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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. Regarding the viral growth curve - is the internal virus present before or after the eclipse period?
After the eclipse period
45XO
Excess estradiol in the blood
Affinity decreases; they are inversely proportional.

2. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Skeletal muscle
Fitz - Hugh - Curtis syndrome
CN VII and VIII
Adipose tissue
Permanent

3. Name the associated chromosomal translocation - Acute promyelocytic leukemia (M3)
Nephrotoxic oxylate stones
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Chromosome 15 - 17
Anticipation

4. What is the lymphatic drainage of the pelvic organs?
Ungated potassium channel
IgD; IgM is also correct.
Internal iliac nodes
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.

5. What CNs arise from x The midbrain?
CN III and IV
Decreases
Primary hypercortisolism
Major

6. What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?
Orbitomedial frontal lobe
Asparagine
Osteosarcoma
IQ

7. What type II hypersensitivity disorder is defined as x Autoantibodies directed against the TSH receptor?
Schistosoma haematobium
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
Alternative hypothesis (What is left after the null has been defined)
Graves disease

8. IgE- mediated mast cell release - C3a and C5a - and IL-1 all trigger the release of what vasoactive amine?
Polycystic ovaries
Histamine
Purkinje cell is the fastest - and the AV node is the slowest.
Mebendazole

9. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Osmolarity
Vitamin B12 deficiency and folate deficiency
Chromosome 5q21
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
300 mOsm/L

10. Are the following conditions associated with a negative or positive nitrogen balance? - AA deficiency
Thymus - independent Ags
Protein A
Liver - kidney - and GI epithelium
Negative

11. What subset of T cells recognizes the MHC class I Ags?
Nucleus pulposus
T wave
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
CD8+ T cells (cytotoxic) Remember - 8

12. Serum concentration of what substance is used as a clinical measure of a patient's GFR?
Primary Hemochromatosis
Chronic alcoholic
Toxic dose for 50% of drug takers (median toxic dose)
Creatinine

13. Name the hepatitis virus based on the following information - Enveloped DNA hepadnavirus
Hepatitis B
Monosodium urate crystals
Stage 3 and 4
MEN II and III syndromes

14. Name the type of mutation: x The deletion or addition of a base
Ventral posteromedial nucleus
Frameshift
Unstable (crescendo) angina
Proencephalon

15. What peripheral chemoreceptor receives the most blood per gram of weight in the body?
Yes
Primary hypercortisolism
The carotid body - which monitors arterial blood directly
Fibroadenoma

16. What is the DOC for treating torsade de pointes?
The hallmarks of LMN lesion injury are absent or decreased reflexes - muscle fasciculations - decreased muscle tone - and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget - LMN lesions are ipsilateral at the level of the
Anemia of chronic disease
Magnesium
CN VII

17. Where does the conversion of CO2 into HCO3- take place?
All are lactose fermenters except Yersinia and Proteus.
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.

18. Name the ventricular muscle membrane channel: x Open at rest; depolarization is stimulus to close; begin to reopen during the plateau phase and during repolarization
Voltage - gated potassium channels
CN VII
GABA and glutamic acid
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.

19. What AD disease associated with chromosome 19 involves a defect in the LDL receptors that leads to skin and tendon xanthomas?
Clozapine
Null hypothesis (what you hope to disprove)
Familial hypercholesterolemia
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.

20. What eukaryotic translation enzyme is associated with the following: x Elongation
eEF-1
Lipoxygenase pathway - from arachidonic acid
Melatonin - serotonin - and CCK
PGE (along with low oxygen tension)

21. What enzyme is blocked by 5- FU?
Ea (activation energy)
Thymidylate synthetase
5 years old
Parkinson disease

22. What cells of the kidney are extravascular chemoreceptors for decreased Na+ - Cl - - and NaCl?
Macula densa
Cardiac muscle
ATP/ADP Translocase
None; they are not formed until a girl reaches puberty.

23. How many months in How many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
V wave
3 months of symptoms in 2 consecutive years
Waldenstr
Calcium oxylate

24. What reflex increases TPR in an attempt to maintain BP during a hemorrhage?
Osteoblast (Remember - blasts make - clasts take)
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Fibroadenoma
The carotid sinus reflex

25. What is the Ig associated with the primary immune response?
Intussusception
Nasopharynx
IgM
No change in length

26. Which muscles of the eye are under parasympathetic control?
Hemostasis
Lead poisoning
Constrictor pupillae and ciliary muscles
Ribozymes

27. What ethnic group has the highest adolescent suicide rate?
Magnesium
Avoidant
Native Americans
V wave

28. Name the compartment of the mediastinum associated with the following thoracic structures: Thoracic duct
Free form determines hormone activity and is responsible for the negative feedback loop.
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
Epinephrine
Superior and posterior

29. What statistical method do you use when analyzing x Cross - sectional studies?
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.
Chi - square.
Vitamin A

30. What phase of the menstrual cycle is dominated by estrogen? Progesterone?
Somatoform pain disorder
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Transposons
Cyproheptadine

31. 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
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
Stratum spinosum
Coagulative
Maxillary artery

32. What deep cerebellar nuclei receive Purkinje cell projections in x The vermis?
Flumazenil
The fastigial nucleus
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
Arch of the aorta and right subclavian artery

33. What disorder is associated with loss of polarity - anaplasia - pleomorphism - discohesiveness - increase in the nuclear:cytoplasmic ratio - hyperchromasia - and increase in the rate of mitosis?
Proportionate mortality rate
Malignancy
Macule (e.g. - a freckle)
Kl

34. Which subset of MEN syndrome is associated with the following? - Parathyroid - pancreatic - and pituitary gland tumors and Zollinger - Ellison syndrome
Blastoconidia
Specific rate (e.g. - men aged 55-60)
MEN I (or Wermer syndrome)
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12

35. Is DM a contraindication to use of a Beta- blocker in a patient who is having an MI?
The promoter indicates where transcription will begin.
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Astrocytoma
Paramesonephric ducts

36. What level of mental retardation is characterized by x Can work in sheltered workshops and learn simple tasks but need supervision?
Obsessive - compulsive
2 NADPHs per acetyl CoA
Moderate (35-49)
Stage 2 - which accounts for approximately 45% of total sleep time - with REM occupying 20%.

37. Can an acute MI be diagnosed only by looking at an ECG?
Phenylalanine hydroxylase
Medial rectus (CN III) (LR6 SO4)3
Edinger - Westphal nucleus (via CN III)
No. Remember - tests do not diagnose - they confirm or refute your diagnosis. Also - diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI - elevated cardiac enzymes consistent with MI - and ST segment elevati

38. What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
Porcelain gallbladder
Temporal arteritis
Odds ratio. (Case control studies deal with prevalence.)
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.

39. On what chromosome is the adenomatous polyposis coli gene?
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
Chromosome 5q21
Nigrostriatal pathways (basal ganglia)

40. A migrating myoelectric complex is a propulsive movement of undigested material of undigested material from the stomach to the small intestine to the colon. During a fast - What is the time interval of its repeats?
Beta- Hydroxybutyrate
Demeclocycline
Processed antigenic peptides bound in the groove of the MHC molecule
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.

41. Name the most common one - Chromosomal disorder
Chromium (Cr)
Bile pigments and bile salts
Down syndrome (trisomy 21)
Labetalol

42. What are the three branches of the celiac trunk?
The left gastric - splenic - and common hepatic arteries
Ischemic heart disease (MIs)
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
Third week

43. Name the antimicrobial agent whose major side effect is listed - Auditory toxicity
Vancomycin
Papillary carcinoma of the thyroid
The energy of activation (Ea)
Four Ms and a U 1. Median 2. Medial antebrachial 3. Medial pectoral 4. Medial brachial cutaneus 5. Ulnar

44. What classical conditioning therapy or modification is described as x Forcing patients to confront their fears by being exposed to them until they are extinguished?
Calcium oxylate
HPV serotypes 1 and 4
1. The child poses an imminent danger to self or others. 2. The child is unable to self - care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety e
Exposure

45. If the family member of a patient asked you to withhold information - would you?
For the USMLE Step 1 the answer is no - but if the information would do more harm than good - withhold. This is very rare but it does occur.
CN X
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.
Al - Anon

46. What is the name of the postganglionic parasympathetic ganglion that innervates x The papillary sphincter and ciliary muscle of the eye?
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III) - B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.
Mentally disabled
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
Teratoma

47. What is the drug of choice for treating Tourette syndrome?
Pimozide
Edrophonium
Thymic epithelial cells - dendritic cells - and macrophages
Calcitriol

48. Abs to what hepatitis B Ag provide immunity?
Abs to HBsAg
EBV
Rheumatic fever
Confounding bias

49. What cytokines do Th2 cells secrete to inhibit Th1 cell function?
IL-4 - IL-10 - and IL-13
Residual volume (RV)
The subclavian artery
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme

50. In regards to solute concentration - how does water flow?
d - ALA synthase
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
Psoas major
ater flows from a low - solute to high - solute concentrations.