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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. Where are the preganglionic neuron cell bodies - the CNS or the PNS?
They are in the grey matter of the CNS.
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
CN V2
Mixed (both cholesterol and calcium)

2. What two factors result in the base of the lung being hyperperfused?
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
hCG
Autograft
Renshaw neuron

3. A complete opposite expression of your inward feeling (e.g. - arguing all the time with someone you are attracted to when your feelings are not known)
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
Catechol - O- methyl transferase (COMT)
The hallmarks of LMN lesion injury are absent or decreased reflexes - muscle fasciculations - decreased muscle tone - and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget - LMN lesions are ipsilateral at the level of the
Reaction formation

4. What is the MCC of the following endocarditis scenarios? - Following biliary infections
Enterococcus faecalis
A low - resistance system is formed by resistors added in parallel.
Down syndrome
Biotin - ATP - and CO2

5. What adult structures are derived from preotic somites?
Pseudohyphae
Rhinoviruses for summer and fall; coronaviruses for winter and spring
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember - it may be negative in the first week of the illness - so retest if you have a high index of suspicion.)
Muscles of the internal eye

6. What two factors lead to the development of the bends (caisson disease)?
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
HBeAb
CD4+ T cells (helper)
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.

7. Name the most common type or cause - Subacute bacterial endocarditis
Glioblastoma multiforme
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
Streptococcus viridans
N-5- methyl THF

8. What Brodmann area is associated with x Primary somatosensory cortex?
Social learning theory
Areas 1 - 2 - and 3
IgM
Left atrial myxoma

9. What mineral is an important component of glutathione peroxidase?
Increased secretion of GH postpuberty leading to acromegaly.
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
Selenium (Se)

10. Is suicidal ideation a component of normal grief?
It is rare with normal grief; however - it is relatively common in depression
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
With arteriolar constriction both the flow and pressure downstream decrease.
S phase

11. What ovarian disease involves psammoma bodies?
Mycoplasma pneumoniae
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e. - pill rolling) is seen in basal ganglia lesions.
Serocystadenocarcinoma
Metaplasia (usually to a more protective cell type)

12. What is the major ketone body produced during alcoholic ketoacidosis?
Somatoform disorder
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Beta- Hydroxybutyrate
CD21; it is a complement receptor for cleaved C3

13. What is the DOC for Beta- blocker - induced bronchospasms?
Methyldopa
Ulcerative colitis
Ipratropium
Enkephalins

14. After fertilization - what cells of the corpus luteum x Secrete estrogen?
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
1. Posterior auricular vein 2. Posterior division of the retromandibular vein
Tyrosine
Streptolysin O

15. What form of anxiety - appearing at 6 months - peaking at 8 months - and disappearing by 1 year of age - is seen in the presence of unfamiliar people?
hyperventilation
UMP
IL-4
Stranger anxiety

16. If you double the infusion rate of a drug - how long will it take to reach steady state?
Middle
Transcription factor IID
Bronchioloalveolar carcinoma
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.

17. What is the most common one? - Solid tumor in the body
alpha2- Receptors
Moving objects - along with large bright objects with curves and complex designs.
Nephroblastoma
Bender Visual Motor Gestalt Test

18. T3 increases bone ossification through synergistic effect with what hormone?
Afferent arteriole
Multiple sclerosis
Increases
GH

19. What form of continuous DNA - used in cloning - has no introns or regulatory elements?
Somatic motor neurons
Thoracic splanchnic fibers
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
cDNA - when it is made from mRNA

20. What artery supplies most of the lateral surfaces of the cerebral hemispheres?
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
Alzheimer disease
Middle cerebral artery
Osteoblasts (Remember - they modulate the function of osteoclasts.)

21. What fungus is characterized by hypopigmented spots on the thorax - spaghetti - and - meatball KOH staining - and pityriasis or tinea versicolor?
Chromosome 17
LTB4
Malassezia furfur (treat with selenium sulfide)
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh

22. What acid form of H+ in the urine cannot be titrated?
NH4+(ammonium)
Hepatocellular carcinoma
Axis V
Factors II - VII - IX - X - and proteins C and S

23. A unilateral lesion In what nucleus will produce ipsilateral paralysis of the soft palate?
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Alanine and glutamine
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.
Haemophilus influenzae type B

24. How many codons code for AAs? How many for termination of translation?
Cohort studies determine incidence and causality - not prevalence.
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.
Chromosome 5p
urease positive

25. What is the only way to increase O2 delivery in the coronary circulation?
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
Rifampin
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.

26. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
The urea cycle
Operon
Clonidine
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.

27. What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy?
2 days prior to ovulation
Actinomyces israelii
Avoidant
Celecoxib

28. What coronary artery vasculitis is seen in Japanese infants and children less than 4 years old with acute febrile illness - conjunctivitis - maculopapular rash - and lymphadenopathy?
Area 4
CD8+ T cells
Avoidant
Kawasaki disease

29. What three organs can be affected by Trypanosoma cruzi?
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
Coronary circulation
Cryptococcus neoformans

30. Shuffling gait - cogwheel rigidity - masklike facies - pill - rolling tremor - and bradykinesia describe what form of dementia?

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31. What substrate is built up in Niemann - Pick disease?
Incidence rate
Intraductal papilloma
Sphingomyelin
Lesser curvature of the antrum of the stomach

32. Why is the apex of the lung hypoventilated when a person is standing upright?
Amiloride
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
Poststreptococcal GN
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.

33. What are the three surrogate criteria?

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34. What sphingolipid cannot be produced without sialic acid and amino sugars?
Creutzfeldt - Jakob disease
Ganglioside
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
Agglutination test

35. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Diencephalon
Mitochondria
Proencephalon
Adipose tissue
Gluteus maximus

36. What subset of CD4 helper T- cell function is helping the development of CD8 T cells?
All (nearly 15-20 times the normal risk)
a - Blockers (- zosins)
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
GnRH pulsatile infusion

37. What structure of a protein describes the interaction among subunits?
Quaternary structure
Orbitomedial frontal lobe
Spironolactone
Rigors - leukopenia - decrease in blood pressure - and increase in temperature

38. Name the muscle type based on the histological features: x Actin and myosin in sarcomeres; striated; multinuclear; lacks gap junctions; troponin:calcium binding; T tubules and SR forming triadic contacts; highest ATPase activity; no calcium channels
Skeletal muscle
Superior
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Posterior hypothalamic zones; lesions here result in poikilothermy (environmental control of one's body temperature).

39. What are the strongest determinants of gender identity?
Parental assignment and culture (not biology)
Adipose tissue
Hemiballismus
M- cells

40. Caf
Giant cell tumor of the bone
Measurement bias
Constriction of efferent arteriole
Neurofibromatosis

41. What AA has a pKa of 13?
CN X
Arginine
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.
Ribonucleotide reductase

42. Which integrin mediates the adhesion to endothelial cells for migration in and out of the blood during an immune response?
Risperidone
Beta2- integrins
A low - resistance system is formed by resistors added in parallel.
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).

43. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH ?
Arterioles have the largest drop - whereas the vena cava has the smallest pressure drop in systemic circulation.
Class 1 (1A - 1B - and 1C)
Primary hypogonadism (postmenopausal women)
Glucocorticoids and amphetamines

44. What artery is formed by the union of the two vertebral arteries?
1. Protest 2. Despair 3. Detachment
Hypospadia
The basilar artery is formed at the pontomedullary junction.
Chief cells

45. Results in vitamin B12 malabsorption.
Waldenstr
Pancreatic insufficiency
Cocaine
Ventral posterolateral nucleus

46. What is the rate - limiting step in the production of steroids?
Cefuroxime and cefaclor
The conversion of CHO to pregnenolone via the enzyme desmolase
Ischemia
Pseudomonas aeruginosa

47. What a1- agonist is used to treat paroxysmal atrial tachycardia with hypotension?
Metaraminol (a1 - Beta1 )
Missense
T9
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.

48. Is the carotid sinus sensitive to pressure or oxygen?

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49. What area of the brain is responsible for emotion - feeding - mating - attention - and memory?
Duodenal ulcer
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
The limbic system
Cytochrome a/a3

50. What nerve is associated with the following functions? - Innervation of the flexor carpi ulnaris - flexor digiti profundus (pinky and ring fingers) - and the intrinsic muscles of the hand
Northern blot
Ulnar nerve
Proline and lysine
Agoraphobia. It also means having a sense of humiliation or hopelessness.