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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 artery travels with the following veins? - Middle cardiac vein
Posterior interventricular artery
Acute tubular necrosis
Glucagon
Pseudomonas aeruginosa

2. What is the most important determinant of drug potency?
Minimal change disease
The affinity of the drug for its receptor
Group A Beta- hemolytic streptococci
Effective dose for 50% of drug takers (median effective dose)

3. What protein is required by prokaryotic RNA polymerases to initiate transcription at the promoter region of DNA?
Duchenne muscular dystrophy
Mesencephalon
Sigma factor
5HT1D

4. What is the only way to increase the Vmax of a reaction?
Prader - Willi syndrome and Angelman syndrome - respectively
Coxsackie A
Palindrome
Increase the concentration of enzymes

5. What is the DOC for esophageal candidiasis?
Anticentromere Abs
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
Fluconazole
5' deiodinase

6. Protein production - bile secretion - detoxification - conjugation - and lipid storage.
Functions of hepatocytes
Ulcerative colitis
2 ATPs - because RBCs use only anaerobic metabolism.
B- cell Ag receptors

7. Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
Lateral medullary (Wallenberg's) syndrome
Rapid efflux of potassium
Trypsin
Embolic

8. What is the drug of choice for penicillin - resistant gonococcal infections?
Spectinomycin
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
Calcarine sulcus
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA

9. What part of the heart forms x Anterior wall?
Right ventricle
Being awake
IDL
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive - compulsive disorder and learning disabilities.

10. What is the only vein in the body with a high O2 content?
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Strongyloides stercoralis is treated with thiabendazole.
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive - compulsive disorder and learning disabilities.

11. What is the most common form of elderly abuse?
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
Tolcapone and entacapone
Cytochrome a/a3
Th2 cells

12. What malabsorption syndrome produces abdominal distention - bloating - flatulence - diarrhea - steatorrhea - and weight loss shortly after eating bread products?
Celiac sprue (gluten - sensitive enteropathy)
Toxic or viral hepatitis
Chemotaxis
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)

13. At What age does a child develop x Exogenous smile?
refractory sexual periods
Alveolar macrophages (dust cells)
8 weeks (response to a face)
Risk factors for cervical cancer

14. What parasympathetic nucleus is found on the floor of the fourth ventricle and supplies preganglionic fibers innervating the terminal ganglias of the thorax - foregut - and midgut?
Dorsal motor nucleus of CN X
Vmax
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma
Superior and posterior

15. What is the period between falling asleep and REM sleep called?
Basophilic stippling
Lewy bodies
Staphylococcus aureus
REM latency; normally it is about 90 minutes.

16. After fertilization - what cells of the corpus luteum x Secrete progesterone?
Primary hypercortisolism
At the end of the PCT 25% of the original volume is left
Turner syndrome
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.

17. What antiviral agents inhibit neuraminidases of influenza A and B?
Kupffer cells
Zanamivir and oseltamivir
5HT1D
Virchow triad - associated with the formation of a thrombus.

18. What scale separates things into groups without defining the relationship between them?
Malignancy
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.
Urinary 17- ketosteroids
Nominal scale (categorical - e.g. - male or female)

19. What is the name of depression and mania alternating within a 48- to 72- hour period?
Right atrium
Multiple sclerosis
Rapid cycling bipolar disorder
Subacute bacterial endocarditis

20. Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
cDNA - when it is made from mRNA
Hyperacute rejection
Clostridium botulinum
Dantrolene

21. What embryonic structure forms the following adult structures? - External genitalia
Liquids - CHO - protein - fat
Large intestine. Water is passively removed from the lumen.
Phallus - urogenital folds - and labioscrotal swellings
Transudative; exudative has the opposite values and has an elevated cellular content.

22. Early menses - late menopause - history of breast cancer - obesity - and multiparity.
Hirschsprung disease
Acanthosis nigricans
Blood
Risk factors for breast cancer

23. What hormone constricts afferent and efferent arterioles (efferent more so) in an effort to preserve glomerular capillary pressure as the renal blood flow decreases?
Basal cell carcinoma
AT II
Permanent
EF-1 and GTP

24. All AAs have titration plateaus At what pH values?
pH of 2 and 9
Decrease (5- HT and dopamine levels do the same)
Mast cells
Acting out

25. What is the term for the number of new events occurring in a population divided by the population at risk?
Humerus (between the medial epicondyle and the trochlea)
Incidence rate
Sphingomyelin
Single - strand DNA binding protein

26. With a decrease in arterial diastolic pressure - what happens to x Stroke volume?
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
Microsporum
ELISA test
Decreases

27. What is the term for the external urethra opening onto the dorsal surface of the penis?
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
Epispadia
igantism
Posterior chamber

28. What is the degree to which two measures are related? Does it imply causation?
Renshaw neuron
NH4+(ammonium)
Correlation. No - correlation does not imply causation.
Cortisol - a 21- carbon steroid - has a - OH group at position 17.

29. What structure or structures cross the diaphragm at x T8 level?
Galactitol
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
G1 phase; G2 and S phase are diploid (2N).
common variable hypogammaglobinemia

30. A 25-year - old black woman presents with nonproductive cough - shortness of breath - fatigue - and malaise; she has bilateral hilar lymphadenopathy on chest radiography and elevated ACE levels. What do you diagnose?
Sarcoidosis
Are inactivated vaccines available in the United States
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Axon hillock

31. Which genus of dermatophytes is associated with the following sites of infection? - Nails and skin only
Endometriosis
Zona fasciculata and zona reticularis
7
Epidermophyton

32. Name the thalamic nucleus based on its input and output - Input from the optic tract; output projects to the primary visual cortex of the occipital lobe
Scleroderma
Ventromedial nucleus; lesions here result in obesity.
LGB (think EYES)
Prefrontal cortex; it is in front of the premotor area.

33. What lymphoma is associated with bleeding and cryoglobulin precipitation at low temperatures - headache and confusion due to hyperviscosity - IgM M- protein spike on serum electrophoresis - and Russell bodies?
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Waldenstr
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.
rRNA

34. Name the B- cell CD marker: x Required for class switching signals from T cells
Parasympathetics (parasympathetics point - sympathetics shoot)
Hepatitis E
CD40
Progressive multifocal leukoencephalopathy

35. What is the term for the load a muscle is trying to move during stimulation?
Hepatitis D
Afterload
Thrush
Superior

36. What IL do T cells secrete to induce T- and B- cell division?
Type II hypersensitivity reaction
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
Increase the concentration of enzymes
Dihydropteroate synthetase

37. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Clearance
Type II hypersensitivity reaction
Purulent exudates
Berry aneurysm in the circle of Willis

38. What two ligaments of the uterus are remnants of the gubernaculum?
Round and ovarian ligaments
Coxsackie B
Osteoarthritis
Avoidant

39. Is an anti - HAV IgG Ab associated with immunization or recent infection?
Bile salts are actively reabsorbed in the distal ileum.
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Rhabdovirus
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.

40. Name the associated chromosome - Cri - du - chat
Red muscle
Nicotine (but it sure has a nasty withdrawal!)
Chromosome 5p
Necrophilia

41. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - CNS neurons
Permanent
Missense
Histamine
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

42. Name the type of hypersensitivity reaction based on the following properties - IgE- mediated release of chemical mediators from basophils and mast cells; need prior exposure to Ag in the past; eosinophils amplify and continue reaction; can be system
Bunyavirus
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)
Type I hypersensitivity (anaphylactic)
PGE 1 - PGI 2 (most potent) - and TXA 2

43. What is the best measure of total body vitamin D if you suspect a deficiency?
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
7
Serum 25- hydroxy- vitamin D (25- OH- D)
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)

44. What sensory system is affected in the late spinal cord manifestation of syphilis?
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see - can't wee - can't kick with your knee
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
CN XI - vertebral arteries

45. What AR disorder is seen by age 1 to 2 with recurrent sinopulmonary infections - uncoordinated muscle movements - and dilation of the blood vessels?
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Left atrial myxoma
Vibrio vulnificus
Ataxia - telangiectasia

46. What is the second leading cause of death in the United States?
The JG cells
CD4+T cells
Staphylococcus
Cancer

47. What is the most common one? - Type of melanoma
Turner syndrome
Zollinger - Ellison syndrome
Superficial spreading melanoma
Glioblastoma multiforme

48. What is the term for the amount of blood in the ventricle after maximal contraction?
IgA nephropathy
Unipolar disorder (major depression)
Residual volume
Membranoproliferative glomerulonephritis (MGN)

49. When does the primitive gut herniate out of the embryo? When does it go back into the embryo?
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
Leuprolide
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
6 weeks 10 weeks

50. What hypothalamic hormone is synthesized in the preoptic nucleus?
GnRH
Cerebral aqueduct
Pasteurella multocida
First - order elimination