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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 are the primary neurotransmitters at the following sites? - The hypothalamus
Secondary spermatocyte
Neutropenia - splenomegaly - and rheumatoid arthritis
Histamine
Hepatitis D

2. What two muscles do you test to see whether CN XI is intact?
Trapezius and sternocleidomastoid
Estradiol
Glycogen phosphorylase
Live vaccines

3. Name the associated chromosomal translocation - Ewing sarcoma
Chromosome 11 - 22
Right coronary artery
IgG
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).

4. Name the form of spina bifida - An open neural tube lying on the surface of the back
GABA - quantitatively
>5 mm
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Maxillary artery

5. What is the term for the pH range where the dissociation of H+ occurs?
Chromosome 11p
pK (think of it as where half is base and half is acid)
Ampicillin and amoxicillin
MEN I (or Wermer syndrome)

6. What structure of the knee is described thus? - Prevents abduction
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.
Medial collateral ligament
gp120
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney

7. What is the term for an inhibitory interneuron?
Primary hypercortisolism
Renshaw neuron
Klebsiella pneumoniae
The energy of activation

8. What aspects of sleep are affected during benzodiazepine use?
Bunyavirus
REM and stage 4 sleep; they decrease.
Simon focus
Mesencephalon

9. Is the hydrophobic or hydrophilic end of the phospholipids of the cell membrane facing the aqueous environment?
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
Ligament teres
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
Flutamide

10. Name the valve abnormality based on the following criteria: x Diastolic murmur - increased right ventricular pressure - left atrial pressure - and atrial to ventricular pressure gradient; decreased left ventricular filling pressure
Stapes artery
Mitral stenosis
IgM
Permanent

11. What segments of the lumbosacral plexus form the following nerves? - Common peroneal nerve
Posterior
Simon focus
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.

12. In a negatively skewed curve is the mean greater than the mode?
Iatrogenesis
Sporozoites
Diverticulosis
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.

13. Name the antidote - Acetaminophen
ASD
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
N- Acetylcysteine
Folic acid deficiency

14. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
Glucokinase
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
The T- test (used when comparing two groups)

15. What antiviral agent for ganciclovir - resistant infections has limited utility because of its nephrotoxic side effect?
hCG can be detected in the blood by day 8 and in the urine by day 10.
Foscarnet
Decreasing potassium conductance - which results in increased excitability
Creutzfeldt - Jakob's disease. Patients first develop vague somatic complaints and anxiety - rapidly followed by dysarthria - myoclonus - ataxia - and choreoathetosis.

16. Are eukaryotic proteins that inhibit viral replication by being virus specific.
Panacinar
Negative
Interferons
Bioavailability

17. Name the type of exudate - given the following examples - Parasitic infection
Eosinophilic exudates
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Degenerates
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors

18. What is the formula to calculate IQ?
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
Increase in erythropoietin and increase in 2 - 3- BPG - also called 2 - 3- diphosphoglycerate (2 - 3- P2Gri) (increase in glycolysis)
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)

19. What are the pharmacologic effects seen sexually with x a1- Blockers?
Confidence interval. It is a way of admitting estimation for the population.
Impaired ejaculation
Hydatidiform mole
Tyramine

20. What is the renal compensation mechanism for alkalosis?
Leucine and lysine
Ependymal cells
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A

21. Name the macrophage based on its location: x Lung macrophages
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.
Accidents
Pulmonary alveolar macrophages
Reverse transcription

22. What is the major pulmonary side effect of
Respiratory depression
Clostridium perfringens
2 and 5HT3 receptors
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)

23. What is the effect of hypoventilation on cerebral blood flow?
Succinylcholine
Total ventilation (minute ventilation or minute volume)
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.

24. With what virus are Downey type II cells associated?
INF- gamma
Primary spermatocyte
Head of the pancreas
EBV

25. What is backward masking - and is there a positive correlation with schizophrenic patients?
Waldenstr
Small cell carcinoma (oat cell)
Cestodes
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.

26. Are hydrolysis - oxidation - and reduction phase I or II biotransformations?
Acute pyelonephritis
H 2
Schizotypal
Phase I

27. What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Increase (5- HT and dopamine levels do the same)
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
Valence

28. What two pathologic conditions occur when the gut does not return to the embryo?
Eosinophils
Constipation and miosis
Omphalocele and gastroschisis
Projective test. Most tests with a wide range of possibilities for the answers are projective.

29. What is the term for headaches - inability to concentrate - sleep disturbances; avoidance of associated stimuli; reliving events as dreams or flashbacks following a psychologically stressful event beyond the normal range of expectation?
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
Apneustic center (deep breathing place)
Succinyl CoA
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.

30. What is the term to describe inability to recall the past and possible assumption of a completely new identity?
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
Dissociative fugue. (Patients are unaware of memory loss.)
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
presence of PMNs

31. Name the area of the cerebral cortex with the function described: x Intellectual processing of sensory information - with the left (dominant) processing verbal information - the right processing visual - spatial orientation
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)
Trazodone
Nodular melanoma
Parietal lobe

32. What hypothalamic hormone is synthesized in the preoptic nucleus?
GnRH
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.
Because it is the largest vessel and has the highest velocity in systemic circulation
Brushfield spots

33. What testicular tumor of infancy is characterized by elevated - fetoprotein levels and Schiller - Duval bodies?
First - pass metabolism and acid lability
Membranous glomerulonephritis
Yolk sac tumor
Right medial longitudinal fasciculus

34. The surge of what hormone induces ovulation?
Undoing
LH
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain

35. What determines the rate of reaction?
Embolic
HPV serotypes 1 and 4
Glyceraldehyde dehydrogenase
The energy of activation

36. Name the associated chromosome - Patau syndrome
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
The surface of the medulla
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Chromosome 13

37. What infection is associated with ring - enhancing lesions seen on computed tomography (CT) of the brain in an HIV- positive individual?
p -53
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
Necrotizing enterocolitis
The portal tract of the liver lobule

38. 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
Oxytocin
Competitive antagonist
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
Chylomicrons

39. What water - associated organism is a weakly stained gram - negative rod that requires cysteine and iron for growth?
Legionella (think air conditioners)
The time it takes ACh to diffuse to the postjunctional membrane
Granulosa cell
Mesencephalon

40. Name the neurotransmitter at the neuromuscular junctions for all of the voluntary muscles in the body.
None; they are the storage sites for ADH and oxytocin.
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)
Motor aspect
ACh; think about the ANS.

41. What three vitamin deficiencies are associated with homocystinemia?
Tylosis
Catechol - O- methyl transferase (COMT)
Folate - vitamin B12 - and vitamin B6
Fossa ovale

42. Do the following structures pick up stain from hematoxylin or eosin? - Calcium
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Hematoxylin
Succinate dehydrogenase
Helicase (requires ATP for energy)

43. Name these anxiety defense mechanisms: x Use of explanations to justify unacceptable behaviors.
Rationalization
Pregnancy
Area 8
Postinfectious GN

44. What abdominal muscle runs horizontally - contributes to the posterior rectus sheath - and contributes to form the conjoint tendon?
Follicular phase
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
Confabulation; it is commonly seen in Korsakoff's syndrome.
Transverse abdominis

45. What part of the heart forms x Posterior wall?
Melanin
Hemochromatosis
Pneumothorax
Left atrium

46. How many mature sperm are produced by one type B spermatogonium?
Bactericidal
Medial midbrain (Weber's) syndrome
Four
Mycobacterium marinum

47. What is the term for taking an mRNA molecule and arranging the AA sequence forming a protein?
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Average
Translation
Stable

48. Name the compartment of the mediastinum associated with the following thoracic structures: Pulmonary artery and veins
Thrush
Antimicrobial agents
Middle
This is the triad of renal cell carcinoma

49. What is the DOC for Beta- blocker - induced bronchospasms?
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.
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Panacinar
Ipratropium

50. What virus is associated with body cavity large B- cell lymphomas?
NADPH oxidase
HHV-8
JC virus
H2PO4- (dihydrogen phosphate)

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USMLE Step 1 Prep

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