5. It also stimulates eosinophil proliferation.
Phenylalanine hydroxylase
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
Nystagmus and ataxia

8. What hematological malignancy is particularly likely to affect patients with Down syndrome?
Protamine sulfate
No change in length
All (nearly 15-20 times the normal risk)
Celiac sprue (gluten - sensitive enteropathy)

9. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Months to years after transplantation; gradual onset of HTN - oliguria - and azotemia; seen as intimal fibrosis of the blood vessels and in
Hematoxylin
Chronic rejection
The small subunit (40S) binds first.
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)

10. ______________ that slow bacterial growth are bactericidal.
Left homonymous hemianopsia
Antimicrobial agents
Superior
Beta2- integrins

11. Does PT or PTT test the extrinsic coagulation pathway?
Aedes (the same for yellow fever)
Hypersegmented neutrophils
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT - which means warfarin - extrinsic - PT; heparin - intrinsic - PTT)

12. Name the associated chromosome - Chronic lymphocytic leukemia (CLL)
Glyceraldehyde dehydrogenase
Chromosome 12
Hypercortisolism (Cushing syndrome)
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.

13. Deposits in the oral cavity.
Excess lead
Seasonal affective disorder (treat with bright light therapy)
Aedes (the same for yellow fever)
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)

14. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Pancreas
Stable
Nystagmus and ataxia
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
HMG CoA synthase

15. Which aminoglycoside is the DOC for tularemia and the bubonic plague?
Ethyl alcohol
1. Cytosine 2. Uracil (only in RNA) 3. Thymidine
Streptomycin
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)

16. Metformin is contraindicated in ________ because of weight gain as its side effect.
Phosphofructokinase -1 and costs 1 ATP
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
Decreases
Obese patients

17. Name the compartment of the lower extremity and the nerve based on its movements - Flex the hip and extend the knee
Anterior compartment of the thigh - femoral nerve
Class 1 (1A - 1B - and 1C)
PGE (along with low oxygen tension)
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)

18. What is the region of an axon where no myelin is found?
Nodes of Ranvier
Roth spots
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.

19. Name the most common cause - Chronic pancreatitis
Plasmodium malariae; the others are tertian.
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
Alcohol abuse
9.3 L - 15% of body weight

20. Where do adult tapeworms develop - in the intermediate or definitive host?
CN III - IV - and VI
Chi - square (when you are in doubt and have nominal data - use chi - square)
P24
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.

21. Name the ocular lesion; be specific - A right LGB lesion (in the thalamus)
Glucose -6- phosphatase
Left homonymous hemianopsia
H 2
Nucleus pulposus

22. What is the period between going to bed and falling asleep called?
transcription
Sleep latency
Edinger - Westphal nucleus (via CN III)
Amygdala; it helps imprint an emotional response in memory.

23. Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
Duodenal atresia
Dantrolene
The CD4 T cell; the APC is the first cell in the immune response.
Positive correlation

24. Name the structure that enters or exits the following foramina: x Hypoglossal canal
CN XII
Isotypes
Median nerve
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns

25. Call - Exner bodies
Goodpasture syndrome
Cauda equina
GH
Granulosa/thecal cell tumor of the ovary

26. What viral infection is known to cause intracerebral calcifications?
Turner syndrome
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
Rathke's pouch; they can result in compression of the optic chiasm.
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)

27. Where are the postganglionic neuron cell bodies - the CNS or the PNS?
They are in ganglia in the PNS.
Mesocortical area
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
Conduction aphasia

28. How does myelination affect conduction velocity of an action potential?
The greater the myelination - the greater the conduction velocity.
Listeria
Uricosuric
Liver - kidney - and GI epithelium

29. What are the five pieces of information considered necessary for fully informed consent?

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30. What is the term for a direct connection between the intestine and the external environment through the umbilicus because the vitelline duct persists?
Oxazepam - temazepam - and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation - not via the cytochrome p450 system.
1. Sartorius 2. Gracilis 3. Semitendinous
3 years old
Vitelline fistula

31. What is the most common one? - Primary tumor of the liver
Hemangioma (benign)
Pneumococcus
Supraoptic nuclei; lesions here result in diabetes insipidus.
Psoas major

32. 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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33. What two post - transcriptional enzymes in collagen synthesis require ascorbic acid to function properly?
Atelectasis
Para - aminohippurate (PAH)
Prolyl and lysyl hydroxylases
Adult T- cell leukemia

34. What term is an index of the effort needed to expand the lungs (i.e. - overcomes recoil)?
Galactitol
Compliance; the more compliant a lung is - the easier it is to inflate.
Posterior interventricular artery
Vitamin K

35. What triggers phase 4 of the action potential in a ventricular pacemaker cell?
Decreasing potassium conductance - which results in increased excitability
PKU
Indirect or unconjugated
N- formyl - methionine LTB4 C5a IL-8

36. What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord?
Transketolase and transaldolase. The reactions they catalyze are reversible.
The fasciculus cuneatus
Enkephalins
Uroporphyrinogen I synthetase

37. What AR disease involves a defect in AA 508 on chromosome 7 - causing a defect in Cl - transportation that leads to recurrent pulmonary infections and an increase in viscid mucoid secretions along with pancreatic insufficiencies?
Rho (D) immune globulin (RhoGAM) - an anti - RhD IgG antibody - prevents generation of RhD- specific memory B cells in the mother.
Parvovirus B-19
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)

38. How much dietary iodine is necessary to maintain normal thyroid hormone secretion?
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
Northern blot
Naloxone or naltrexone
Somatization

39. Name the most common type or cause - Lung abscess
Aspiration
Congenital heart disease
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
Acanthosis nigricans

40. What carpal bone is most commonly fractured? Dislocated?
Streptococcus pyogenes
The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated.
Aspartate transcarbamylase
Puberty

41. Name these cluster A personality disorders: x Odd - strange; has magical thinking; socially isolated - paranoid - lacks close friends; has incongruous affect
Pyrantel pamoate
Dendrites receive information - whereas axons send information.
Psammoma bodies
Schizotypal

42. What virus is associated with body cavity large B- cell lymphomas?
Entamoeba histolytica
HHV-8
Broca's aphasia
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.

43. What are the five components of portal HTN?
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane

44. What happens to plasma concentration of a drug if there is a large volume of distribution?
Mitochondria - linked disorders are always inherited from the mother.
The larger the volume of distribution - the lower the plasma concentration of a drug.
Desipramine
1. Skin 2. Liver 3. Kidney

45. Which type of cerebral herniation is associated with CN III palsy?
Without children (but don't think about this one for too long)
HHV 8
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
Transtentorial (uncal)

46. What are the three left - to - right shunts?
1. VSD 2. ASD 3. PDA
Sulfonamides
Niclosamide
Eclipse period

47. What potentially fatal disease occurs in children who are given aspirin during a viral illness?
Reye syndrome
Pyrantel pamoate
Diethylcarbamazine
Kinesins. Dynein generates retrograde transportation of information.

48. What happens to the lung if the intrapleural pressure exceeds lung recoil?
The lung will expand; also the opposite is true.
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.
1. Skin 2. Liver 3. Kidney
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.

49. What two drugs - when mixed - can lead to malignant hyperthermia?
Succinylcholine and halothane (Treatment is with dantrolene.)
Parietal cells (Remember - they secrete HCl - too.)
Pseudomonas sp.
Urinary trigone

50. What are the primary neurotransmitters at the following sites? - Chromaffin cells of the adrenal medulla
Epinephrine
The time it takes ACh to diffuse to the postjunctional membrane
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
Trypanosoma cruzi