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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 is the most common one? - Liver tumor
Medullary carcinoma of the thyroid
Positive reinforcement
Musculocutaneous nerve
Metastatic carcinoma

2. From What embryonic structure are the following structures derived? - The sinus venarum - coronary sinus - and the oblique vein of the left atrium
Fovea
Osteoma
Sinus venosus
Stratum granulosum

3. What is the first epidermal layer without organelles and nuclei
VLDLs
Hypoglycemia for secretion and hyperglycemia for inhibition
Both
Stratum lucidum

4. Name the hepatitis virus based on the following information - Naked capsid RNA calicivirus
Salmonella typhi
Pontocerebellar angle syndrome
Hepatitis E
Coronavirus

5. What lysosomal enzyme is deficient in x Tay- Sachs disease?
Varicocele
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)
Hexosaminidase A
Azathioprine

6. What enzyme found in a cholinergic synapse breaks down ACh? What are the byproducts?
Bronchiectasis
Low interstitial free Ca2+ concentrations
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
Posterior

7. What component of an ECG is associated with the following? - Atrial depolarization
P wave
Vitamin B 6 (pyridoxine)
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
Medial compartment of the thigh - obturator nerve

8. What hormones - secreted in proportion to the size of the placenta - are an index of fetal well - being?
Hepatocellular carcinoma
Trapezius and sternocleidomastoid
K1 capsule
hCS and serum estriol - which are produced by the fetal liver and placenta - respectively - are used as estimates of fetal well - being.

9. What statistical method do you use when analyzing x Cohort studies?
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
PGE2
MEN I (or Wermer syndrome)
Chromosome 19

10. The inferior mesenteric artery drains into it.
The splenic vein
Cestodes
Cushing's ulcers
Proencephalon

11. If the P value is less than or equal to .05 - What do you do to the null hypothesis?
Reject it
CN X
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs - TCADs - dextromethorphan - and meperidine. Treat it with cyproheptadine.
VLDL

12. What complex of the ETC contains Cu2+?
Anterior compartment of the leg - deep peroneal nerve
Complex 4
Medial nuclear group (limbic system)
The Fc region of IgG and C3b

13. What are the two best indices of left ventricular preload?
Medial compartment of the thigh - obturator nerve
LVEDV and LVEDP (left ventricular end - diastolic volume and end - diastolic pressure - respectively)
Echinococcus multilocularis
Dopamine antagonists

14. What are the two leading causes of cancer - related death in men?
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Prostate and lung cancer - respectively
The promoter indicates where transcription will begin.
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.

15. What is the polarity (i.e. - 5'-3' or 3'-5') of a positive sense RNA?

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16. What modified smooth muscle cells of the kidney monitor BP in the afferent arteriole?
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
GH
Lipoprotein lipase
The JG cells

17. Where is the action potential generated on a neuron?
Axon hillock
Neisseria meningitidis
Constipation and miosis
Size

18. What triggers phase 4 of the action potential in a ventricular pacemaker cell?
Motor aspect
Decreasing potassium conductance - which results in increased excitability
Multiple myeloma
First - pass effect

19. What is the name of the force that develops in the wall of the lungs as they expand?
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
T lymphocyte
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.

20. What is the biochemical trigger for REM sleep?
Alkaline phosphatase
IGF-1 (somatomedin C)
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Ch

21. In what form are triglycerides sent to adipose tissue from the liver?
VLDLs
Primary Hemochromatosis
Proton pump inhibitors
In the dorsal horn of the spinal cord on the primary afferent neurons

22. What is the drug of choice for threadworm - trichinosis - and larva migrans?
Bronchial asthma (eosinophil membranes)
Multiple myeloma
Thiabendazole
A decrease in Ca2+ and an increase in PO4

23. What is the only anesthetic that causes cardiovascular stimulation?
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
MEN II and III syndromes
Ketamine

24. What two pathologic conditions occur when the gut does not return to the embryo?
IQ
Positive
Omphalocele and gastroschisis
Gonorrhea

25. Which CNs are found in the midline of the brainstem?
TB meningitis
Giant cell bone tumor (osteoclastoma)
Cervical neoplasia
CN I - II - III - VI - and XII Add 1 + 1 = 2 - 1 + 2 = 3 - 1 + 2 + 3 = 6 - 1 + 2 + 3 + 6 = 12

26. What is the main factor determining GFR?
Protein A
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)

27. What organ is responsible for the elimination of excess nitrogen from the body?
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Craniopharyngioma
PGE 1 - PGI 2 (most potent) - and TXA 2
Decrease (5- HT and dopamine levels do the same)

28. What transports iron in the blood?
Transferrin
Actinomyces israelii
Gilbert's syndrome
presence of PMNs

29. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 46/2n (divide mitotically)
Spermatogonia (type B)
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
Transcription factor IID
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.

30. What two vessels come together to form the external jugular vein?
Diphyllobothrium latum
1. Posterior auricular vein 2. Posterior division of the retromandibular vein
Spinothalamic tract (anterolateral system)
epithelial lining

31. What muscle or muscles are innervated by the following nerves? - Suprascapular nerve
HPV infection
First - order elimination
V wave
Supraspinatus and infraspinatus

32. Name the associated chromosome - Patau syndrome
Displacement
Neisseria gonorrhoeae
Chromosome 13
Rickets

33. Name the T- cell CD marker: Is a costimulatory molecule in T cell activation
Excess lead
Inactivated
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
CD28

34. Name the lung measurement based on the following descriptions: x Additional air that can be taken in after normal inspiration
Small to medium - sized cerebral vessels
Factors II - VII - IX - X - and proteins C and S
Beta- Galactosidase
Inspiratory reserve volume (IRV)

35. What component of the ETC is inhibited by the following? - Rotenone
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
Complex I

36. What is the MCC of the following meningitides? - In renal transplant patients
Alzheimer disease
Semicircular canal
Tryptophan
Listeria monocytogenes

37. What type of error is made if you accept the null hypothesis when it is false?

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38. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Months to years after transplantation; gradual onset of HTN - oliguria - and azotemia; seen as intimal fibrosis of the blood vessels and in
Inferior Oblique (CN III) (LR6 SO4)3
Duodenal atresia
Paramyxovirus
Chronic rejection

39. What pattern of genetic transmission affects only M and has no M- to - M transmission - and mother is usually an unaffected carrier?
Iatrogenesis
Total lung capacity (TLC)
X- linked recessive
Carnitine acyl CoA transferase II

40. What judgment states that the decision - by rights of autonomy and privacy - belongs to the patient - but if the patient is incompetent to decide - the medical decision is based on subjective wishes?
Progestins
Substituted judgment. It is made by the person who best knows the patient - not the closest relative.
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
Specific rate (e.g. - men aged 55-60)

41. What is the most common primary malignant tumor in bone?
Porcelain gallbladder
Osteosarcoma
Chromosome 14 - 18
Streptokinase

42. All Proteus species are...
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Protamine sulfate
NREM sleep. Night terrors are dreams that we are unable to recall.
urease positive

43. What is the label given to an individual whose IQ is x Below 69
NE
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.
Mentally disabled
Biotin (only if eaten in large quantities)

44. Name the antimicrobial agent whose major side effect is listed - Dental staining in children
Right brachiocephalic artery
Gerstmann's syndrome; spoken language is usually understood.
Third week
Tetracycline

45. What is the term for the load a muscle is trying to move during stimulation?
HHV 6
5HT1D
Afterload
Taenia solium

46. Is T3 or T4 responsible for the negative feedback loop on to the hypothalamus and anterior pituitary gland?
Transmembrane potential (an absolute number)
Primary hypoaldosteronism (Addison's disease)
RSV
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.

47. What form of hemophilia is X- linked recessive and is due to a deficiency in factor IX?
Bitemporal heteronymous hemianopsia
Hemophilia B
pH of 2 and 9
Methicillin

48. Which Streptococcus pyogenes toxin is immunogenic?
Gastrinoma
Albumin
Streptolysin O
The affinity of the drug for its receptor

49. Development of what T cell line follows low affinity for self - MHC class II Ags in the thymus?
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
First - pass metabolism and acid lability
CD4+T cells

50. What is the term for the point on a scale that divides the population into two equal parts?
Median (think of it as the halfway point)
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
Hemostasis
Clearance