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

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2. What immunologic test checks for a reaction between Abs and a particular Ag? (hint: ABO typing)
Histidine
Excess estradiol in the blood
Agglutination test
Metaphase II

3. Which M- protein strain of Streptococcus pyogenes is associated with acute glomerulonephritis?
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.
NREM sleep. Night terrors are dreams that we are unable to recall.
Massive influx of calcium
M12 strains

4. Which phenotype of osteogenesis imperfecta is incompatible with life?
Four high energy bonds - two from ATP in AA activation and two from GTP
Type II
Phenytoin
IL-5. It also stimulates eosinophil proliferation.

5. What is the relationship between ventilation and PCO2 levels?
1. ADP 2. PG 3. TXA2
HMG CoA synthase
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
Cocaine - induced coronary ischemia

6. Name the eukaryotic DNA polymerase based on the following information: x Replicates mitochondrial DNA
Medial rectus (CN III) (LR6 SO4)3
DNA polymerase -?
ASA
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------

7. What enzyme is deficient in hereditary protoporphyria?
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.
Ferrochelatase
Osteosarcoma
The Fc region of IgG and C3b

8. Name the antidote - Atropine
Nocardia asteroides
Physostigmine
ACE inhibitors (the - pril agents)
Sheehan syndrome

9. Name the most common type or cause - Liver transplantation in adults
urease positive
HPV serotypes 6 and 11
Alcoholic cirrhosis
Alveolar macrophages

10. Name the MCC - Pneumonia in a neutropenic burn patient
Correlation. No - correlation does not imply causation.
Impotence
Cancer
Pseudomonas sp.

11. A patient with a history of epilepsy goes to the ER with sedation - gait ataxia - diplopia - and vertical nystagmus. Which anticonvulsant overdose resulted in the patient's symptoms?
Phenytoin
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
Epinephrine
Budd - Chiari syndrome

12. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Epidermis
On the superior body of the posterior wall of the uterus
Bronchial asthma (eosinophil membranes)
Amphotericin B
Labile

13. What cell converts androgens to estrogens?
Variola (smallpox)
Granulosa cell
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol

14. Which is the conditioned response - the conditioned stimulus - the unconditioned response - the unconditioned stimulus in this case? A patient has blood withdrawn and faints. The next time she goes to have blood taken - she faints at the sight of the
Physiologic antagonism
Primary hypoparathyroidism
Meclizine
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting). The needle is part of the blood - drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in th

15. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Dorsal root?
Repolarization is from base to apex and from epicardium to endocardium.
gag gene
Pia mater
Sensory

16. What determines the overall force generated by the ventricular muscle during systole?
Lead
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels
Clavicle - acromion - and glenoid fossa of the scapula and the humerus

17. What obligate extracellular fungus is silver stain - positive and is associated with pneumonia in patients with AIDS?
Akathisia
Prader - Willi syndrome and Angelman syndrome - respectively
Achondroplasia
Pneumocystis carinii

18. What mixed a - antagonists are used for patients with pheochromocytoma?
Phentolamine and phenoxybenzamine
The energy of activation
C wave
Pyelonephritis

19. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Weeks to months after transplantation; abrupt onset of oliguria and azotemia; seen as neutrophilic vasculitis and interstitial lymphocytes
Toxoplasma gondii
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
Homocysteine methyl transferase and methylmalonyl CoA transferase
Acute rejection

20. What disease is seen in children younger than 5 years of age and is characterized by X- linked recessive cardiac myopathies - calf pseudohypertrophy - lordosis - protuberant belly - an increase then a decrease in CPK - and death commonly in the secon
PCT
Duchenne muscular dystrophy
Clavicle - acromion - and glenoid fossa of the scapula and the humerus
Antigenic determinant (epitope)

21. Name the eukaryotic RNA polymerase based on the following: x Synthesizes 28S - 18S and 5.8S rRNAs
Plasmodium falciparum
Candida
H 2
RNA polymerase I

22. What are the three rules governing a secondary immune response?
Middle
1. Covalent bonding between the hapten and carrier 2. B- cell exposure to hapten twice 3. T- cell exposure to carrier twice
Crohn disease
Convergence

23. What class of drugs is used in the treatment of demineralization of the bone?
Bisphosphonates
Heinz bodies
Isoleucine - leucine - and valine
Beta2- Adrenergic agents

24. There is an inverse relationship between fat content and...
Aortic insufficiency
total body water
Yersinia pestis
Decreases

25. What is the most likely causative organism for a patient with folliculitis after spending time in a hot tub?
Trimethoprim/sulfamethoxazole (TMP- SMX)
Pseudomonas aeruginosa
Gastric carcinoma
Granulosa cell

26. Why will turbulence first appear in the aorta in patients with anemia?
Action potential
Clofazimine
Because it is the largest vessel and has the highest velocity in systemic circulation
Paramyxovirus

27. Is used to detect Abs in a patient?
CN IX
Kl
Ferritin
Direct fluorescent Ab test

28. What endotoxin receptor is the best marker for macrophages?
CD14
Beta- Galactosidase
Glucocorticoids and amphetamines
Candida

29. What is the first sign of megaloblastic anemia on a peripheral blood smear?
Urinary 17- OH steroids
Fibrocystic change of the breast
pK (think of it as where half is base and half is acid)
Hypersegmented neutrophils

30. Where is the action potential generated on a neuron?
Acetazolamide
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
Group A Beta- hemolytic streptococci
Axon hillock

31. What complex of the ETC contains Cu2+?
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
Xenograft
Complex 4
T cells - not B cells

32. What parasitic infection is associated with cholangiocarcinoma?
Clonorchis sinensis
Vesicle (e.g. - poison ivy)
almitate
Stage 4

33. What embryonic structure forms the adult male structure? - Corpus cavernosus - corpus spongiosum - and glans and body of the penis
SSRIs
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
Phallus
Erythema nodosum

34. Name the type of mutation: x New codon specifies for the same AA
Silent
Hepatitis B
Langerhans cells
Hydroxyproline

35. What variant of polyarteritis nodosa is associated with bronchial asthma - granulomas - and eosinophilia?
Churg - Strauss syndrome
tRNA
The conus medullaris terminates at the level of the second lumbar vertebra.
Clozapine

36. What are the five effects of insulin on fat metabolism?
Serratus anterior
Pedophilia
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
Urogenital folds

37. Name the antimicrobial agent whose major side effect is listed - Cartilage abnormalities
Quinolones
Ovarian cancer
Autograft
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.

38. What enzyme catalyzes the rate - limiting step in fatty acid oxidation?
Nystagmus and ataxia
Carnitine acyltransferase - I
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs - TCADs - dextromethorphan - and meperidine. Treat it with cyproheptadine.
>5 mm

39. What area of the hypothalamus is the feeding center?
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
Alzheimer disease

40. Name the most common type or cause - Breast lump in females
Pernicious anemia
Fibrocystic change of the breast
JC virus
Negative

41. What toxin - produced by Clostridium tetani - binds to ganglioside receptors and blocks the release of glycine and GABA at the spinal synapse?
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
Tetanospasmin (also called tetanus toxin)
Zero - order elimination
Pseudomonas aeruginosa

42. What direct - pathway basal ganglia disease is described by masklike facies - stooped posture - cogwheel rigidity - pill - rolling tremor at rest - and a gait characterized by shuffling and chasing the center of gravity?

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43. At what vertebral level does the trachea bifurcate?
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
5HT1D
Renin
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.

44. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Spinal nerve?
Both
Anterior wall of the first part of the duodenum
Being single
Secondary lysosome (think of the primary as inactive and secondary as active)

45. What fungus is characterized by hypopigmented spots on the thorax - spaghetti - and - meatball KOH staining - and pityriasis or tinea versicolor?
PGE2
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
Malassezia furfur (treat with selenium sulfide)
Superior gluteal nerve

46. What lymphoma is associated with bleeding and cryoglobulin precipitation at low temperatures - headache and confusion due to hyperviscosity - IgM M- protein spike on serum electrophoresis - and Russell bodies?
Molluscum contagiosum
Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance - taking longer to reach threshold and slowing the rate of firing.
Waldenstr
Subarachnoid hemorrhage

47. Name the valve abnormality based on the following criteria: x Back - filling into the left atrium during systole; increased v - wave - preload - left atrial volume - and left ventricular filling
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Factors II - VII - IX - and X and proteins C and S.
Mitral insufficiency
Pneumocystis carinii

48. Has proteolytic metabolic effects.
Increased androgen secretion at puberty drives the increased GH secretion.
Vibrio parahaemolyticus
Epinephrine
overall dopamine activity

49. Name the lipoprotein based on the following characteristics - apo A-1 - apo E - apo C- II
HDL
Tolcapone and entacapone
Posterior compartment of the leg - tibial nerve
Zanamivir and oseltamivir

50. What are the four functions of SER?
Placental alkaline phosphatase
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
Areas 5 and 7
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling