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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. In what organelle does the TCA cycle occur?
Mitochondria
Wernicke's aphasia
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.
Glutamine

2. What disorder is due to a deficiency in tyrosinase?
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
Albinism
Labile

3. What is the drug of choice for steroid - induced osteoporosis?
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
Superior gluteal nerve
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
Alendronate

4. What two Ags must be positive for a patient to have chronic active hepatitis?
Left atrium
Validity (remember - reliability is necessary but not the only thing needed for validity)
HBsAg and HBeAg
Euchromatin - the dark stuff in the nucleus on an electron microscope image.

5. What cestode causes cysticercosis?
Vibrio vulnificus
Selegiline
Graves disease
Taenia solium

6. What pathology involves excessive fibrosis throughout the body via increased fibroblast activity - occurs in women more than men - and is most commonly seen in the third to the fifth decade?
Metaphase II
Scleroderma
100% - with about 20% remaining positive after 1 year
Vibrio parahaemolyticus

7. What disorder causes joint stiffness that worsens with repetitive motion - crepitus - effusions - and swelling and commonly affects the knees - hips - and spine?
Common and internal carotid arteries
Edinger - Westphal nucleus (via CN III)
Premature ejaculation
Osteoarthritis

8. What is the size of a positive PPD test for the following? (Reactive) x Recent immigrant from India
Anxiety disorders; for men it is substance abuse.
Indirect pathway (Tourette syndrome for example)
Parvovirus (it is the only ssDNA virus)
>10 mm

9. What happens to the tonicity of the urine with increased ADH secretion?
Hypercortisolism (Cushing syndrome)
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Borderline
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)

10. What syndrome is associated with the following brainstem lesions? - Contralateral corticospinal and medial lemniscus tract deficits and an ipsilatera medial strabismus secondary to a lesion in CN VI
Transketolase and transaldolase. The reactions they catalyze are reversible.
Medial pontine syndrome
Microglial cells
It is produced by the preload on the muscle prior to contraction.

11. What is the primary predisposing factor for vascular dementia?
The fastigial nucleus
Hypertension
C5a
P24

12. With which CN are preganglionic parasympathetic axons arising from the Edinger - Westphal nucleus associated?
CN III
Trypsin
Effective dose for 50% of drug takers (median effective dose)
Obsessive - compulsive

13. What three muscles constitute the erector spinae?

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14. What is the most common one? - Location of ependymomas in children
Cortisol levels increase. Lymphocyte levels decrease in sleep - deprived individuals.
Obese patients
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Ventral anterior nucleus

15. What linkage of complex CHOs does pancreatic amylase hydrolyze? What three complexes are formed?
Increased erection and libido
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.
Nasopharynx

16. What is the effect of T3 on heart rate and cardiac output?
T3 increases both heart rate and cardiac output by increasing the number of Beta - receptors and their sensitivity to catecholamines.
DNA ligase
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
At birth (reflex)

17. What are the three main components of amyloid?
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
The respiratory system
Interferons
Homocysteine methyl transferase

18. Name the associated chromosome - Neurofibromatosis type 1
ACE inhibitors (the - pril agents)
Chromosome 17
Cricothyroid muscles
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.

19. What IV- only agent inhibits water reabsorption in the PCTs and is used to treat increased intracranial pressure - increased intraocular pressure - and acute renal failure?
Persistent truncus arteriosus
Oblique fissure
Paramyxovirus
Mannitol

20. What area of the lymph node contains germinal centers?
Proportionate mortality rate
Endometriosis
Hormone - sensitive lipase
The outer cortex contains most of the germinal centers and therefore also most B cells.

21. Which class of antiarrhythmics blocks sodium channels?
IL-8 (IL-1 and TNF- gamma also)
Escherichia coli and Pseudomonas sp.
Niacin (B3)
Class 1 (1A - 1B - and 1C)

22. What is the name of the process in which cells migrate toward an attractant along a concentration gradient?
N- Acetylcysteine
Chemotaxis
Fibroadenoma
Coronary circulation

23. Is the hydrophobic or hydrophilic end of the phospholipids of the cell membrane facing the aqueous environment?
Infection
Paranoid
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.

24. What nerves provide sensory innervation above the vocal cords? Below the vocal cords?
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
Dystrophic calcification
Mercury
ATP/ADP Translocase

25. What vessels carry deoxygenated blood into the lungs from the right ventricle?
Myelofibrosis with myeloid metaplasia
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
Propionibacterium acnes

26. On the venous pressure curve - What do the following waves represent? - C wave?
Lithium
Ventricular contraction Atrial - Contraction - Venous
Aldolase B deficiencies are treated by eliminating fructose from the diet.
MHC class I antigens; they are also found on the surface of platelets.

27. Is splenomegaly more commonly associated with intravascular or extravascular hemolysis?
Chromosome 14 - 18
Propofol
Left coronary artery
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.

28. Are the following conditions associated with a negative or positive nitrogen balance? - Kwashiorkor
H 1
Vibrio parahaemolyticus
Negative
2 ATPs - via the amino acyl tRNA synthase enzyme

29. What hormone is characterized by the following renal effects? - Calcium excretion - phosphate excretion
Hgb F
Rotavirus
Calcitriol
Gout

30. Where are the LMN cell bodies of the corticospinal tract?
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.
Acetaldehyde dehydrogenase
CD4
well - fed and fasting

31. What facultative intracellular fungus is associated with hepatosplenomegaly?
The increased H+ moves intracellularly and is buffered by K+ leaving the cells - resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis - even though the serum
Imipenem and meropenem
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Prader - Willi syndrome and Angelman syndrome - respectively

32. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Asbestos
<2
Clearance
The conus medullaris terminates at the level of the second lumbar vertebra.
Mesothelioma and bronchogenic carcinoma

33. Which region of the variable domain comprises the Ag - binding site of the Ab?
Proencephalon
Psoriasis
Hypervariable region (three per light chain; three per heavy chain)
SITS

34. Name the antidote - Warfarin
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
Leiomyoma
Vitamin K
Squamous cell carcinoma (skin - lung) and angiosarcoma of the liver

35. How many carbons do androgens have?
Berger disease (IgA nephropathy)
Androgens are 19- carbon steroids.
Null hypothesis (what you hope to disprove)
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.

36. If a patient with a cerebellar lesion has nystagmus - which way is the fast component directed - toward or away from the lesion?
Reverse transcriptase
The fast component is directed toward the affected side of a cerebellar lesion.
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.
Plasmodium falciparum

37. What is the name of the T cell - rich area of the lymph node?
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.
Hepatitis B
Chlamydia
Paracortex

38. What is the term for the difference between systolic and diastolic pressures?
Rhombencephalon
Pulse pressure
Hepatitis C
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns

39. What are the three C's of a TCAD overdose?
Pott disease
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament
Coma - convulsions - and cardiotoxicity
Treacher Collins syndrome

40. What two ligaments of the uterus are remnants of the gubernaculum?
Methanol
Zero - order elimination
Proencephalon
Round and ovarian ligaments

41. Name the type of graft described by these transplants: x From one person to the next (the same species)
Dominant temporal lobe
Allograft
Erythromycin
RNA polymerase III

42. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Ventral rami?
Simple diffusion; it does not use protein - mediated transport
relaxation
Both
Osler nodes

43. Which class of antiarrhythmics are Beta- blockers?
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)
Neisseria meningitidis
Adenocarcinoma (30% to 35%)
Class II

44. What picornavirus is associated with hand - foot - and - mouth disease?
Naloxone - naltrexone
Coxsackie A
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Separation anxiety

45. A 20-year - old college student has fever - grey- white membranes over the tonsils - posterior auricular lymphadenitis - and hepatosplenomegaly. What is your diagnosis? What test do you order to confirm your diagnosis?
Autograft
Polycystic kidney disease of childhood
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.)
Plasma cell

46. What is the term for the potential difference across a cell membrane?
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Transmembrane potential (an absolute number)
Ewing sarcoma
Hirschsprung disease

47. Are the following responses associated with histamines H1 or H2 receptor activation? - Inotropic action and automaticity
Ligamentum arteriosum
Serous exudates
H 2
Sphingomyelin

48. What pituitary hormone is inhibited during sleep?
Adhesions and hernias
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
HIV and poxvirus

49. What is the term for the difference between the highest and the lowest score in a population?
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
Onset of bleeding
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Range

50. What three factors do Sertoli cells produce for normal male development?
Hemangioblastoma
Inhibin - m
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Since they are independent events - their probabilities would be multiplied.