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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 from a deficiency in the enzyme hexosaminidase A?
Maxillary artery
Homeodomain proteins
Hereditary spherocytosis
Tay- Sachs disease

2. What three cells are essential for T- cell differentiation in the thymus?
Ephedrine
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
Dendritic cells - macrophages - and thymic epithelial cells
Left anterior descending artery

3. What three substances stimulate parietal cells?
Vitamin K
ACh - histamine - and gastrin
antiemetic
Mural infarct

4. What is the major Ig of the secondary immune response?
Turcot syndrome
Humerus with ulna (major) and radius (minor)
Hemophilia B
IgG

5. Are more Abs produced in a primary or a secondary immune response?
More Ab is produced in less time in a secondary immune response (shorter lag period).
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
Vimentin

6. Name the most common type or cause - Urethritis in a young - newly sexually active individual
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
Staphylococcus saprophyticus
Metronidazole
Because they do not block D2A receptors - they are antagonists of 5HT2 receptors.

7. What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
Grasp proceeds release
Dimercaprol
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
Pneumococcus (Streptococcus pneumoniae)

8. Name the compartment of the mediastinum associated with the following thoracic structures: Splanchnic nerves
CD4
Adenine and guanine
They are preganglionic sympathetic axons. They are white because they are myelinated.
Posterior

9. If a sample of DNA has 30% T - What is the percent of C?

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10. In the mitochondria - what complex is needed for pyruvate carboxylase to catalyze the reaction from pyruvate to OAA?
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
Biotin - ATP - and CO2
Hepatitis C
Ischemic heart disease (MIs)

11. In a positively skewed curve the mean is ______ than the mode.
greater
Creatinine
Labioscrotal swelling
Lymph nodes

12. What disease is associated with the HLA- DR2 and HLA- DR3 alleles
Systemic lupus erythematosus
Escherichia coli
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
Secondary hypocortisolism (pituitary)

13. With What thoracic vertebra or vertebrae does rib 7 articulate?
The Fc region of IgG and C3b
Hematoxylin
Poliomyelitis; it is a bilateral LMN lesion.
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.

14. What are the four reasons for hypochromic microcytic anemia with a low MCV?
As flow increases - the urine becomes more dilute because of decreased time for H2O reabsorption.
Corticosteroid
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
Patent urachus

15. What organism is associated with the following types of diarrhea? Watery diarrhea from beef - poultry - or gravies
CD3
Clostridium perfringens
Mebendazole
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.

16. At the base of the lung - What is the baseline intrapleural pressure - and what force does it exert on the alveoli?
Negative correlation
All (nearly 15-20 times the normal risk)
Since they are independent events - their probabilities would be multiplied.
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.

17. What is the most common one? - Stromal tumor of the ovary
In the tuberoinfundibular pathway - dopamine release will decrease prolactin release - Which is why dopamine agonists are used in the treaatment of hyperprolactinemic states.
Ovarian fibroma
Addition (They are mutually exclusive.)
Pulmonary infections

18. Pseudopalisades
Isotonic contraction
Ependymoma
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
Glioblastoma multiforme

19. What autoimmune syndrome is characterized by keratoconjunctivitis - corneal ulcers - xerostomia - and an increased risk of high - grade B- cell lymphomas? What two Ab tests are used in making the diagnosis?
Sj
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Fixation (arrested development)
Frontal lobe

20. What is the most common one? - Site for atherosclerotic plaques in the abdominal aorta
give a warning
VIPoma
Membranoproliferative glomerulonephritis (MGN)
The bifurcation of the abdominal aorta

21. When does cortisol secretion peak?
Flumazenil
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
In early- morning sleep - usually between the sixth and eighth hours

22. What protozoal parasite forms flasked - shaped lesions in the duodenum - is transmitted via fecal - oral route - and is commonly seen in campers who drank stream water?
EF-1 and GTP
Right - sided
Giardia lamblia (treat with metronidazole)
Aspartic acid and glutamic acid

23. What is the only DNA virus that does not replicate its DNA in the nucleus of the host cell?
Poxvirus replicates its DNA in the cytoplasm.
Autosomal recessive
Mantle cell lymphoma
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia

24. How many high - energy bonds are used to activate an AA?
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
2 ATPs - via the amino acyl tRNA synthase enzyme
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
Peau d'orange

25. Protein production - bile secretion - detoxification - conjugation - and lipid storage.
Acebutolol and Pindolol
Functions of hepatocytes
Dystrophic calcification
Legionella (think air conditioners)

26. What cestode causes cysticercosis?
Cytochrome a/a3
Taenia solium
C5- C8 deficiency
Area 17

27. What part of the heart forms x Posterior wall?
Antithyroglobulin and antimicrosomal Abs
Left atrium
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.

28. Name the antimicrobial agent whose major side effect is listed - Teratogenicity
Metronidazole
Gardner syndrome
Syringomyelia
Constriction of afferent arteriole

29. What negative sense RNA virus is associated with intracytoplasmic inclusion bodies called Negri bodies?
C3 - C4 - and C5 keep the diaphragm alive!
Rotavirus
Rabies
Epidermophyton

30. Name these cluster A personality disorders: x Odd - strange; has magical thinking; socially isolated - paranoid - lacks close friends; has incongruous affect
Lente insulin and either NPH or protamine zinc insulin (PZI)
Schizotypal
alpha2- Receptors
antiemetic

31. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x Ki - ras and erb -2
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.
Penicillin G (benzylpenicillin)
Lung cancer
Beta- Endorphin

32. What does hepatitis D virus need from hepatitis B virus to be infective?
Alcohol abuse
Respiratory depression
Candida
HBsAg as its envelope

33. Name the hormone
Glucagon
Goodpasture syndrome
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
The lung will expand; also the opposite is true.

34. In an adult - Where does the spinal cord terminate and What is it called?
Tetanospasmin (also called tetanus toxin)
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
1. Liver 2. Kidney 3. Pituitary gland (via 5'- deiodinase enzyme)
The conus medullaris terminates at the level of the second lumbar vertebra.

35. What is the term for days 15 to 28 in the female cycle?
Luteal phase
Unconjugated (indirect)
Residual volume
There are 10 bronchopulmonary segments on the right and 8 on the left.

36. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Smooth muscle
Oxygen
Ungated channels
Stable
Repolarization is from base to apex and from epicardium to endocardium.

37. What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
G0 phase
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Aged adult
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.

38. What syndrome causes inability to concentrate - easy distractibility - apathy - and regression to an infantile suckling or grasping reflex?
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
Frontal lobe syndrome (lesion in the prefrontal cortex)
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
Arch of the aorta and right subclavian artery

39. What attaches to protons and allows them to enter into the mitochondria without going through the ATP- generating system?
Thymidylate synthetase
Copper
Amantadine
2 - 4- Dinitrophenol

40. What maintains the osmotic gradient that is critical to the concentrating ability of the kidney?
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)
Bunyavirus
Transference. When it is from the physician to the patient it is called countertransference.
The venae recta maintain the gradient via countercurrent flow.

41. What is the most common one? - Type of melanoma
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.
Superficial spreading melanoma
HHV-8
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.

42. Indicates the patient has active pulmonary disease.
A positive PPD skin test
The poly(A) site on the DNA
Anopheles mosquito
Mitral valve stenosis

43. What class of drugs is used in the treatment of demineralization of the bone?
TXA2
Action potential
Bisphosphonates
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate

44. What occurs when the lower esophageal sphincter fails to relax during swallowing due to abnormalities of the enteric nervous plexus?
Epidermophyton
Achalasia
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Prevalence rate

45. What is the major hormone produced in the following areas of the adrenal cortex? - Zona fasciculata
Eosin
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Right coronary artery

46. What is the term for panhypopituitarism secondary to ischemic necrosis and hypotension postpartum?
No - it is never acceptable to lie.
Bacteria
Sheehan syndrome
Eosinophil

47. Name the associated chromosome - Edward syndrome
Chromosome 18
Denial
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Resistance increases as resistors are added to the circuit.

48. What is the most common one? - Cardiac anomaly in children
NSAIDs
Thoracic splanchnic fibers
Coma - convulsions - and cardiotoxicity
PDA

49. Will a unilateral lesion in the spinothalamic tract result in a contralateral or ipsilateral loss of pain and temperature?
Phase I
Granulosa cell tumor of the ovary
Vanillylmandelic acid (VMA)
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.

50. What type of potential is characterized as being an all - or - none response - propagated and not summated?
Action potential
Increase (5- HT and dopamine levels do the same)
Primary hyperaldosteronism (Conn syndrome)
Suppression