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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 condition results in the following CSF results? - Opening pressure 250 mm H2O; WBCs 250 (90% lymphocytes); glucose 35; protein 100
TB meningitis
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
Ventricular contraction Atrial - Contraction - Venous
The vagina

2. What is the triad of Horner's syndrome?
Acute tubular necrosis
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
Astrocytoma
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.

3. If a drug is ionized - is it water or lipid soluble? Can it cross a biomembrane?
Vmax
Pirenzepine
Job syndrome
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.

4. Name the most common type or cause - Breast lump in females
H 2
During REM sleep
Fibrocystic change of the breast
Chromosome 6

5. Name the DNA virus: x Partially dsDNA circular; enveloped; virion - associated polymerases; has RNA intermediate; replicates in the nucleus
Common peroneal nerve
Utricle and saccule
Hepadnavirus
Lateral pontine syndrome

6. Do newborns have a preference for still or moving objects?
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
From age 5 onward IQ stabilizes.
Erythema marginatum
Moving objects - along with large bright objects with curves and complex designs.

7. What cell converts androgens to estrogens?
Granulosa cell
T3 increases both heart rate and cardiac output by increasing the number of Beta - receptors and their sensitivity to catecholamines.
LTB4
CML and All

8. What CNS demyelinating disease is characterized by diplopia - ataxia - paresthesias - monocular blindness and weakness - or spastic paresis?
CN VII
Job syndrome
Multiple sclerosis
Ependymoma

9. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x CDK4
Melanoma
Limbic system
GH deficiency
Anterior spinal artery

10. What is the binding site for RNA polymerase?
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
The promoter indicates where transcription will begin.
0157:H7
Staphylococcus aureus

11. What mosquito is the vector for dengue fever?
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
Broca's aphasia
Aedes (the same for yellow fever)
VIPoma

12. What is the most common one? - Germ cell tumor in men
They prevent mast cell degranulation.
Primary spermatocyte
Gubernaculum
Seminoma

13. What disease is associated with the HLA- A3 allele
Primary Hemochromatosis
Hemiazygous vein
Parvovirus B-19
16S subunit

14. What is the MCC of the following meningitides? - In adults
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
Streptococcus pneumoniae
Rheumatoid arthritis
Liver - kidney - and GI epithelium

15. Auer rods
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
No CHO - AA - ketones - or peptides are left in the tubular lumen.
AML- M3
Mikulicz syndrome

16. What portion of the intervertebral disk is a remnant of the notochord?
The energy of activation
Nucleus pulposus
Clearance
Poxvirus

17. Which form of melanoma carries the best prognosis?
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).
Superior and anterior
Lentigo maligna melanoma
Lateral medullary (Wallenberg's) syndrome

18. What is the name of the B cell that secretes Ig?
Yes - because they both activate the BZ1- receptors - which can be reversed by flumazenil.
Plasma cell (mature B lymphocyte)
Atracurium
3 years old

19. In the alveoli - what cell type is x for gas exchange?
School phobia
Stable
Type I pneumocytes
Candida

20. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Sphingomyelin (lecithin also - but it is not a sphingolipid)
Respiratory depression
Motor aspect
Type II hypersensitivity reaction

21. What are the four effects of suckling on the mother?
Size
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
Bridging veins draining into the sagittal sinus
Thymidylate synthase

22. What vitamin is necessary for the transfer of one amino group from a carbon skeleton to another?
Testicular feminization syndrome (Dude looks like a lady!)
Zollinger - Ellison syndrome
Thoracic and sacral
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.

23. What four conditions result in secondary hyperaldosteronism?
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
Third week
Trichomonas vaginalis (treat with metronidazole)
JC virus

24. What cytokine do Th1 cells secrete to inhibit Th2 cell function?
Metaphase II
Confabulation; it is commonly seen in Korsakoff's syndrome.
INF- gamma
Sj

25. Why isn't the incidence of a disease decreased when a new treatment is initiated?
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
Conidia
Iatrogenesis
One - and it provides the energy for mechanical contraction.

26. Do local anesthetics bind to the activated or inactivated sodium channels?
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
Squamous cell carcinoma (skin - lung) and angiosarcoma of the liver
Inactivated

27. What organ must metastasize for carcinoid heart disease to occur?
Hemiazygous vein
Liver
Nephrotoxicity
Chromosome 15

28. In prokaryotes - What is the name of the RNA sequence that ribosomes bind to so translation can occur?
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+
Papillary carcinoma
Chromosome 5 - 21
Shine - Dalgarno sequence

29. What class of antimicrobial agents should be avoided in patients with a history of GPDH deficiency?
Hypertrophic scar
Yes - because they both activate the BZ1- receptors - which can be reversed by flumazenil.
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
Sulfonamides

30. What Beta- blocker is also an a - blocker?
Mumps
Amiloride
Labetalol
Postinfectious GN

31. What are the cells of the parathyroid gland that produce PTH?
Picornaviridae
VSD - RVH - overriding aorta - and pulmonary stenosis
Chief cells
Inulin

32. What three cephalosporins can produce disulfiram - like reactions?
Ovulation
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Lac repressor protein
Familial hypercholesterolemia

33. Name the hypochromic microcytic anemia based on the following laboratory values - Decreased iron - TIBC - and percent saturation; increased ferritin
Laminin
Anemia of chronic disease
Reject it
Afferent arteriole

34. What disease is associated with the HLA- DR2 and HLA- DR3 alleles
Temporal arteritis
3 years old
Osmosis; water will diffuse from higher to lower water concentrations.
Systemic lupus erythematosus

35. In what form is excess folate stored in the body?
Limbic system
N-5- methyl THF
17- alpha - Hydroxylase deficiency
Acetyl CoA carboxylase

36. What is the term for how well a drug produces its desired response?
Phosphofructokinase -1 and costs 1 ATP
Chlortetracycline
Subarachnoid hemorrhage
Efficacy

37. What are the genetic variants of a molecule within members of the same species?
Allotypes
Stable angina
Anterior wall of the first part of the duodenum
Xanthine oxidase

38. What ocular muscle x Depresses and adducts the eyeball?
Zero correlation
Inferior rectus (CN III) (LR6 SO4)3
Yolk sac tumor
Mesocortical area

39. What vitamin is necessary for epithelial health?
Dilator pupillae muscle
Plasmodium ovale
Vitamin A is responsible for vision and epithelial health.
The death of a spouse. The higher the score - the greater the risk of developing an illness in the next 6 months.

40. What ocular muscle x Depresses and abducts the eyeball?
Microglia. All others are neuroectodermal derivatives.
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.
Superior Oblique (CN IV) (LR6 SO4)3
Pneumococcus

41. What three carcinomas are associated with EBV?

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42. Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
Folate deficiency (very common in the elderly)
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
Pertussis toxin
Progestins

43. What is the limited portion of a large Ag that will actually be recognized and bound to an Ab and that contains approximately five to six amino acids or four to five hexose units?
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Imipenem and meropenem
Lateral fissure (fissure of Sylvius)
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)

44. Name the type of graft described by these transplants: x From one site to another on the same person
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
Autograft
Thrush
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.

45. What syndrome is due to a deficiency of surfactant?
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.
Itraconazole
Phase 1
Ventral posteromedial nucleus

46. Which drug is used to treat respiratory depression associated with an overdose of opioids?
1 day prior to ovulation
The time it takes ACh to diffuse to the postjunctional membrane
Glycine/arginine
Naloxone or naltrexone

47. Why is there an increase in prolactin if the hypothalamic - pituitary axis was severed?
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed - thereby increasing the secretion of prolactin.
C5- C9
CD4+ T cells (helper)
epithelial lining

48. What is the term for the inherent ability to induce a specific immune response?
Osteitis fibrosa cystica (von Recklinghausen disease)
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
P wave

49. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Chromium and nickel
Bronchogenic carcinoma
Vibrio cholera
Hemosiderin
The DCML system. (Remember - everything but pain and temperature.)

50. Without ADH the collecting duct would be...
impermeable to water
Clarke's nucleus
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.