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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 happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
Plasmodium vivax
Transcortical aphasia
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Fixed ratio (rewards set behaviors)

2. What condition is characterized by a 46XY karyotype - testes present - and ambiguous or female external genitalia?
Male pseudohermaphrodite (dude looks like a lady!)
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
Kidney
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion

3. How many kilocalories per gram are produced from the degradation of fat? CHO? Protein?
Osteogenesis imperfecta
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
When it crosses the teres major
IgA

4. What term describes the inability to recall personal information - commonly associated with trauma?
Methionine (start) and tryptophan are the only two AAs with only one codon.
Cytochrome c
A right CN V lesion results in weakened muscles of mastication - and the jaw deviates to the right.
Amnesia. (The person is aware of the memory loss.)

5. What structure of a protein describes the interaction among subunits?
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Quaternary structure
Herpes virus

6. What nematode is known as whipworms? What is the treatment?
Copper (Cu+)
Trichuris trichiura is treated with albendazole.
EBV
Sublimation

7. What three substances stimulate glycogenolysis?
Insulinoma
Prolactinoma
Ea (activation energy)
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon

8. What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue?
Disorganized schizophrenia
Bainbridge reflex
Fluconazole
Metastatic calcification

9. Name the hormone
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c
Diazoxide
Glucagon

10. Paranoid and catatonic schizophrenia are good...
Alendronate
Coxsackie A
REM
prognostic predictors

11. What pathology is associated with podagra - tophi in the ear - and PMNs with monosodium urate crystals?
Gout
Bioavailability
Galactoside permease
Riboflavin (B2) deficiency

12. What happens to the following during skeletal muscle contraction? - A band
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Anopheles mosquito
No change in length
The aorta

13. What seven structures are found in more than one mediastinum?
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve
Avidity. There is a positive correlation between valence numbers and avidity.
M
Fading

14. What component of the ANS is responsible for dilation of the blood vessels in the erectile tissue of the penis - resulting in an erection?
Parasympathetics (parasympathetics point - sympathetics shoot)
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)
The death of a spouse. The higher the score - the greater the risk of developing an illness in the next 6 months.
Systematic desensitization

15. What remains patent in a hydrocele of the testis - allowing peritoneal fluid to form into a cyst?
A patent processus vaginalis
Glanzmann syndrome
Proencephalon
Venlafaxine. (It also has a mild dopaminergic effect.)

16. What is the epithelial lining of the prostatic portion of the urethra?
eEF-1
>5 mm
Trichophyton
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.

17. What disorder is characterized by autoantibodies to IF?
The aorta has the greatest velocity and the capillaries have the slowest velocity.
Heroin
Pernicious anemia
Succinate dehydrogenase

18. What are the nonoxidative enzymes of the HMP shunt? Are the reactions they catalyze reversible or irreversible?
Transketolase and transaldolase. The reactions they catalyze are reversible.
Lactulose
Thoracic splanchnic fibers
Cytochrome b/c1

19. What is the most common condition leading to an intracerebral bleed?
Hypoglycemia for secretion and hyperglycemia for inhibition
HTN
The urea cycle
Narcissistic

20. Which trophoblast layer of the placenta remains until the end of pregnancy?
Astrocytoma
Bacillus cereus
refractory sexual periods
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)

21. What is the most common primary malignant tumor in bone?
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
Obesity - DM - HTN - multiparity - early menarche - and late menopause
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
Osteosarcoma

22. What organism is associated with the following types of diarrhea? Day care - associated diarrhea in infants
Public speaking (Remember: stage fright)
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.
Plasmodium malariae
Rotavirus

23. What is the most common one? - Malignant tumor of the esophagus
GH deficiency
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
Myasthenia gravis
Squamous cell carcinoma

24. Name the compartment of the mediastinum associated with the following thoracic structures: Vagus nerve
1. Liver 2. Muscle 3. Adipose tissue
Posterior
Kimmelstiel - Wilson disease
produce bile

25. What happens to muscle tone and stretch reflexes when there is a LMN lesion?

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26. All of the hormones in the hypothalamus and anterior pituitary gland are...
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia
Water soluble
Bitemporal heteronymous hemianopsia
EF- Tu and EF- Ts of the 30S ribosomal subunit

27. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH ?
GnRH constant infusion
Gardner syndrome
Hashimoto thyroiditis
CN IX and X

28. What HIV structural gene produces GP120 and GP41?
well - fed and fasting
env structural protein
Ipsilateral loss at and below the level of the lesion
Pons

29. What disease is produced by a deficiency in the enzyme tyrosinase?
Transverse abdominis
Waterhouse - Friderichsen syndrome
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
Mural infarct

30. What is the term to describe how easily a vessel stretches?
Compliance (think of it as distensibility)
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.
Variable ratio If it is based on time - it is an interval - and if it is based on the number of responses - it is a ratio.
Shine - Dalgarno sequence

31. What vascular pathology is associated with HTN in the upper extremities - hypotension in the lower extremities - and a radial - femoral delay?
Head of the pancreas
Postductal coarctation of the aorta (adult)
Atrial contraction Atrial - Contraction - Venous
Id (pleasure principle)

32. A patient can ______ a feeding tube.
Biotin - ATP - and CO2
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
HMG- CoA reductase
refuse

33. Projectile nonbilious vomiting and a small knot at the right costal margin (olive sign) are hallmarks of What embryonic disorder?
The venae recta maintain the gradient via countercurrent flow.
Childhood
Vitelline fistula
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet

34. Name the most common type - Mental retardation
Macrophages
Cestodes
Fetal alcohol syndrome
Alteplase

35. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x CDK4
IgA
Toxoplasma gondii
Fungiform papillae
Melanoma

36. What branch off the vertebral artery supplies x The cerebellum and the dorsolateral part of the medulla?
Macula densa
PICA
Escherichia coli
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation

37. What embryonic structure forms the following adult structures? - Nephrons - kidney
Processed antigenic peptides bound in the groove of the MHC molecule
Metanephros
Volume of distribution is decreased when a large percentage of drug is protein bound.
4.7 L - 5% of body weight

38. What syndrome is due to a deficiency of surfactant?
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.
Osteosarcoma
Progestin
Clear cell

39. In high altitudes - What is the main drive for ventilation?
Afferent arteriole
Mallory- Weiss syndrome
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).

40. Name the most common type or cause - Subacute bacterial endocarditis
Renal failure
Type III hypersensitivity reaction
Streptococcus viridans
Supraoptic nuclei; lesions here result in diabetes insipidus.

41. Depolarization of the postsynaptic membrane...
Sciatic nerve
31 pairs
excites the neuron
von Hippel - Lindau syndrome

42. What results when the maxillary prominence fails to fuse with the medial nasal prominence?
Cleft lip
Atropine and 2- PAM (pralidoxime)
C1 - C2 - or C4 deficiency
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.

43. Has proteolytic metabolic effects.
Gastrinoma
Epinephrine
Superoxide dismutase - glutathione peroxidase - catalase
Encapsulated bacteria

44. Which hepatitis strain is a defective virus that can replicate only inside HBV- infected cells?
Hepatitis D
Necrotizing enterocolitis
The primitive streak grows caudal to rostral.
Residual volume

45. What cell surface marker do all T cells have?
Ependymal cells
CD3
Ritodrine and terbutaline
Polycystic ovary disease (Stein - Leventhal syndrome)

46. Name the antimicrobial agent whose major side effect is listed - Hemolytic anemia
CD8+ T cells
Medulla blastoma
Nitrofurantoin
RNA polymerase III

47. Name the four right - to - left congenital cardiac shunts.
Phase 1
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Reliability (think of it as 'nice grouping' or 'precise')
Bactericidal

48. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Acellular; some are enveloped; replicate within the host cell; no cell walls
Pancreatic insufficiency
There is a difference; it takes about 7 to 8 half - lives to reach mathematical steady state and 4 to 5 half - lives to reach clinical steady state.
Rhinovirus
Viruses

49. What is the name of the monoclonal antibody used in the treatment of Crohn disease and rheumatoid arthritis?
Infliximab
Aged adult
Glucagon
ACh

50. What type of hypersensitivity is a T cell - mediated response to Ags that are not activated by Ab or complement?
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)
Basal ganglia
Total lung capacity (TLC)
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.