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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 nucleus of the hypothalamus receives visual input from the retina and helps set the circadian rhythm?
prior to birthThe foramen ovale closes just...
Humor
Suprachiasmatic nucleus
Intellectualization

2. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF ? - capillary pressure ?
H1 histones
Constriction of efferent arteriole
Constipation and miosis
Rapidly progressive glomerulonephritis (RPGN)

3. Name the MCC - Aspiration pneumonia in an alcoholic
G2 phase
Sj
>5 mm
Klebsiella pneumoniae

4. What is the term that refers to the number of channels open in a cell membrane?
Fibrocystic change of the breast
Membrane conductance (think conductance = channels open)
pI (isoelectric point)
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.

5. With What three enzymes is thiamin pyrophosphate (TPP) associated?
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.
Coma - convulsions - and cardiotoxicity
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -
Squamous cell carcinoma

6. What bedside test is used to differentiate a dorsal column lesion from a lesion in the vermis of the cerebral cortex?

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7. Which is the conditioned response - the conditioned stimulus - the unconditioned response - the unconditioned stimulus in this case? A patient has blood withdrawn and faints. The next time she goes to have blood taken - she faints at the sight of the
Third M PITS for pharyngeal pouch derivatives
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
Ethyl alcohol
Left homonymous hemianopsia

8. What drug blocks glucose uptake - leading to decreased formation of ATP and resulting in immobilization of the parasite?
The parasympathetic nervous system
Risk factors for breast cancer
Niclosamide
Albendazole

9. What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency - glucocorticoid deficiency - and an excess of adrenal androgens?
Duchenne muscular dystrophy
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
Class II
HTN

10. What is the name of bilateral flaccid paralysis - hyporeflexia - and hypotonia due to a viral infection of the ventral horn of the spinal cord?
Cytochrome b/c1
Afterload
HIV
Poliomyelitis; it is a bilateral LMN lesion.

11. Eating fava beans can produce the Mediterranean type of what deficiency?
2 and 5HT3 receptors
G-6- PD deficiency
GnRH pulsatile infusion
HBcAb IgG - HBV- DNA - HBeAg - HBsAg

12. What are the genetic variants of a molecule within members of the same species?
Streptococcus pneumoniae
Alcohol consumption
Allotypes
Reovirus

13. What organ of the body has the smallest AV oxygen difference?
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.
IgM
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
IgM

14. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Fixed interval
Type II hypersensitivity reaction
Pseudomonas aeruginosa
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.

15. RBC casts in the urine
DNA polymerases
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Acute glomerulonephritis
12 days after ovulation

16. What are the three carboxylase enzymes that require biotin?
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Cushing's ulcers
Cocaine
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.

17. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF ? - capillary pressure ?
None; they are not formed until a girl reaches puberty.
Staphylococcus aureus (but they are more prone to salmonella infections)
Folic acid
Dilation of efferent arteriole

18. How can you differentiate between a medial temporal lobe and a hippocampal lesion based on memory impairment?
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
Osteoarthritis
Labioscrotal swelling
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.

19. Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid?
Areas 5 and 7
Parafollicular C cells
Rapidly progressive glomerulonephritis (RPGN)
Doxycycline

20. What is the term for RBCs with smooth undulations on the surface of their membrane - commonly seen in uremia?
Burr cells (echinocytes)
Osteosarcoma
Medullary carcinoma of the thyroid
The mouth

21. Which protozoal parasitic vaginal infection produces a positive whiff test with KOH staining?
Trichomonas vaginalis (treat with metronidazole)
Glycogen synthase
Isolation of affect
Large segment deletions

22. Is there a shift in p50 values with anemia? Polycythemia?
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
give a warning

23. What is the most common one? - Organism associated with mastitis
Staphylococcus aureus
Narcissistic
Hashimoto thyroiditis
Vibrio cholera

24. What hormone is necessary for normal GH secretion?
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
IF-2 of the 30S subunit
Histiocytosis X

25. What Brodmann area is associated with x Wernicke's area?
Reject it
Hypospadia
Area 22 and occasionally 39 and 40
TXA2

26. What protein deficiency results in respiratory distress syndrome of newborns?
Deficiency in surfactant
Nodular melanoma
PICA
1. Covalent bonding between the hapten and carrier 2. B- cell exposure to hapten twice 3. T- cell exposure to carrier twice

27. What AR disease involves a decreased amount of sphingomyelinase - massive organomegaly - zebra bodies - and foamy histiocytes and is associated with chromosome 11p?
Streptococcus viridans
Medulla blastoma
Niemann - Pick disease
Niacin (B3)

28. In the alveoli - what cell type is x for gas exchange?
Orbitomedial frontal lobe
Rhinovirus
Type I pneumocytes
Chromosome 15q

29. What is the name of violent projectile movements of a limb resulting from a lesion in the subthalamic nuclei of the basal ganglia?
Lung cancer
Amiloride
Mebendazole
Hemiballismus

30. What area of the posterior aspect of the eye has no photoreceptors?
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.
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.
The conus medullaris terminates at the level of the second lumbar vertebra.
The optic disk is the blind spot.

31. Name the antidote - Carbon monoxide (CO)
GERD
Formal operations (> 12 years)
Oxygen
Psoriasis

32. What enzyme is deficient in congenital erythropoietic porphyria?
Uroporphyrinogen III cosynthase
Squamous cell carcinoma
Week four - and they remain dormant there until puberty.
Pergolide

33. Name the compartment of the mediastinum associated with the following thoracic structures: Left subclavian artery
Osteocyte
Positive predictive value
1. Cytosine 2. Uracil (only in RNA) 3. Thymidine
Superior

34. What somatoform disorder is described as x Having a F:M ratio of 20:1 - onset before age 30 - and having 4 pains (2 gastrointestinal - 1 sexual - 1 neurologic)?
Hemolytic uremic syndrome
Methanol
Somatization disorder
REM sleep. Remember - awake brain in a sleeping body.

35. What happens to intrapleural pressure when the diaphragm is ontracted during inspiration?
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Dissociation
Apneustic center (deep breathing place)
Intrapleural pressure decreases (becomes more negative).

36. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Telencephalon
Proencephalon
Squamous cell carcinoma
Duchenne muscular dystrophy
Lateral rectus (CN VI) (LR6 SO4)3

37. What signals are used to direct an enzyme to a lysosome?
Phosphorylation of mannose residues
Circumvallate papillae
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
Oligodendroglioma

38. What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?
Lithium
Tetany
Onion skinning
Ischemic heart disease (MIs)

39. Name the product or products of arachidonic acid: x Vasodilation and inhibition of platelet aggregation produced by vascular endothelium
They innervate LMNs.
PGI2
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh

40. Which class of antiarrhythmics blocks sodium channels?
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
GH- producing adenoma
Class 1 (1A - 1B - and 1C)
1. Glycine 2. Aspartate 3. Glutamine

41. If a drug is ionized - is it water or lipid soluble? Can it cross a biomembrane?
C1 inhibitor (C1- INH)
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
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.

42. What enzyme of the purine salvage pathway is deficient in the following? - SCID
Adenosine deaminase
Major
Toxoplasmosis
Internal carotid artery

43. What period is described when a larger - than - normal stimulus is needed to produce an action potential?
Relative refractory period
Clonidine
common variable hypogammaglobinemia
Thiamine

44. What two vessels in fetal circulation have the highest PO2 levels?
Sensitivity (it deals with the sick)
Chromosome 15
Acetyl CoA carboxylase
Umbilical vein and ductus venosus (80%)

45. Used in the treatment of barbiturate overdose.
Flumazenil
S phase
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Listeria monocytogenes

46. What hypothesis states that the findings of a test are a result of chance?
Null hypothesis (what you hope to disprove)
Kinesins. Dynein generates retrograde transportation of information.
Depolarization is from apex to base and from endocardium to epicardium.
Thymidylate synthase

47. What illegal drug can cause rhabdomyolysis - MI - cerebral infarct - and lethal cardiac arrhythmias?
Cocaine
Omphalocele and gastroschisis
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.

48. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x L- myc
Prolyl and lysyl hydroxylases
eEF-1
Phase II
Small cell cancer of the lung

49. Are used in combination with estrogens to decrease the risk of endometrial cancer.
Progestins
Skin - liver - and kidneys
The pH of CSF is 7.33 - acidotic.
Clostridium perfringens

50. DNA replication occurs During what phase of the cell cycle?
Aspartate transcarbamylase
Flea - bitten kidney (can also be seen in pyelonephritis)
Operon
S phase