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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 bactericidal agent is the DOC for MRSA - enterococci - and Clostridium difficile?
Vancomycin
Keloid
Galactose and glucose
Site 3

2. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Calcitonin
Negative predictive value
Metastatic carcinoma
Medullary carcinoma of the thyroid
Cocaine

3. Name the antidote - Opioids
Huntington disease
They prevent mast cell degranulation.
Naloxone - naltrexone
Anterior tibial artery

4. What is the main mechanism for exchange of nutrients and gases across a capillary membrane?
G-6- PD deficiency
Simple diffusion; it does not use protein - mediated transport
14 days in most women (Remember - the luteal phase is always constant.)
Alveoli; they are part of the respiratory portion.

5. What hereditary bone disorder is due to decreased osteoclast function - resulting in thick - sclerotic bones that fracture easily?
Osteopetrosis (Albers - Sch
Rhinovirus and hepatitis A virus
Superior and posterior
Achondroplasia

6. Are used in diagnosing CREST syndrome.
Chromosome 4p
Neurofibromatosis
Aortic stenosis
Anticentromere Abs

7. What is the most common one? - Primary CNS tumor
Glioblastoma multiforme
Mitral valve prolapse
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Saccule and utricle

8. As what AAs do muscles send nitrogen to the liver?
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Median nerve
Alanine and glutamine
Ciliary ganglion

9. Would a G- C or an A- T rich dsDNA sequence have a higher melting point? Why?
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Treacher Collins syndrome
Chromophobe adenoma
excites the neuron

10. What type II hypersensitivity disorder is defined as x Autoantibodies directed against ACh receptors?
Borderline
Onion skinning
Zanamivir and oseltamivir
Myasthenia gravis

11. Name the macrophages by location: x Liver
Staphylococcus aureus
Kupffer cells
Urachus
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.

12. Name the phase of the ventricular muscle action potential based on the following information: x Slow channels open - allowing calcium influx; voltage - gated potassium channels closed; potassium efflux through ungated channels; plateau stage
Phase 2
No change in length
Isotonic contraction
antiemetic

13. Name the antimicrobial agent whose major side effect is listed - Cartilage abnormalities
Target cell
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
Quinolones
Pygmalion effect (experimenter expectancy). This can be eliminated with double - blind studies.

14. What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN - hypokalemia - and low rennin levels?
Vesicular stomatitis virus
Conn syndrome (primary hyperaldosteronism)
Diethylcarbamazine
Sphingomyelin (lecithin also - but it is not a sphingolipid)

15. What embryonic structure forms the following adult structures? - Collecting ducts - calyces - renal pelvis - and ureter
Enterococcus faecalis
Histrionic
Mesonephric duct (ureteric bud)
Dilation of efferent arteriole

16. What sphingolipid cannot be produced without sialic acid and amino sugars?
90% of benign myxomas arise within the left atrium near the fossa ovalis.
Insulin
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember - it may be negative in the first week of the illness - so retest if you have a high index of suspicion.)
Ganglioside

17. What is the essential reservoir host for Toxoplasma gondii?
Alternative hypothesis (What is left after the null has been defined)
14 days in most women (Remember - the luteal phase is always constant.)
Protamine sulfate
The cat

18. Which dopamine receptor excites the direct pathway of the basal ganglia?
Coxsackie B
CD16 and CD56
Volvulus
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.

19. What is the most common one? - Skin tumor in the United States
Bunyavirus
Rho (D) immune globulin (RhoGAM) - an anti - RhD IgG antibody - prevents generation of RhD- specific memory B cells in the mother.
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
Basal cell carcinoma

20. What is the MCC of viral conjunctivitis?
Fo/F1 complex
Malassezia furfur (treat with selenium sulfide)
Dantrolene
Adenovirus

21. 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 ?
Dilation of afferent arteriole
1. ADP 2. PG 3. TXA2
Glycogen phosphorylase
Marijuana

22. What is the term for any stimulus that increases the probability of a response happening?
Reinforcement
Obese patients
C2 deficiency
Ataxia - telangiectasia

23. What CNS tumor arises from Rathke's pouch?
Squamous cell carcinoma
Craniopharyngioma
Glycine/arginine
Mitochondria

24. What type of GN - associated with celiac disease and dermatitis herpetiformis - has mesangial deposits of IgA - C3 - properdin - IgG - and IgM?
Estradiol
Intraductal papilloma
2.0 or greater
Berger disease (IgA nephropathy)

25. What enzyme of the purine salvage pathway is deficient in the following? - Lesch - Nyhan syndrome
Meclizine
CN III
Coccidioides immitis
HGPRT

26. The increased oxygen consumption after phagocytosis is for...
Afterload
Taenia saginata
Proton pump inhibitors
ATP production

27. Has very little effect on arteriolar dilation or constriction.
The parasympathetic nervous system
Squamous cell carcinoma
Spironolactone
Frameshift

28. What are the three carboxylase enzymes that require biotin?
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
VLDLs
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
NH4+(ammonium)

29. What disease is associated with the HLA- DR2 and HLA- DR3 alleles
Cytochrome a/a3
Bronchiectasis
Systemic lupus erythematosus
Carbamazepine

30. Name the type of exudate - given the following examples - Parasitic infection
No - it is never acceptable to lie.
Addition (They are mutually exclusive.)
Eosinophilic exudates
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)

31. What are the first signs of phenobarbital overdose?
Broca's aphasia
Secondary hypercortisolism (pituitary)
Nystagmus and ataxia
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse - hyperreflexia - spastic paralysis - increased muscle tone - and weakness are commonly seen in UMN lesions.

32. Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
Anticentromere Abs
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.

33. What enzyme is deficient in patients with CGD?
O2
Confidence interval. It is a way of admitting estimation for the population.
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
Chronic end - stage renal disease

34. Name the antimicrobial agent whose major side effect is listed - Grey baby syndrome
Chloramphenicol
Itraconazole
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.
Permanent

35. What enzyme requires molybdenum as a cofactor?
Xanthine oxidase
Median nerve lesion
competency
1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors

36. What neuroleptic agent causes agranulocytosis but does not induce tardive dyskinesia?
Atrial filling (venous filling) Atrial - Contraction - Venous
Mean
Clozapine
Fructose -1 - 6- bisphosphatase

37. What receptor is in the smooth muscle cells of the small bronchi - is stimulated during inflation - and inhibits inspiration?
Lesch - Nyhan syndrome
Hurler syndrome and Hunter syndrome - respectively
The primitive streak grows caudal to rostral.
Stretch receptors prevent overdistension of the lungs during inspiration.

38. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Hypothalamus
Proencephalon diencephalon derivative
Alcohol consumption
Hodgkin lymphoma
Chromomycosis

39. What is the most common one? - Helminthic parasite worldwide
Alveoli; they are part of the respiratory portion.
Direct; in males less than 50 years old indirect hernias are the most common type.
Ascaris lumbricoides
M12 strains

40. Which leukotriene is chemotactic for neutrophils?
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
As the name indicates - there is no change in volume but there is an increase in pressure.
LTB4
Dihydrofolate reductase

41. Which type of hepatitis is a picornavirus?
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
Hepatitis A (infectious)
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Foscarnet

42. Stimulate hair cells at the base of the cochlea.
High - frequency sound waves
Cholera toxin
A positive PPD skin test
Glucokinase

43. By What age should children be able to draw the following figures? - Circle
ASA (salicylate)
3 years old
Massive influx of calcium
Erectile dysfunction

44. What happens to affinity if you increase Km?
Osteosarcoma
Anatomical dead space - which ends at the level of the terminal bronchioles.
Raynaud's phenomenon
Affinity decreases; they are inversely proportional.

45. Regarding the Lac operon - for What do the following genes code? - A gene
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
Thiogalactoside transacetylase
Hirschsprung's disease (colonic gangliosus)
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.

46. After traveling in a plane across the Atlantic Ocean - an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose?
CN XI and X
PDA
M 2
Pulmonary embolism due to a DVT; this is not absolute but a classic description.

47. A 60-year - old man has back pain (compression spinal fracture) - hypercalcemia - increased serum protein - Bence - Jones proteinuria - and monoclonal M- spike on serum electrophoresis. What is your diagnosis?
3 to 4 days
Dopamine
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
Multiple myeloma

48. What is the term for drug removal per unit of time in a given volume of blood?
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Clearance
Denial

49. What term describes the reflex that increases the curvature of the lens - allowing near vision?
Accommodation
S phase
Isoniazid
Breast

50. What region of the pharynx does the eustachian tube enter?
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
Staphylococcus aureus
Nasopharynx
Autoimmune thrombocytopenia purpura

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