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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 term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
Lateral medullary (Wallenberg's) syndrome
No change in length
The splenic vein
Porcelain gallbladder

2. Fixing impulses by acting out the opposite of an unacceptable behavior
Median nerve lesion
Rhinovirus
Superior and posterior
Undoing

3. Oxidation of Hgb forms what bodies in patients with G-6- PD deficiency?
Bladder cancer
During stage 3 and 4 (remember - it is called deep sleep.)
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
Heinz bodies

4. What subtype of IgG does not activate complement cascade?
Surface tension; in the alveoli - it is a force that acts to collapse the lung.
The primitive streak grows caudal to rostral.
IgG4
The liver (in the mitochondria)

5. What three cephalosporins inhibit vitamin K- dependent factors?
Uricosuric
Cefamandole - cefoperazone - and moxalactam
Valence
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.

6. What are the three functions of surfactant?
Vitamin E
Metaraminol (a1 - Beta1 )
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Clostridium perfringens

7. What are the three most common sites for left - sided heart embolisms to metastasize?
Brain - spleen - and kidney
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells
Thyroid hormones are necessary for conversion of carotene to vitamin A.
GLUT 3 and 4

8. What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
CD40 ligand
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.
LC4 - LD4 - and LE 4
Lateral fissure (fissure of Sylvius)

9. Depolarization of the postsynaptic membrane...
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.
excites the neuron
Sphingomyelinase
Two major or one major and two minor

10. What is the most common one? - Cardiac pathology in patients with SLE
Seminoma
Resistance increases as resistors are added to the circuit.
S2 - S3 - S4
Libman - Sacks endocarditis

11. What syndrome results if the enzyme ?-1- iduronidase is deficient? L- iduronate sulfatase deficiency?
Hurler syndrome and Hunter syndrome - respectively
Listeria monocytogenes
LH
Carbamazepine

12. Development of what T cell line follows low affinity for self - MHC class II Ags in the thymus?
Dilation of efferent arteriole
overall dopamine activity
Clonidine
CD4+T cells

13. Are the following responses associated with histamines H1 or H2 receptor activation? - Inotropic action and automaticity
Merkel cells (Merkel's tactile cells)
X- linked recessive
Glycine/arginine
H 2

14. Is Dubin - Johnson or Rotor syndrome associated with black pigmentation of the liver?
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Multiple myeloma
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
Corticosteroid

15. What is the most common one? - Acquired GI emergency of infancy
1. Protest 2. Despair 3. Detachment
Substance P. (Opioids relieve pain in part by blocking substance P.)
Metformin
Necrotizing enterocolitis

16. What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Volkmann's contracture
Nodes of Ranvier
Marrow failure - cancer - and leukemia

17. What enzyme of the TCA cycle catalyzes the production of the following: x NADH (hint: 3 enzymes)
Femoral hernias
Proton pump inhibitors
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase
>5 mm

18. What is the difference between a Ghon focus and a Ghon complex?
Sexual aversion disorder
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Type 2
Fungi

19. Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery?
DNA ligase
Propofol
Repression
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e. - pill rolling) is seen in basal ganglia lesions.

20. Which of the following
Multiple myeloma
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Primary Hemochromatosis
Erythema nodosum

21. What two monosaccharides are produced when lactose is hydrolyzed?
Galactose and glucose
The venae recta maintain the gradient via countercurrent flow.
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
Superior

22. What is the most common one? - Malignancy of the female genital tract
It causes a buildup of dATP - which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate - a precursor of DNA - resulting in overall bone marrow suppression.
Endometrial cancer
Dissociation
Granulosa/thecal cell tumor of the ovary

23. What are the pharmacologic effects seen sexually with x Beta- Blockers?
Breast cancer
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Impotence
MHC class II Ags. This is accomplished via CD4 T cells.

24. Name the antimicrobial agent whose major side effect is listed - Dental staining in children
Sensitivity (it deals with the sick)
The zygote divides mitotically; only germ cells divide meiotically.
Id (pleasure principle)
Tetracycline

25. What is the major hormone produced in the following areas of the adrenal cortex? - Zona fasciculata
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
Borderline
Picornaviridae

26. What CN is associated with the x Second pharyngeal arch?
CN VII
S phase
Melanoma
CMV retinitis and HSV-2

27. What enzyme produces an RNA primer in the 5'-3' direction and is essential to DNA replication because DNA polymerases are unable to synthesize DNA without an RNA primer?
DNA polymerase - a
HBcAb IgM
Ventral lateral nucleus
Primase

28. What wave is the cause of the following venous pulse deflections? - The bulging of the tricuspid valve into the right atrium
Since they are independent events - their probabilities would be multiplied.
Housemaid's knee
C wave
Melanoma - cancer of the stomach and bladder

29. What phase of the menstrual cycle is dominated by estrogen? Progesterone?
Mikulicz syndrome
Aspartic acid and glutamic acid
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Squamous cell carcinoma

30. What component of the inner ear x Contains endolymph and responds to head turning and movement?
Semicircular duct
Dilation of afferent arteriole
Streptococci
Actually - yes. You should encourage your patient to try other forms of medicine as long as they are not contraindicated with the patient's preexisting illness. You must be able to accept the health beliefs of your patients - even if you don't agree.

31. How does ventricular repolarization take place - base to apex or vice versa?
Superficial spreading melanoma
They innervate skeletal muscle.
Pergolide
Repolarization is from base to apex and from epicardium to endocardium.

32. Innervate the striated muscle of the bulbospongiosus and ischiocavernous muscles and result in ejaculation of semen.
For the USMLE Step 1 the answer is no - but if the information would do more harm than good - withhold. This is very rare but it does occur.
Somatic motor neurons
Parietal lobe
Cyanide

33. What complement factor or factors are associated with x Chemotaxis?
Testosterone
C5a
Passive - aggressive
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.

34. Which type of hepatitis is a picornavirus?
Hepatitis A (infectious)
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
HMG- CoA reductase
First - pass effect

35. Name the RNA subtype based on the following: x Only type of RNA that is translated
Mannitol
Schwannoma
The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated.
mRNA

36. If the ratio of a substance's filtrate and plasma concentrations are equal - What is that substance's affect on the kidney?
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
Pregnancy
Churg - Strauss syndrome
Doxacurium

37. Males are more likely to develop _______ than females.
Femoral hernias
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.
Intrapleural pressure decreases (becomes more negative).

38. What is the name of a thin brown ring around the outer edge of the cornea - seen in Wilson's disease?
Primary hypercortisolism
Proud flesh
Regular insulin
Kayser - Fleischer ring

39. What enzyme catalyzes the rate - limiting step in cholesterol metabolism?
4.7 L - 5% of body weight
M
HMG- CoA reductase
CD16 and CD56

40. What hormones are produced in the median eminence region of the hypothalamus and the posterior pituitary gland?
None; they are the storage sites for ADH and oxytocin.
extrapyramidal dysfunction
ASA (salicylate)
Cystic fibrosis

41. Name the most common type or cause - Hypoxia
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Ischemia
Area 22 and occasionally 39 and 40
CN V2

42. What region of the brain houses the central chemoreceptors responsible for control of ventilation?
Allopurinol
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Clostridium tetani
The surface of the medulla

43. What virus is associated with progressive multifocal leukoencephalopathy?
JC virus
Constrictor pupillae and ciliary muscles
Scrotal cancer - due to the high exposure to polycyclic aromatic hydrocarbons
F- Met - Peptides

44. In what rare AR disorder do you see neutropenia - defective degranulation - and delayed microbial killing due to a problem in chemotaxis and migration?
Ch
Ephedrine
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
Moderate (35-49)

45. Name the MCC - Pneumonia in an HIV- positive patient with CD4 less than 200
Spectinomycin
Biotin - ATP - and CO2
Pneumocystis carinii
Plasmodium falciparum

46. What scale assesses a rank order classification but does not tell the difference between the two groups?
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
2 ATPs - via the amino acyl tRNA synthase enzyme
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.
Ordinal scale (e.g. - faster/slower - taller/shorter)

47. What is the monoamine oxidase B (MAOB) inhibitor?
Selegiline
Osteoarthritis
Sporozoites
Yellow fever (flavivirus)

48. Which class of antiarrhythmics blocks sodium channels?
Waterhouse - Friderichsen syndrome
Para - aminohippurate (PAH)
Protease - integrase - and reverse transcriptase
Class 1 (1A - 1B - and 1C)

49. If the P value is less than or equal to .05 - What do you do to the null hypothesis?
Reject it
Rotavirus
AT II
T3 increases both heart rate and cardiac output by increasing the number of Beta - receptors and their sensitivity to catecholamines.

50. What cell membrane structure increases the surface area of a cell and has actin randomly assorted within its structure?
Plasma concentration and excretion rate
Patau syndrome (trisomy 13)
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.
Microvillus