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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 component of the renin - angiotensin - aldosterone axis increases sodium reabsorption in the proximal convoluted tubules and increases thirst drive?
CN V3 and the lesser petrosal nerve
Convergence
AT II
Proton pump inhibitors

2. What stage of sleep is associated with somnambulism?
gamma and delta chains
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Epidural hematoma
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.

3. What carcinoma produces hematuria - flank pain - and a palpable mass?
This is the triad of renal cell carcinoma
CN V
The portal tract of the liver lobule
Albendazole

4. What are the two leading causes of cancer - related death in men?
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
Prostate and lung cancer - respectively
Myeloperoxidase
In the first and second bronchi

5. Name the form of spina bifida - An open neural tube lying on the surface of the back
CCK stimulates the pancreas to release amylase - lipase - and proteases for digestion.
Amyl nitrate - sodium nitrate - or sodium thiosulfate
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Acute glomerulonephritis

6. Should information flow from the patient to the family or vice versa?

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7. What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated?
2 and 5HT3 receptors
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Fixed interval
Enterokinase

8. What paraphilia is defined as x Deriving sexual pleasure from watching others having sex - grooming - or undressing?
Malignancy
Pseudomembranous exudates
Voyeurism
An internal elastic lamina

9. What are the rules of 2 for Meckel diverticulum?
Reiter syndrome
They prevent mast cell degranulation.
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors
Mean

10. What two factors result in the apex of the lung being hypoperfused?
Tylosis
Two major or one major and two minor
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.
mRNA

11. What cell in bone is a part of the mononuclear phagocytic system?
Osteoclasts
Rochalimaea quintana (now called Bartonella quintana)
Histamine
Social learning theory

12. What is the most common one? - Malignant thyroid tumor
Guanethidine and bretylium
IgA
Papillary carcinoma of the thyroid
Day 14

13. Why is O2 content depressed in anemic patients?
Pneumococcus (Streptococcus pneumoniae)
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
Amyloidosis
Increase in erythropoietin and increase in 2 - 3- BPG - also called 2 - 3- diphosphoglycerate (2 - 3- P2Gri) (increase in glycolysis)

14. What disorder causes joint stiffness that worsens with repetitive motion - crepitus - effusions - and swelling and commonly affects the knees - hips - and spine?
Osteoarthritis
Arginine
Maxillary artery
Resistance of the system increases. (Remember - when resistors are connected in a series - the total of the resistance is the sum of the individual resistances.)

15. A suspected dermatophyte infection is stained with KOH. What spore type do you expect to see?
Arthroconidia with hyphae
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Acetaminophen
Right ventricle

16. Name the most common type - Learning disability
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Reverse transcriptase
Dyslexia
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

17. How many pairs of spinal nerves are associated with x Cervical vertebrae?
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Empyema
Penicillin G (benzylpenicillin)
Herpes I

18. What is the name of the major chemotactic agent released from x Bacteria?
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
F- Met - Peptides
The increased H+ moves intracellularly and is buffered by K+ leaving the cells - resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis - even though the serum
Prophase of meiosis I (between 12th and 22nd week in utero)

19. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x et
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.
HBeAb
MEN II and III syndromes

20. What is the most common one? - Primary malignant tumor of the lungs
CN IX
The right gonadal vein drains into the inferior vena cava directly - and the left gonadal vein drains into the left renal vein.
Albumin
Adenocarcinoma (30% to 35%)

21. What rate removes any difference between two populations - based on a variable - to makes groups equal?
True hermaphrodism
Mycobacterium marinum
C wave
Standardized rate

22. Which chromosome is associated with MHC genes?
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
5' deiodinase
Chi - square.
Chromosome 6

23. What is the name of the superficial subcutaneous fascia of the abdomen containing fat?

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24. Are the following responses associated with histamines H1 or H2 receptor activation? - Bronchial smooth muscle activity
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
H 1
Small cell cancer of the lung
hnRNA

25. Name the ventricular muscle membrane channel: x Open at rest; depolarization is stimulus to close; begin to reopen during the plateau phase and during repolarization
Voltage - gated potassium channels
Hyperkalemia
Lead
Amnesia. (The person is aware of the memory loss.)

26. What is the rate - limiting step in the production of steroids?
Protein A
Thiazide diuretics
Accuracy (think of it as all the trues - because they are the ones correctly identified)
The conversion of CHO to pregnenolone via the enzyme desmolase

27. What type of erythema do you see in x Ulcerative colitis?
Erythema nodosum
Topoisomerase I (Relaxase)
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
7 years old

28. How many bases upstream is the eukaryotic TATA box promoter?
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
Dysgerminoma
Superoxide dismutase - glutathione peroxidase - catalase
Surface tension; in the alveoli - it is a force that acts to collapse the lung.

29. What part of the heart forms x Apex?
Berry aneurysm
Tip of the left ventricle
Isotypes
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat

30. What is the term when the brachial artery is compressed - resulting in ischemic contracture of the hand?

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31. What are the three Beta - lactamase inhibitors?
Osteosarcoma
Neuroblastoma
Eclipse period
1. Clavulanic acid 2. Sulbactam 3. Tazobactam

32. Which of the following is not a risk factor for cholesterol gallstones: pregnancy - OCP use - female gender - hemolytic anemia - cirrhosis - and obesity? (May be more than one answer.)
They block the midcycle surge of LH.
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
Look for broken blood vessels in the baby's eyes.
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.

33. What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?
The carotid sinus reflex
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Hemorrhagic exudates
Beryllium

34. Risk factors for endometrial carcinoma.
Xanthine oxidase
Obesity - DM - HTN - multiparity - early menarche - and late menopause
Motilin
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.

35. How can you differentiate between a medial temporal lobe and a hippocampal lesion based on memory impairment?
Ego syntonic
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
High average
Corynebacterium diphtheriae

36. Regarding the venous system - what happens to blood volume if there is a small change in pressure?
Chromosome 1
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.

37. What is the term for the strength of the association between Ags and Abs?
Carbamoyl phosphate synthetase I
prognostic predictors
Thyroarytenoid muscles
Avidity. There is a positive correlation between valence numbers and avidity.

38. Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?

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39. Is the following description characteristic of competitive or noncompetitive antagonists: parallel shift to the right on a dose - response curve - complete reversibility with increase of the dose of the agonist drug - and capacity to decrease the pot
Competitive antagonist
Coagulative
Streptococcus viridans
Primase

40. Name the compartment of the mediastinum associated with the following thoracic structures: Brachiocephalic vein
Stable
Superior
Dysgerminoma
A patent processus vaginalis

41. What is the term for a congenital absence of the ganglionic cells of the Auerbach and Meissner plexus in the rectum and sigmoid colon?
Hirschsprung disease (aganglionic megacolon)
Chromosome 19
Mitochondria - linked disorders are always inherited from the mother.
C5a

42. What factors are needed for elongation in eukaryotes?
EF-1 and GTP
Legionella (think air conditioners)
Infliximab
Hereditary spherocytosis

43. What are the three functions of surfactant?
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Chromosome 15
Areas 18 and 19
The vaccine contains 23 capsular polysaccharides.

44. What cytokine do CD4 T cells secrete to activate B cells when the specific peptide in the groove of the MHC II molecule interacts with the TCR?
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages
The Purkinje cell
Production of HCO3- - shifting the reaction to the left and thereby decreasing H+

45. Which thalamic nucleus receives auditory input from the inferior colliculus?
Chloral hydrate
MGB
Hapten; if it is coupled with a carrier - it may become immunogenic.
apo B-48

46. What phase of the cell cycle are the following antineoplastic agents specific for? - Alkylating agents
Pyridoxine
Shaping (successive approximation)
G0 phase
Erectile dysfunction

47. What is the term for ventilation of unperfused alveoli?
Alveolar dead space
Staphylococcus aureus
Osteosarcoma
Hepatitis B

48. What virus is associated with the Norwalk agent?
Herpes virus I and II
Hypoglycemia for secretion and hyperglycemia for inhibition
Calicivirus
Cytochrome c

49. Serious psychiatric illness is more common _______ than childbirth.
Xenograft
Temporal arteritis
after abortion
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma

50. Place in order from fastest to slowest the rate of gastric emptying for CHO - fat - liquids - and proteins.
Yes
Primitive atrium
Liquids - CHO - protein - fat
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT - which means warfarin - extrinsic - PT; heparin - intrinsic - PTT)