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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 drug of choice for treating ADHD?
Methylphenidate (Ritalin)
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
Lysine and arginine
Previous suicide attempt

2. What is the size of a positive PPD test for the following? (Reactive) x IV drug abuser
Autosomal dominant
>10 mm
Splenomegaly and anemia (with a high index of suspicion)
Impotence

3. What thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 decreased
HBsAg and HBeAg
Acarbose
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
CN III

4. A 60-year - old man has back pain (compression spinal fracture) - hypercalcemia - increased serum protein - Bence - Jones proteinuria - and monoclonal M- spike on serum electrophoresis. What is your diagnosis?
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
On the superior body of the posterior wall of the uterus
Hyperacute rejection
Multiple myeloma

5. What glycoprotein in the HIV virus is used for fusion?
Glucuronidation
S2 - S3 - S4
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
GP41

6. Name the antimicrobial agent whose major side effect is listed - Cartilage abnormalities
Inspiratory reserve volume (IRV)
Azithromycin
Phototherapy
Quinolones

7. What mineral is required for cross - linking of collagen molecules into fibrils?
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
Southern blot
S phase

8. What does a loss of afferent activity from the carotid sinus onto the medulla signal?
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
total body water
Transcription factor IID
HBeAb

9. What is the most serious form of tinea capitis - which results in permanent hair loss and is highly contagious?
Glycogen synthase
Tinea favosa (favus)
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
Klinefelter syndrome

10. Is the bound form or free form of a lipid - soluble hormone responsible for the negative feedback activity?
Macula densa
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
Free form determines hormone activity and is responsible for the negative feedback loop.
Pedophilia

11. Which of the following
Duchenne muscular dystrophy
Chromosome 17
Breast cancer
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.

12. What phase of the female reproductive cycle is 14 days long?
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies
Rheumatoid arthritis
Giardia lamblia (treat with metronidazole)
Ventral lateral nucleus

13. What is the term for thickened - hyperpigmented skin in the axillae - groin - and skin folds associated with malignancies - obesity - and DM?
Yohimbine
Pseudomembranous colitis
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
Acanthosis nigricans

14. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Weeks to months after transplantation; abrupt onset of oliguria and azotemia; seen as neutrophilic vasculitis and interstitial lymphocytes
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
0.21; it is a fancy way of saying 21% of the air is O2.
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
Acute rejection

15. What germ cell tumor is seen in the 15- to 35-year - old age group - peaks when the person is 35 years of age - and is a bulky mass that spreads via the lymphatic system?
Affinity
Seminoma
Hydroxyproline
Rhabdovirus

16. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Midbrain
Vibrio parahaemolyticus
Lead
Mesencephalon
SER

17. What are the three left - to - right shunts?
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.
1. VSD 2. ASD 3. PDA
2.0 or greater
Neisseria meningitidis

18. What is the main factor determining GFR?
Cholesterol biosynthesis
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
Eclipse period
Doxacurium

19. What are the two most important features in the diagnosis of malaria?
Splenomegaly and anemia (with a high index of suspicion)
All are lactose fermenters except Yersinia and Proteus.
Ultraviolet B (UVB) sunlight
Neuroblastoma

20. What is the most common one? - Intraspinal tumor
Plasmodium falciparum
Beta- Oxidation of fatty acids
Lactose must be present and glucose must be absent
Ependymoma

21. What is the name of the force that develops in the wall of the lungs as they expand?
Glucose
presence of PMNs
Diverticulosis
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.

22. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Clonidine
Cytochrome a/a3
The greater the myelination - the greater the conduction velocity.
Being single

23. What prevents the down - regulation of the receptors on the gonadotrophs of the anterior pituitary gland?
The pulsatile release of GnRH
The lung will expand; also the opposite is true.
3 to 4 days
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.

24. Describe the organism based on the following information: x Beta - hemolytic Streptococcus sensitive to bacitracin
Streptococcus pyogenes
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
TB meningitis
Estrone

25. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Epidermis
Scavenger receptor (SR- B1)
Labile
Obesity - DM - HTN - multiparity - early menarche - and late menopause
VLDLs

26. What drug is being given to HIV- positive mothers during labor and to the children after birth to decrease the risk of mother - to - child HIV transmission?
The vermis
Constrictor pupillae and ciliary muscles
Repolarization is from base to apex and from epicardium to endocardium.
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.

27. When is the first arrested stage of development in the female reproductive cycle?
Cestodes
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Autosomal dominant
Prophase of meiosis I (between 12th and 22nd week in utero)

28. What disorder is due to a 5-- reductase deficiency - resulting in testicular tissue and stunted male external genitalia?
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
Choriocarcinoma

29. What is the label given to an individual whose IQ is x 120 to 129
Superior
BPH
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
Hypoparathyroidism

30. An 80-year - old woman presents to you with right - sided temporal headache - facial pain and blurred vision on the affected side - and an elevated ESR. Your diagnosis?
Alkaline phosphatase
Lewy bodies
Temporal arteritis (giant cell arteritis)
Stage 4

31. What component of an ECG is associated with the following? - Ventricular depolarization
Eosin
QRS complex
Ventral lateral nucleus
Tetralogy of Fallot

32. What is the term for production of a DNA copy from an RNA molecule?
Diacylglycerols and phosphatidic acid
Case fatality rate
Area 6
Reverse transcription

33. What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100 - 00); decreased LAP levels; and nonspecific symptoms of fatigue - malaise - weight loss - and anorexia?
EBV
Small cell carcinoma (oat cell)
CML
IgA

34. Metformin is contraindicated in ________ because of weight gain as its side effect.
Galactose and glucose
Jejunum (upper)
Obese patients
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.

35. ______________ that slow bacterial growth are bactericidal.
Antimicrobial agents
VLDLs
Primitive ventricle
Microvillus

36. What condition results in the following CSF results? - Opening pressure 250 mm H2O; WBCs 250 (90% lymphocytes); glucose 35; protein 100
CN III
Vesicular stomatitis virus
TB meningitis
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis

37. In what X- linked recessive disease is there a decrease in the HMP shunt - along with Heinz body formation?
Verbigeration
Fragile X syndrome
Hypnozoite
G-6- PD deficiency

38. What are the two ways to leave the prevalence pot?
Recovery and death
Radial nerve and the profunda brachii artery
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
Dihydrotestosterone

39. What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
Mitral insufficiency
Syringomyelia
Vitreous humor

40. What are the most common causes of osteomyelitis x In patients with sickle cell disease?
Hydatidiform mole
Staphylococcus aureus (but they are more prone to salmonella infections)
Glutamine
LTC4 - LTD4 - and LTE4

41. Are the following parameters associated with an obstructive or restrictive lung disorder: decreased FEV1 - FVC - peak flow - and FEV1/FVC; increased TLC - FRC - and RV?
Middle meningeal artery
Parvovirus B 19
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.

42. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
Rheumatoid arthritis
Pyridoxine (B6) deficiency
The T- test (used when comparing two groups)
Selection bias

43. Name the most common type or cause - Cyanotic heart disease
Tryptophan
Tetralogy of Fallot
Dihydrofolate reductase
Isograft

44. Ensures emancipation.
Uricosuric
Pregnancy
Flucytosine
45XO

45. What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
Crohn disease
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Hemolytic uremic syndrome
Cystadenocarcinoma

46. Name the stages of sleep with these EEG patterns: x Sawtooth waves - random low voltage pattern
REM
Middle
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.
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)

47. What vitamin is a component of the enzymes fatty acid synthase and acyl CoA?
Pantothenic acid
Astrocytes
Virchow triad - associated with the formation of a thrombus.
Niacin (B3)

48. What percentage of nephrons is cortical?
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.
Intellectualization
Hyperkalemia

49. What enzyme is deficient in hereditary protoporphyria?
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.
No - therapeutic indices can tell which drug is safer - not more toxic.
Ferrochelatase
TAT (Thematic apperception test)

50. What enzyme is deficient in selective T cell immunodeficiency?
Somatomedins
Purine nucleoside phosphorylase
Left homonymous hemianopsia
Roth spots