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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 phase of the cell cycle are the following antineoplastic agents specific for? - Vinblastine
Staphylococcus aureus
Mitosis
Bainbridge reflex
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.

2. What is the most common one? Site of congenital diaphragmatic hernias
Liquefaction necrosis
Adenocarcinoma (30% to 35%)
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.
Clavicle - acromion - and glenoid fossa of the scapula and the humerus

3. What stage of male development is characterized by the following LH and testosterone levels? - Decreased testosterone production is accompanied by an increase in LH production.
At least 15%
Aged adult
Bacterial meningitis
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.

4. What is the only way to increase maximum velocity (Vmax)?
The left gastric - splenic - and common hepatic arteries
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.
Increase enzyme concentrations
Invariant chain

5. What statistical method do you use when analyzing x Cohort studies?
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
Ribonucleotide reductase
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
The fasciculus cuneatus

6. Which class of antihypertensives is used in the treatment of BPH?
Pituitary hypogonadism
Actinomyces israelii
a - Blockers (- zosins)
Simple diffusion; it does not use protein - mediated transport

7. Are the following major or minor Jones criteria of rheumatic fever? - Subcutaneous nodules
Major
RSV
Phase 4; NE increases the slope of the prepotential - allowing threshold to be reached sooner - and increases the rate of firing.
PGE 1 - PGI 2 (most potent) - and TXA 2

8. What type of hemostasis in an intravascular space consists of fibrin - platelets - RBCs - and WBCs?
Anterior hypothalamic zone; lesions here result in hyperthermia.
White muscle; short term too
Thrombus
Lead poisoning

9. What part of the ANS is affected in the biofeedback model of operant conditioning?
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.
The biofeedback model is based on the parasympathetic nervous system.
Squamous cell carcinoma
More Ab is produced in less time in a secondary immune response (shorter lag period).

10. What bedside test is used to differentiate a dorsal column lesion from a lesion in the vermis of the cerebral cortex?

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11. Which IL is associated with increases of IgG and IgE?
Sinus venosus
IL-4
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.

12. What antiviral agents inhibit neuraminidases of influenza A and B?
Zanamivir and oseltamivir
Homocysteine methyl transferase
Oblique fissure
Depolarization is from apex to base and from endocardium to epicardium.

13. What mast cell mediator is a chemotactic agent?
Eosinophil chemotactic factor A
igantism
Excess lead
REM sleep. Nightmares are frightening dreams that we recall.

14. To what viral family does the polio virus belong?
REM and stage 4 sleep; they decrease.
Teratoma (dermoid cyst)
Picornaviridae
Alanine and glutamine

15. What is the name for the most prominent spinous process?
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)
Yellow fever (flavivirus)
Diethylcarbamazine
Acetyl CoA (pyruvate to acetyl CoA)

16. What complement factor or factors are associated with x Membrane attack complex (MAC)?
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
HBcAb IgG - HBV- DNA - HBeAg - HBsAg
Cardiac muscle
C5- C9

17. What happens to plasma concentration of a drug if there is a large volume of distribution?
Rickets prior to fusion - osteomalacia if the deficiency occurs after epiphyseal fusion.
The larger the volume of distribution - the lower the plasma concentration of a drug.
Hepatitis C
Premature ejaculation

18. In men - At What embryonic week do the primordial germ cells migrate to the indifferent gonad?
Gastrinoma
Week four - and they remain dormant there until puberty.
Campylobacter jejuni
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result) - these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease - when obstructive symptoms begin to occur.

19. Testing of a drug in a small group of volunteers without the disease is a component of which phase of clinical drug testing?
Phase 1
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
Turner syndrome

20. What facultative intracellular fungus is associated with hepatosplenomegaly?
Right nasal hemianopsia
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Carbamazepine
Polycystic kidney disease of childhood

21. Do you monitor heparin's therapeutic levels by PT or PTT?
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
No - it is never acceptable to lie.
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse - hyperreflexia - spastic paralysis - increased muscle tone - and weakness are commonly seen in UMN lesions.

22. Which hepatitis virus is in the Picornaviridae family?
Variable ratio If it is based on time - it is an interval - and if it is based on the number of responses - it is a ratio.
Hepatitis A
Phase 2
Streptokinase

23. Do local anesthetics bind to the activated or inactivated sodium channels?
1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors
Kl
Inactivated
5HT1D

24. What are the three components to the asthma triad?
Ipratropium
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.
Nasal polyps - rhinitis - and aspirin hypersensitivity
ACh

25. In an adrenergic nerve terminal - Where is dopamine converted to NE? By what enzyme?
DNA polymerase - a
1. Iliocostalis 2. Longissimus 3. Spinalis ('I Love Science' muscles)
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Apoptosis (Remember - there is a lack of inflammatory response.)

26. What is the term for programmed cell death?
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
Picornaviridae
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
Apoptosis (Remember - there is a lack of inflammatory response.)

27. Name the most common type - Psychiatric disorder in women of all ages
Anxiety disorders; for men it is substance abuse.
Guanethidine and bretylium
Papovavirus
The time it takes ACh to diffuse to the postjunctional membrane

28. What part of the heart forms x Posterior wall?
Left atrium
Areas 5 and 7
Sphingomyelin
Succinyl CoA synthetase

29. What is the term to describe a man who has x The ability to have an erection sometimes and other times not?
Selective erectile disorder
H 1
Diphyllobothrium latum
MEN IIa (or Sipple syndrome)

30. What is the function of the cerebellum?
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia
Echinococcus multilocularis
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
Fat necrosis

31. What three substances stimulate glycogenolysis?
Glutamine
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
Tyramine

32. Name the MCC - Pneumonia in a neutropenic burn patient
Mean
Megaloblasts
Methionine (start) and tryptophan are the only two AAs with only one codon.
Pseudomonas sp.

33. What is the name of the pathway that produces leukotrienes?
Tetanospasmin (also called tetanus toxin)
Chromaffin cells (adrenal medulla)
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
Lipoxygenase pathway - from arachidonic acid

34. What phase of the cell cycle are the following antineoplastic agents specific for? - 6- Mercaptopurine
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
S phase
Dissociative fugue. (Patients are unaware of memory loss.)
Cancer of the lung - stomach - colon - and breast

35. What hormone has the following effects: chondrogenic in the epiphyseal end plates of bones; increases AA transport for protein synthesis; increases hydroxyproline (collagen); and increases chondroitin sulfate synthesis?
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Major
Internal carotid artery
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.

36. What is the term for Candida infection of the oral mucosa?
Thrush
Al - Anon
Reverse transcription
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)

37. What two factors cause PTH to be secreted?
Ewing's sarcoma
A decrease in Ca2+ and an increase in PO4
Hgb F
Pyridoxine

38. What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
IgM
Listeria
PICA
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.

39. How many kilocalories per gram are produced from the degradation of fat? CHO? Protein?
Vitamin D
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
The alveolar PO2 and PCO2 levels
Gaucher disease

40. What syndrome is associated with the following brainstem lesions? - Posterior cerebral artery occlusion resulting in a contralateral corticospinal tract signs - contralateral corticobulbar signs to the lower face - and ipsilateral CN III palsy

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41. Outburst to cover up true feelings (emotion is covered - not redirected).
The stomach
Acting out
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Escherichia coli

42. What splanchnic carries preganglionic parasympathetic fibers that innervate the hindgut and the pelvic viscera?
Pelvic splanchnics (They all begin with P.)
Schizotypal
BPH
The second pharyngeal pouch and groove

43. What enzyme of heme synthesis is deficient in the autosomal dominant disorder acute intermittent porphyria?
Lateral cricoarytenoid muscles
Cleft lip
Mantle cell lymphoma
Uroporphyrinogen - I synthase

44. What happens to the following during skeletal muscle contraction? - Sarcomere
Streptococcus pneumoniae
Shortens
Affinity
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)

45. What are the three end products of amylase digestion?
Systemic lupus erythematosus
IgE
>5 mm
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)

46. Increases the risk of developing squamous cell carcinoma of the penis.
HPV infection
Amyloidosis
Penicillin V
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.

47. How many high - energy bonds are used to activate an AA?
Terbinafine
Ligament teres
2 ATPs - via the amino acyl tRNA synthase enzyme
12 days after ovulation

48. What three cephalosporins inhibit vitamin K- dependent factors?
Carnitine acyltransferase - I
ll
Cushing's ulcers
Cefamandole - cefoperazone - and moxalactam

49. In a topographical arrangement of the cerebellar homunculus map - What area or lobe x Controls distal musculature?
Intermediate part of the hemispheres
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Clostridium botulinum
Popliteus

50. Name the most common type or cause - Acute tubular necrosis
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get
Catechol - O- methyl transferase (COMT)
Ischemic
Mumps and influenza virus