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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. On the venous pressure curve - What do the following waves represent? - A wave?
Picornaviridae
Pulmonary shunt (i.e. - pulmonary embolism)
Axis III
Atrial contraction Atrial - Contraction - Venous

2. What happens to the following during skeletal muscle contraction? - Actin and myosin lengths
Homogentisic oxidase
Coxiella burnetii
No change in length
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid

3. Which CNs are found in the midline of the brainstem?
Parvovirus B 19
CN I - II - III - VI - and XII Add 1 + 1 = 2 - 1 + 2 = 3 - 1 + 2 + 3 = 6 - 1 + 2 + 3 + 6 = 12
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland
M- cells

4. What part of the ANS is affected in the biofeedback model of operant conditioning?
alpha2- Receptors
Antigenic determinant (epitope)
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
The biofeedback model is based on the parasympathetic nervous system.

5. What is the only DNA virus that is not icosahedral?
Southern blot
Poxvirus
Courvoisier's law
Reinforcement

6. What disorder leads to IgG autoantibodies to the TSH receptor?
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
Lesch - Nyhan syndrome
Graves disease

7. What is the most common one? - Benign tumor of the ovary
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Nondominant parietal lobe
Serocystadenoma
Cricothyroid muscles

8. What AR syndrome is due to a deficiency of glycoprotein Ib - resulting in a defect in platelet adhesion?
Bernard - Soulier syndrome
Cystadenocarcinoma
Leydig cell tumor
Menstruation

9. What is the primary method of nonverbal communication of emotional states?
Varicella virus and influenza virus
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
Facial expression (the second is vocal intonation)
Klinefelter syndrome

10. What childhood pathology involves anterior bowing of the tibia - epiphyseal enlargements - and costochondral widening - with the endochondral bones being affected?
Processed antigenic peptides bound in the groove of the MHC molecule
Tryptophan
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.
Rickets

11. What event signifies the first day of the menstrual cycle?
Tinea favosa (favus)
Iron (Fe)
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Onset of bleeding

12. Which way will the O2 dissociation curve shift with the addition of 2 - 3- bisphosphoglycerate (2 - 3- BPG) to adult hemoglobin (Hgb)?
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting). The needle is part of the blood - drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in th
Shifts it to the right
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.

13. What type of potential is characterized as graded - decremental - and exhibiting summation?
Erythema marginatum
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
Subthreshold potential

14. What type of Plasmodium affects x Only mature RBCs?
wave
Spinothalamic tract (anterolateral system)
Cytochrome c
Plasmodium malariae

15. How many attacks are needed over how much time before panic disorder is diagnosed?
Ewing's sarcoma
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
Stratum spinosum
Proencephalon

16. Ophthalmic artery is a branch of What artery?
Internal carotid artery
Left homonymous hemianopsia
Hypotonia (rag doll appearance)
Preload. It is the load on a muscle Prior to contraction.

17. Name the DNA virus: x ssDNA; naked; icosahedral; replicates in the nucleus
Parvovirus
Spearman correlation
The JG cells
It both begins and ends at T4 (sternal angle [of Louis]).

18. What papillae send their senses via chorda tympani of CN VII?
Fungiform papillae
Mitral insufficiency
The subclavian artery
Alcoholics Anonymous

19. Name the type of graft described by these transplants: Between genetically identical individuals
Howell - Jolly bodies
PALS (Parietolateral lymphocytic sheath)
Isograft
von Hippel - Lindau syndrome

20. What muscle is the chief flexor of the hip?
DNA polymerase - d
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
Psoas major
Inferior rectus (CN III) (LR6 SO4)3

21. What element is needed for the proper alignment of tropocollagen molecules?
Zoophilia
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
Alveolar macrophages (dust cells)
Copper (Cu+)

22. What DNA virus is associated with heterophile - negative mononucleosis?
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
Huntington disease
Osmosis; water will diffuse from higher to lower water concentrations.
Thoracic splanchnic fibers

23. What area of the lymph node is considered the thymic - dependent area?
Carnitine acyl CoA transferase II
The inner cortex (paracortex) contains the T cells - so it is considered the thymic - dependent area.
Chromaffin cells (adrenal medulla)
IgE

24. Name the most common type or cause - Urinary tract obstruction
Laminin
The venae recta maintain the gradient via countercurrent flow.
BPH
3 to 4 days

25. It degenerates 4 to 5 days post fertilization - and implantation occurs __ days post fertilization!
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
Abs to HBsAg
It increases Ca2+ excretion from the kidney and increases bone mineralization.
7

26. What portion of the pericardium adheres to the tunica adventitia of the great vessels?
Hyperkalemia
Vitamin D3
5' deiodinase
Fibrous pericardium

27. What cells of the adrenal gland are neural crest derivatives?
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.
Creutzfeldt - Jakob disease
Chromaffin cells (adrenal medulla)
Hepatitis B and hepatitis C

28. What must be supplemented in patients with medium - chain acyl CoA dehydrogenase (MCAD) deficiency?
Short - chain fatty acids
Streptococcus agalactiae and Escherichia coli
Anatomical dead space - which ends at the level of the terminal bronchioles.
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.

29. What five main oxidizing reactions are used to kill ingested organisms?
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Molybdenum (Mb)
Invasive ductal carcinoma

30. What percentage of the bone marrow must be composed of blast for leukemia to be considered?
5' deiodinase
Stercobilin
Metronidazole
At least 30% blast in the bone marrow

31. What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels?
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
G0 phase
C5a
Monosodium urate crystals

32. What glycogen storage disease is due to the following enzyme deficiencies? - Lysosomal glucosidase (acid maltase)

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33. What AA is a precursor of the following substances? - GABA
Levator palpebrae superioris
Cefuroxime and cefaclor
Glutamine
Glutamate

34. Notching of the ribs - seen on chest radiograph in patients with postductal coarctation of the aorta - is due to collateralization of What arteries?
Chronic end - stage renal disease
Ethyl alcohol
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.

35. What type of random controlled test is least subjective to bias?
Double - blind study. It is the most scientifically rigorous study known.
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
Flumazenil
Patau syndrome (trisomy 13)

36. What TCAD causes sudden cardiac death in children?
Nondominant parietal lobe
Cefuroxime and cefaclor
Herpes I
Desipramine

37. What hormone can be affected by dopamine release in the tuberoinfundibular pathway?
In the tuberoinfundibular pathway - dopamine release will decrease prolactin release - Which is why dopamine agonists are used in the treaatment of hyperprolactinemic states.
Type II error (beta error). (Remember it as saying something doesn't work when it does.)
Zona fasciculata and zona reticularis
LH

38. What mosquito is the vector for dengue fever?
IL-5. It also stimulates eosinophil proliferation.
Coagulative necrosis
Pyrantel pamoate
Aedes (the same for yellow fever)

39. What type of hallucination occurs during awakening?
Anterior nuclear group (Papez circuit of the limbic system)
GH- producing adenoma
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.
Arnold - Chiari malformation type 2

40. Name the lung measurement based on the following descriptions: x Amount of air in the lungs after maximal inspiration
Glucose
Total lung capacity (TLC)
PCT
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.

41. What branch off the vertebral artery supplies x The cerebellum and the dorsolateral part of the medulla?
Poxvirus
PICA
Primitive atrium
Motor

42. What are two causes of diffusion impairment in the lungs?
Escherichia coli
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
Hydrolysis
Klinefelter syndrome

43. What determines the plasma level at steady state?
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
The rate of infusion
Methylphenidate (Ritalin)
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.

44. What form of angina is characterized by x Coronary artery luminal narrowing - symptom occurrence during exertion - ST segment depression on ECG?
Obsessive - compulsive
Stable angina
Glioblastoma multiforme
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)

45. What are the four characteristics of all protein - mediated transportation?
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero - order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than i
Pneumocystis carinii
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
First - order elimination

46. What are the primary neurotransmitters at the following sites? - Brainstem cells
Neisseria meningitidis
Serotonin
Action potential
Plasmodium vivax

47. Name the most common cause - Croup
Parainfluenza virus
Alteplase
Rectum
Prostate and lung cancer - respectively

48. What leukemia is associated with four - leaf - clover lymphocytes on peripheral blood smear?
Spermatogonia (type B)
Adult T- cell leukemia
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Type IV collagen

49. What is the most common one? - Cancer of the esophagus in the world
Squamous cell carcinoma
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Without children (but don't think about this one for too long)
Labioscrotal swelling

50. What happens to intrapleural pressure when the diaphragm is ontracted during inspiration?
Intrapleural pressure decreases (becomes more negative).
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
IgG
Medial midbrain (Weber's) syndrome