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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 enzyme of the purine salvage pathway is deficient in the following? - Selective T- cell immunodeficiency
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Purine nucleoside phosphorylase
Alzheimer disease
One - way ANOVA

2. What CNs arise from x The medulla?
CN IX - X - and XII CN XI arises from the cervical spinal cord.
Leukotriene B4 (LTB4)
Palms - up before palms - down maneuvers
GABA - quantitatively

3. What is the most common lethal AR disorder affecting white Americans?
2 ATPs by oxidative phosphorylation
Cystic fibrosis
Confounding bias
VSD

4. What component of the ETC is inhibited by the following? - CO
Guillain - Barr
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Gout
Cytochrome a/a3

5. Name the antimicrobial agent whose major side effect is listed - Teratogenicity
Muscle spindles
Metronidazole
Streptococcus agalactiae
Red blood cell distribution width index (RDW)

6. What Beta- blocker is also a membrane stabilizer?
HBeAb
Propranolol
Melanin
Systematic desensitization

7. What type of fatty acid is associated with a decrease in serum triglycerides and cardiovascular disease?
Corynebacterium diphtheriae
Homogentisic oxidase
Omega -3 fatty acids
Persistent truncus arteriosus

8. What are the pharmacologic effects seen sexually with x a1- Blockers?
Clofazimine
Hepatitis A
Ultraviolet B (UVB) sunlight
Impaired ejaculation

9. What two substances stimulate Sertoli cells?
Ovulation
False - positive rate
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
FSH and testosterone

10. How many oogonia are present at birth?
Decreases
Cryptococcus
None; they are not formed until a girl reaches puberty.
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.

11. Via what pathway is glycolysis increased after phagocytosis?
Pseudomembranous exudates
Cryptococcus
Thioridazine
HMP shunt

12. What two forces affect movement of ions across a membrane?
BPH
Parietal cells (Remember - they secrete HCl - too.)
Concentration force and electrical force
Cholesterol biosynthesis

13. Which subset of MEN syndrome is associated with the following? - Medullary carcinoma of the thyroid - pheochromocytoma - and mucocutaneous neuromas
Right coronary artery
MEN III (or IIb)
Avoidant
IgA

14. What toxicities are caused by the following agents? - Halothane
Arnold - Chiari malformation type 2
AT II
Chondroitin sulfate and keratan sulfate
Hepatitis - with or without necrosis

15. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Clonidine
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.
Malpighian layer (made up of the stratum basale and stratum spinosum)
Staphylococcus aureus

16. Is ulcerative colitis or Crohn disease more commonly associated with primary sclerosing cholangitis?
Testicular feminization syndrome (Dude looks like a lady!)
PR interval
Mycoplasma pneumoniae
Ulcerative colitis

17. Name the stages of sleep with these EEG patterns: x Delta waves
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Adult T- cell leukemia
Misoprostol
Stage 3 and 4

18. Name the macrophage based on its location: x Brain macrophages
NREM sleep. Night terrors are dreams that we are unable to recall.
TCR
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
Microglia

19. Name the insulin preparation based on the peak effect and duration of action - Peak - 0.5 to 3 hours; duration - 5 to 7 hours
Mesolimbic system
Premature ejaculation
Arsenic
Regular insulin

20. What rate removes any difference between two populations - based on a variable - to makes groups equal?
The lung will expand; also the opposite is true.
Eosinophil
Standardized rate
Nucleolus. Ribosomal assembly also takes place in the nucleolus.

21. What is the most common one? - Neurotransmitter in the brain
GABA - quantitatively
Type III hypersensitivity (immune complex)
Glucose
Hyperkalemia

22. What syndrome results if the enzyme ?-1- iduronidase is deficient? L- iduronate sulfatase deficiency?
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
Extrahepatic biliary atresia
Hurler syndrome and Hunter syndrome - respectively
Medial rectus (CN III) (LR6 SO4)3

23. What must be supplemented in patients with medium - chain acyl CoA dehydrogenase (MCAD) deficiency?
Stages 3 and 4 (NREM)
Short - chain fatty acids
ACh receptor
Fovea

24. Name the most common type or cause - Diarrhea in children
Streptococcus pyogenes
Water soluble
Lateral pontine syndrome
Rotavirus

25. Name the bony articulations of the following sites. Be specific - Shoulder
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
Clavicle - acromion - and glenoid fossa of the scapula and the humerus
Hemangioma (benign)

26. What antidepressant - which recently was approved for general anxiety disorder - inhibits the reuptake of NE and 5- HT?
Superior
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.
Venlafaxine. (It also has a mild dopaminergic effect.)

27. Is the coding or the template strand of DNA identical to mRNA (excluding the T/U difference)?
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
VSD
Primary hypoparathyroidism
Pirenzepine

28. What is the end product of purine catabolism?
Uric acid
RSV
Benign lentigo
Internal carotid artery

29. Name four major risk factors for atherosclerosis.
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.
MHC class II Ags. This is accomplished via CD4 T cells.
No. Prions are infectious proteins - so antibiotics are useless.
Ungated channels

30. What is the term for an inhibitory interneuron?
Renshaw neuron
None; they are the storage sites for ADH and oxytocin.
gp120
Marrow failure - cancer - and leukemia

31. What enzyme requires molybdenum as a cofactor?
ydroxyproline
Xanthine oxidase
Validity (remember - reliability is necessary but not the only thing needed for validity)
Cortisol

32. Where is most of the body's Ca2+ stored?
One - and it provides the energy for mechanical contraction.
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
2 and 5HT3 receptors
Supraoptic nuclei; lesions here result in diabetes insipidus.

33. What disorder is characterized by autoantibodies to IF?
Pernicious anemia
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
The fastigial nucleus

34. What do UMNs innervate?
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
No. Prions are infectious proteins - so antibiotics are useless.
Listeria monocytogenes
They innervate LMNs.

35. All Proteus species are...
1. Short attention span 2. Impulsivity 3. Hyperactivity
>5 mm
First - pass metabolism and acid lability
urease positive

36. What determines the plasma level at steady state?
The rate of infusion
Amyloidosis
The gut rotates clockwise around the superior mesenteric artery.
Roth spots - and they are seen in bacterial endocarditis.

37. Name the most common type or cause - Pyogenic osteomyelitis
For the USMLE Step 1 the answer is no - but if the information would do more harm than good - withhold. This is very rare but it does occur.
Dihydrofolate reductase
Staphylococcus aureus
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.

38. What CNs are affected if there is a lesion in x The upper medulla?
It is produced by the preload on the muscle prior to contraction.
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
CN IX - X - and XII
IgA

39. Name the form of spina bifida - An open neural tube lying on the surface of the back
Down syndrome
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Streptococcus agalactiae
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.

40. What wave is the cause of the following venous pulse deflections? - The rise in right atrial pressure secondary to blood filling and terminating when the tricuspid valves opens
V wave
Third week; they are derived from the wall of the yolk sac.
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.)
Allotypes

41. What is the most common one? - Form of arthritis
Primary hypoparathyroidism
Osteoarthritis
Adenocarcinoma of the cervix
Ulcerative colitis

42. What is the most common one? - Site for atherosclerotic plaques in the abdominal aorta
Tolcapone and entacapone
Residual volume
2 ATPs - because RBCs use only anaerobic metabolism.
The bifurcation of the abdominal aorta

43. Which hepatitis B serology markers
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Nigrostriatal pathways (basal ganglia)
CN IX - X - and XII CN XI arises from the cervical spinal cord.
HBcAb IgG and HBsAb IgG

44. What syndrome has multiple adenomatous colonic polyps and CNS gliomas?
Turcot syndrome
Bell pad
Superior and middle
F- Met - Peptides

45. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Denies being blind - cortical blindness

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46. Which form of melanoma carries the best prognosis?
The bifurcation of the abdominal aorta
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>
Lentigo maligna melanoma

47. What organ of the body has the smallest AV oxygen difference?
Cancer
16S subunit
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
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.

48. What three muscles constitute the erector spinae?

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49. What is the only DNA virus that has the reverse transcriptase enzyme?
Lysosomal a -1 - 4- glucosidase
Gastric carcinoma
Hepadnavirus
Chlortetracycline

50. Which leukotrienes are associated with the late - phase inflammatory response?
LTC4 and LTD4
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
Anterior nuclear group (Papez circuit of the limbic system)