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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. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Months to years after transplantation; gradual onset of HTN - oliguria - and azotemia; seen as intimal fibrosis of the blood vessels and in
Sympathetic nervous system
Chronic rejection
Lesser curvature of the antrum of the stomach
Ciliary ganglion

2. What is the term for an increase in the number of cells in a tissue?
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)
Hyperplasia
The placenta
Klatskin tumor

3. What is the term for the number of Ag - binding sites on an Ig?
Valence
Isotonic contraction
G2 phase
Negative selection. This helps to prevent autoimmune diseases.

4. Name the Plasmodium species based on the following information: No persistent liver stage or relapse; blood smear shows multiple ring forms and crescent - shaped gametes; irregular febrile pattern; associated with cerebral malaria
All (nearly 15-20 times the normal risk)
Glossopharyngeal nerve
Plasmodium falciparum
Poxvirus

5. Name the most common type or cause - Acute tubular necrosis
Maxillary division of CN V and glossopharyngeal nerves
Ischemic
Erythromycin
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)

6. What vascular tumor associated with von Hippel - Lindau syndrome involves the cerebellum - brainstem - spinal cord - and retina?
Hemangioblastoma
Gastrinoma
Permanent
Neisseria gonorrhoeae

7. Name the type of mutation: x New codon specifies for the same AA
Silent
Osler nodes
The second pharyngeal pouch and groove
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.

8. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.
Both
Ipsilateral loss at and below the level of the lesion
Transference. When it is from the physician to the patient it is called countertransference.

9. What thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 increased
Chloral hydrate
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
Right medial longitudinal fasciculus

10. What disorder of aldosterone secretion is characterized by x Decreased total body sodium - ECF volume - plasma volume - BP - and pH; increased potassium - renin - and AT II activity; no edema?

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11. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Hypothalamus
DiGeorge syndrome
Schistosoma have separate males and females.
Dorsal motor nucleus of CN X
Proencephalon diencephalon derivative

12. Has analgesic and antipyretic activities but lacks anti - inflammatory effects.
Ligamentum venosum
FSH and testosterone
Acetaminophen
Atropine with pralidoxime

13. What is the most common one? - Location of a duodenal ulcer
Coarctation of the aorta
Frontal lobe
Osler nodes
Anterior wall of the first part of the duodenum

14. Charcot - Leyden crystals
1. Streptomycin 2. Gentamicin 3. Tobramycin
Verbigeration
Bronchial asthma (eosinophil membranes)
Neutropenia - splenomegaly - and rheumatoid arthritis

15. With an increase in arterial systolic pressure - what happens to x Heart rate?
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Measurement bias
Decreases
Yes

16. Name the associated chromosomal translocation - Ewing sarcoma
The surface of the medulla
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
Concentration gradient
Chromosome 11 - 22

17. Which class of antihypertensives produces angioedema - hyperkalemia - and a dry cough?
Proportionate mortality rate
Amantadine
ACE inhibitors (the - pril agents)
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.

18. What projective test asks the patient to tell a story about What is going on in the pictures - evaluating the conflicts - drives - and emotions of the individual?
CD4
Fixed ratio (rewards set behaviors)
Meningocele All except occulta cause elevated - fetoprotein levels.
TAT (Thematic apperception test)

19. Name the stages of sleep with these EEG patterns: x Disappearance of alpha waves - appearance of theta waves
Autosomal recessive
Hyperacute rejection
Stage 1
Neonatal respiratory distress syndrome (NRDS)

20. What three circumstances allow a child to be committed to institutional care?

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21. For what disease are SS- A(Ro) - SS- B(La) - and R- ANA diagnostic markers?
Sj
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Unipolar disorder (major depression)
Blastoconidia

22. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Psychosocial and environmental problems (stressors)?
give a warning
Resistance increases as resistors are added to the circuit.
Axis IV
Clarke's nucleus

23. What microaerophile is a motile gram - negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)?
AML- M3
Neisseria meningitidis
Postductal coarctation of the aorta (adult)
Campylobacter jejuni

24. What is the major pulmonary side effect of
Paracortex
gag gene
Respiratory depression
Streptococcus pneumoniae

25. What two requirements must be met for the Lac operon to be activated?
Copper (Cu+)
Cross - sectional studies determine prevalence - not incidence or cause and effect.
Lactose must be present and glucose must be absent
Cryptococcus

26. A patient can ______ a feeding tube.
refuse
Anterior compartment of the leg - deep peroneal nerve
T3
Penicillin G (benzylpenicillin)

27. Name the six vitamin K- dependent coagulation factors.
Mycosis fungoides (cutaneous T- cell lymphoma)
The basilar artery is formed at the pontomedullary junction.
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Factors II - VII - IX - and X and proteins C and S.

28. What is the MCC of the following endocarditis scenarios? - Non - IV drug user
Staphylococcus aureus
ater flows from a low - solute to high - solute concentrations.
Primary biliary cirrhosis
Histiocytosis X

29. What happens to blood flow and pressure downstream with local arteriolar constriction?
Fragile X syndrome
With arteriolar constriction both the flow and pressure downstream decrease.
Adenocarcinoma (because of Barrett esophagus)
Klebsiella pneumoniae

30. Fixing impulses by acting out the opposite of an unacceptable behavior
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
The thyroid gland
Chromosome 18
Undoing

31. Active protein transport requires a...
Concentration gradient
The respiratory system
Monocytosis
GLUT 2

32. How many base pairs upstream is the prokaryotic TATA box promoter?
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
gp120
HBeAb

33. What is the most common site for an aneurysm in cerebral circulation?
Umbilical vein and ductus venosus (80%)
von Hippel - Lindau syndrome
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
BPH

34. What hormone causes milk letdown?
Arginine
Somatization disorder
Medullary carcinoma of the thyroid
Oxytocin

35. Name the structure that enters or exits the following foramina: x Optic canal
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>
CN II and ophthalmic artery
Oblique fissure
Fibrinous exudates

36. What protective covering adheres to the spinal cord and CNS tissue?
TCA cycle.
Pia mater
Ribavirin
Helicobacter pylori - Which is also associated with an increased risk of gastric carcinoma

37. What antitubercular agent requires vitamin B6 supplementation?
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Conidia
Transferrin
Isoniazid

38. What is the only way to increase O2 delivery in the coronary circulation?
Homicide. It is also the leading cause of death in black females aged 15 to 24.
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
Farnesyl pyrophosphate (FPP)
Substantia nigra

39. In MHC class II molecules - what chain blocks access to the peptide - binding groove during transportation within the cell - ensuring that the MHC class II- peptide complex is transported to the surface?
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
Nicotine (but it sure has a nasty withdrawal!)
Lateral part of the hemispheres

40. What disorder is associated with loss of polarity - anaplasia - pleomorphism - discohesiveness - increase in the nuclear:cytoplasmic ratio - hyperchromasia - and increase in the rate of mitosis?
Voltage - gated calcium channel
Malignancy
Small cell carcinoma (oat cell)
The promoter indicates where transcription will begin.

41. In a topographical arrangement of the cerebellar homunculus map - What area or lobe x Controls balance and eye movements?
Flocculonodular lobe (one of my favorite words in all of medicine!)
Kupffer cells
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
Crossover study

42. What organ is responsible for the elimination of excess nitrogen from the body?
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Depolarization is from apex to base and from endocardium to epicardium.
Follicular lymphoma
Middle meningeal artery

43. What immunosuppressive agent is converted to 6- mercaptopurine?
The left is a branch of the aortic arch - while the right is a branch of the brachiocephalic trunk.
Risk factors for breast cancer
Azathioprine
Reye syndrome

44. What triggers phase 0 of the action potential in a ventricular pacemaker cell?
Parafollicular C cells
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
Calcium influx secondary to slow channel opening
NADPH and molecular O 2

45. What percent of sexual abuse cases are committed by family members?
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.
Cytochrome b/c1
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Disseminated intravascular coagulation (DIC)

46. What vitamin is necessary for the transfer of one amino group from a carbon skeleton to another?
Superoxide dismutase - glutathione peroxidase - catalase
Alcohol abuse
DiGeorge's syndrome
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.

47. What is the name for the most prominent spinous process?
Limbic system
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)
Duodenal atresia
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.

48. Name the type of necrosis - Histologically resembles fibrin
Crossover study
Somatic motor neurons
Fibrinoid necrosis
Subclavian vein

49. If the radius of a vessel doubles - what happens to resistance?
Farnesyl pyrophosphate (FPP)
The resistance will decrease one - sixteenth of the original resistance.
SSRIs
B lymphocyte

50. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol increased - ACTH decreased
Citrate - via the citrate shuttle
Primary hypercortisolism
Proportionate mortality rate
Neomycin