Test your basic knowledge |

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 structure of the knee is described thus? - Prevents abduction
The lung will expand; also the opposite is true.
Medial collateral ligament
In men it is prostate cancer - and in women it is breast cancer.
The affinity of the drug for its receptor

2. What CNs arise from x The medulla?
Schistosoma haematobium
CN IX - X - and XII CN XI arises from the cervical spinal cord.
Labile
Myasthenia gravis

3. What is the ratio of pulmonary to systemic blood flow?
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.
Obsessive - compulsive
Fixed ratio (rewards set behaviors)
Proencephalon diencephalon derivative

4. What malignant bone tumor is associated with familial retinoblastoma?
Bitemporal heteronymous hemianopsia
Muscle glycogen phosphorylase
Osteosarcoma
Primitive ventricle

5. What transient deficiency may result in a hypercoagulable state if warfarin is given alone?
Riboflavin (B2)
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Being a female physician increases the risk of suicide nearly four times the general population.
S phase

6. What bronchogenic carcinoma is associated with an elevated level of Ca2+ - involves keratin pearls - occurs in men more than women - is associated with smoking - occurs in the major bronchi - and is seen in the central areas of the lung?
Afterload
Thiogalactoside transacetylase
Squamous cell carcinoma
Myeloschisis All except occulta cause elevated - fetoprotein levels.

7. What subset of CD4 T cells is responsible for mast cell and eosinophil precursor proliferation?
Th2 cells
Ovarian cancer
Streptococcus viridans
Superego

8. What term describes the reflex that increases the curvature of the lens - allowing near vision?
Accommodation
Saccule and utricle
Tensor tympani
Null hypothesis (what you hope to disprove)

9. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x Ki - ras and erb -2
Childhood
Bronchial asthma (eosinophil membranes)
Diazoxide
Lung cancer

10. What is the rate - limiting step in a conduction of a NMJ?
The time it takes ACh to diffuse to the postjunctional membrane
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
Initiate and manage gross skeletal muscle movement control
Rifampin

11. From What embryonic structure are the following structures derived? - The right and left atria
Ischemic heart disease (MIs)
Caplan syndrome
Primitive atrium
Being a white male

12. What are the three branches of the celiac trunk?
Alcohol abuse
Eosin
The left gastric - splenic - and common hepatic arteries
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)

13. What chromosome codes for HLA gene products?
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.
The short arm of chromosome 6
Rifampin
None; it degenerates.

14. What is the maximum rate possible with a given amount of enzyme?
wave
Serocystadenoma
Vmax
Rotavirus

15. What enzyme is deficient in the following glycogen storage disease? - von Gierke's disease
Glucose -6- phosphatase
Case fatality rate
Tryptophan
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)

16. What is the term for the difference between the highest and the lowest score in a population?
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Appendix (second is terminal ileum)
Range
Ganciclovir

17. What triggers phase 3 of the action potential in a ventricular pacemaker cell?
Prostate cancer
Rapid efflux of potassium
Kl
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels

18. What is the most common one? - Vasculitis
Temporal arteritis
Leiomyoma
Mast cells
Microsporum

19. What complement factor deficiency leads to x Increased susceptibility to pyogenic infections?
IDL
IGF-1 (somatomedin C)
C3 deficiency
The optic disk is the blind spot.

20. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Cardiac muscle
H 2
Chromosome 6
Permanent
Ciliary ganglion producing a tonic pupil

21. If the family member of a patient asked you to withhold information - would you?
ASA (salicylate)
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
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.
The bifurcation of the abdominal aorta

22. Inhibits glucose uptake in skeletal muscle.
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
tRNA
Granulosa cells
Cortisol

23. Where are the tonsillar tissues?

24. The duodenal - jejunal flexure is suspended from the posterior abdominal wall by what?
Risk factors for cervical cancer
Ligament of Treitz
Voltage - gated channel
Poststreptococcal GN

25. What enzyme of the TCA cycle catalyzes the production of the following: x NADH (hint: 3 enzymes)
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase
Squamous cell carcinoma
Muscle glycogen phosphorylase
Bulla

26. What AD disease is associated with chromosome 4p; does not present until the person is in his or her 30s; and involves atrophy of the caudate nucleus - dilatation of the lateral and third ventricles - and signs of extrapyramidal lesions?
RSV
Huntington disease
Myeloschisis All except occulta cause elevated - fetoprotein levels.
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension

27. What is the term to describe jumping from one topic to the next without any connection?
B cells; macrophages and dendritic cells are nonspecific.
H 2
Metanephros
Loose association

28. What type II hypersensitivity disorder is defined as x Autoantibodies directed against ACh receptors?
Flocculonodular lobe (one of my favorite words in all of medicine!)
Myasthenia gravis
Pseudomonas sp.
Hepatitis E

29. On the venous pressure curve - What do the following waves represent? - V wave?
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
Atrial filling (venous filling) Atrial - Contraction - Venous
Cytochrome c

30. What is the most common one? - Cancer of the vulva
Urachus
MEN IIa (or Sipple syndrome)
Squamous cell carcinoma
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.

31. What structure is derived from the prochordal plate?
C5a
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
The mouth
DNA polymerase - d

32. What is the most potent NMJ blocker and also has no cardiovascular side effects?
Doxacurium
Citrate - via the citrate shuttle
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
Since they are independent events - their probabilities would be multiplied.

33. Where do the primordial germ cells arise?
From the wall of the yolk sac
IL-4 - IL-10 - and IL-13
Hypercortisolism (Cushing syndrome)
Alanine cycle

34. Are used in the management of an acute asthmatic attack.
Epidermophyton
Beta2- Adrenergic agents
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels

35. Name the most common type or cause - Infantile diarrhea
5' deiodinase
Streptolysin O
Nodular sclerosis
Rotavirus

36. Name these cluster A personality disorders: x Socially withdrawn - seen as eccentric but happy to be alone
Schizoid
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
Methylphenidate (Ritalin)

37. Name the lipoprotein based on the following characteristics - apo E - apo B-100 - apo C- II
VLDL
Squamous cell carcinoma
Median nerve lesion
Somatomedins (IGF-1)

38. Name the most common cause - Blindness worldwide
Chlamydia trachomatis
H 1
Intellectualization
Anorgasmia. (The overall prevalence is 30%.)

39. What is the only neuroglial cell of mesodermal origin?
Glucose -6- phosphatase
Fibroadenoma
Microglia. All others are neuroectodermal derivatives.
Pearson correlation

40. What IL down - regulates cell mediated immunity?
Impotence
IL-10
Fibrous pericardium
Frontal eye field (Brodmann area 8)

41. What is the venous and arterial stretch receptors' function regarding the secretion of ADH?
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.
Bordetella pertussis
They are all formed by the fifth month of fetal life.
Copper

42. What ribosomal subunit sizes do eukaryotic cells have?
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns
Acetyl CoA - FADH2 - and NADH
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.

43. What disorder is associated with decreased platelet count - prolonged PT and PTT - decreased fibrinogen - and increased fibrin split products (D- dimers)?
Gastric ulcer
Clostridium perfringens
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
Disseminated intravascular coagulation (DIC)

44. What CNs are affected if there is a lesion in x The upper pons?
Sensory
CN V
Ulcerative colitis
Muscles of the internal eye

45. In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
Itraconazole
Folate deficiency (very common in the elderly)
Malignant mesothelioma
IgA

46. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Chromium and nickel
Homocysteine methyl transferase and methylmalonyl CoA transferase
Area 4
Passive - aggressive
Bronchogenic carcinoma

47. What component of an ECG is associated with the following? - Ventricular repolarization
Pituitary hypogonadism
Gastric carcinoma
Follicular phase
T wave

48. What is the term for excessive amounts of granulation tissue that can block re - epithelialization and wound healing?
Akathisia
Proud flesh
Pyrantel pamoate
Sphingomyelin

49. What syndrome is characterized by sweating - insomnia - nausea - diarrhea - cramps - delirium - and general restlessness secondary to MAOI and SSRI in combination?
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.
Internal abdominal oblique
Melanoma - cancer of the stomach and bladder
Gap junctions

50. What part of the 30S ribosome binds to the Shine - Dalgarno sequence?
Methylation of bacterial DNA
16S subunit
Mitosis
Idiotypes