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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. T cells can recognize - bind - and internalize...
Left coronary artery
Postinfectious GN
unprocessed Ags
Depolarization (i.e. - Na+ influx)

2. Name the most common type or cause - Neonatal septicemia and meningitis
Amyotrophic lateral sclerosis (Lou Gehrig's disease) is a LMN lesion at the level of the lesion and UMN lesion below the level of the lesion.
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Streptococcus agalactiae (Group B Streptococcus - or GBS)
GH- producing adenoma

3. What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?
Gastric ulcer
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.
B cells; macrophages and dendritic cells are nonspecific.
Turcot syndrome

4. What cells of the thyroid gland are stimulated in response to hypercalcemia?
Strongyloides stercoralis is treated with thiabendazole.
Rhinoviruses for summer and fall; coronaviruses for winter and spring
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Hemochromatosis

5. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Calcitonin
Medullary carcinoma of the thyroid
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).
Kawasaki disease
IGF-1

6. What subset of T cells recognizes the MHC class II Ags?
CD4+ T cells (helper)
The liver (in the mitochondria)
Spearman correlation
Neuroblastoma

7. What are the two most common chains of the TCR?
Where the cell bodies for the DCML and spinothalamic sensory systems are...
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
Lethal dose for 50% of drug takers (median lethal dose)
a - and Beta- chains are on most T cells.

8. What is the term for a single isolated antigenic determinant?
Thoracic and sacral
There would be two Fab and Fc regions.
Extinction
Hapten (not immunogenic)

9. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Osteoblasts
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Retinoblastoma
The gut rotates clockwise around the superior mesenteric artery.
IQ

10. Name the most common type or cause - Infantile bacterial diarrhea
The T- test (used when comparing two groups)
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
Lisch nodules
The thyroid gland

11. What is the renal compensation mechanism for alkalosis?
Necator americanus is treated with mebendazole and iron therapy.
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result) - these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease - when obstructive symptoms begin to occur.
Bunyavirus
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+

12. What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?
Fungi
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
Ganglioside
Melasma

13. What female follicular cell is under LH stimulation and produces androgens from cholesterol?
Theca cell
Epispadia
Wiskott - Aldrich syndrome
Diethylcarbamazine

14. What acid - base disturbance is produced from vomiting?
CML and All
Addition (They are mutually exclusive.)
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.

15. Name the lipoprotein based on the following characteristics - apo A-1 - apo E - apo C- II
Female pseudohermaphrodite
HDL
Follicular adenoma
Follicular lymphoma

16. What rate is indicated by 1- sensitivity?
Accommodation
False - negative rate
Duchenne muscular dystrophy
Salmonella

17. What causes transcription to stop in eukaryotes?
Yolk sac tumor
Francisella tularensis
Ischemia
The poly(A) site on the DNA

18. What chromosome codes for HLA gene products?
The short arm of chromosome 6
Excess estradiol in the blood
Carbonic anhydrase
Fc portion of IgG - C3b - and mannose - binding proteins

19. Name the lung measurement based on the following descriptions: x Volume in the lungs at the end of passive expiration
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells
Functional residual capacity (FRC)
Free form determines hormone activity and is responsible for the negative feedback loop.
The limbic system

20. Name the Hgb - O2 binding site based on the following information: x Requires a PO2 level of 40 mm Hg to remain attached
The energy of activation
Site 3
Metronidazole
unprocessed Ags

21. Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms?
Histrionic
Craniopharyngioma
Nimodipine
Primary Hemochromatosis

22. What is the term for the ability of a test to measure something consistently?

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23. Have catalase.
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Vibrio vulnificus
Trypsin
Streptococci

24. Name the associated chromosome - Neurofibromatosis type 2
Chromosome 22q
Gametocytes
Nigrostriatal pathways (basal ganglia)
Tryptophan

25. What cell of the male reproductive system produces testosterone?
Aversive conditioning
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
There is a difference; it takes about 7 to 8 half - lives to reach mathematical steady state and 4 to 5 half - lives to reach clinical steady state.
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)

26. What encapsulated group of nerve endings seen at the muscle - tendon junction responds to an increase in tension generated in that muscle? (This is dropping a box that is too heavy to carry.)
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
Chronic rejection
Dominant parietal lobe (Gerstmann's syndrome)
Substance P. (Opioids relieve pain in part by blocking substance P.)

27. Where is lithium metabolized and excreted?

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28. Name the most common type or cause - Cyanotic heart disease
Dysplasia
Tetralogy of Fallot
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
Yes - because they both activate the BZ1- receptors - which can be reversed by flumazenil.

29. What P value defines whether the hull hypothesis should or should not be rejected?
In the JG cells of the kidney
P = .05; P < .05 rejects the null hypothesis
Metronidazole
Somatization disorder

30. What is the costliest health care problem in the United States?
Streptococcus agalactiae
Preganglionic sympathetic neurons
Alcohol and its related problems cost the country approximately $100 billion a year.
Argyll Robertson pupils

31. Kayser - Fleischer rings
Lateral medullary (Wallenberg's) syndrome
Afferent arteriole
Red pulp (Remember - Red pulp and RBCs begin with R.)
Wilson disease

32. What enzyme is deficient in hereditary protoporphyria?
Ferrochelatase
C2 deficiency
Granulosa cell
G0 phase

33. Is hirsutism a side effect of estrogen or progestin therapy?
Tolcapone and entacapone
Progestin
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
3 to 4 days

34. In a ventricular pacemaker cell - what phase of the action potential is affected by NE?
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
Prolactin
The time it takes ACh to diffuse to the postjunctional membrane
Phase 4; NE increases the slope of the prepotential - allowing threshold to be reached sooner - and increases the rate of firing.

35. What illegal drug can cause rhabdomyolysis - MI - cerebral infarct - and lethal cardiac arrhythmias?
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
Cocaine
Achondroplasia
CN VII and VIII

36. What happens to diastolic and systolic intervals with an increase in sympathetic activity?
Prostatic carcinoma
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
The lateral vestibular nucleus
Knee

37. What microaerophile is a motile gram - negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)?
Campylobacter jejuni
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.
Calcium oxalate
ACTH

38. Name five causes for zero - order metabolism.
1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
Erythema marginatum
Phentolamine and phenoxybenzamine

39. What type of correlation is defined as x One variable that diminishes in the presence of the other?
Negative correlation
Minor
Mode
IL-4

40. What vein drains the lower third of the thoracic wall?
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)
Pseudomonas aeruginosa
Hemiazygous vein

41. Contracting both medial rectus muscles simultaneously makes the images of near objects remain on the same part of the retina. What term describes this process?
Rickets
Bitemporal heteronymous hemianopsia
Haemophilus influenzae type B
Convergence

42. What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy?
Gardner syndrome
Mean corpuscular volume (MCV)
Celecoxib
Histidine

43. What type of collagen is abnormal in patients with osteogenesis imperfecta?
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Psammoma bodies
Pubis - ilium - and ischium
Erythema nodosum

44. Where does the conversion of CO2 into HCO3- take place?
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.
Internal carotid artery
Cancer
Sciatic nerve

45. What is given to pregnant women within 24 hours after birth to eliminate Rh+ fetal blood cells from their circulation?
Reinforcement
P = .05; P < .05 rejects the null hypothesis
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age
Rho (D) immune globulin (RhoGAM) - an anti - RhD IgG antibody - prevents generation of RhD- specific memory B cells in the mother.

46. Does light or darkness regulate the pineal gland?
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
a - and Beta- chains are on most T cells.
During REM sleep

47. Should not be treated with (beta) Beta- blockers.
1. Decrease alpha -1 activity 2. Increase Beta -2 activity 3. Increase ACh levels
Glioblastoma multiforme
Cocaine - induced coronary ischemia
Progestins

48. What disorder is associated with decreased platelet count - prolonged PT and PTT - decreased fibrinogen - and increased fibrin split products (D- dimers)?
Production of oxygen free radicals
Urinary 17- ketosteroids
Disseminated intravascular coagulation (DIC)
Moving objects - along with large bright objects with curves and complex designs.

49. What is the only valve in the heart with two cusps?
Mitral (bicuspid) valve
Boutonni
Prolactin
MGN

50. Name the area of the cerebral cortex with the function described: x Important for REM sleep; origin of NE pathway
Osteogenesis imperfecta
Cytochrome a/a3
Pons
Beryllium