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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 are the five effects of insulin on fat metabolism?
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
Autosomal recessive
Renal plasma flow (decrease flow - increase FF)
Marrow failure - cancer - and leukemia

2. A 20-year - old woman who was recently diagnosed with a sexually transmitted disease goes to the ER with a tender - painful - swollen - and erythematous knee (monoarticular). What organism is the likely culprit?
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
Ulnar nerve
Hypervariable region
Janeway lesions

3. What is the most common one? - Type of melanoma
Superficial spreading melanoma
Brushfield spots
Major
Constipation and miosis

4. What are the three glycogenic organs?
NADPH and molecular O 2
Opsonization
Liver - kidney - and GI epithelium
Apneustic center (deep breathing place)

5. What cell of the duodenum contains high concentrations of lysozymes and has phagocytic activity?
Chromosome 20q (deficiency in adenosine deaminase)
Streptomycin
Paneth cells
Alzheimer disease

6. Is a marker for increased bone formation.
MstII; changing codon 6 (from A to T) destroys the restriction site.
Bacillus anthracis
An elevated serum osteocalcin level
Motilin

7. Calf pseudohypertrophy
Anterior spinal artery
Duchenne muscular dystrophy
Id (pleasure principle)
UMP

8. What IL is essential for lymphoid cell development?
Moving objects - along with large bright objects with curves and complex designs.
IL-7 (A 7 upside down is an L; L is for Lymphoid)
Astrocytes
Alkaline phosphatase

9. Which organism releases endotoxins prior to cell death?
overall dopamine activity
Dystrophic calcification
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.
Neisseria meningitidis

10. Corticotropin - releasing hormone promotes the synthesis and release of what prohormone?
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
1. Skin 2. Liver 3. Kidney
Permanent
Subarachnoid hematoma

11. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ increased - Pi decreased
Global aphasia
High - frequency sound waves
Primary hyperparathyroidism
Hepatitis E

12. What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue?
Metastatic calcification
Hashimoto thyroiditis
S phase
Left coronary artery

13. What drug is an M1- specific antispasmodic?
Hypoxia
Acute rejection
C1 inhibitor (C1- INH)
Pirenzepine

14. In what stage of sleep is it easiest to arouse a sleeping individual?
Fluconazole
Public speaking (Remember: stage fright)
The myotatic reflex is responsible for the tension present in all resting muscle.
During REM sleep

15. What nucleus - found in the intermediate zone of the spinal cord - sends unconscious proprioception to the cerebellum?

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16. What is the most common one? - Renal calculus type
Primary follicle (in the white pulp)
Fibrocystic change of the breast
G0 phase
Calcium oxylate

17. Which subset of MEN syndrome is associated with the following? - Medullary carcinoma of the thyroid - pheochromocytoma - and mucocutaneous neuromas
MEN III (or IIb)
Hypoactive sexual desire disorder
NE
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.

18. With what stage of sleep are bruxisms associated?
1 day prior to ovulation
Riboflavin (B2) deficiency
Teeth grinding is associated with stage 2 sleep.
Middle meningeal artery

19. What are the three branches of the inferior mesenteric artery?
Kawasaki disease
Squamous cell carcinoma
Swan - neck deformities
Left colic - superior rectal - and sigmoidal arteries

20. Name the bony articulations of the following sites. Be specific - Shoulder
Salpingitis
Clavicle - acromion - and glenoid fossa of the scapula and the humerus
Acetyl CoA (pyruvate to acetyl CoA)
Deficiency in surfactant

21. All Proteus species are...
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Multiple sclerosis
Labile
urease positive

22. Which medication requires an acidic gastric pH for activation to form a protective gel - like coating over ulcers and GI epithelium?
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
Sucralfate
Fibrocystic change of the breast
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.

23. What mineral is required for cross - linking of collagen molecules into fibrils?
Chi - square (when you are in doubt and have nominal data - use chi - square)
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Water soluble

24. What branch off the vertebral artery supplies x The ventrolateral two - thirds of the cervical spinal cord and the ventrolateral part of the medulla?
White muscle; short term too
Anterior spinal artery
Kawasaki disease
H2PO4- (dihydrogen phosphate)

25. What is secretin's pancreatic action?
Squamous cell carcinoma
Rhombencephalon
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.
V wave

26. What disease is X- linked recessive - is associated with eczema thrombocytopenia and an increased chance of developing recurrent infections - involves a decrease in serum IgM and in the T cell - dependent paracortical areas of the lymph nodes - and m
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
Wiskott - Aldrich syndrome
Phosphofructokinase -1 and costs 1 ATP
G2 phase (gap 2)

27. What is the term for new made - up words?

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28. Which integrin mediates adhesion by binding to lymphocyte function - associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors?
8 to 25 hours
REM
Ultraviolet B (UVB) sunlight
Intercellular adhesion molecule (ICAM) 1

29. What disease involves microcephaly - mental retardation - cleft lip or palate - and dextrocardia?
The lung will expand; also the opposite is true.
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Patau syndrome (trisomy 13)
Residual volume (RV)

30. What are the three most common sites for left - sided heart embolisms to metastasize?
PGI 2
Macrophages
Brain - spleen - and kidney
Melanocytes

31. What is the term for nonneoplastic abnormal proliferation of cell size - shape - and cellular organization?
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)
Voltage - gated sodium channel
Dysplasia
gamma and delta chains

32. What is the MCC of the following meningitides? - In those 12 months to 6 years of age
Adenosine deaminase (ADA) deficiency
Stapedius muscle
Erythema marginatum
Haemophilus influenzae type B

33. What right - to - left shunt occurs when only one vessel receives blood from both the right and left ventricles?
Diethylcarbamazine
The lateral vestibular nucleus
Carbamazepine
Persistent truncus arteriosus

34. Name the eukaryotic RNA polymerase based on the following: x Synthesizes hnRNA - mRNA - and snRNA
Berry aneurysm in the circle of Willis
RNA polymerase II
Visceral pleura
Secondary hypoparathyroidism (vitamin D toxicity)

35. What happens to dopamine levels when we awaken?
Viral meningitis
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Giant cell bone tumor (osteoclastoma)

36. What is used as an index for both adrenal and testicular androgens?
Chronic rejection
Goodpasture disease
Chylomicrons
Urinary 17- ketosteroids

37. What variant of polyarteritis nodosa is associated with bronchial asthma - granulomas - and eosinophilia?
Churg - Strauss syndrome
Average
Pelvic splanchnics (They all begin with P.)
Class III

38. What operant conditioning therapy or modification is described as x Stopping the reinforcement that is leading to an undesired behavior?
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Extinction
The alveolar PO2 and PCO2 levels

39. Abs to what hepatitis B Ag provide immunity?
Abs to HBsAg
Labioscrotal swelling
Areas 1 - 2 - and 3
Sacrococcygeal teratoma

40. What organelle is responsible for ribosomal RNA synthesis?
Simon focus
Middle meningeal artery
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
Deferoxamine - penicillamine

41. What is the term for the negative resting membrane potential becoming more negative?
Ganglioside
TB meningitis
Hyperpolarization (i.e. - K+ influx)
Total ventilation (minute ventilation or minute volume)

42. What happens to the following during skeletal muscle contraction? - Actin and myosin lengths
Legionella
Flutamide
Osteitis fibrosa cystica (von Recklinghausen disease)
No change in length

43. What artery turns into the dorsalis pedis when it crosses the extensor retinaculum?
12 days after ovulation
Anterior tibial artery
No change in length
Superior and posterior

44. Which genus of dermatophytes is associated with the following sites of infection? - Nails and skin only
Pneumocystis carinii
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
Introjection (a sports fan is a good example)
Epidermophyton

45. Objective tests that base the result of the examination on a preset standard use what form of reference?
Mees lines
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
ASA
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+

46. Testing of a drug in a small group of volunteers without the disease is a component of which phase of clinical drug testing?
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Phase 1
Ventral anterior nucleus
Glucose -6- phosphatase

47. What is the rule of one - third regarding muscle type of the esophagus?
unprocessed Ags
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
Erythema multiforme

48. Dopamine antagonists are...
CD21; it is a complement receptor for cleaved C3
Serotonin
antiemetic
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.

49. What scale has a true zero point - graded into equal increments - and also orders them?
Th2 cells
Succinyl CoA synthetase
Masochism
Ratio scale

50. What is the rate - limiting step of the following? - Fatty acid synthesis
Acetyl CoA carboxylase
Streptokinase
Physostigmine
Chromosome 15 - 17