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Test your basic knowledge |
USMLE Step 1 Prep
Start Test
Study First
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. The most frequent number occurring in a population is what?
Mode
ICF volume decreases when there is an increase in osmolarity and vice versa.
Standardized rate
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
2. Councilman bodies
Toxic or viral hepatitis
Protamine sulfate
Viral meningitis
Ventral posteromedial nucleus
3. Name the most common type or cause - Nephritic syndrome in adults
Aspartic acid and glutamic acid
Left heart failure
Taenia saginata
MGN
4. In the window phase of a hepatitis B infection - which Abs do you see?
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
Obese patients
HBcAb and HBeAb. You see the antibodies c and e.
H 2
5. During What embryonic week do somites begin to form?
Allotypes
T cells - B cells - and macrophages
Third week
embranoproliferative glomerulonephritis (MPGN)
6. After traveling in a plane across the Atlantic Ocean - an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose?
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
Isotypes
Alanine and glutamine
7. 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
BPH
Haemophilus ducreyi
Lipoxygenase pathway - from arachidonic acid
Global aphasia
8. What is the only enzyme in the body that uses N-5- methyl folate?
Homocysteine methyl transferase
PGE2 and PGF2a
Meiosis I; disjunction with centromere splitting occurs during meiosis II.
GH and prolactin are produced by acidophils; all others are by basophils.
9. What enzyme - induced by insulin and activated by apo C- II - is required for chylomicron and VLDL metabolism?
S phase
Lipoprotein lipase
The conus medullaris terminates at the level of the second lumbar vertebra.
Bisphosphonates
10. The dose of which second - generation sulfonylurea agent must be decreased for patients with hepatic dysfunction?
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11. What is the most common lethal AR disorder affecting white Americans?
A gene (a rather simple definition but accurate)
Primary spermatocyte
Cystic fibrosis
Thiamine and folate
12. What enzyme is blocked by hydroxyurea?
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
Mild (50-70)
Ribonucleotide reductase
Primary spermatocyte
13. What phase of the cell cycle are the following antineoplastic agents specific for? - Cytarabine
CD40 ligand
Sigmoid colon
Lead
S phase
14. What mineral is an important component of the enzyme xanthine oxidase?
Molybdenum (Mb)
Minoxidil (orally and topically - respectively!)
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
15. What virus lies dormant in the x Trigeminal ganglia?
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
Herpes I
Urogenital folds
PGE2 and PGF2a
16. What muscle of the middle ear is innervated by the mandibular division of CN V?
Chromosome 12
Folate - vitamin B12 - and vitamin B6
Yolk sac tumor
Tensor tympani
17. What is the most likely organism causing cellulitis in a patient who was cut by an oyster shell?
Eosin
Osteogenesis imperfecta
Neuroblastoma
Vibrio vulnificus
18. What phase of the cell cycle are the following antineoplastic agents specific for? - Cisplatin
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
Escherichia coli
G-6- PD
G0 phase
19. Which cerebral herniation results in compression of the anterior cerebral artery?
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
Large segment deletions
snRNA
Cingulate gyrus herniation (subfalcine)
20. What pancreatic islet cell tumor is associated with MEN I syndrome?
Opsonization
Gastrinoma
The Beta -2- microglobin. It is the separately encoded Beta - chain for class I Ags.
Pasteurella multocida
21. Indicates the patient has active pulmonary disease.
IgG4
All
A positive PPD skin test
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
22. What endogenous pigment found in the substantia nigra and melanocytes is formed by the oxidation of tyrosine to dihydroxyphenylalanine?
Melanin
Somatomedins
Bile pigments and bile salts
Primitive ventricle
23. What is the most common one? - Benign lesion that affects the breast
Fibrocystic change of the breast
Positive predictive value
Misoprostol
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
24. A 30-year - old woman goes to your office with bilateral multiple breast nodules that vary with menstruation and have cyclical pain and engorgement. What is your diagnosis?
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Primary sclerosing cholangitis
Maxillary division of CN V and glossopharyngeal nerves
Being awake
25. What are the three main components of amyloid?
Pott disease
Streptococcus agalactiae and Escherichia coli
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP
26. How many hydrogen bonds link A- T? C- G?
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Ephedrine
Area 17
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
27. What happens to intrapleural pressure when the diaphragm is ontracted during inspiration?
G0 phase
Autograft
Intrapleural pressure decreases (becomes more negative).
Melatonin - serotonin - and CCK
28. Is CO2 a perfusion - or diffusion - limited O2 gas?
Mitochondria - linked disorders are always inherited from the mother.
Misoprostol
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
gamma and delta chains
29. Mandibular hypoplasia - down - slanted palpebral fissures - colobomas - malformed ears - and zygomatic hypoplasia are commonly seen In what pharyngeal arch 1 abnormality?
Treacher Collins syndrome
>5 mm
The pH of CSF is 7.33 - acidotic.
GH and prolactin are produced by acidophils; all others are by basophils.
30. How many ATPs per glucose are produced by pyruvate dehydrogenase?
Mallory- Weiss syndrome
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)
Nocardia asteroides
Gametocytes
31. Results in vitamin B12 malabsorption.
Pancreatic insufficiency
Pasteurella multocida
Pons
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
32. What form of depression is due to abnormal metabolism of melatonin?
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
Anemia
Granulosa/thecal cell tumor of the ovary
Seasonal affective disorder (treat with bright light therapy)
33. Insulin - induced hypoglycemia is the most reliable (by far not the safest) test For what hormone deficiency?
Epstein - cardiac anomaly of the tricuspid valve
GH deficiency
Naloxone - naltrexone
Fibrous pericardium
34. What is the effect of T3 on the glucose absorption in the small intestine?
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine.
Labile
All
35. What AR syndrome is due to a deficiency of glycoprotein Ib - resulting in a defect in platelet adhesion?
Plasma cell (mature B lymphocyte)
Processed antigenic peptides bound in the groove of the MHC molecule
Bernard - Soulier syndrome
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
36. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Dorsal root?
Fat necrosis
Sensory
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
Polyarteritis nodosa
37. What disease has a genetically low level of UDPglucuronate transferase - resulting in elevated free unconjugated bilirubin?
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38. What primary acid - base disturbance is cause by a decrease in alveolar ventilation (increasing CO2 levels) resulting in the reaction shifting to the right and increasing H+ and HCO3- levels?
A low - resistance system is formed by resistors added in parallel.
Adenovirus
Streptococcus agalactiae (Group B Streptococcus - or GBS)
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
39. What happens to intracellular volume when there is an increase in osmolarity?
Succinyl CoA synthetase
ICF volume decreases when there is an increase in osmolarity and vice versa.
Gubernaculum
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
40. What component of the ETC is inhibited by the following? - Cyanide
Cytochrome a/a3
Parasites
Sertoli cell
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
41. In a topographical arrangement of the cerebellar homunculus map - What area or lobe x Is involved in motor planning?
Lateral part of the hemispheres
Arsenic
None; it degenerates.
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
42. What drug that penetrates the blood - brain barrier is found in asthma preparations and used as a nasal decongestant?
Ephedrine
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
NREM sleep. Remember awake body - sleeping brain
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
43. Megaloblastic anemia and thrombocytopenia are signs of what vitamin deficiency?
C1 through C4
RBCs. That is why it is called red pulp.
gamma and delta chains
Folic acid deficiency
44. If no fertilization occurs - How many days after ovulation does the corpus luteum begin to degenerate?
Compliance; the more compliant a lung is - the easier it is to inflate.
12 days after ovulation
Chylomicrons
Small cell cancer of the lung
45. What form of antimicrobial therapy is best for an immunocompromised patient?
Type 2
Bactericidal
Physiologic antagonism
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
46. What direction does the primitive gut rotate? What is its axis of rotation?
Naloxone - naltrexone
The gut rotates clockwise around the superior mesenteric artery.
Varicella
Malassezia furfur (treat with selenium sulfide)
47. What Ig activates the complement cascade most efficiently?
IgM
Deferoxamine - penicillamine
Mitochondria - linked disorders are always inherited from the mother.
The stapedius muscle
48. What parasite found in raw fish can produce vitamin B12 deficiency?
It is rare with normal grief; however - it is relatively common in depression
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.
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.
Diphyllobothrium latum
49. Where does the parotid (Stensen's) duct enter the oral cavity?
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
Opposite the second upper molar tooth
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
50. Have catalase.
Astrocytoma
F- Met - Peptides
Conus arteriosus of the right ventricle and right and left auricles
Streptococci