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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 term when the brachial artery is compressed - resulting in ischemic contracture of the hand?

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2. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Percentage of original filtered volume left in the lumen
Jejunum (upper)
At the end of the PCT 25% of the original volume is left
Afterload
Free form determines hormone activity and is responsible for the negative feedback loop.

3. What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord?
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
1. ADP 2. PG 3. TXA2
The fasciculus cuneatus
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse - hyperreflexia - spastic paralysis - increased muscle tone - and weakness are commonly seen in UMN lesions.

4. Name the most common type or cause - Anovulation
Haemophilus influenzae type B
Dystrophic calcification
Kupffer cells
Polycystic ovaries

5. What segment of the nephron has the highest concentration of inulin? Lowest concentration of inulin?

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6. What nephrotic syndrome has effacement of the epithelial foot processes without immune complex deposition?
Proencephalon diencephalon derivative
PGD2 - PGE2 - and PGF 2
Hypnozoite
Minimal change disease

7. What IL down - regulates cell mediated immunity?
Thyroid hormones are necessary for conversion of carotene to vitamin A.
Short - chain fatty acids
Eosin
IL-10

8. Of what serotonin receptor is sumatriptan an agonist?
5HT1D
Empyema
Between the renal arteries and at the bifurcation of the abdominal aorta
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.

9. What form of the Plasmodium species are injected into humans by mosquitoes?
The placenta
Formal operations (> 12 years)
Sporozoites
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)

10. What papillae send their senses via chorda tympani of CN VII?
3 to 4 days
Fungiform papillae
NADPH and molecular O 2
Plasmodium vivax

11. What three organs participate in production of vitamin D?
1. Skin 2. Liver 3. Kidney
Gardner syndrome
RSV
Lysine and arginine

12. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol decreased - ACTH increased

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13. Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
Succinyl CoA synthetase
Dantrolene
ASD
Tip of the loop of Henle (1200 mOsm/L)

14. What is the most superficial layer of the epidermis?
IL-4 - IL-10 - and IL-13
Basal cell carcinoma
Stratum corneum (keratinized)
Muscle spindles

15. Name the most common reported STD - In males
Ipsilateral flaccid paralysis
Embolism
Gonorrhea
Osteoarthritis

16. At What three sites can the HMP shunt enter into glycolysis?
Limbic system
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
Bronchogenic carcinoma

17. What three structures increase the surface area of the GI tract?
Amyloidosis
Outside the cell
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
HBeAb

18. The surge of what hormone induces ovulation?
PKU
Parvovirus B-19
Viral meningitis
LH

19. What restriction endonuclease site is destroyed in sickle Beta- globin allele?
Hemangioblastoma
Arnold - Chiari malformation type 2
MstII; changing codon 6 (from A to T) destroys the restriction site.
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.

20. What is the function of white rami communicantes?
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.
Superior and posterior
They are preganglionic sympathetic axons. They are white because they are myelinated.
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)

21. What cytoplasmic organelle carries the enzymes for elongation and desaturation of fatty acyl CoA?
Proencephalon
SER
IgA nephropathy
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.

22. Name the antimicrobial agent whose major side effect is listed - Auditory toxicity
ATP/ADP Translocase
Vancomycin
Anemia
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.

23. What hormone - stimulated by epinephrine - results in an increase in lipolysis?
Axon hillock
Succinyl CoA synthetase
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
prior to birthThe foramen ovale closes just...

24. What X- linked recessive disorder is characterized by hyperuricemia - spastic cerebral palsy - mental retardation - and self - mutilation?
Lesch - Nyhan syndrome
Chylomicrons
M
Intraductal papilloma

25. Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
SSRIs
Phase 4
HTLV-1
Gout

26. Deficiencies In what enzyme result in insoluble glycogen synthesis formation?
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Secondary hypocortisolism (pituitary)
Graves disease
a -1 - 6 transferase

27. What is the rate - limiting step in a conduction of a NMJ?
Renshaw neuron
Lymph nodes
Hemiballismus
The time it takes ACh to diffuse to the postjunctional membrane

28. How do elevated blood glucose levels decrease GH secretion? (Hint: what inhibitory hypothalamic hormone is stimulated by IGF-1?)
Iodine (I)
Erectile dysfunction
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.
ASA

29. What is the name of the program that deals with codependency and enabling behaviors for family members of alcohol abusers?
Clozapine
ACTH
Creutzfeldt - Jakob disease
Al - Anon

30. What lysosomal enzyme is deficient in x Niemann - Pick disease?
Areas 1 - 2 - and 3
The affinity of the drug for its receptor
CD19
Sphingomyelinase

31. Which thalamic nucleus receives auditory input from the inferior colliculus?
refuse
MGB
hCG
Gastric carcinoma

32. What is the only pharyngeal muscle not innervated by CN X?
Staphylococcus saprophyticus
Atropine - 2- PAM (pralidoxime)
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
Akathisia

33. What nematode is known as threadworms? What is the treatment?
Strongyloides stercoralis is treated with thiabendazole.
Postductal coarctation of the aorta (adult)
Medial rectus (CN III) (LR6 SO4)3
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.

34. If you double the infusion rate of a drug - how long will it take to reach steady state?
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Tetracycline
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
enveloped

35. What cells of the epidermis - derived from the neural crest - act as mechanoreceptors?

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36. What type of chromatin is transcriptionally inactive?
ACE inhibitors (- pril)
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
Chordae tendineae
Pedophilia

37. What lower extremity nerve is described by the following motor loss? - Loss of knee extension - weakened hip flexion
Coronary circulation
Palms - up before palms - down maneuvers
Femoral nerve
Hepatitis E (enteric)

38. What bursa is inflamed in clergyman's knee?
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Acetyl CoA (pyruvate to acetyl CoA)
Infrapatellar bursa
A high - resistance system is formed when resistors are added in a series.

39. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Personality and mental disorders?
Membranous glomerulonephritis
Orbitomedial frontal lobe
Axis II
5HT1D

40. What is the term for an inhibitory interneuron?
Axon hillock
Renshaw neuron
Thiazide diuretics
Carcinoid tumor

41. What enzyme is inhibited by disulfiram?
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
IL-8 (IL-1 and TNF- gamma also)
Increased androgen secretion at puberty drives the increased GH secretion.
Leydig cell tumor

42. What chromosome is autism linked to?
Cerebral aqueduct
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
Chromosome 15
Total lung capacity (TLC)

43. The vertebral artery is a branch of What artery?
Middle
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.
Clear cell
The subclavian artery

44. What embryonic structure forms the adult female structures? - Labia minora
Cell - mediated immunity
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
Urogenital folds
Increase enzyme concentrations

45. What is the PO2 of aortic blood in fetal circulation?
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.
60%
Pedophilia
Inactivated

46. What connects the third and the fourth ventricles?
Cerebral aqueduct
Haemophilus influenzae type B
Iodine - resulting in congenital hypothyroidism
Acetyl CoA - FADH2 - and NADH

47. What lower extremity nerve is described by the following motor loss? - Loss of eversion; inversion - dorsiflexion - and plantarflexion of the foot
Common peroneal nerve
Duodenum
Lipoid nephrosis
Kidney

48. Name the lipoprotein based on the following characteristics - apo A-1 - apo E - apo C- II
Negative
Helicase (requires ATP for energy)
HDL
Metformin

49. Name the form of spina bifida - An open neural tube lying on the surface of the back
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Listeria monocytogenes
Phenytoin

50. What is the most common organ involved in amyloidosis?
Kidney
Hepatitis A
Common and internal carotid arteries
Alanine cycle

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USMLE Step 1 Prep

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