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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?
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
HMP shunt
Suprachiasmatic nucleus
Pyridoxine (B6)

2. Are the following major or minor Jones criteria of rheumatic fever? - Fever
Minor
Ulnar to radial progression
Affinity
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.

3. Name the most common type - Phobia
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Parkinson disease
Fragile X syndrome
Stage fright (discrete performance anxiety)

4. Name the most common type or cause - Acute renal failure in the United States
Acute tubular necrosis
Shortens
Sporothrix schenckii
Mantle cell lymphoma

5. What is the drug of choice for hypertensive patients with a decreased renal function?
Lactulose
a - Methyldopa (Guanabenz or clonidine is also used.)
Stibogluconate
A gene (a rather simple definition but accurate)

6. What is the ratio of T4:T3 secretion from the thyroid gland?
Snails
Complex I
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
Rhabdovirus

7. What adrenal enzyme deficiency results in hypertension - hypernatremia - and virilization?
ASD
11- Beta - Hydroxylase deficiency results in excess production of 11- deoxycorticosterone - a weak mineralocorticoid. It increases BP - Na+ - and ECF volume along with production of adrenal androgens.
Mitral (bicuspid) valve
MHC class II Ags. This is accomplished via CD4 T cells.

8. Name the antidote - Heparin
Short - chain fatty acids
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
IgA
Protamine sulfate

9. Name the product or products of arachidonic acid: x Vasodilation and inhibition of platelet aggregation produced by vascular endothelium
Phase I
PGI2
Fragile X syndrome
Duchenne muscular dystrophy (Remember - Becker's is slower in progress - less severe - later in onset - and lacks cardiac involvement.)

10. What is the most common primary diagnosis resulting in an office visit for males? For females?
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
For males - HTN; for females - pregnancy.
Cancer
Glycogen synthase

11. What protein carries free fatty acids to the liver?
Albumin
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
IGF-1
Pernicious anemia (secondary to a lack of vitamin B12 absorption)

12. In what layer of the epidermis is melanin transferred from melanocytes to keratinocytes?
Stratum spinosum
Progestins
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.

13. What form of bilirubin can cross the blood - brain barrier?
Calcium influx secondary to slow channel opening
Unconjugated free bilirubin
Hypotonia (rag doll appearance)
Major

14. What are the three microscopic pathologic changes seen in Alzheimer's disease?
IgA
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons
First - order elimination
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)

15. Name the phase of the eukaryotic cell cycle: x Period of cellular growth (translation and transcription) before DNA synthesis
G1 phase (gap 1)
Isotonic contraction
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.

16. What enzyme of the TCA cycle catalyzes the production of the following: x GTP
Succinyl CoA synthetase
>10 mm
Calcarine sulcus
ASA (salicylate)

17. What antidepressant - which recently was approved for general anxiety disorder - inhibits the reuptake of NE and 5- HT?
Housemaid's knee
Stibogluconate
Neisseria gonorrhoeae and Chlamydia trachomatis
Venlafaxine. (It also has a mild dopaminergic effect.)

18. What is the bioactive form of thyroid hormone?
T3
IgD; IgM is also correct.
Renin
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors

19. What hormone controls relaxation of the lower esophageal sphincter during swallowing?
Bacterial meningitis
H 2
Confounding bias
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.

20. What is the name for the following RBC indices? - Average volume of a RBC
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Mean corpuscular volume (MCV)
Blocking
Frontal lobe

21. Name the DNA virus: x Partially dsDNA circular; enveloped; virion - associated polymerases; has RNA intermediate; replicates in the nucleus
Hepadnavirus
Bronchial asthma (eosinophil membranes)
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
Ipsilateral flaccid paralysis

22. RBC casts in the urine
Acute glomerulonephritis
The energy of activation
From age 5 onward IQ stabilizes.
Arginine

23. Name the thalamic nucleus based on its input and output - Input from the optic tract; output projects to the primary visual cortex of the occipital lobe
Formation of an identity through issues of independence and rebellion; they define who they are.
Beta- Oxidation of fatty acids
Thyroid gland
LGB (think EYES)

24. What CNs are affected if there is a lesion in x The midbrain?
CD15 and CD30
CN III and IV
CN VII
Temporal arteritis

25. What branches of CN X are the sensory and motor components of the cough reflex? Be specific.
Ethyl alcohol
Decreasing potassium conductance - which results in increased excitability
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.
Yes - by three to four times. Having multiple sexual partners - being overweight - and pelvic pain and/or inflammatory disorders are also likely to be seen in sexually abused females.

26. What cell type of the epidermis originates from the neural crest?
Melanocytes
pI (isoelectric point)
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Histrionic

27. What type of jaundice is seen in Dubin - Johnson syndrome?
Conjugated (direct) hyperbilirubinemia - a transport defect
Pneumocystis carinii
45XO
Severe combined immunodeficiency disease

28. In regard to motor development during infancy - choose the motor response that happens first - Proximal or distal progression
Sacrococcygeal teratoma
3' end. Phosphate (PO4) is at the 5' end.
HDL
Proximal to distal progression

29. What embryonic structure forms the adult male structure? - Epididymis - ductus deferens - seminal vesicle - and ejaculatory duct
Water - soluble hormones are considered fast - acting hormones.
The cat
Chromosome 5 - 21
Mesonephric duct

30. What embryonic structure forms the adult male structure? - Corpus cavernosus - corpus spongiosum - and glans and body of the penis
Phallus
Atropine - 2- PAM (pralidoxime)
Axis II
Rhinovirus and hepatitis A virus

31. What organelles make ATP - have their own dsDNA - and can synthesize protein?
Smooth muscle
Osteosarcoma
Mitochondria
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see - can't wee - can't kick with your knee

32. What small gram - positive - non - spore - forming rod is a facultative intracellular parasite that grows in the cold and is associated with unpasteurized milk products?
MEN III (or IIb)
Listeria monocytogenes
Diffuse proliferative GN
Laminin

33. What component of the inner ear x Contains endolymph and responds to head turning and movement?
Imipenem and meropenem
Atelectasis
Total ventilation (minute ventilation or minute volume)
Semicircular duct

34. As what compound do the carbons for fatty acid synthesis leave the mitochondria?
Mean corpuscular volume (MCV)
Minimal change disease
Giant cell tumor of the bone
Citrate - via the citrate shuttle

35. What enzyme catalyzes the rate - limiting step in cholesterol metabolism?
Para - aminohippurate (PAH)
HMG- CoA reductase
Melanoma - cancer of the stomach and bladder
Burkitt lymphoma

36. What MHC class acts to remove foreign Ags from the body?
Erythema marginatum
Melanocytes
MHC class II Ags. This is accomplished via CD4 T cells.
Bell pad

37. What enzyme is deficient in selective T cell immunodeficiency?
CN III - IV - and VI
Purine nucleoside phosphorylase
Fibrous pericardium
Metabolic rate and alveolar ventilation (main factor)

38. What size ribosomes do fungi have?
Kl
Streptococci
80S ribosomes (because they are eukaryotic)
HPV

39. What nerve roots constitute the cervical plexus?
Anterior hypothalamic zone; lesions here result in hyperthermia.
C1 through C4
1. Tinea coli 2. Haustra 3. Epiploic appendages
G0 phase

40. What is the most common one? Esophageal cancer in the United States
Adenocarcinoma (because of Barrett esophagus)
Hemochromatosis
Cryptococcus
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.

41. Name the antimicrobial agent whose major side effect is listed - CN VIII damage (vestibulotoxic)
Cysticerci
Aminoglycosides
Spermatogonia (type A)
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)

42. What adrenal enzyme deficiency results in hypertension - hypernatremia - increased ECF volume - and decreased adrenal androgen production?
Thrush
Anticipation
17- alpha - Hydroxylase deficiency
Viruses

43. What are the five penicillinase - resistant penicillins?
Thyroid hormones are necessary for conversion of carotene to vitamin A.
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Granulosa cell
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)

44. What type of foods should patients taking MAOIs avoid? Why?
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs - TCADs - dextromethorphan - and meperidine. Treat it with cyproheptadine.
Seminoma
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
Hematoxylin

45. What determines the rate of a reaction?
The energy of activation (Ea)
The short arm of chromosome 6
Beta- Blockers
Brucella and Listeria (has tumbling motility)

46. Is marital satisfaction higher for couples with or without children?

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47. What is the amount in liters and percent body weight for the following compartments? - ICF
P wave
28 L - 40% of body weight
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Picornaviridae

48. Which hepatitis B Ag correlates with infectivity and viral proliferation?
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Parasympathetic
HBeAg

49. What is the term for the heart's inability to maintain perfusion and meet the metabolic demands of tissues and organs?
Leuprolide
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
CHF
Dapsone

50. Name the eukaryotic DNA polymerase based on the following information: x Synthesizes the leading strand during replication
DNA polymerase - d
Middle
Sciatic nerve
Factor XII for the intrinsic; factor VII for the extrinsic pathway