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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 is the relationship between chance of error and x Sample size?
As sample size increases - the lower the chance of error.
Dysmetria; this is seen in a finger - to - nose test.
Down syndrome (trisomy 21)
One day after the LH surge and 2 days after the estrogen peak.

2. What two factors cause PTH to be secreted?
Bacillus anthracis
5HT1D
A decrease in Ca2+ and an increase in PO4
Dopamine

3. What are the primary neurotransmitters at the following sites? - The hypothalamus
Histamine
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
prognostic predictors
Paget disease of the breast

4. IgE- mediated mast cell release - C3a and C5a - and IL-1 all trigger the release of what vasoactive amine?
Histamine
Progestins
G-6- PD deficiency
Galactose and glucose

5. Which bacteria are associated with the following pigment production? - Black - gray pigmentation
Corynebacterium diphtheriae
Medial midbrain (Weber's) syndrome
Hyperpolarization (i.e. - K+ influx)
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.

6. What is the rate - limiting step of the following? - Ketogenolysis
Breast cancer
Myasthenia gravis
HMG CoA synthase
Enterococcus (Streptococcus faecalis)

7. From What embryonic structure are the following structures derived? - The ascending aorta and the pulmonary trunk
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Truncus arteriosus
Axis II
Fragile X syndrome

8. What happens to diastolic and systolic intervals with an increase in sympathetic activity?
ACE inhibitors (the - pril agents)
Subarachnoid hematoma
Trypsin
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.

9. With what stage of sleep is enuresis associated?
Rickets
Phosphorylation of mannose residues
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
Four high energy bonds - two from ATP in AA activation and two from GTP

10. What are the pharmacologic effects seen sexually with x Neuroleptics?
Smoking
Undoing
Muscle spindles
Erectile dysfunction

11. HIV's capsid - core nucleocapsid - and matrix proteins are products of what structural gene?
Autoimmune thrombocytopenia purpura
gag gene
Haemophilus influenzae type B
Ampulla of the fallopian tube

12. What gram - positive anaerobic rod with branching filaments is a component of the normal flora of the mouth and female genital tract and is responsible for draining abscesses with sulfur granules in the exudates?
Thyroarytenoid muscles
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available - but the renal collecting ducts are impermeable to its actions.
Burkitt lymphoma
Actinomyces israelii

13. If a patient with a cerebellar lesion has nystagmus - which way is the fast component directed - toward or away from the lesion?
The anterior nucleus of the thalamus
Coxiella burnetii
Masochism
The fast component is directed toward the affected side of a cerebellar lesion.

14. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH
Alzheimer disease
Pituitary hypogonadism
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Sciatic nerve

15. What basic reflex regulates muscle tone by contracting muscles in response to stretch of that muscle?
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Validity (remember - reliability is necessary but not the only thing needed for validity)
Left abducens nerve
The myotatic reflex is responsible for the tension present in all resting muscle.

16. What three muscles constitute the pes anserinus?
1. Sartorius 2. Gracilis 3. Semitendinous
T3
The biofeedback model is based on the parasympathetic nervous system.
At 8 to 9 years of age. Prior to this age they view death as a form of punishment.

17. Which class of antiarrhythmics are Beta- blockers?
Class II
The odontoid process of C2
Rheumatic fever
Decreases

18. Name the hepatitis virus based on the following information - Enveloped DNA hepadnavirus
Primary follicle (in the white pulp)
Hepatitis B
Glucose -6- phosphatase
Hormone - sensitive lipase

19. Which benzodiazepine is most commonly used IV in conscious sedation protocols?
The systemic veins have the largest blood volume - and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.
Midazolam
Burkitt lymphoma
premature ejaculation

20. What hormone constricts afferent and efferent arterioles (efferent more so) in an effort to preserve glomerular capillary pressure as the renal blood flow decreases?
AT II
90% of benign myxomas arise within the left atrium near the fossa ovalis.
The affinity of the drug for its receptor
The notochord

21. What is the term for dilated veins within the spermatic cord?
Paranoid
Previous suicide attempt
Varicocele
Herpes II

22. Which virus is the MCC of a cold in the summer and fall? Winter and spring?
Rhinoviruses for summer and fall; coronaviruses for winter and spring
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
Ergotamines

23. Where is the action potential generated on a neuron?
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Axon hillock
Affinity
Medullary carcinoma of the thyroid

24. What is the MCC of inherited mental retardation?
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.
Superior and posterior
Ventricular contraction Atrial - Contraction - Venous
Down syndrome

25. Is excretion greater than or less than filtration for net secretion to occur?
Excretion is greater than filtration for net secretion to occur.
Since they are independent events - their probabilities would be multiplied.
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.

26. What is the name for inability to stop a movement at the intended target?
Dysmetria; this is seen in a finger - to - nose test.
Lateral part of the hemispheres
Invariant chain
Terminal ileum

27. Name the most common cause - Blindness worldwide
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Dystrophic calcification
Large segment deletions
Chlamydia trachomatis

28. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Imipenem and meropenem
Rochalimaea quintana (now called Bartonella quintana)
Type II hypersensitivity reaction
Water soluble

29. What area of the hypothalamus is responsible for recognizing an increase in body temperature and mediates the response to dissipate heat?
Anterior hypothalamic zone; lesions here result in hyperthermia.
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
2 days prior to ovulation
Clostridium perfringens

30. What fungus is urease positive?
Al - Anon
Cryptococcus
Rochalimaea quintana (now called Bartonella quintana)
Lymphoblastic lymphoma

31. Name the most common type or cause - Hematologic cause of papillary necrosis
Week four - and they remain dormant there until puberty.
Sj
Sickle cell disease
Latency stage (6-12 years)

32. Name the lung measurement based on the following descriptions: x Additional volume that can be expired after normal expiration
Surface tension; in the alveoli - it is a force that acts to collapse the lung.
Chromosome 17
T9
Expiratory reserve volume (ERV)

33. Are the following major or minor Jones criteria of rheumatic fever? - Subcutaneous nodules
ACh - histamine - and gastrin
ASA (salicylate)
Progestins
Major

34. What AD syndrome involves 1000 or more edematous polyps - most commonly affects the colorectal area - and is associated with chromosome 5q21?
Familial polyposis coli
Rigors - leukopenia - decrease in blood pressure - and increase in temperature
Carbamazepine
Rhombencephalon

35. What enzyme is deficient in acute intermittent porphyria?
Uroporphyrinogen I synthetase
Cysticerci
With arteriolar constriction both the flow and pressure downstream decrease.
Penicillin G (benzylpenicillin)

36. If no fertilization occurs - How many days after ovulation does the corpus luteum begin to degenerate?
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.
12 days after ovulation
Areas 44 and 45
Erythema multiforme

37. What type of hypersensitivity is a result of high circulating levels of soluble immune complexes made up of IgG or IgM Abs?
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
Muscle spindles
Type III hypersensitivity reaction
Cytosine

38. Does ELISA or Western blot confirm whether a patient is HIV- positive?
Hydralazine - isoniazid - and procainamide (HIP)
ELISA screens and Western blot confirms the diagnosis.
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
Middle meningeal artery

39. What family do the following viruses belong to? - Ebola
Ristocetin
Filovirus
Bulla
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.

40. What three carcinomas are associated with EBV?

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41. What is the MCC of the following endocarditis scenarios? - Post dental work
The bifurcation of the abdominal aorta
Formal operations (> 12 years)
Streptococcus viridans
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.

42. What are the most common causes of osteomyelitis x In patients with sickle cell disease?
Alveoli; they are part of the respiratory portion.
Plasmodium falciparum
Staphylococcus aureus (but they are more prone to salmonella infections)
Erythema multiforme

43. What structure is derived from the prochordal plate?
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
Parainfluenza virus
Hepatoma and nonseminomatous testicular germ cell tumors
The mouth

44. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Dorsal root?
Sensory
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Paramyxovirus
Selection bias

45. What CN is associated with the x Second pharyngeal arch?
Desipramine
Ostium secundum defects
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
CN VII

46. Projectile nonbilious vomiting and a small knot at the right costal margin (olive sign) are hallmarks of What embryonic disorder?
Chromosome 4p
RU 486
A transport maximum (Tm) system
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet

47. Name the three ketone bodies.
Haemophilus ducreyi
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
Middle meningeal artery
Acetoacetate - acetone - and Beta- hydroxybutyrate

48. What area of the small intestine is characterized by Peyer's patches?
Rods
Ileum
Adenovirus
Primary biliary cirrhosis

49. Name the most common type or cause - Neonatal septicemia and meningitis
Streptococcus agalactiae (Group B Streptococcus - or GBS)
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies
>15 mm
Osteogenesis imperfecta

50. How many NADPHs are used per addition of acetyl CoA into a fatty acid chain?
Somatomedins
Since they are independent events - their probabilities would be multiplied.
Galactoside permease
2 NADPHs per acetyl CoA