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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 enzyme is inhibited by disulfiram?
Succinate dehydrogenase
Superior
Acetaldehyde dehydrogenase
Tyramine

2. Where is the cupola of the lung in relation to the subclavian artery and vein?
impermeable to water
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
Proencephalon diencephalon derivative
d - Tubocurarine

3. Name the pattern of genetic transmission characterized thus: both M and F are affected; M may transmit to M; each generation has at least one affected parent; and one mutant allele may produce the disease.
Vagus nerve
Autosomal dominant
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
CD21; it is a complement receptor for cleaved C3

4. What CN transmits sensory information from the cornea?
Afferent arteriole
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
d - Tubocurarine
Acetyl CoA carboxylase

5. What is the longest and most convoluted segment of the nephron?
Sarcoidosis
PCT
Spinal trigeminal nucleus
80S ribosomes (because they are eukaryotic)

6. Can a patient refuse life - saving treatment for religious reasons?

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7. What enzyme produces an RNA primer in the 5'-3' direction and is essential to DNA replication because DNA polymerases are unable to synthesize DNA without an RNA primer?
EF- Tu or EF- ts and GTP
Primase
MGB (think EARS)
Gastrin - releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)

8. What three cells are essential for T- cell maturation?
Thymic epithelial cells - dendritic cells - and macrophages
Second M PITS for pharyngeal pouch derivatives
Astrocytoma
Fibroadenoma

9. What aphasia produces a nonfluent pattern of speech with the abilty to understand written and spoken language seen in lesions in the dominant hemisphere?
robenecid - a uricosuric agent
Turcot syndrome
Cytochrome a/a3
Expressive aphasia

10. Which leukotriene
LTB4
Mural infarct
Mesonephric duct (ureteric bud)
VLDL

11. What water - soluble - vitamin deficiency may result from eating raw eggs?
Biotin (only if eaten in large quantities)
Heart disease
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
Papovavirus

12. What is defined as a general estimate of the functional capacities of a human?
IQ
Streptococcus pyogenes
Berry aneurysm
Hemiballismus

13. What scale assesses a rank order classification but does not tell the difference between the two groups?
Gain of hypotonic fluid (water intoxication or hypotonic saline)
Salmonella typhi
Ordinal scale (e.g. - faster/slower - taller/shorter)
Area 22 and occasionally 39 and 40

14. Which dimorphic fungus is endemic in the Ohio - Mississippi - Missouri - and Eastern Great Lakes - is found in soil with bird and bat feces - and is associated with infections in spelunkers and chicken coop cleaners?
IgM
Urinary trigone
Histoplasma capsulatum
4.7 L - 5% of body weight

15. What branch off the vertebral artery supplies x The ventrolateral two - thirds of the cervical spinal cord and the ventrolateral part of the medulla?
Necrophilia
Lactulose
Velocity is inversely related to cross - sectional area.
Anterior spinal artery

16. 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.)
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
6 years old
Degenerates
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.

17. What type of hemostasis in an intravascular space consists of fibrin - platelets - RBCs - and WBCs?
All
Ewing's sarcoma
Thrombus
Conjugated (direct) hyperbilirubinemia - a transport defect

18. What disease is diagnosed by findings of ANAs and anti - SCL-70 antibodies?
Staphylococcus aureus
C1 - C2 - or C4 deficiency
Scleroderma
Phase 1

19. What type II hypersensitivity disorder is defined as x Autoantibodies directed against the TSH receptor?
Graves disease
Osteogenesis imperfecta
Alzheimer disease
Asbestosis

20. What organ of the body has the smallest AV oxygen difference?
Phase 4
Erythromycin
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.
Lower lobe

21. What potentially lethal side effect of clozapine should be monitored with frequent blood drawing?
Pyelonephritis
Agranulocytosis; approximately 2% develop this side effect.
Ipratropium
No enzymes are needed. When the stop codon reaches the A site - it results in termination.

22. What embryonic structure forms the adult female structures? - Urinary bladder - urethra - greater vestibular glands - vagina
Yes
Urogenital sinus
Lysine and arginine
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)

23. What enzyme is inhibited by sulfonamides?
Arnold - Chiari malformation type 2
EBV
Dihydropteroate synthetase
Hurler syndrome and Hunter syndrome - respectively

24. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Agraphia - acalculia - finger agnosia - right - left disorientation

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25. What carcinoma produces hematuria - flank pain - and a palpable mass?
This is the triad of renal cell carcinoma
ICF volume decreases when there is an increase in osmolarity and vice versa.
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
Basal cell carcinoma

26. Is CO2 a perfusion - or diffusion - limited O2 gas?
Goodpasture syndrome
Candida
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
Primary intention

27. What enzyme of the TCA cycle catalyzes the substrate level phosphorylation?
It is rare with normal grief; however - it is relatively common in depression
CSF
Streptococcus viridans
Succinyl CoA synthetase

28. What is the term for the number of Ag - binding sites on an Ig?
Tensor tympani
VLDL
Valence
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.

29. Name the lipoprotein based on the following characteristics - apo E - apo C- II - apoB-48
IDL
Chylomicrons
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Angiosarcoma of the liver

30. What catecholamine - hypersecreting tumor - a secondary cause of HTN - results in headache - diaphoresis - anxiety - tachycardia - and palpitations?
Purine nucleoside phosphorylase
Pheochromocytoma
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Carbidopa and benserazide

31. What are the four ways to down - regulate the immune system?
Paramesonephric ducts
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
Thrombus
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

32. What is the most common one? - Primary malignant tumor of the ovary
Frotteurism
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Cryptococcus neoformans
Serocystadenocarcinoma

33. 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
Obsessive - compulsive
Ulnar to radial progression
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.
Left homonymous hemianopsia

34. What cell's axons are the only ones that leave the cerebellar cortex?
Plasmodium vivax
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
Both
The Purkinje cell

35. What is the MCC of viral conjunctivitis?
transcription
Adenovirus
Hepatitis E
Positive correlation

36. Name the cluster B personality disorder: x In a constant state of crisis - promiscuous - unable to tolerate anxiety- causing situations - afraid of being alone - and having intense but brief relationships
Borderline
Competitive antagonist
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
14 days

37. Name the hormone
Frameshift
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
Epinephrine
Enterobius vermicularis; the treatment is albendazole.

38. Where does the conversion of CO2 into HCO3- take place?
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
Moving objects - along with large bright objects with curves and complex designs.
Trazodone
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.

39. What is the lymphatic drainage of the pelvic organs?
PDA
Popliteus
Parietal lobe
Internal iliac nodes

40. How many attacks are needed over how much time before panic disorder is diagnosed?
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
SITS
Lingual nerve of CN V3

41. On the venous pressure curve - What do the following waves represent? - C wave?
The sandfly
Pinpoint pupils - decreased respiratory rate - and coma
Enkephalins
Ventricular contraction Atrial - Contraction - Venous

42. How many carbons do estrogens have?
IgG4
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
Posterior cruciate ligament
Verbigeration

43. What are five clinical signs of portal HTN?
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Left homonymous hemianopsia
Rheumatoid arthritis
Cryptococcus

44. Describe What type of fluid is either gained or lost with the following changes in body hydration for the ECF volume - ICF volume - and body osmolarity - respectively: x ECF - decrease; ICF - decrease; body: increase
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
Splitting
Semicircular canal
Rectum

45. What signals are used to direct an enzyme to a lysosome?
No change in length
Third week
Phosphorylation of mannose residues
The energy of activation (Ea)

46. Name the antidote - Iron
Chromosome 15
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Deferoxamine - penicillamine
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available - but the renal collecting ducts are impermeable to its actions.

47. What is the effect of hypoventilation on cerebral blood flow?
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
REM sleep. Remember - awake brain in a sleeping body.
Loose association
Rickets

48. Name the cluster B personality disorder: x Colorful - dramatic - extroverted - seductive - and unable to hold long - term relationships
Mycosis fungoides (cutaneous T- cell lymphoma)
ASA
Histrionic
HBeAg

49. Name the DNA virus: x ssDNA; naked; icosahedral; replicates in the nucleus
Serratus anterior
Parvovirus
Granulosa/thecal cell tumor of the ovary
PALS

50. What protein catalyzes the formation of the last PDE bond between the Okazaki fragments to produce a continuous strand?
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.
DNA ligase
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
CN V3 and the lesser petrosal nerve