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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 three structures increase the surface area of the GI tract?
Nucleus pulposus
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
Fluconazole

2. The clearance of what substance is the gold standard of renal plasma flow?
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
Para - aminohippurate (PAH)
Griseofulvin
External 3' - 5' PDE bonds

3. What is the most common STD?
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.
Plasmin
HPV
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.

4. Clue cells are associated with which organism that causes vaginal discharge?
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Gardnerella vaginalis
Succinylcholine and halothane (Treatment is with dantrolene.)
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.

5. Name the associated chromosome - Cri - du - chat
ACh receptor
Chromosome 5p
Listeria monocytogenes
Methylphenidate (Ritalin)

6. What type II hypersensitivity disorder is defined as x Autoantibodies directed against ACh receptors?
Site 2
Cones (C for color and cones)
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
Myasthenia gravis

7. Do the following structures pick up stain from hematoxylin or eosin? - Bacteria
Hematoxylin
The left gastric - splenic - and common hepatic arteries
AT II
Misoprostol

8. What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
Courvoisier's law
Adrenarche
Tryptophan
Left anterior descending artery

9. What AA is a precursor of the following substances? - Histamine
Penicillin V
Varicocele
Histidine
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)

10. What are the three functions of surfactant?
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Type II hypersensitivity (cytotoxic)
The inner cortex (paracortex) contains the T cells - so it is considered the thymic - dependent area.
Spinothalamic tract (anterolateral system)

11. Name the Hgb - O2 binding site based on the following information: x Greatest affinity of the three remaining sites for attachment; requires PO2 levels of 26 mm Hg to remain attached
Pseudomonas aeruginosa
CO
Brain abscess
Site 2

12. What organelle is responsible for ribosomal RNA synthesis?
Adrenarche
Seminoma
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.
Nucleolus. Ribosomal assembly also takes place in the nucleolus.

13. What three cephalosporins have good penetration against Bacteroides fragilis?
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Risk factors for cervical cancer
Urophilia

14. What vein is formed by the union of the right and left brachiocephalic veins?
Superior vena cava
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
ater flows from a low - solute to high - solute concentrations.
Spinal trigeminal nucleus

15. What is the most common one? - Solid tumor in children
Neuroblastoma
Klebsiella pneumoniae
Pseudogout
Middle cerebral artery

16. What three circumstances allow a child to be committed to institutional care?

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17. Is the clearance for a substance greater than or less than for inulin if it is freely filtered and secreted? If it is freely filtered and reabsorbed?
Spearman correlation
Streptococcus agalactiae (Group B Streptococcus - or GBS)
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.
Zollinger - Ellison syndrome

18. What is the first human disease successfully treated with gene therapy?
Rifampin
Proton pump inhibitors
Adenosine deaminase (ADA) deficiency
Normal values

19. What are the four chemotactic agents?
Phallic stage (4-6 years)
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
Nephrotoxic oxylate stones
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase

20. What form of coarctation of the aorta is associated with Turner syndrome?
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)
Preductal (infantile)
Estrone
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.

21. Name the ocular lesion; be specific - A right lateral compression of the optic chiasm (as in aneurysms in the internal carotid artery)
Musculophrenic and superior epigastric arteries
Right nasal hemianopsia
1. Protest 2. Despair 3. Detachment
Relative refractory period

22. What family do the following viruses belong to? - Hantavirus
Chemotaxis
Bunyavirus
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
CN V

23. Circulating levels of what hormone cause the cervical mucus to be thin and watery - allowing sperm an easier entry into the uterus?
Mitochondria
Prophase of meiosis I (between 12th and 22nd week in utero)
3 ATPs by oxidative phosphorylation
Estrogen

24. In What area of the GI tract are water - soluble vitamins absorbed?
Id
Duodenum
Vitamin E
Water soluble

25. Is the hydrophobic or hydrophilic end of the phospholipids of the cell membrane facing the aqueous environment?
Middle meningeal artery
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Umbilical vein and ductus venosus (80%)
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.

26. What type of DNA library is made from the mRNA from a tissue expressing a particular gene?
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.
Correlation. No - correlation does not imply causation.
Papillary carcinoma of the ovary
Negative

27. What atypical pneumonia can be diagnosed with elevated cold agglutinin titers?
Mycoplasma pneumoniae
Filiform papillae
Eclipse period
CD8

28. As what AAs do muscles send nitrogen to the liver?
The conversion of CHO to pregnenolone via the enzyme desmolase
True hermaphrodism
Shortens
Alanine and glutamine

29. Name the nephritic disease based on the immunofluorescent staining - Smooth and linear pattern of IgG and C3 in the GBM
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Goodpasture disease
Roth spots
Gastric carcinoma

30. What is the term for chronic necrotizing pulmonary infections resulting in permanent airway dilation and associated with Kartagener syndrome?
Ligament of Treitz
Amanita phalloides
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
Bronchiectasis

31. What chromosome codes for HLA gene products?
Thoracic and sacral
The short arm of chromosome 6
7 years old
Paranoid schizophrenia

32. Progesterone has __________ activities.
Coagulative necrosis
Thermogenic
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
Gradient - time system

33. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral hemispheres
Repression
Proencephalon
Hot pink with PAS and grey to black with silver stain
Serous exudates

34. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x erb -1
Squamous cell carcinoma of the lung
Eosinophils
Neuroblastoma
Thioridazine

35. Outburst to cover up true feelings (emotion is covered - not redirected).
Acting out
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).

36. What must be supplemented in patients with medium - chain acyl CoA dehydrogenase (MCAD) deficiency?
Vitamin E
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
LTB4
Short - chain fatty acids

37. What operant conditioning therapy or modification is described as x Providing the person with information regarding his or her internal responses to stimuli with methods of controlling them?
Biofeedback
CN II and ophthalmic artery
Thiamine and folate
Vancomycin

38. What is the term for inflamed - thickened skin on the breast with dimpling associated with cancer?

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39. What is the triad of Reiter syndrome?

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40. What is the pentad of TTP?

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41. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 23/2n
They prevent mast cell degranulation.
Escherichia coli
Secondary spermatocyte
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.

42. Which mycoplasma species is associated with urethritis - prostatitis - and renal calculi?
Ureaplasma urealyticum
Osteosarcoma
Erythema multiforme
Dihydrofolate reductase

43. Takes place in both the cytoplasm and the mitochondria.
Griseofulvin
The urea cycle
Eisenmenger syndrome - which can also occur with any left - to - right shunt
Middle meningeal artery

44. What subset of T cells recognizes the MHC class II Ags?
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
Histamine
CD4+ T cells (helper)
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.

45. What enzyme of the TCA cycle catalyzes the production of the following: x FADH2
Nephroblastoma
Succinate dehydrogenase
A positive PPD skin test
The aorta has the greatest velocity and the capillaries have the slowest velocity.

46. What two PGs are used to induce labor?
PGE2 and PGF2a
Thyroid hormones are necessary for conversion of carotene to vitamin A.
The affinity of the drug for its receptor
Glucagon and epinephrine

47. What condition results in a strawberry gallbladder?
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Nitrates
Cholesterolosis

48. Is an active process due to increased gonadal sex hormones
Hematoxylin
The small subunit (40S) binds first.
Menstruation
Osler nodes

49. What vessels have the largest total cross - sectional area in systemic circulation?
Vesicle (e.g. - poison ivy)
Capillaries
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)

50. Which type of cerebral herniation is associated with CN III palsy?
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Atrial contraction Atrial - Contraction - Venous
Transtentorial (uncal)
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.