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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. Multiple pregnancies - early age of intercourse - multiple sexual partners - OCP use - smoking - HIV - and STDs.
Factors II - VII - IX - X - and proteins C and S
Risk factors for cervical cancer
The raphe nuclei
Nystagmus and ataxia

2. What is the only CN to arise from the dorsal surface of the midbrain?
Rhinovirus
ater flows from a low - solute to high - solute concentrations.
CN IV
Dihydrofolate reductase

3. If a mother delivers a Rho - positive baby - she should receive...
Internal carotid artery
Phentolamine and phenoxybenzamine
Rho-immunoglobin
Vitamin A

4. What blood disorder is a side effect of metformin?
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
GH

5. What hormone - produced by the syncytiotrophoblast - stimulates the production of progesterone by the corpus luteum?
Rathke's pouch; they can result in compression of the optic chiasm.
Hepatitis B
hCG
Posterior

6. What peripheral chemoreceptor receives the most blood per gram of weight in the body?
The carotid body - which monitors arterial blood directly
Pseudohyphae
Reye syndrome
Single - strand DNA binding protein

7. What is the DOC for trigeminal neuralgia?
Carbamazepine
Medullary carcinoma of the thyroid
1. Large sample size 2. Large effect size 3. Type I error is greater
Sigmoid colon

8. What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis?
Accessory nucleus
Positive reinforcement
Swan - neck deformities
RES(Reticular endothelial system)

9. How does ventricular depolarization take place - base to apex or vice versa?
Depolarization is from apex to base and from endocardium to epicardium.
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
Pyelonephritis
Primary Hemochromatosis

10. What are defined by Ag - binding specificity?
Idiotypes
In the dorsal horn of the spinal cord on the primary afferent neurons
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Metastatic carcinoma

11. What organism would you suspect in a patient with diarrhea after eating rice?
Thoracic and sacral
Type II
Cell - mediated immunity
Bacillus cereus

12.
Autograft
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
prior to birthThe foramen ovale closes just...
Meningococcus (Gonococcus does not)

13. Name the antidote - Opioids
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
Misoprostol
Mitochondria - linked disorders are always inherited from the mother.
Naloxone - naltrexone

14. Name the MCC - Pneumonia in adults
Surface tension; in the alveoli - it is a force that acts to collapse the lung.
The T- test (used when comparing two groups)
Squamous cell carcinoma
Streptococcus pneumoniae

15. What phase of Interphase is haploid (N)?
GnRH
Testicular feminization syndrome (Dude looks like a lady!)
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
G1 phase; G2 and S phase are diploid (2N).

16. What aphasia produces a nonfluent pattern of speech with the abilty to understand written and spoken language seen in lesions in the dominant hemisphere?
Expressive aphasia
Alveolar macrophages
Parvovirus
The rate of infusion

17. Name these mature defense mechanisms: x Helping others without expecting any return
Melanocytes
Altruism
Carnitine acyltransferase - I
Selegiline

18. Name the cluster C personality disorder: x Orderly - inflexible - perfectionist; makes rules - lists - order; doesn't like change - has a poor sense of humor - and needs to keep a routine
Obsessive - compulsive
The interposed nucleus
At least 5 lobes
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)

19. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - poor grooming - poor ability to think abstractly - decreased drive - poor attention span (Hint: if the lesion is in the
Dorsal prefrontal cortex
Pyelonephritis
Osteitis fibrosa cystica (von Recklinghausen disease)
Streptococcus pneumoniae

20. What seven structures are found in more than one mediastinum?
Syringomyelia
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve
Down syndrome (it is slightly more common than fragile X syndrome.)
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.

21. By What age should children be able to draw the following figures? - Rectangle
Uracil
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Cocaine

22. What is the DOC for CMV retinitis?
Chromophobe adenoma
Negative
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
Ganciclovir

23. What disease involves microcephaly - mental retardation - cleft lip or palate - and dextrocardia?
Patau syndrome (trisomy 13)
100% - with about 20% remaining positive after 1 year
Atrial contraction Atrial - Contraction - Venous
CN VII

24. Regarding the viral growth curve - is the internal virus present before or after the eclipse period?
Blocking
Chromosome 6
After the eclipse period
Leiomyoma

25. Is the hydrophobic or hydrophilic end of the phospholipids of the cell membrane facing the aqueous environment?
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
Renin
Thalassemia minor

26. What virus causes hoof - and - mouth disease?
Eosin
Staphylococcus
1. Sartorius 2. Gracilis 3. Semitendinous
Vesicular stomatitis virus

27. What is the term for vitamin D deficiency prior to epiphyseal fusion?
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
Rickets prior to fusion - osteomalacia if the deficiency occurs after epiphyseal fusion.
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.

28. What nucleus - found in the intermediate zone of the spinal cord - sends unconscious proprioception to the cerebellum?

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29. What component of the pelvic diaphragm forms the rectal sling (muscle of continence)?
Nigrostriatal pathways (basal ganglia)
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
Puborectalis

30. What enzyme produces an RNA primer in the 5'-3' direction and is essential to DNA replication because DNA polymerases are unable to synthesize DNA without an RNA primer?
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Primase
Palindrome
Production of HCO3- - shifting the reaction to the left and thereby decreasing H+

31. When does most of the NREM sleep (stage 3 and 4) occur - in the first or second half of sleep?
Lactulose
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.

32. What is the only way to increase O2 delivery in the coronary circulation?
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
Enterobius vermicularis; the treatment is albendazole.
Acral - lentiginous melanoma
Recall bias. These problems arise in retrospective studies.

33. The nucleus is the site of...
transcription
1. Sweat glands 2. Arterioles 3. Veins
Case control studies cannot assess incidence or prevalence - but they can determine causal relationships.
It is produced by the preload on the muscle prior to contraction.

34. What syndrome is associated with the following brainstem lesions? - Vertebral artery or anterior spinal artery occlusion - resulting in contralateral corticospinal tract and medial lemniscus tract deficits and an ipsilateral CN XII lesion
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Medial medullary syndrome
NREM sleep. Remember awake body - sleeping brain
PGE2 and PGF2a

35. Name these immature defense mechanisms: x Inability to remember a known fact (aware of forgetting)
Low interstitial free Ca2+ concentrations
Rationalization
Blocking
The small subunit (40S) binds first.

36. Name the thalamic nucleus based on its input and output - Input from inferior colliculus; output to primary auditory cortex
Major basic protein
MGB (think EARS)
The kidneys excrete the excess nitrogen from the body as urea in the urine.
TXA2

37. What artificial sweetener must patients with PKU avoid?
Afterload
Aspartame
Sphingomyelinase
CD8+ T cells

38. What bonds are broken by endonucleases?

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39. 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?
Parallel circuit
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Radial nerve
Biofeedback

40. What is released from the mitochondria to trigger apoptosis?
CD21; it is a complement receptor for cleaved C3
Cytochrome c
45XO
Lipoprotein lipase

41. All spore formers are...
gram positive
Hepadnavirus
Nigrostriatal pathways (basal ganglia)
Ego syntonic

42. What three structures are in contact with the left colic flexure? With the right colic flexure?
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
Melanoma - cancer of the stomach and bladder
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
Glioblastoma multiforme

43. What are the two reasons for megaloblastic anemia with elevated MCV?
One day after the LH surge and 2 days after the estrogen peak.
Gap junctions
Huntington's chorea. (Death in 15-20 years - often via suicide.)
Vitamin B12 deficiency and folate deficiency

44. What breast pathology involves malignant cells with halos invading the epidermis of the skin?
Paget disease of the breast
Agoraphobia. It also means having a sense of humiliation or hopelessness.
Acetaminophen
Penicillin G (benzylpenicillin)

45. What protein deficiency results in respiratory distress syndrome of newborns?
Viral meningitis
Deficiency in surfactant
Atropine with pralidoxime
Eosin

46. Name the area of the cerebral cortex with the function described: x Intellectual processing of sensory information - with the left (dominant) processing verbal information - the right processing visual - spatial orientation
Remember the mnemonic PAM SMIDT P - (hyper) Parathyroid/ Paget disease A - Addison's disease M - Milk - alkali syndrome/metastatic cancer S - Sarcoidosis M - Multiple myeloma I - Immobilization/idiopathic D - Vitamin D intoxication T - Tumors
CD19
Parietal lobe
Phentolamine and phenoxybenzamine

47. From What aortic arch are the following structures derived?
Alternative hypothesis (What is left after the null has been defined)
Arch of the aorta and right subclavian artery
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.
First pharyngeal groove; all others degenerate.

48. What nematode is known as hookworms? What is the treatment?
Kayser - Fleischer ring
Hepatic glycogen phosphorylase
Necator americanus is treated with mebendazole and iron therapy.
Suppression

49. Regarding muscle mechanics - How is passive tension produced?
Ileum
VSD
It is produced by the preload on the muscle prior to contraction.
Integrase

50. Which subtype of AML is most commonly associated with Auer rods?
The vermis
Cirrhosis
Ampulla of the fallopian tube
M3 (promyelocytic leukemia)