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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 antiviral agent is used to treat RSV - influenza A and B - Lassa fever - and hantavirus and as an adjunct to IFN- in hepatitis C?
Ribavirin
Anterior hypothalamic zone; lesions here result in hyperthermia.
Intellectualization
Recall bias. These problems arise in retrospective studies.

2. What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls?
Rhinovirus and hepatitis A virus
Parasympathetic
Bronchioloalveolar carcinoma
Head of the pancreas

3. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH
IgG4
apo A-1
Pregnancy
Pituitary hypogonadism

4. What disorder - experienced more than half of the time for a 6- month period - is described as being fearful - worrisome - or impatient and having sleep disturbances - poor concentration - hyperactivity - and an overall sense of autonomic hyperactivi
The primitive streak grows caudal to rostral.
Neurofibromatosis
Generalized anxiety disorder
Medulla blastoma

5. What is the DOC for bipolar disorder?
1 day prior to ovulation
Internal iliac nodes
Selection bias
Lithium

6. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x sis
Astrocytoma
Empyema
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
Ischemic heart disease (MIs)

7. What enzyme of the purine salvage pathway is deficient in the following? - Lesch - Nyhan syndrome
HGPRT
Misoprostol
CD3
Ventromedial nucleus; lesions here result in obesity.

8. What are the three effects of insulin on protein metabolism?
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Cancer
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
Plasma cell

9. Which a - blocking agent is used to treat refractory hypertension and baldness?
At 8 to 9 years of age. Prior to this age they view death as a form of punishment.
DNA polymerase -?
Sarcoidosis
Minoxidil (orally and topically - respectively!)

10. What is the central issue regarding the Roe vs. Wade decision (legalization of abortion)?
Negative selection. This helps to prevent autoimmune diseases.
Homeodomain proteins
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.
Lethal dose for 50% of drug takers (median lethal dose)

11. What form of depression is due to abnormal metabolism of melatonin?
During stage 3 and 4 (remember - it is called deep sleep.)
Granulosa/thecal cell tumor of the ovary
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Seasonal affective disorder (treat with bright light therapy)

12. What is the most common one? - Neurotransmitter in the brain
Primary hypocortisolism (Addison's disease)
Cortisol levels increase. Lymphocyte levels decrease in sleep - deprived individuals.
GABA - quantitatively
CN V2

13. Which of the following
Emphysematous bleb
Ampicillin and amoxicillin
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.

14. Preeclampsia in the first trimester - hCG levels above 100 - 00 mIU/mL - and an enlarged bleeding uterus are clinical signs of what?
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid
Vital capacity (VC)
Hydatidiform mole
Edrophonium

15. What molecule that is needed to trigger T cell activation is noncovalently linked to TCR?
Public speaking (Remember: stage fright)
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
Vibrio cholera
Since they are independent events - their probabilities would be multiplied.

16. What part of a neuron receives information?
PGE 1 - PGI 2 (most potent) - and TXA 2
Bunyavirus
Glucose -6- phosphatase
Dendrites receive information - whereas axons send information.

17. What diseases are associated with the HLA- DR3 allele

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18. What two CD cell surface markers do Reed - Sternberg cells stain positive for?
Chromomycosis
Kimmelstiel - Wilson disease
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
CD15 and CD30

19. Active protein transport requires a...
Ungated potassium channel
Concentration gradient
Chromosome 11p
Hyperpolarization (i.e. - K+ influx)

20. What are two causes of diffusion impairment in the lungs?
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
Rhombencephalon
Osteitis fibrosa cystica (von Recklinghausen disease)
HBcAb IgG - HBV- DNA - HBeAg - HBsAg

21. What are the four muscles of mastication?
RSV
Expressive aphasia
Systemic lupus erythematosus
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid

22. What are the three components to the asthma triad?
Major
Buffers (remember that buffers are best when they are used in a pH range near its pK)
Mitochondria
Nasal polyps - rhinitis - and aspirin hypersensitivity

23. What generate anterograde transport of information in a neuron?
Kinesins. Dynein generates retrograde transportation of information.
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.
Erythema marginatum
2 days prior to ovulation

24. What type of collagen is associated with keloid formation?
Type III
Herpes I
Psammoma bodies
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma

25. What disorder is characterized by autoantibodies to IF?
Exposure
The first trimester
Uroporphyrinogen I synthetase
Pernicious anemia

26. What is the most superficial layer of the epidermis?
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Stratum corneum (keratinized)
Mycoplasma pneumoniae

27. What vertebral level is marked by the xiphoid process?
G0 phase
T9
Expiratory reserve volume (ERV)
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells

28. What is the only 17- hydroxysteroid with hormonal activity?
Rotavirus
Cortisol - a 21- carbon steroid - has a - OH group at position 17.
In the JG cells of the kidney
Tyrosine

29. If one event precludes another event - their probabilities are combined By what method?
Calcarine sulcus
Addition (They are mutually exclusive.)
Alveolar macrophages (dust cells)
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A

30. Which group of antihypertensive agents best decreases left ventricular hypertrophy?
Pompe's disease
Mitral valve prolapse
Ultraviolet B (UVB) sunlight
Thiazide diuretics

31. Should you refer a patient to a form of folk medicine even if you don't believe in it?

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32. What myeloid disorder is characterized by dry bone marrow aspirations - splenomegaly - leukoerythroblastosis - teardrop RBCs - and hyperuricemia due to increased cell turnover?
Internal carotid artery
1. Sleep paralysis 2. Hypnagogic hallucinations (while falling asleep) 3. Sleep attacks with excessive daytime sleepiness 4. Cataplexy (pathognomonic) Narcolepsy is a disorder of REM sleep - with REM occurring within 10 minutes of sleep.
Magnesium ammonium phosphate (struvite)
Myelofibrosis with myeloid metaplasia

33. What type of questions should you begin with when a patient seeks your medical opinion?
Ventral posteromedial nucleus
Chylomicrons
Yohimbine
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.

34. What syndrome is seen in iron - deficient middle - aged women with esophageal webs?
Proton pump inhibitors
Plummer - Vinson syndrome
Griseofulvin
Sadism

35. What type of lysosome is formed when lysosome fuses with a substrate for breakdown?
Posterior compartment of the thigh - tibial nerve
Secondary lysosome (think of the primary as inactive and secondary as active)
Thymic epithelial cells - dendritic cells - and macrophages
Quinolones

36. How are drugs that are excreted via the biliary system resorbed by the GI tract?
Streptomycin
Preoperational (2-6 years)
Undoing
Enterohepatic cycling

37. What Ig is responsible for Antibody- Dependent Cell - mediated Cytotoxicity of parasites - has a high - affinity Fc receptor on mast cells and basophils - and is responsible for the allergic response?
Asbestosis
IgE
2 ATPs - because RBCs use only anaerobic metabolism.
Residual volume

38. A 20-year - old black woman goes to you with nonspecific joint pain - fever - and a malar rash over the bridge of her nose and on her cheeks. This is a classic example of What autoimmune disease? What are three autoantibody tests you could order to m
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Radial nerve
reflexes
Chemotaxis

39. What MAOI does not cause a hypertensive crisis?
Selegiline
IgA - IgD - IgE - IgG - and IgM
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
1. Liver 2. Muscle 3. Adipose tissue

40. What is the term for occlusion of a blood vessel due to an intravascular mass that has been carried downstream?
Four high energy bonds - two from ATP in AA activation and two from GTP
Embolism
The left is a branch of the aortic arch - while the right is a branch of the brachiocephalic trunk.
Rapid efflux of potassium

41. What do LMNs innervate?
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
Exposure
Translation
They innervate skeletal muscle.

42. Name the antidote - Carbon monoxide (CO)
1. Large sample size 2. Large effect size 3. Type I error is greater
Oxygen
Middle cerebral artery
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------

43. What water - associated organism is a weakly stained gram - negative rod that requires cysteine and iron for growth?
Fluconazole
Legionella (think air conditioners)
Propranolol
Chief cells

44. What hormone is necessary for normal GH secretion?
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
McArdle's syndrome

45. What thyroiditis presents as a tender - enlarged - firm thyroid gland - usually preceded by an upper respiratory viral illness?
SITS
Berry aneurysm in the circle of Willis
X- linked recessive
de Quervain thyroiditis

46. In reference to membrane potential (Em) and equilibrium potential (Ex) - which way do ions diffuse?
Osteoma
Zafirlukast
Lispro insulin
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.

47. Who decides competency and sanity?
The courts. These are legal - not medical terms.
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Metronidazole
Selegiline

48. DNA replication occurs During what phase of the cell cycle?
Cardiac output
2.0 or greater
S phase
Dystrophic calcification

49. What AR disorder of copper metabolism can be characterized by Kayser - Fleischer rings - decreased ceruloplasmin levels - and increased urinary copper excretion and tissue copper levels?
Increased GABA levels decrease the likelihood of learned helplessness.
Quinolones
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)

50. What phase of the menstrual cycle is dominated by estrogen? Progesterone?
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Achalasia
Estrogen
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.

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