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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 name of the T cell - rich area of the lymph node?
Paracortex
Being a female physician increases the risk of suicide nearly four times the general population.
PDA
6 weeks 10 weeks

2. When do hCG concentrations peak in pregnancy?
Chlamydia
Bisphosphonates
In the first 3 months
CN IX

3. What fissure of the cerebral cortex separates the frontal and temporal lobes rostrally and partially separates the parietal and temporal lobes?
The limbic system
Eaton - Lambert syndrome
Lateral fissure (fissure of Sylvius)
Musculophrenic and superior epigastric arteries

4. Is an embryologic foregut derivative.
The thyroid gland
Proencephalon
Gardner syndrome
epithelial lining

5. All aluminum - containing antacids can cause...
Pneumotaxic center (short - fast breaths)
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
hypophosphatemia

6. What are the five Ig isotypes?
HHV-8
Gerstmann's syndrome; spoken language is usually understood.
MEN IIa (or Sipple syndrome)
IgA - IgD - IgE - IgG - and IgM

7. What are the functions of the zonula occludens and the zonula adherens
Aspartame
To provide attachment between contiguous cells and to maintain a semipermeable barrier
CML
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.

8. Name the phase of the eukaryotic cell cycle: x Period of cellular growth (translation and transcription) before DNA synthesis
Molindone
Positive
Chlamydia trachomatis
G1 phase (gap 1)

9. How does ventricular repolarization take place - base to apex or vice versa?
Marfan syndrome
Repolarization is from base to apex and from epicardium to endocardium.
Fixed interval
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.

10. What cerebral vessel size is affected in patients with vascular dementia?
Small to medium - sized cerebral vessels
The DCML system. (Remember - everything but pain and temperature.)
Head of the pancreas
Muscle glycogen phosphorylase

11. Are the quadrate and caudate lobes of the liver functionally part of the left or right lobe?
Hypertrophic scar
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
Aschoff bodies of rheumatic fever
Bridging veins draining into the sagittal sinus

12. What neuropsychologic test has five basic scales testing for the presence and localization of brain dysfunction?
Stercobilin
No. Remember - tests do not diagnose - they confirm or refute your diagnosis. Also - diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI - elevated cardiac enzymes consistent with MI - and ST segment elevati
Gubernaculum
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.

13. What carpal bone is most commonly fractured? Dislocated?
Heart disease
Pseudomonas aeruginosa
The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated.
Amygdala; it helps imprint an emotional response in memory.

14. Which macrolide is given as 1200 mg/week for the prophylaxis of Mycobacterium avium intracellulare complex?
They block the midcycle surge of LH.
Azithromycin
The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
EF- G of the 50S subunit

15. What structure of the knee is described thus? - C- shaped shock absorber; aids in attachment of the tibia to the femur via the medial collateral ligament
An internal elastic lamina
Langerhans cells (found in the stratum spinosum)
Medial meniscus
Tibial nerve

16. What is the neurotransmitter at the d - receptor?
IgA
Iron deficiency anemia
Enkephalin
Rapid efflux of potassium

17. What specifies how accurately the sample values and the true values of the population lie within a given range?
Confidence interval. It is a way of admitting estimation for the population.
Secondary lysosome (think of the primary as inactive and secondary as active)
Gout
Iodine (I)

18. What Enterobacteriaceae are prone to produce osteomyelitis in sickle cell patients?
Picornaviridae
Omphalocele and gastroschisis
Anorgasmia. (The overall prevalence is 30%.)
Salmonella

19. If a patient with a cerebellar lesion has nystagmus - which way is the fast component directed - toward or away from the lesion?
K1 capsule
Adipose tissue
The fast component is directed toward the affected side of a cerebellar lesion.
Caplan syndrome

20. Below the ___________ - all the aponeurotic fibers run anterior to the rectus abdominis.
X- linked recessive
IgA
LGB (think EYES)
Arcuate line

21. Name the compartment of the mediastinum associated with the following thoracic structures: Splanchnic nerves
The dentate nucleus
Posterior
IgG
By asking a patient to close the eyes while standing with feet together

22. What vascular injury may result from a supracondylar fracture of the femur?
Spectinomycin
CD3
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
Herpes I

23. Name the macrophage based on its location: x Bone macrophages
Langerhans cells
Mesencephalon
Osteoclasts
Mean corpuscular volume (MCV)

24. What naturally occurring substances mimic the effects of opioids?
igantism
Supraspinatus and infraspinatus
Enkephalins
Serous exudates

25. What mineral is an important component of the enzyme xanthine oxidase?
Toxoplasma gondii
Splenic flexure
Molybdenum (Mb)
The small subunit (40S) binds first.

26. What catecholamine - hypersecreting tumor - a secondary cause of HTN - results in headache - diaphoresis - anxiety - tachycardia - and palpitations?
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Pheochromocytoma
Adulthood
Enterococcus faecalis

27. Influenza - Vibrio cholera - hepatitis A - rabies - and adenovirus.
IL-5. It also stimulates eosinophil proliferation.
Adenovirus
Are inactivated vaccines available in the United States
Hirschsprung's disease (colonic gangliosus)

28. What hormone is required for 1 - 25- dihydroxy- vitamin D (1 - 25- diOH- D) to have bone resorbing effects?
Herpes virus I and II
PTH
Proencephalon
Enterohepatic cycling

29. How are resistance and length related regarding flow?
Decreasing potassium conductance - which results in increased excitability
Conduction aphasia
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.
Proto - oncogenes

30. What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
Stibogluconate
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.
Kimmelstiel - Wilson disease
Hypersegmented neutrophils

31. Is a marker for increased bone formation.
Duchenne muscular dystrophy
Glucagon
Translation
An elevated serum osteocalcin level

32. What happens to diastolic and systolic intervals with an increase in sympathetic activity?
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
Somatization
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
Fentanyl

33. What is the statistical term for the proportion of truly nondiseased persons in the screened population who are identified as nondiseased?
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
CD28
Northern blot
Specificity (it deals with the healthy)

34. What is the valence of an Ig molecule equal to?
Membranous glomerulonephritis
The number of Ags that the Ab can bind
CML
Mees lines

35. What is the most common lysosomal storage disorder?
P24
Gaucher disease
Bunyavirus
Serous exudates

36. How many carbons do androgens have?
Pyridoxine (B6)
Hepatitis D
Androgens are 19- carbon steroids.
Sphingosine

37. What diseases are associated with the HLA- B27 allele

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38. What motile - gram - negative spiral bacillus with flagella is oxidase positive - urease positive - and associated with gastritis - peptic ulcer disease - and stomach cancer?
Osteosarcoma
Middle meningeal artery
Staphylococcus
Helicobacter pylori

39. What are the four signs of acute inflammation?
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages
Denial
VLDL
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function

40. What type of muscle contraction occurs when the muscle shortens and lifts the load placed on it?
Churg - Strauss syndrome
1. Sartorius 2. Gracilis 3. Semitendinous
REM latency; normally it is about 90 minutes.
Isotonic contraction

41. What is the most common one? - Site for colonic diverticula
Id
Sigmoid colon
Stable
Splitting

42. Movement disorders are associated with what dopamine pathway (What part of the brain)?
Nigrostriatal pathways (basal ganglia)
Eisenmenger's syndrome
Acute rejection
The greater the myelination - the greater the conduction velocity.

43. What is a plasma cell's life expectancy?
Sympathetic chain ganglion
7 to 14 days
IgG
Anterior hypothalamic zone; lesions here result in hyperthermia.

44. What area of the lymph node contains germinal centers?
HPV
Citrate - via the citrate shuttle
Primary biliary cirrhosis
The outer cortex contains most of the germinal centers and therefore also most B cells.

45. A 20-year - old woman goes to the ER with ptosis - diplopia - weakness in her jaw muscles when chewing - and muscle weakness with repeated use. What is your diagnosis?
Embolism
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
ydroxyproline
Myasthenia gravis

46. What level of mental retardation is characterized by x Can work in sheltered workshops and learn simple tasks but need supervision?
Chromosome 4p
Moderate (35-49)
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.
Diethylcarbamazine

47. What muscles insert in or on the intertubercular groove of the humerus?

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48. Is suicidal ideation a component of normal grief?
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.
Succinate dehydrogenase
Volvulus
It is rare with normal grief; however - it is relatively common in depression

49. What is the term for the number of Ag - binding sites on an Ig?
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
Valence
Anticentromere Abs
DiGeorge's syndrome

50. Name the thalamic nucleus based on its input and output - Input from globus pallidus and substantia nigra; output to primary motor cortex
Ventral anterior nucleus
CN IX - X - and XI; sigmoid sinus
Hypoparathyroidism
Ventricular fibrillation (V fib)