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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 embryonic structure forms the adult female structures? - Glans clitoris - corpus cavernosus - and spongiosum
Metronidazole
Phallus
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
Cortisol

2. What cardiomyopathy is due to a ventricular outflow obstruction as a result of septal hypertrophy and leads to sudden cardiac death in young athletes?
Myasthenia gravis
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis - or IHSS)
Residual volume
No - therapeutic indices can tell which drug is safer - not more toxic.

3. What component of the ETC is inhibited by the following? - Cyanide
Cytochrome a/a3
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
DNA polymerase - d
Embolic

4. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Thalamus
Dissociative fugue. (Patients are unaware of memory loss.)
Phase I
IgA
Proencephalon

5. What area of the brain is responsible for emotion - feeding - mating - attention - and memory?
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
Enterobius vermicularis; the treatment is albendazole.
Molindone
The limbic system

6. Are the following responses associated with histamines H1 or H2 receptor activation? - Bronchial smooth muscle activity
Clonorchis sinensis
Acute glomerulonephritis
H 1
Spearman correlation

7. Name the cluster C personality disorder: x Orderly - inflexible - perfectionist; makes rules - lists - order; doesn't like change - has a poor sense of humor - and needs to keep a routine
In the first 3 months
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
Obsessive - compulsive
>5 mm

8. What component of the ANS is responsible for movement of semen from the epididymis to the ejaculatory ducts?
Spleen
Sympathetic nervous system
Axis I
Pseudomonas aeruginosa

9. IgE- mediated mast cell release - C3a and C5a - and IL-1 all trigger the release of what vasoactive amine?
Histamine
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti - Ab
Hepatitis A (infectious)
Staphylococcus aureus

10. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Personality and mental disorders?
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Clostridium botulinum
CN IX and X
Axis II

11. What is the function of the basal ganglia?
Supraoptic nuclei; lesions here result in diabetes insipidus.
Initiate and manage gross skeletal muscle movement control
Extinction
7

12. What is the most common one? - Intraspinal tumor
Ataxia - telangiectasia
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.
Ependymoma
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.

13. What part of the ANS (i.e. - PNS or CNS) controls the constriction of the pupil in response to light?
Syphilitic
REM
Parasympathetic
G-6- PD deficiency

14. A patient with a history of epilepsy goes to the ER with sedation - gait ataxia - diplopia - and vertical nystagmus. Which anticonvulsant overdose resulted in the patient's symptoms?
The parasympathetic nervous system
Phenytoin
Minor
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.

15. What artery travels with the following veins? - Middle cardiac vein
Gluteus maximus
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
EF- Tu and EF- Ts of the 30S ribosomal subunit
Posterior interventricular artery

16. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Metencephalon
Median nerve
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
Rhombencephalon
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.

17. If a patient cannot pay - can you refuse services?

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18. Where on the codon and anticodon does the wobble hypothesis take place?

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19. How many acetyl CoAs per glucose enter into the TCA cycle?
Hemolytic uremic syndrome
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Neutrophils - eosinophils - and basophils

20. What percentage of children born to HIV- positive mothers will test positive for HIV at birth?
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
100% - with about 20% remaining positive after 1 year
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Succinate dehydrogenase

21. What is the term for a large VSD that leads to pulmonary HTN - RVH - and cyanosis due to right - to - left reversal of the shunt?
Concentration force and electrical force
Venlafaxine. (It also has a mild dopaminergic effect.)
The vaccine contains 23 capsular polysaccharides.
Eisenmenger syndrome - which can also occur with any left - to - right shunt

22. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Medulla
Phenylephrine
Rigors - leukopenia - decrease in blood pressure - and increase in temperature
Rhombencephalon
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.

23. What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities - red cell aplasia - and muscle weakness?
Chondroitin sulfate and keratan sulfate
Right nasal hemianopsia
Myasthenia gravis
Sertoli cell

24. What are the two actions of calcitonin?
It increases Ca2+ excretion from the kidney and increases bone mineralization.
Calcarine sulcus
Plasmodium ovale
Mumps

25. From What aortic arch are the following structures derived?
Wiskott - Aldrich syndrome
Maxillary artery
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma
Thiamine and folate

26. What disease involves a lack of both T cell - mediated and humoral immune responses that can be either X- linked or AR?
Infliximab
Childhood
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
Severe combined immunodeficiency disease

27. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Percentage of Na+ - Cl - - K+ left in the lumen
t the end of the PCT 25% of Na+ - Cl - - K+ is left
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
Giardia lamblia (treat with metronidazole)

28. Which medication requires an acidic gastric pH for activation to form a protective gel - like coating over ulcers and GI epithelium?
The notochord
Sucralfate
Sexual aversion disorder
Stage 3 and 4

29. Objective tests that base the result of the examination on a preset standard use what form of reference?
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Superior
Outside the cell
Carbamoyl phosphate synthetase I

30. What are the two precursors of heme?
After the latent period
Idiotypes
Glycine and succinyl - CoA
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)

31. What two requirements must be met for the Lac operon to be activated?
The vermis
HBc Ab
Lactose must be present and glucose must be absent
1. Skin 2. Liver 3. Kidney

32. What embryonic structure forms the adult female structures? - Ovarian and round ligaments
Mentally disabled
Proencephalon
Gubernaculum
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries

33. What three complement fragments are also anaphylatoxins?
N- Acetylcysteine
Desipramine
C3a - C4a - and C5a
alpha2- Receptors

34. What is the only Plasmodium that is quartan?
Plasmodium malariae; the others are tertian.
Ewing sarcoma
Conn syndrome (primary hyperaldosteronism)
Day 14

35. What is the function of the cerebellum?
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
For males - HTN; for females - pregnancy.
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.
Alcohol abuse

36. What is the term for neurologic signs consistent with a cerebrovascular accident but lasting 24 hours with full recovery?
Transient ischemic attack
Medulla blastoma
Dissociation
Catalase - negative bacteria secrete H2O2 as a byproduct (remember - catalase breaks down H2O2) - allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase - positive bacterial infect

37. What protein allows Mycoplasma to attach to the respiratory epithelium?
Duodenum
Pyridoxine
P1 protein
env structural protein

38. Codman triangle on radiograph
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
Osteosarcoma
Glucose -6- phosphatase
Roth spots - and they are seen in bacterial endocarditis.

39. What seven structures are found in more than one mediastinum?
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve
SA node; it is the reason it is the primary pacemaker of the heart.
Radial nerve
Ulcerative colitis

40. What happens to capillary oncotic pressure with dehydration?
The Fc region of IgG and C3b
Oncotic pressure increases because of the removal of water.
Flow cytometric analysis
Gubernaculum

41. What germ cell tumor is seen in the 15- to 35-year - old age group - peaks when the person is 35 years of age - and is a bulky mass that spreads via the lymphatic system?
Hot pink with PAS and grey to black with silver stain
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Cones (C for color and cones)
Seminoma

42. Are excitatory neurotransmitters in the CNS.
Pneumocystis carinii
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
GABA and glutamic acid

43. What would be the result if an Ab were cleaved with papain?
There would be two Fab and Fc regions.
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Vanillylmandelic acid (VMA)
Aedes (the same for yellow fever)

44. Which two negative sense RNA viruses have neuraminidase enzymes?
Hydroxyproline (breakdown product of collagen)
Aortic insufficiency
Edrophonium
Mumps and influenza virus

45. What cells of the epidermis carry the pigment melanin?
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Prolactin
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.
Syphilitic

46. What is the most common one? - Type of melanoma
Urophilia
Superficial spreading melanoma
Osteoclasts
Azithromycin

47. What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
Metaphase II
Lithium
Astrocytoma
In men it is prostate cancer - and in women it is breast cancer.

48. Hereditary angioneurotic edema (AD) produces local edema in organs (e.g. - GI - skin - respiratory tract). What enzyme deficiency causes increased capillary permeability due to a release of vasoactive peptides?
C1 esterase inhibitor (C1INH)
Quaternary structure
HIV and poxvirus
MHC class II Ags. This is accomplished via CD4 T cells.

49. What disorder of bone remodeling results in thick - weak bones and is associated with high - output cardiac failure?
IL-4
Paget disease (osteitis deformans)
Fibroadenoma
Dependent

50. Which hepatitis B serology markers
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.
HBcAb IgM
Basophilic stippling
Beta- Oxidation of fatty acids