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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. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Nitrosamines
TXA2
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
Gastric cancer
Inhibin - m

2. Does PT or PTT test the extrinsic coagulation pathway?
Klinefelter syndrome
Palms - up before palms - down maneuvers
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT - which means warfarin - extrinsic - PT; heparin - intrinsic - PTT)
EF-2 and GTP

3. Senile plaques
The anterior nucleus of the thalamus
IgA
Pneumocystis carinii
Alzheimer disease

4. What cell type of the body or fundus of the stomach secretes pepsinogen?
Trimethoprim
Urogenital sinus
Histiocytes
Chief cells

5. What part of the heart forms x Superior border?
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major
Conus arteriosus of the right ventricle and right and left auricles
Primary hyperparathyroidism
Aschoff bodies of rheumatic fever

6. What happens to dopamine levels when we awaken?
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Birds
>5 mm

7. Name the type of necrosis - Soft - friable - cottage - cheese appearing; characteristically seen in TB
Arsenic - thorotrast - and vinyl chloride
Caseous necrosis
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Hypochondriasis (they will begin with 'I think I have...')

8. What regulates the rate of ketone body formation?
Calicivirus
The rate of Beta- oxidation
Histamine
Hematogenous

9. If a peripheral blood smear shows schistocytes - reticulocytes - and thrombocytopenia - is it more commonly seen in patients with ITP or TTP?
Scleroderma
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
Turcot syndrome

10. What muscle of the middle ear is innervated by the mandibular division of CN V?
Granulosa/thecal cell tumor of the ovary
ASA (salicylate)
Confabulation; it is commonly seen in Korsakoff's syndrome.
Tensor tympani

11. What vitamin deficiency can result in high - output cardiac failure?
Thymidylate synthase
7 to 14 days
Coronary circulation
Thiamine

12. What is the term for an inhibited female orgasm?
Anorgasmia. (The overall prevalence is 30%.)
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.

13. Is the hydroxyl (- OH) end of DNA and RNA at the 3' or the 5' end?

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14. What CN is associated with the x Fifth pharyngeal arch?
Humerus with ulna (major) and radius (minor)
None; it degenerates.
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
Glycogen synthase

15. What enzyme catalyzes the rate - limiting step in purine synthesis?
Normal values
PRPP aminotransferase
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
C5a

16. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 23/1n
Spermatid
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm
The T- test (used when comparing two groups)
Coxiella burnetii

17. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Metabolic rate and alveolar ventilation (main factor)
Preload. It is the load on a muscle Prior to contraction.
Type II hypersensitivity reaction
Remember the mnemonic PAM SMIDT P - (hyper) Parathyroid/ Paget disease A - Addison's disease M - Milk - alkali syndrome/metastatic cancer S - Sarcoidosis M - Multiple myeloma I - Immobilization/idiopathic D - Vitamin D intoxication T - Tumors

18. Damage to what nerve will give you winged scapula?
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
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
Arterioles have the largest drop - whereas the vena cava has the smallest pressure drop in systemic circulation.
No change in length

19. What TCAD causes sudden cardiac death in children?
Rhombencephalon
Hydralazine - isoniazid - and procainamide (HIP)
Desipramine
X- linked recessive

20. What is the most common genetic cause of mental retardation?
Down syndrome (it is slightly more common than fragile X syndrome.)
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Axis I

21. Name the structure that enters or exits the following foramina: x Foramen magnum
CN XI - vertebral arteries
Leuprolide
Parvovirus
Down syndrome

22. Are the following conditions associated with a negative or positive nitrogen balance? - Pregnancy
Bile salts are actively reabsorbed in the distal ileum.
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
Positive
Volkmann's contracture

23. What pancreatic islet cell tumor is associated with watery diarrhea - hypokalemia - and achlorhydria?
Squamous cell carcinoma
Minoxidil (orally and topically - respectively!)
Chemotaxis
VIPoma

24. What is the term for the degree to which a test measures what it is intended to measure?
Folic acid deficiency
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Coxsackie A
Validity (remember - reliability is necessary but not the only thing needed for validity)

25. What test uses p24 protein when diagnosing HIV?
CSF
Ticlopidine or clopidogrel
IgM; IgD follows shortly thereafter.
ELISA test

26. Name the four ventral mesentery derivatives.
Superior
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.
Seminoma
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim

27. Why is hypothyroidism associated with night blindness?
Stage 2 - which accounts for approximately 45% of total sleep time - with REM occupying 20%.
Cilia
Thiazide diuretics
Thyroid hormones are necessary for conversion of carotene to vitamin A.

28. Why is the clearance of creatinine always slightly greater than the clearance of inulin and GFR?
Because creatinine is filtered and a small amount is secreted
Erythema multiforme
Edinger - Westphal nucleus (via CN III)
Streptococcus viridans

29. At what point does the axillary artery become the brachial artery?
Vibrio parahaemolyticus
MGB (think EARS)
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
When it crosses the teres major

30. What three drugs are associated with SLE- like syndrome in slow acetylators?
Gain of isotonic fluid (isotonic saline)
Autoimmune thrombocytopenia purpura
Phase 0
Hydralazine - isoniazid - and procainamide (HIP)

31. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Citrate - via the citrate shuttle
Contralateral loss below and bilateral loss at the level of the lesion
Liver
Ewing sarcoma

32. What obligate extracellular fungus is silver stain - positive and is associated with pneumonia in patients with AIDS?
Eosin
C5b - C9
Pneumocystis carinii
They block the midcycle surge of LH.

33. What water - soluble - vitamin deficiency is associated with neural tube defects in the fetus?
Folic acid
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
Amiloride
Posterior

34. What childhood pathology involves anterior bowing of the tibia - epiphyseal enlargements - and costochondral widening - with the endochondral bones being affected?
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Rickets
Areas 1 - 2 - and 3
Positive correlation

35. What is the term for panhypopituitarism secondary to ischemic necrosis and hypotension postpartum?
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)
Sheehan syndrome
Risk factors for breast cancer
Osteoarthritis

36. What is the most common form of dementia?

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37. Neurofibrillary tangles
Bronchial asthma (whorled mucous plugs)
Alzheimer disease
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.
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

38. Name the macrophage based on its location: x Brain macrophages
Superficial spreading melanoma
Thick skin
Microglia
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

39. Are the quadrate and caudate lobes of the liver functionally part of the left or right lobe?
Guanethidine and bretylium
Chordae tendineae
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration

40. What is the most common one? - Thyroid cancer
Pulmonary alveolar macrophages
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
Lymphoblastic lymphoma
Papillary carcinoma

41. Depolarization of the postsynaptic membrane...
Fitz - Hugh - Curtis syndrome
Calcium oxylate
excites the neuron
SITS

42. What ganglion supplies the postganglionic parasympathetic fibers to the ciliary muscles of the eye?
PALS
Mannitol
Ciliary ganglion
Expressive aphasia

43. How many strains of Pneumococcus capsular polysaccharides are present in the vaccine?
Simon focus
CHF - cirrhosis - and nephrosis
Introjection (a sports fan is a good example)
The vaccine contains 23 capsular polysaccharides.

44. What virus is associated with body cavity large B- cell lymphomas?
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.
Vibrio vulnificus
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)
HHV-8

45. How many ATPs per glucose are generated in glycolysis?
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
Stibogluconate
Chromosome 19
Obsessive - compulsive

46. How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle?
Voltage - gated channel
Clavicle - acromion - and glenoid fossa of the scapula and the humerus
3 ATPs by oxidative phosphorylation
CN V - VI - VII - and VIII

47. What is the most common primary diagnosis resulting in an office visit for males? For females?
Vitamin E
2 and 5HT3 receptors
IgA
For males - HTN; for females - pregnancy.

48. What are the adult remnants of the following structures? - Right and left umbilical arteries
Medial umbilical ligaments
Pseudomonas aeruginosa
Chromosome 15
Transcription (C comes before L in the alphabet - and transCription comes before transLation)

49. What is the term for the external urethra opening onto the dorsal surface of the penis?
Epispadia
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
Adenocarcinoma
Voltage - gated calcium channel

50. All of the hormones in the hypothalamus and anterior pituitary gland are...
Water soluble
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
Positive
HBcAb and HBeAb. You see the antibodies c and e.