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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 operant conditioning therapy or modification is described as x Stopping the reinforcement that is leading to an undesired behavior?
Infection
Metastatic
Filiform papillae
Extinction

2. Name the phase of the ventricular muscle action potential based on the following information: x Slow channels open - allowing calcium influx; voltage - gated potassium channels closed; potassium efflux through ungated channels; plateau stage
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
Phase 2
Cytochrome a/a3
von Hippel - Lindau syndrome

3. With an increase in arterial systolic pressure - what happens to x Heart rate?
Secondary hypoparathyroidism (vitamin D toxicity)
Decreases
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Chloral hydrate

4. What is the term for a single isolated antigenic determinant?
Type IV hypersensitivity (cell - mediated)
Hapten (not immunogenic)
1. Cefamandole 2. Cefoperazone 3. Moxalactam
mRNA

5. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Type II hypersensitivity reaction
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)
3 to 4 days
IL-10

6. What are the three stimuli that result in the reninangiotensin - aldosterone secretion?
Labioscrotal swelling
Mebendazole
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells
Doxycycline and minocycline

7. What is the most common one? - Lymph node affected in non - Hodgkin lymphoma
Periaortic lymph nodes
Fluconazole
Left coronary artery
PKU

8. What bone disorder is characterized by brown tumors - bone pain - deformities - and fractures due to excessive PTH?
CD15 and CD30
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Thymine (B1)
Osteitis fibrosa cystica (von Recklinghausen disease)

9. What negative sense RNA virus is associated with cough - coryza - and conjunctivitis with photophobia?
Measles (rubeola)
Rhabdomyoma
Bacterial meningitis
Rationalization

10. What mineral deficiency involves blood vessel fragility?
Chromosome 20q (deficiency in adenosine deaminase)
Copper deficiency
42 L - 67% of body weight
Ductus epididymis - Which is lined by pseudostratified epithelium with stereocilia.

11. Which direct - acting vasodilator is associated with SLE- like syndrome in slow acetylators?
Distal convoluted tubules
Ulnar and radial arteries (ulnar is the main supplier)
Hydralazine
ACE inhibitors (- pril)

12. RBCs anaerobically use glucose in both the __________ states.
Herpes II
well - fed and fasting
Being single
Valine

13. What artificial sweetener must patients with PKU avoid?
1. The child poses an imminent danger to self or others. 2. The child is unable to self - care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety e
Chromosome 15 - 17
Berylliosis
Aspartame

14. The first sensory neuron is in the dorsal root ganglia. It carries ascending sensory information in the dorsal root of a spinal nerve - eventually synapsing with second sensory neuron. In the brainstem (DCML) and the spinal cord (spinothalamic) the s
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.
CML and All
Granulosa/thecal cell tumor of the ovary
Where the cell bodies for the DCML and spinothalamic sensory systems are...

15. What type of cell is surrounded by mineralized bone?
Undoing
Osteocyte
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
18 years old (except if emancipated)

16. What is the MCC of death in the United States?
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Right atrium
Benign lentigo
Heart disease

17. What is the term for the syndrome consisting of hepatomegaly - ascites - and abdominal pain due to hepatic vein thrombosis?
Ciliary ganglion
Budd - Chiari syndrome
The hallmarks of LMN lesion injury are absent or decreased reflexes - muscle fasciculations - decreased muscle tone - and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget - LMN lesions are ipsilateral at the level of the
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.

18. What endogenous pigment found in the substantia nigra and melanocytes is formed by the oxidation of tyrosine to dihydroxyphenylalanine?
Melanin
Ego dystonic
Major
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.

19. What is the most common one? - Pituitary adenoma
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Prolactinoma
For males - HTN; for females - pregnancy.
Cortisol - a 21- carbon steroid - has a - OH group at position 17.

20. Panic attacks can be induced by __________ or carbon dioxide.
hyperventilation
impermeable to water
Without children (but don't think about this one for too long)
Purine nucleoside phosphorylase

21. Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium?
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Francisella tularensis
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.
Carbamazepine

22. Induces the cytochrome P-450 enzymes.
Fixation (arrested development)
Nimodipine
Invariant chain
Ethyl alcohol

23. What is the function of the arachnoid granulations?
Cause - specific mortality rate
B lymphocyte
Adenocarcinoma (30% to 35%)
Resorb CSF into the blood

24. What embryonic structure forms the adult male structure? - Gubernaculum testes
Gubernaculum
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
hCG can be detected in the blood by day 8 and in the urine by day 10.
RSV

25. Which cestode in raw or rare beef containing cysticerci results in intestinal tapeworms?
Taenia saginata
Poxvirus
transcription
Preductal (infantile)

26. The surge of what hormone induces ovulation?
LH
Lung cancer
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
Masochism

27. Name the insulin preparation based on the peak effect and duration of action - Peak - 0.5 to 3 hours; duration - 5 to 7 hours
GH deficiency
Regular insulin
Libman - Sacks endocarditis
Rhinovirus and hepatitis A virus

28. A Japanese man has weight loss - anorexia - early satiety - epigastric abdominal pain - and a palpable left supraclavicular lymph node. On endoscopy you find a large - irregular ulcer with elevated margins on the lesser curvature of the stomach. What
Encapsulated bacteria
Quaternary structure
Chloral hydrate
Gastric carcinoma

29. What CN is associated with the x Third pharyngeal arch?
Malignant mesothelioma
Isovolumetric contraction
Diazepam is longest acting and midazolam is shortest acting.
CN IX

30. What is the term for hypoperfusion of an area involving only the inner layers?
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Urogenital sinus
Selection bias
Mural infarct

31. What segments of the lumbosacral plexus form the following nerves? - Tibial nerve
Bunyavirus
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
Biotin - ATP - and CO2
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)

32. The increased oxygen consumption after phagocytosis is for...
Borderline
Invariant chain
ATP production
3'-5' direction - synthesizing RNA in the 5'-3' direction

33. What adult structures are derived from preotic somites?
The rate of Beta- oxidation
Kinesins. Dynein generates retrograde transportation of information.
Muscles of the internal eye
Chromosome 11p

34. What is the label given to an individual whose IQ is x Below 69
Mentally disabled
CN XI - vertebral arteries
Lymph nodes
CMV retinitis and HSV-2

35. Does light or darkness regulate the pineal gland?
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.
Papule
Fc portion of IgG - C3b - and mannose - binding proteins
Eosinophil chemotactic factor A

36. What is the term for pupils that react normally to accommodation but have bilateral loss of constriction in response to light?
Range
Right ventricle
IgA nephropathy
Argyll Robertson pupils

37. Name the compartment of the mediastinum associated with the following thoracic structures: Left subclavian artery
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
Superior
Combined metabolic and respiratory acidosis
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.

38. Is a cause of asthma.
GERD
Amanita phalloides
Histrionic
Adenocarcinoma of the cervix

39. What medication is used to help alcoholics avoid relapse by decreasing glutamate receptor activity?
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Lymph nodes
Osteoarthritis

40. What organism is associated with the following types of diarrhea? Day care - associated diarrhea in infants
Inferior phrenic artery
Paracortex
Rotavirus
Biotin - ATP - and CO2

41. Name the compartment of the mediastinum associated with the following thoracic structures: Brachiocephalic vein
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
Enterokinase
Quinolones
Superior

42. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Clinical disorders (e.g. - schizophrenia)?
Axis I
Budd - Chiari syndrome
Calcium oxalate
Opposite the second upper molar tooth

43. 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?
Amiloride
None; they are the storage sites for ADH and oxytocin.
Squamous cell carcinoma
Increased GABA levels decrease the likelihood of learned helplessness.

44. What is the only neuroglial cell of mesodermal origin?
Rhinovirus and hepatitis A virus
Imipenem and meropenem
Minor
Microglia. All others are neuroectodermal derivatives.

45. What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
Prophase of meiosis I (between 12th and 22nd week in utero)
Mitral (bicuspid) valve
Streptococci
Astrocytoma

46. What is a plasma cell's life expectancy?
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Physostigmine
7 to 14 days

47. What pancreatic islet cell tumor is associated with MEN I syndrome?
Atrial filling (venous filling) Atrial - Contraction - Venous
Gastrinoma
ACh receptor
NE - via its vasoconstrictive action on blood vessels

48. How can you differentiate between a medial temporal lobe and a hippocampal lesion based on memory impairment?
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
Pearson correlation
The sandfly
Swan - neck deformities

49. Acts as the vertebral body of C1 allowing lateral rotation of the head. The first cervical vertebra has no vertebral body.
The odontoid process of C2
As sample size increases - the lower the chance of error.
hCG can be detected in the blood by day 8 and in the urine by day 10.
Vibrio vulnificus

50. Where on the codon and anticodon does the wobble hypothesis take place?

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