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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. A Japanese man has weight loss - anorexia - early satiety - epigastric abdominal pain - and a palpable left supraclavicular lymph node. On endoscopy you find a large - irregular ulcer with elevated margins on the lesser curvature of the stomach. What
Cocaine
Chromosome 21
Hemochromatosis
Gastric carcinoma

2. What type of bilirubin is found in neonatal jaundice?
Valence
Thyroarytenoid muscles
Clostridium botulinum
Indirect or unconjugated

3. What determines the overall force generated by the ventricular muscle during systole?
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
Vitamin D
Squamous cell carcinoma
Hydatidiform mole

4. Name the aphasia based on these characteristics: x Both Broca's and Wernicke's areas damaged by lesion in the presylvian speech area; trouble repeating statements; poor comprehension with telegraphic speech
Cytochrome a/a3
Global aphasia
Parainfluenza virus
Quaternary structure

5. What is the only DNA virus that has the reverse transcriptase enzyme?
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Hepadnavirus
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
Tay- Sachs disease

6. What is the most common one? - Helminthic parasite worldwide
Frontal lobe syndrome (lesion in the prefrontal cortex)
Paranoid
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
Ascaris lumbricoides

7. What happens to free hormone levels when the liver decreases production and release of binding proteins?
Physiologic dead space is the total dead space of the respiratory system.
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Medial compartment of the thigh - obturator nerve
Magnesium

8. Name the cerebral vessel associated with the following vascular pathologies - Epidural hemorrhage
Middle meningeal artery
NREM sleep. Night terrors are dreams that we are unable to recall.
Breast cancer
CN XI - vertebral arteries

9. Influenza - Vibrio cholera - hepatitis A - rabies - and adenovirus.
Are inactivated vaccines available in the United States
14 days
Paranoid
Pseudohyphae

10. Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
Intermediate part of the hemispheres
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
3 years old
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns

11. Name the DNA virus: x Circular dsDNA; naked; icosahedral; replicates in the nucleus
Papovavirus
7 to 14 days
Sympathetic chain ganglion
Capillaries

12. What is the most common one? - Cardiac anomaly in Turner syndrome
Terminal bronchioles. (No gas exchange occurs here.)
Rotavirus
Flutamide
Coarctation of the aorta

13. What bacterium found in poorly preserved canned food causes flaccid paralysis?
Antisocial
Akathisia
Clostridium botulinum
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs - TCADs - dextromethorphan - and meperidine. Treat it with cyproheptadine.

14. There is an inverse relationship between fat content and...
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Negative
total body water
Motor

15. Which dimorphic fungus is found as Arthroconidia in desert sand of the southwestern United States (e.g. - San Joaquin Valley)?
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Coccidioides immitis
Serocystadenocarcinoma
Familial polyposis coli

16. What is the antidote for organophosphate ingestion?
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.
Atropine and 2- PAM (pralidoxime)
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Ego

17. What two glycolytic enzymes catalyze the substrate - level phosphorylations?
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Sphingosine
Superior
EBV

18. Name the most common one - Heart defect in Down syndrome
Hypnozoite
Target cell
Endocardial cushion defect
IgG4

19. Which IgG cannot activate complement?
IgG4
Klinefelter syndrome
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
HMG CoA synthase

20. What is the term to describe homosexuals who x Are comfortable with their own person and agree with their sense of self?
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Kawasaki disease
Atelectasis
Ego syntonic

21. What organ is responsible for the elimination of excess nitrogen from the body?
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
Hirschsprung's disease (colonic gangliosus)
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Streptococcus pneumoniae

22. Which drug is used to treat opioid withdrawal - ADHD - and sometimes Tourette's syndrome?
Diazoxide
Alveolar dead space
Sporothrix schenckii
Clonidine

23. Do local anesthetics bind to the activated or inactivated sodium channels?
Inactivated
RU 486
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
Homicide. It is also the leading cause of death in black females aged 15 to 24.

24. What bonds are broken by exonucleases?

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25. What viral infection is associated with black vomit?
Ephedrine
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Quinolones
Yellow fever (flavivirus)

26. What P value defines whether the hull hypothesis should or should not be rejected?
P = .05; P < .05 rejects the null hypothesis
IgA
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.

27. Which overdose carries a higher mortality rate - that of benzodiazepines or barbiturates?
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
Opposite the second upper molar tooth
Shortens
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.

28. What hormone is secreted by the placenta late in pregnancy - stimulates mammary growth during pregnancy - mobilizes energy stores from the mother so that the fetus can use them - and has an amino acid sequence like GH?
PRPP aminotransferase
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
Parietal cells (Remember - they secrete HCl - too.)
They are all formed by the fifth month of fetal life.

29. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Estrogen use
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
Clonidine

30. What is the main inhibitor of pyruvate dehydrogenase?
Acetyl CoA (pyruvate to acetyl CoA)
Lysine and arginine
5HT1D
S phase

31. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Percentage of Na+ - Cl - - K+ left in the lumen
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)
t the end of the PCT 25% of Na+ - Cl - - K+ is left
Atracurium

32. What is the most common primary malignant tumor in bone?
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Osteosarcoma
CD21; it is a complement receptor for cleaved C3
GP120

33. Which penicillin can cause interstitial nephritis?
Methicillin
Validity (remember - reliability is necessary but not the only thing needed for validity)
Lipoprotein lipase
Left ventricle and auricle of left atrium

34. What is the region of the fallopian tube where fertilization most commonly occurs?
Ampulla
von Hippel - Lindau syndrome
Riboflavin (B2)
P = .05; P < .05 rejects the null hypothesis

35. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Osteoblasts
Negative
Validity (remember - reliability is necessary but not the only thing needed for validity)
Infiltrating ductal carcinoma
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)

36. Which streptococcal species is characterized by being catalase negative - turning bile esculin agar black - producing a positive PYR test - and resulting in biliary and urinary tract infections?
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
Sphingomyelin
Enterococcus (Streptococcus faecalis)
Adenocarcinoma (30% to 35%)

37. Name the 10 retroperitoneal organs.
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum
Cardiac output
Kawasaki disease
Proteus

38. How early can a pregnancy be detected by hCG assays in the blood? In urine?
Francisella tularensis
hCG can be detected in the blood by day 8 and in the urine by day 10.
REM sleep. Remember - awake brain in a sleeping body.
Vitamin K

39. What AR disorder is due to a deficiency in glycoprotein IIb - IIIa - resulting in a defect in platelet aggregation?
Negative correlation
IgA nephropathy
Glanzmann syndrome
Metastatic

40. Name the most common type or cause - Sudden cardiac death
Ventricular fibrillation (V fib)
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.
Epinephrine
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.

41. What medication is a PGE1 analog that results in increased secretions of mucus and HCO3- in the GI tract?
Axillary nerve and posterior humeral artery
Ewing sarcoma
Misoprostol
Head of the pancreas

42. Why is the apex of the lung hypoventilated when a person is standing upright?
Middle
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
1. Protest 2. Despair 3. Detachment
Medial compartment of the thigh - obturator nerve

43. Are the following parameters associated with an obstructive or restrictive lung disorder: decreased FEV1 - FVC - peak flow - and FEV1/FVC; increased TLC - FRC - and RV?
Bronchogenic carcinoma
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
Hepatitis - with or without necrosis
0157:H7

44. What artery is formed by the union of the two vertebral arteries?
Dysplasia
Anaerobes
Four high energy bonds - two from ATP in AA activation and two from GTP
The basilar artery is formed at the pontomedullary junction.

45. What are the four most common causes of femoral head necrosis?
300 mOsm/L
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia

46. What is the treatment for nephrogenic diabetes insipidus induced by lithium?
Right - sided valves
Amiloride
Positive
Obesity - DM - HTN - multiparity - early menarche - and late menopause

47. Are antibiotics helpful in treating a disease caused by a prion?
Yolk sac tumor
No. Prions are infectious proteins - so antibiotics are useless.
Air flows into the respiratory system.
Chemotaxis

48. What microaerophile is a motile gram - negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)?
Campylobacter jejuni
Cryptococcus
Spinal trigeminal nucleus
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.

49. What two muscles do you test to see whether CN XI is intact?
Francisella tularensis
Tryptophan
Chondroitin sulfate and keratan sulfate
Trapezius and sternocleidomastoid

50. What is the only site in the body that uses M1 receptors?
Anticipation - associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
The stomach
NADPH and molecular O 2