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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 antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Terbinafine
Dihydrofolate reductase
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
CD19

2. What right - to - left shunt occurs when only one vessel receives blood from both the right and left ventricles?
Persistent truncus arteriosus
Fungi
Ventral anterior nucleus
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis

3. What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
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.
Heroin
Ovulation
Constipation and miosis

4. What disease has multiple schwannomas - caf
Plasmodium malariae; the others are tertian.
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)
Gonads

5. What remains patent in a hydrocele of the testis - allowing peritoneal fluid to form into a cyst?
The optic disk is the blind spot.
Calicivirus
A patent processus vaginalis
Posterior interventricular artery

6. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Smooth muscle
1. Big 2. Bilateral 3. Berry aneurysm
Increased GABA levels decrease the likelihood of learned helplessness.
Stable
Nephrotoxicity

7. Where does most circulating plasma epinephrine originate?
Schistosoma have separate males and females.
The notochord
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Gluteus maximus

8. What is the most common opportunistic infection of the CNS in HIV?
Mitral stenosis
Toxoplasmosis
Testicular feminization syndrome (Dude looks like a lady!)
Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone - produced by Leydig cells - is needed for spermatogenesis.

9. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x sis
Astrocytoma
Rigors - leukopenia - decrease in blood pressure - and increase in temperature
Varicella virus and influenza virus
TCR

10. Homer - Wright rosettes
Neuroblastoma
S phase
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
hCG can be detected in the blood by day 8 and in the urine by day 10.

11. What causes the lysis of RBCs by oxidizing agents in a G-6- PD deficiency?
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.
Flea - bitten kidney (can also be seen in pyelonephritis)
The T- test (used when comparing two groups)
AT II

12. What bonds are broken by endonucleases?

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13. What components of the coagulation cascade are affected by estrogen?
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Hirschsprung's disease (colonic gangliosus)
Luteal phase
Kartagener's syndrome (also known as immotile cilia syndrome) -------------------------------------------------------------------------------

14. What organism is associated with megaloblastic anemia?
Diphyllobothrium latum
Labioscrotal swelling
Somatomedins (IGF-1)
Renin

15. What bone houses the ulnar groove?
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Humerus (between the medial epicondyle and the trochlea)
Glucagon
Diphyllobothrium latum

16. What AR disease involves a decreased amount of sphingomyelinase - massive organomegaly - zebra bodies - and foamy histiocytes and is associated with chromosome 11p?
Cortisol levels increase. Lymphocyte levels decrease in sleep - deprived individuals.
Gout
Phallus
Niemann - Pick disease

17. What three AAs are used to synthesize the purine ring?
Pyelonephritis
1. Glycine 2. Aspartate 3. Glutamine
Pentoxifylline
Bladder cancer

18. Name the antimicrobial agent whose major side effect is listed - Teratogenicity
Metronidazole
Mitochondria
NADPH and molecular O 2
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)

19. What is the most stressful event as determined by the Holmes and Rahe scale?
HMP shunt
Nephroblastoma
enveloped
The death of a spouse. The higher the score - the greater the risk of developing an illness in the next 6 months.

20. What transient deficiency may result in a hypercoagulable state if warfarin is given alone?
Area 6
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Fluconazole
Large intestine. Water is passively removed from the lumen.

21. Why is the apex of the lung hypoventilated when a person is standing upright?
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
Blastoconidia
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.
Brucella and Listeria (has tumbling motility)

22. The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?
Preoperational (2-6 years)
PGE2 and PGF2a
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.

23. What are the two broad - spectrum penicillins?
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
Splenic flexure
Mercury
Ampicillin and amoxicillin

24. What is the largest nucleus in the midbrain?
Liver - kidney - and GI epithelium
MEN II and III syndromes
Internal 3' - 5' PDE bonds
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.

25. What is the most common circulation Ig in the plasma?
Polycystic ovaries
Adenine and guanine
The zygote divides mitotically; only germ cells divide meiotically.
IgG

26. What is the confirmatory test for HIV?
By causing rebound insomnia and decrease in REM sleep
In the first and second bronchi
MHC class I antigens; they are also found on the surface of platelets.
Western blot

27. What is the respiratory compensation mechanism for metabolic alkalosis?
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
Vanillylmandelic acid (VMA)
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
The stomach

28. Preeclampsia in the first trimester - hCG levels above 100 - 00 mIU/mL - and an enlarged bleeding uterus are clinical signs of what?
Substantia nigra
Glucose and galactose
Global aphasia
Hydatidiform mole

29. What part of the heart forms x The right border?
Hurler syndrome and Hunter syndrome - respectively
MI
Subscapularis
Right atrium

30. What enzyme catalyzes the rate - limiting step in heme synthesis?
d - ALA synthase
Catatonic schizophrenia
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
Naloxone or naltrexone

31. What is the most common one? - Bone disorder in the United States
HBeAb
Osteoarthritis
Osteoporosis
Blood

32. What is the most common one? - Pituitary tumor
IDL
Direct pathway; a good example is Parkinson's disease.
Chromophobe adenoma
GP Ib

33. Name the structure that enters or exits the following foramina: x Cribriform plate
Lead poisoning
Metronidazole
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)
CN I

34. Name the ocular lesion; be specific - Optic chiasm lesion
Phase 0
Minocycline
Bitemporal heteronymous hemianopsia
Major

35. Do the following structures pick up stain from hematoxylin or eosin? - RBCs
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Calcitriol
Eosin

36. What pyrimidine base is produced by deaminating cytosine?
Uracil
Primitive ventricle
Hydrolysis
a -1 - 6 transferase

37. Is a brush border enzyme.
In the first and second bronchi
Haemophilus ducreyi
C5b - C9
Enterokinase

38. What do the following values indicate? - TD50
Niacin (B3)
Acute CO poisoning
Toxic dose for 50% of drug takers (median toxic dose)
42 L - 67% of body weight

39. What is the term for ascending bacterial infection of the renal pelvis - tubules - and interstitium causing costovertebral angle tenderness - fever - chills - dysuria - frequency - and urgency?
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
Class III
Pyelonephritis
60%

40. What enzyme is inhibited by disulfiram?
7 years old
Periaortic lymph nodes
Acetaldehyde dehydrogenase
Diazoxide

41. What seronegative spondyloarthropathy is seen in HLA- B27- positive young men - involves the sacroiliac joints - has no subcutaneous nodules - and has a bamboo spine appearance on radiograph?
Left homonymous hemianopsia
Emphysematous bleb
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.
Ankylosing spondylitis

42. What is the most common site for an aneurysm in cerebral circulation?
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
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Smooth muscle
IgG3

43. What is the only nonmotile pathogenic Clostridium species?
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
BPH
Clostridium perfringens
One day after the LH surge and 2 days after the estrogen peak.

44. Which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida?
Carbamazepine
TB meningitis
The lung will expand; also the opposite is true.
IF-2 of the 30S subunit

45. What is the first branch of the abdominal artery?
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Hepatocellular carcinoma
IgA
Inferior phrenic artery

46. What is the term for the amount of a drug that is needed to produce the desired effect?
Western blot
Popliteus
Osteogenesis imperfecta
Potency

47. Are the following major or minor Jones criteria of rheumatic fever? - Migratory polyarthritis
Thiamine
The small subunit (40S) binds first.
CN III and IV
Major

48. Name the associated chromosome - Gaucher disease
Somatomedins
H 1
Chromosome 1
Y - W-135 - and C and A capsular polysaccharides

49. Which form of emphysema is associated with an alpha1- antitrypsin deficiency?
Hematoxylin
Northern blot
Silent
Panacinar

50. What is the term for cytoplasmic remnants of RNA in RBCs - seen in lead poisoning?
The carotid sinus is a pressure - sensitive (low) receptor - while the carotid body is an oxygen - sensitive (low) receptor. (Remember 'Sinus Pressure').
Blood
Basophilic stippling
Neomycin