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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 factors are needed for translation in prokaryotes?
Necrophilia
Melanin
No - unsaturated fatty acids have double bonds.
Elongation factor - G and GTP

2. Name the most common type or cause - Acute metal poisoning in the United States
Anhedonia
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.
Arsenic
Plasmodium malariae; the others are tertian.

3. What water - soluble - vitamin deficiency is associated with cheilosis and magenta tongue?
Luteal phase
Homogentisic oxidase
Chemotaxis
Riboflavin (B2)

4. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol decreased - ACTH decreased
Secondary hypocortisolism (pituitary)
Azithromycin
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.

5. What is the name for the following RBC indices? - Average mass of the Hgb molecule/RBC
Astrocytoma
Ganciclovir
Glucagon
Mean corpuscular hemoglobin (MCH)

6. What is the renal compensation mechanism for acidosis?
Production of HCO3- - shifting the reaction to the left and thereby decreasing H+
Rectum
Medial pontine syndrome
Peyer's patch

7. What is the main factor determining GFR?
Achondroplasia
In men it is prostate cancer - and in women it is breast cancer.
Kimmelstiel - Wilson disease
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)

8. Which M- protein strain of Streptococcus pyogenes is associated with acute glomerulonephritis?
Cestodes
Aortic stenosis
Aged adult
M12 strains

9. Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?
PGI 2
CSF
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.

10. What is the only organ supplied by the foregut artery that is of mesodermal origin?
Metronidazole
Spleen
Coarctation of the aorta
Nitrofurantoin

11. Name the associated chromosome - Patau syndrome
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Occipital lobe
Chromosome 13
ELISA. It detects anti - p24 IgG.

12. Name the DNA virus: x ssDNA; naked; icosahedral; replicates in the nucleus
Puborectalis
Parvovirus
H 1
Vitamin B12 deficiency and folate deficiency

13. What Brodmann area is associated with x Visual association cortex?
hCS and serum estriol - which are produced by the fetal liver and placenta - respectively - are used as estimates of fetal well - being.
Areas 18 and 19
IgG4
Axillary nerve and posterior humeral artery

14. What malignant neoplasm of the skin is associated with keratin pearls?
Biotin (only if eaten in large quantities)
Squamous cell carcinoma
7 years old
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.

15. What is the size of a positive PPD test for the following? (Reactive) x Posttransplantation patient taking immunosuppressive agents
common variable hypogammaglobinemia
Varicella virus and influenza virus
The short arm of chromosome 6
>5 mm

16. What is the only pharyngeal muscle not innervated by CN X?
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
M12 strains
Streptococcus agalactiae and Escherichia coli
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.

17. What is the most common one? - Organism associated with liver abscesses
Amantadine
Galactitol
Entamoeba histolytica
Vesicular stomatitis virus

18. What general pattern of sleep is described by slowing of EEG rhythms (high voltage and slower synchronization) - muscle contractions - and lack of eye movement or mental activity?
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
Areas 44 and 45
NREM sleep. Remember awake body - sleeping brain
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion

19. People who believe that luck - chance - or the actions of others control their fate have an internal locus of control.
Urogenital folds
Social learning theory
300 mOsm/L
Ascaris lumbricoides

20. What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
CMV - Toxoplasma gondii - and Listeria
Terbinafine
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)

21. Do the following structures pick up stain from hematoxylin or eosin? - Nuclei
IL-4 - IL-10 - and IL-13
Bronchiectasis
Hematoxylin
Sheehan syndrome

22. The inferior mesenteric artery drains into it.
Arcuate line
The splenic vein
Pedophilia
Right nasal hemianopsia

23. What chromosome is autism linked to?
Venlafaxine. (It also has a mild dopaminergic effect.)
Chromosome 15
Arginine
wave

24. What bone houses the ulnar groove?
The mouth
Francisella tularensis
Humerus (between the medial epicondyle and the trochlea)
By causing rebound insomnia and decrease in REM sleep

25. What viral infection in patients with sickle cell anemia results in aplastic crisis?
EF- G of the 50S subunit
Parvovirus B 19
Lingual nerve of CN V3
Superior gluteal nerve

26. What is the vector for Leishmania infections?
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
The sandfly
Acetazolamide
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.

27. Is linolenic acid an omega -3 or omega -6 fatty acid?
Omega -3; linoleic is omega -6
PGE2
Kartagener's syndrome (also known as immotile cilia syndrome) -------------------------------------------------------------------------------
pK (think of it as where half is base and half is acid)

28. Where is the lesion that produces these symptoms when a patient is asked to look to the left? Neither eye can look left with a slow drift to the right
Klinefelter syndrome
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
Mitral valve prolapse
Left abducens nucleus or right cerebral cortex

29. Name the type of graft described by these transplants: x From one person to the next (the same species)
Flucytosine
Catatonic schizophrenia
Allograft
Knee

30. How many carbons do estrogens have?
Iodine - resulting in congenital hypothyroidism
Resorb CSF into the blood
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
Frameshift

31. What topoisomerase makes ssDNA cuts - requires no ATP - relaxes supercoils - and acts as the swivel in front of the replication fork?
1. The child poses an imminent danger to self or others. 2. The child is unable to self - care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety e
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.
Topoisomerase I (Relaxase)
Oxytocin

32. What is the period between going to bed and falling asleep called?
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
The energy of activation (Ea)
Sleep latency
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.

33. What hormone's release is strongly associated with stage 4 sleep?
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Carbamazepine
Methylphenidate (Ritalin)

34. What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria?
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
Bcl -2
Cocaine
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)

35. What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency - glucocorticoid deficiency - and an excess of adrenal androgens?
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
Crohn disease
Hypoactive sexual desire disorder
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase

36. What negative sense RNA virus is associated with cough - coryza - and conjunctivitis with photophobia?
Measles (rubeola)
HHV 6
Caisson disease
Dendritic cells - macrophages - and thymic epithelial cells

37. What type of cell surface projection lies on the lateral surface of cells closest to the apex and acts to seal off the outside environment from the rest of the body?
Healing by secondary intention
Zonula occludens (tight junctions)
Juxtaglomerular (JG) cell
Accidents

38. What happens to the following during skeletal muscle contraction? - Sarcomere
Norm reference (i.e. - 75% of the students in the class will pass)
Direct; in males less than 50 years old indirect hernias are the most common type.
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)
Shortens

39. Name the most common type or cause - Rectal bleeding
gram positive
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Diverticulosis

40. If a sample of DNA has 30% T - What is the percent of C?

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41. What enzyme of pyrimidine synthesis is inhibited by the following? - Hydroxyurea
The CD4 T cell; the APC is the first cell in the immune response.
Ribonucleotide reductase
Uracil
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.

42. What hormone acts on Granulosa cells?
HHV 6
Glucose -6- phosphatase
FSH
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.

43. Where are the postganglionic neuron cell bodies - the CNS or the PNS?
They are in ganglia in the PNS.
Labetalol
Candida albicans
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.

44. Replacing normal affect with 'brain power'
Bainbridge reflex
At birth (reflex)
Complex 4
Intellectualization

45. To What does failure to resolve separation anxiety lead?
School phobia
Thiabendazole
Latency stage (6-12 years)
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.

46. What type of anemia is the result of a deficiency in intrinsic factor?
Graves disease
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
Alcohol and its related problems cost the country approximately $100 billion a year.
C5a

47. Being college educated increases a man's risk of having...
Streptokinase
The carotid sinus is a pressure - sensitive (low) receptor - while the carotid body is an oxygen - sensitive (low) receptor. (Remember 'Sinus Pressure').
premature ejaculation
Site 4

48. Via what pathway is glycolysis increased after phagocytosis?
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
TCA cycle.
HMP shunt
Negative

49. Metformin is contraindicated in ________ because of weight gain as its side effect.
Buffers (remember that buffers are best when they are used in a pH range near its pK)
Obese patients
Schistosoma have separate males and females.
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.

50. What is the effect of insulin on protein storage?
Lactulose
CN III - VII - IX - and X
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
Primary hyperparathyroidism