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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 mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
Prolactinoma
In the medulla; all the other structures are cortical.
Amanita phalloides
Isotonic contraction

2. What type of hypersensitivity is a result of high circulating levels of soluble immune complexes made up of IgG or IgM Abs?
Type III hypersensitivity reaction
Substituted judgment. It is made by the person who best knows the patient - not the closest relative.
EF- G of the 50S subunit
Entamoeba histolytica (treat with metronidazole)

3. What hormone - produced by Sertoli cells - if absent would result in the formation of internal female structures?
IF
Asbestosis and silicosis
Schizoid
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.

4. What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord?
P24
Paramyxovirus
robenecid - a uricosuric agent
The fasciculus cuneatus

5. IgE- mediated mast cell release - C3a and C5a - and IL-1 all trigger the release of what vasoactive amine?
Urogenital sinus
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
Histamine
Corynebacterium diphtheriae

6. What enzyme is essential for the conversion of CO2 to HCO3-?
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
Pseudomonas aeruginosa
Carbonic anhydrase
External 3' - 5' PDE bonds

7. What are the first signs of overdose from phenobarbitals?
Substance P. (Opioids relieve pain in part by blocking substance P.)
Nystagmus and ataxia
Sarcoplasmic reticulum
Doxacurium

8. Which major cell type is found in the red pulp of the spleen?
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
RBCs. That is why it is called red pulp.
Four high energy bonds - two from ATP in AA activation and two from GTP
Cytochrome a/a3

9. What is the most common one? Site of congenital diaphragmatic hernias
Autoimmune hemolytic anemia
Left anterior descending artery
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.
Stratum spinosum

10. Name the most common one - Chromosomal disorder
Osteoclasts
Down syndrome (trisomy 21)
CN XI and X
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.

11. What is the term for occlusion of a blood vessel due to an intravascular mass that has been carried downstream?
IGF-1 (somatomedin C)
No. Prions are infectious proteins - so antibiotics are useless.
Purine nucleoside phosphorylase
Embolism

12. Are modified skeletal muscle fibers. They are the sensory component of the stretch reflexes.
Proencephalon
2 days prior to ovulation
Primary biliary cirrhosis
Muscle spindles

13. What type of hepatitis has the highest mortality rate among pregnant women?
Hepatitis E
Your duty is to tell the patient - not the family. The patient decides who gets to know and who doesn't - not you.
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Dorsal motor nucleus of CN X

14. What naturally occurring substances mimic the effects of opioids?
Kimmelstiel - Wilson disease
Concentration gradient
Enkephalins
Succinylcholine

15. What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
Direct; in males less than 50 years old indirect hernias are the most common type.
Production of oxygen free radicals
Placental alkaline phosphatase
Myasthenia gravis

16. What mixed a - antagonists are used for patients with pheochromocytoma?
Disorganized schizophrenia
Purine nucleoside phosphorylase
Mesencephalon
Phentolamine and phenoxybenzamine

17. Name the aphasia based on these characteristics: x Nonfluent speech - telegraphic and ungrammatical; lesion in Brodmann's area 44; unimpaired comprehension

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18. What is the name for the following RBC indices? - The coefficient of variation of the RBC volume
Red blood cell distribution width index (RDW)
Sideroblastic anemia
Internal carotid artery
Arsenic

19. When does cortisol secretion peak?
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Nodular melanoma
In early- morning sleep - usually between the sixth and eighth hours
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.

20. What is the primary predisposing factor for vascular dementia?
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.
Fixation (arrested development)
Hypertension
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase

21. What hematological malignancy is particularly likely to affect patients with Down syndrome?
Aspartic acid and glutamic acid
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
Pancreatic cancer
All (nearly 15-20 times the normal risk)

22. What component of the basement membrane binds to collagen type IV and heparin sulfate and is a cell surface receptor?
Coccidioides immitis
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
gamma and delta chains
Laminin

23. What type of correlation is defined as x Two variables that go together in the same direction?
Hepatitis A (infectious)
Cystadenocarcinoma
Positive correlation
Shigella

24. What is the most common one? - Complication of PDA
Eosinophil
Subacute bacterial endocarditis
Caisson disease
Wernicke's encephalopathy

25. What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy?
Blocking
Negative
Celecoxib
Primary spermatocyte

26. What is the term for the heart's inability to maintain perfusion and meet the metabolic demands of tissues and organs?
T9
CHF
Subarachnoid hemorrhage
A high - resistance system is formed when resistors are added in a series.

27. As what AAs do muscles send nitrogen to the liver?
Alanine and glutamine
IgG
Amyloidosis
Trapezius and sternocleidomastoid

28. What is the start codon - and What does it code for in eukaryotes? Prokaryotes?
Water
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.
Serratia

29. What water - soluble - vitamin deficiency may result from eating raw eggs?
Biotin (only if eaten in large quantities)
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).
Turner syndrome
Hepatoma and nonseminomatous testicular germ cell tumors

30. What is the most common one? - Malignant tumor of the breast
Third week; they are derived from the wall of the yolk sac.
HBcAb IgG - HBV- DNA - HBeAg - HBsAg
The subclavian artery
Invasive ductal carcinoma

31. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Telencephalon
Proencephalon
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
True hermaphrodism

32. What two requirements must be met for the Lac operon to be activated?
Lactose must be present and glucose must be absent
Pergolide
Tinea favosa (favus)
NREM sleep. Remember awake body - sleeping brain

33. Name the eukaryotic RNA polymerase based on the following: x Synthesizes tRNA - snRNA - and the 5S rRNA
Superior gluteal nerve
Premature ejaculation
transcription
RNA polymerase III

34. What chronic inflammatory WBC is associated with IgE- mediated allergic reactions and parasitic infections?
Urinary trigone
Flea - bitten kidney (can also be seen in pyelonephritis)
Eosinophils
Selenium (Se)

35. Name the associated chromosome - Albinism
Chromosome 11p
Marfan syndrome
Mesolimbic system
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.

36. What microaerophile is a motile gram - negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)?
More Ab is produced in less time in a secondary immune response (shorter lag period).
Affinity
Sucralfate
Campylobacter jejuni

37. What is the PO2 of aortic blood in fetal circulation?
Radial nerve
Axis III
Pertussis toxin
60%

38. What is the most common causative organism of acne vulgaris?
HTN
Propionibacterium acnes
N-5- methyl THF
Kl

39. Do newborns have a preference for still or moving objects?
Moving objects - along with large bright objects with curves and complex designs.
Pancreatic insufficiency
PKU
Carbamazepine

40. Name the structure that enters or exits the following foramina: x Internal auditory meatus
CN VII and VIII
Operon
Haemophilus ducreyi
Distal convoluted tubules

41. Cherry red intoxication is associated with what form of poisoning?
CO
Phosphofructokinase -1 and costs 1 ATP
Pertussis toxin
Astrocytes

42. What case is best known for use of the 'best interest standard'?

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43. Name the RNA subtype based on the following: x Found only in the nucleus of eukaryotic cells and are precursors of mRNA
Y - W-135 - and C and A capsular polysaccharides
hnRNA
Liquefaction necrosis
Positive

44. What hypothesis states that the findings of a test are a result of chance?
Small to medium - sized cerebral vessels
HMG- CoA reductase
Null hypothesis (what you hope to disprove)
Interferons

45. What two forms of insulin - if mixed together - precipitate zinc?
Lente insulin and either NPH or protamine zinc insulin (PZI)
Acarbose
Superoxide dismutase - glutathione peroxidase - catalase
Rhabdovirus

46. Has no underlying pathology.

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47. Name the cerebral vessel associated with the following vascular pathologies - Epidural hemorrhage
Psoriasis - ankylosing spondylitis - inflammatory bowel disease - and Reiter's syndrome
Dysgerminoma
GLUT 4
Middle meningeal artery

48. What nonmotile gram - negative - non - lactose - fermenting facultative anaerobic rod uses the human colon as its only reservoir and is transmitted by fecal - oral spread?
Shigella
hCG
5- hydroxyindoleacetic acid (5- HIAA)
Pulmonary embolism due to a DVT; this is not absolute but a classic description.

49. Causes of avascular necrosis of bone.
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Middle
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Copper deficiency

50. Which cestode in raw or rare beef containing cysticerci results in intestinal tapeworms?
Taenia saginata
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Beta- Blockers
Non - Hodgkin lymphoma