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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 are the three end products of amylase digestion?
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)
Small cell cancer of the lung
Creutzfeldt - Jakob's disease. Patients first develop vague somatic complaints and anxiety - rapidly followed by dysarthria - myoclonus - ataxia - and choreoathetosis.

2. In skeletal muscle ________ is an active event.
Endometriosis
relaxation
Brain abscess
Endocardial cushion defect

3. What is the costliest health care problem in the United States?
Melanoma
Alcohol and its related problems cost the country approximately $100 billion a year.
Lysine and arginine
Aspartate and carbomoyl PO4

4. What is the most common one? - Cancer of the esophagus in the world
Crossover study
Squamous cell carcinoma
Emphysematous bleb
Ulcerative colitis

5. What is the label given to an individual whose IQ is x 80 to 89
Flocculonodular lobe (one of my favorite words in all of medicine!)
CD19
Bacillus anthracis
Low average

6. What disorder is characterized by an alternating pattern of depressed mood with periods of hypomania for more than 2 years?
Hepatitis A (infectious)
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia
Hashimoto thyroiditis
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.

7. Name the most common type or cause - Neonatal bowel obstruction
Venous pressure above the heart is subatmospheric - so a puncture there has the potential to introduce air into the system.
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone - whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
Estrone
Hirschsprung disease

8. In what form are triglycerides sent to adipose tissue from the liver?
Waterhouse - Friderichsen syndrome
The venae recta maintain the gradient via countercurrent flow.
VLDLs
a1- Receptors

9. What Staphylococcus aureus protein inhibits phagocytosis?
Klebsiella pneumoniae
Protein A
excites the neuron
Decreasing potassium conductance - which results in increased excitability

10. What enzyme of pyrimidine synthesis is inhibited by the following? - 5- FU
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.
TB meningitis
Thymidylate synthase
Cervical neoplasia

11. Is a subdural hematoma an arterial or venous bleed?
Arginine
Pneumotaxic center (short - fast breaths)
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Coagulative

12. Bloody tap on lumbar puncture
The T- test (used when comparing two groups)
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Dyslexia
Subarachnoid hemorrhage

13. What is the term when the brachial artery is compressed - resulting in ischemic contracture of the hand?

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14. Name the hepatitis virus based on the following information - Enveloped RNA flavivirus
Anhedonia
Hepatitis C
A patent processus vaginalis
Herpes I

15. What is the pyrimidine intermediate that joins PRPP (5- Phosphoribosyl -1- Pyrophosphate)?
PALS (Parietolateral lymphocytic sheath)
Renal cell carcinoma
Orotic acid (purine metabolism)
LC4 - LD4 - and LE 4

16. What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells - not a fixed number?
Log - kill hypothesis (follows first order kinetics)
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament
Urogenital sinus
Blastoconidia

17. In biostatistics - What are the three criteria required to increase power?
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling
1. Large sample size 2. Large effect size 3. Type I error is greater
Aspartate transcarbamylase
M3 (promyelocytic leukemia)

18. What is the only DNA virus that has the reverse transcriptase enzyme?
EBV
MHC class II Ags. This is accomplished via CD4 T cells.
Id
Hepadnavirus

19. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF normal - capillary pressure ?
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
Enterococcus (Streptococcus faecalis)
Medullary carcinoma of the thyroid
Dilation of afferent arteriole

20. Name the hepatitis virus based on the following information - Naked capsid RNA picornavirus
Hepatitis A
Effective dose for 50% of drug takers (median effective dose)
Placental alkaline phosphatase
Free - unprocessed Ag

21. What is the essential reservoir host for Toxoplasma gondii?
Log - kill hypothesis (follows first order kinetics)
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
Phallus
The cat

22. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Midbrain
RSV
Secondary lysosome (think of the primary as inactive and secondary as active)
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Mesencephalon

23. What is the function of white rami communicantes?
Riedel thyroiditis
They are preganglionic sympathetic axons. They are white because they are myelinated.
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
Chromosome 5 - 21

24. What three major cell lines participate in the acquired immune system?
T cells - B cells - and macrophages
Meningococcus (Gonococcus does not)
LTC4 - LTD4 - and LTE4
Primary Hemochromatosis

25. What toxin ADP- ribosylates via Gs protein to increase cAMP?
ASA
Cholera toxin
Palindrome
Varicella

26. In the classical conditioning model - when a behavior is learned - what must occur to break the probability that a response will happen?
HBc Ab
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see - can't wee - can't kick with your knee
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
Reye syndrome

27. What gram - positive spore - forming anaerobic rod blocks the release of ACh at the NMJ - resulting in reversible flaccid paralysis?
transcription
Pneumocystis carinii
Clostridium botulinum
Laminin

28. Which class of antihyperlipidemics would you avoid for a patient with elevated triglyceride levels?
Cytochrome b/c1
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.
Burkitt lymphoma
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.

29. What protein is required by prokaryotic RNA polymerases to initiate transcription at the promoter region of DNA?
Complex I
Minocycline
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.)
Sigma factor

30. What phase of the female cycle occurs during days 1 to 15?
Left ventricle and auricle of left atrium
Follicular phase
Ethyl alcohol
Bile salts are actively reabsorbed in the distal ileum.

31. What molecule that is needed to trigger T cell activation is noncovalently linked to TCR?
Acetyl CoA carboxylase
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Cones (C for color and cones)

32. What two vessels in fetal circulation have the highest PO2 levels?
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
Umbilical vein and ductus venosus (80%)
Riboflavin (B2) deficiency

33. What are the three Beta - lactamase inhibitors?
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Mumps
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
They are all formed by the fifth month of fetal life.

34. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x abl
Aversive conditioning
CML and All
Muscle glycogen phosphorylase
Papillary carcinoma of the thyroid

35. What is the name of the B cell that secretes Ig?
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.
Plasma cell (mature B lymphocyte)
Hypospadia

36. What happens to O2 affinity with a decrease in p50?
Integrase
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
9.3 L - 15% of body weight
Minimal change disease

37. What embryonic structure forms the adult female structures? - Ovarian and round ligaments
Hypotonia (rag doll appearance)
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
Gubernaculum
Chromosome 15

38. What scale has a true zero point - graded into equal increments - and also orders them?
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Arnold - Chiari malformation type 2
Brain - spleen - and kidney
Ratio scale

39. Name the most common type or cause - Lobar pneumonia
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.
The rate of Beta- oxidation
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
Streptococcus pneumoniae

40. What pancreatic islet cell tumor is associated with watery diarrhea - hypokalemia - and achlorhydria?
VIPoma
Arterioles
Streptolysin O
Knee

41. Name three purine bases that are not found in nucleic acids.
Internal carotid artery
Sheehan syndrome
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
No change in length

42. Name the type of mutation: x New codon specifies for the same AA
A transport maximum (Tm) system
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius
Silent

43. What is the name of inflammation of the prepatellar bursa?

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44. What is the name of the regulatory protein that covers the attachment site on actin in resting skeletal muscle?
Tropomyosin
Salmeterol
Right medial longitudinal fasciculus
0.2

45. What disease involves a lack of both T cell - mediated and humoral immune responses that can be either X- linked or AR?
Tryptophan
Severe combined immunodeficiency disease
Obturator nerve
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.

46. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Withdrawn - fearful - explosive moods - violent outbursts - and loss of inhibitions
Metronidazole
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
Orbitomedial frontal lobe
Osteosarcoma

47. Which hepatitis B serology markers
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
HBcAb IgG - HBV- DNA - HBeAg - HBsAg
Oxygen
Ganciclovir

48. What form of GN is characteristically associated with crescent formation?
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Rapidly progressive glomerulonephritis (RPGN)
CD4+T cells
Hemophilia B

49. What form of penicillin is stable in acid environments?
Penicillin V
Iodine (I)
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
Volume of distribution is decreased when a large percentage of drug is protein bound.

50. When attempting to make up sleep - what stage of sleep is recovered?
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.
Acetyl CoA carboxylase
More than 75% of the vessel
Macule (e.g. - a freckle)