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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. Name the thalamic nucleus based on its input and output - Input from the trigeminal pathways; output to primary somatosensory cortex of the parietal lobe
Monosodium urate crystals
Depolarization (i.e. - Na+ influx)
Ventral posteromedial nucleus
Histamine

2. What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
Melatonin - serotonin - and CCK
Homocysteine methyl transferase
Adrenarche
Reiter syndrome

3. Name the Hgb - O2 binding site based on the following information: x Remains attached under most physiologic conditions
Skin - liver - and kidneys
Transposons
Site 1
Carbamazepine

4. What classical conditioning therapy or modification is described as x Triage of a hierarchy of fears (from least to most) - then teaching muscle relaxation techniques in the presence of those fears until the subject is not afraid anymore?
Osteoblast (Remember - blasts make - clasts take)
Zero correlation
Site 4
Systematic desensitization

5. What thyroid abnormality has the following? - TRH increased - TSH increased - T4 decreased
Papillary carcinoma of the ovary
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
Primary hypothyroidism (Low T4 has a decreased negative feedback loop - resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release - respectively.)
Escherichia coli

6. What Beta2- agonist is used as a prophylactic agent in the treatment of asthma?
Salmeterol
Streptococcus agalactiae and Escherichia coli
Mycosis fungoides (cutaneous T- cell lymphoma)
Common peroneal nerve

7. What skin carcinoma is a superficial dermal infiltrate of T lymphocytes seen in males more than 40 years old and presents as scaly red patches or plaques?
Borrelia burgdorferi
Papovavirus
Mycosis fungoides (cutaneous T- cell lymphoma)
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)

8. What DNA virus is associated with exanthem subitum (roseola)?
HHV 6
Pheochromocytoma
CN VII
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.

9. What is the most common one? - Renal calculus type
Hurler syndrome and Hunter syndrome - respectively
Free form determines hormone activity and is responsible for the negative feedback loop.
Calcium oxylate
Bacillus anthracis

10. Name the following descriptions associated with bacterial endocarditis: x Retinal emboli
Multiple sclerosis
Arginine
Roth spots
Permanent

11. What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis?
Swan - neck deformities
Benign lentigo
Copper
3 months of symptoms in 2 consecutive years

12. What is the site of action of the following? - Aldosterone antagonists
Mesonephric duct
IF
Distal convoluted tubules
Parental assignment and culture (not biology)

13.
Ipsilateral loss at and below the level of the lesion
Insulin
REM sleep. Nightmares are frightening dreams that we recall.
prior to birthThe foramen ovale closes just...

14. What nematode is known as whipworms? What is the treatment?
Trichuris trichiura is treated with albendazole.
Rapid cycling bipolar disorder
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern - my senior resident asked me this question more times than I would like to remember.)
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.

15. What three chemical agents are associated with angiosarcomas of the liver?
Terminal ileum
Onset of bleeding
Arsenic - thorotrast - and vinyl chloride
Coagulative necrosis

16. Have catalase.
EBV
EF-1 and GTP
Streptococci
Truncus arteriosus

17. What is the term for RBCs with smooth undulations on the surface of their membrane - commonly seen in uremia?
Aortic insufficiency
Burr cells (echinocytes)
Right vagus innervates the SA node and the left vagus innervates the AV node
Coarctation of the aorta

18. What is the most common one? - Primary lung cancer
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
Adenocarcinoma
Gonads
NADPH and molecular O 2

19. What skin condition is a localized proliferation of melanocytes presenting as small - oval - light brown macules?
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
Benign lentigo
Aspartate and carbomoyl PO4
Serum 25- hydroxy- vitamin D (25- OH- D)

20. What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?
Middle
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
Splenomegaly and anemia (with a high index of suspicion)
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.

21. Megaloblastic anemia and thrombocytopenia are signs of what vitamin deficiency?
Molluscum contagiosum
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
Ligament teres
Folic acid deficiency

22. Lucid interval
CN IX - X - and XII
Glucuronidation
12 days after ovulation
Epidural hematoma

23. Name the compartment of the mediastinum associated with the following thoracic structures: Left subclavian artery
G1 phase; G2 and S phase are diploid (2N).
X- linked dominant
Clozapine
Superior

24. What B cell disorder is characterized by pre - B cells in the bone marrow - no circulating B cells in plasma - normal cell - mediated immunity - low Igs - and appearance by 6 months of age?
Housemaid's knee
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.
Fungiform papillae
CN IX - X - and XI; sigmoid sinus

25. Which organism releases endotoxins prior to cell death?
Neisseria meningitidis
Affinity
Eisenmenger syndrome - which can also occur with any left - to - right shunt
a - Blockers (- zosins)

26. Do you monitor heparin's therapeutic levels by PT or PTT?
Churg - Strauss syndrome
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
31 pairs
Posterior chamber

27. In what organ system would you attempt to localize a sign for shaken baby syndrome'? What do you look for?

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28. In the elderly - what happens to total sleep time - percentage of REM sleep - and percentage of NREM sleep?
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
GLUT 3 and 4
Ulnar to radial progression

29. What happens to dopamine levels when we awaken?
Afterload
Cytosine
Flumazenil
Dopamine levels rise with waking; dopamine is associated with wakefulness.

30. What disorder is characterized by autoantibodies to IF?
Pernicious anemia
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.
Pseudomembranous colitis

31. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral aqueduct
give a warning
Mesencephalon
Encapsulated bacteria
Bcl -2

32. Name the antidote - Carbon monoxide (CO)
Type II error (beta error). (Remember it as saying something doesn't work when it does.)
The aorta has the greatest velocity and the capillaries have the slowest velocity.
Oxygen
H2PO4- (dihydrogen phosphate)

33. What happens to the tonicity of the urine with increased ADH secretion?
Poxvirus
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Proencephalon diencephalon derivative
Unconjugated free bilirubin

34. What enzyme is needed to activate the following reactions? - Chymotrypsinogen to chymotrypsin
Thymine (B1)
Chronic alcoholic
Succinate dehydrogenase
Trypsin

35. What chromosome 4 - AD disorder is a degeneration of GABA neurons in the striatum of the indirect pathway of the basal ganglia?

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36. Name the three benzodiazepines that are not metabolized by the cytochrome P450 enzyme system.
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)
The left is a branch of the aortic arch - while the right is a branch of the brachiocephalic trunk.
Capillaries
greater

37. How many acetyl CoAs per glucose enter into the TCA cycle?
PKU
Isoniazid treatment
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)

38. What is used as an index for both adrenal and testicular androgens?
Transcortical aphasia
Urinary 17- ketosteroids
Depolarization (i.e. - Na+ influx)
IgG

39. What is the statistical term for the proportion of truly nondiseased persons in the screened population who are identified as nondiseased?
Mode
Specificity (it deals with the healthy)
Altruism
Rhabdomyoma

40. Name the compartment of the lower extremity and the nerve based on its movements - Flex the hip and extend the knee
Papillary carcinoma of the thyroid
Anterior compartment of the thigh - femoral nerve
Pontocerebellar angle syndrome
Increased secretion of GH postpuberty leading to acromegaly.

41. What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
Resistance of the system increases. (Remember - when resistors are connected in a series - the total of the resistance is the sum of the individual resistances.)
Primary hyperparathyroidism
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Stable

42. What vitamin deficiency causes a glove - and - stocking neuropathy seen in alcoholics?
Carbamazepine
Pyridoxine (B6) deficiency
The aorta
Succinylcholine

43. What is the term for ejaculation before or immediately after vaginal penetration on a regular basis?
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
Premature ejaculation
Glucose -6- phosphatase
Fixed interval

44. Name the compartment of the lower extremity and the nerve based on its movements - Adduct the thigh and flex the hip
Internal iliac nodes
The rectouterine pouch (of Douglas)
Stable
Medial compartment of the thigh - obturator nerve

45. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x CDK4
CD40
Lente or NPH insulin (neutral protamine Hagedorn insulin)
Melanoma
apo A-1

46. In What three areas of the body are sympathetics the predominant tone?
Unstable (crescendo) angina
1. Sweat glands 2. Arterioles 3. Veins
Tolcapone and entacapone
Rhabdomyoma

47. What neurotransmitter is presynaptically inhibited by reserpine and guanethidine?
Labetalol
Alveolar dead space
NE
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent

48. What level of mental retardation is characterized by x Being self - supportive with minimal guidance and able to be gainfully employed (includes 85% of the mentally retarded)?
Grasp proceeds release
CD28
Mild (50-70)
GLUT 4

49. What is the term for Ags that activate B cells without T- cell signaling?
Thymus - independent Ags
CD4
Agoraphobia. It also means having a sense of humiliation or hopelessness.
Stable

50. What water - soluble - vitamin deficiency may result from eating raw eggs?
Phallus
Gain of hypotonic fluid (water intoxication or hypotonic saline)
The lung will expand; also the opposite is true.
Biotin (only if eaten in large quantities)