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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. How many months in How many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
3 months of symptoms in 2 consecutive years
Chromosome 22q
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
ACTH

2. What is the most common one? - Congenital heart defect in adults
ASD
Chromosome 17
Alzheimer disease
Viruses

3. In what disease is there a genetic absence of UDP- glucuronate transferase - resulting in an increase in free unconjugated bilirubin?
Crigler - Najjar syndrome
CN IX - X - and XII CN XI arises from the cervical spinal cord.
Sphingomyelinase
Vancomycin

4. What viral infection is known to cause intracerebral calcifications?
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
CN III and IV
With arteriolar constriction both the flow and pressure downstream decrease.
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae

5. What law states that an enlarged - palpable gallbladder is more likely due to cancer than stone obstruction?

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6. What disorder is due to a 5-- reductase deficiency - resulting in testicular tissue and stunted male external genitalia?
Langerhans cells (found in the stratum spinosum)
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
Thiazide diuretics
Bipolar disorder (manic - depressive disorder)

7. What is the term for the heart's inability to maintain perfusion and meet the metabolic demands of tissues and organs?
Glucosyl cerebroside
CHF
Primary Hemochromatosis
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS

8. What oral hypoglycemic agent inhibits a - glucosidase in the brush border of the small intestine?
Cingulate gyrus herniation (subfalcine)
Entamoeba histolytica
Acarbose
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans

9. 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.
The notochord
The folding of an AA chain
The pulsatile release of GnRH

10. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x Ki - ras and erb -2
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.
enveloped
Sideroblastic anemia
Lung cancer

11. As what compound do the carbons for fatty acid synthesis leave the mitochondria?
Citrate - via the citrate shuttle
C3 deficiency
Allopurinol
Prokaryotes. Polycistronic and prokaryotes both start with P.

12. What stage of sleep is associated with somnambulism?
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.
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Aspiration pneumonia
CD28

13. What are the five components of portal HTN?
The portal tract of the liver lobule
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
CN X (Remember - the vagus nerve supplies the parasympathetic information from the tip of the pharynx to the end of the midgut and all between.)
Familial polyposis coli

14. Describe the organism based on the following information: x Alpha - Hemolytic Streptococcus; lysed by bile; sensitive to Optochin
Pneumococcus (Streptococcus pneumoniae)
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
Axis II
HMG- CoA reductase

15. What AA is a precursor of the following substances? - GABA
Chorda tympani of CN VII
Glutamate
Lipoid nephrosis
There would be a Fab' region; thus - it would still be able to participate in precipitation and agglutination.

16. What component of the cardiovascular system has the largest blood volume? Second largest blood volume?
Third M PITS for pharyngeal pouch derivatives
1. Iliocostalis 2. Longissimus 3. Spinalis ('I Love Science' muscles)
The systemic veins have the largest blood volume - and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.

17. What is needed to initiate translation?
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency
IF and GTP (eIF for eukaryotes)
Proencephalon
Autosomal recessive

18. Which fungus is found worldwide on plants - is a cigar - shaped yeast in tissue form - and results in rose gardener's disease?
Secondary spermatocyte
Acanthosis nigricans
Relative refractory period
Sporothrix schenckii

19. In what X- linked recessive disease is there a decrease in the HMP shunt - along with Heinz body formation?
Duchenne muscular dystrophy (Remember - Becker's is slower in progress - less severe - later in onset - and lacks cardiac involvement.)
G-6- PD deficiency
Testicular lymphoma
Superior

20. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Percentage of Na+ - Cl - - K+ left in the lumen
t the end of the PCT 25% of Na+ - Cl - - K+ is left
RSV
Superior and posterior
Dopamine antagonists

21. What area of the posterior aspect of the eye has no photoreceptors?
The optic disk is the blind spot.
Clarke's nucleus
BPH
Removal of the ileum

22. What form of arthritis is associated with calcium pyrophosphate crystals?
Pseudogout
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.
Outside the cell

23. What are the two most common chains of the TCR?
Posterior cruciate ligament
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
a - and Beta- chains are on most T cells.
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material

24. How long is the transit time through the small intestine?
Acarbose
2 to 4 hours
Biotin - ATP - and CO2
IgA nephropathy (Berger disease)

25. What medication is used to help alcoholics avoid relapse by decreasing glutamate receptor activity?
B lymphocyte
H 2
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
Pertussis toxin

26. What Ig is associated with ADCC for parasites?
IgE
LH
Spermatogonia (type A)
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.

27. What are the longest - acting and shortest - acting benzodiazepines?
Diazepam is longest acting and midazolam is shortest acting.
Hepatitis B and hepatitis C
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae
Squamous cell carcinoma

28. Ventral rami of what cervical nerves constitute the phrenic nerve?
Neisseria gonorrhoeae and Chlamydia trachomatis
Urophilia
C3 - C4 - and C5 keep the diaphragm alive!
Right medial longitudinal fasciculus

29. What blotting technique uses the following for analysis? - DNA
Bacteria
Southern blot
Autosomal recessive
Testicular feminization syndrome (Dude looks like a lady!)

30. Is a subdural hematoma an arterial or venous bleed?
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Null hypothesis (what you hope to disprove)
8 to 25 hours
Low molecular weight heparin (LMWH)

31. Name the type of mutation: x The deletion or addition of a base
Free - unprocessed Ag
Frameshift
Dilation of efferent arteriole
Dihydrofolate reductase

32. What reticular nuclei synthesize serotonin from L- tryptophan and plays a role in mood - aggression - and inducing sleep?
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase
Cancer of the lung - stomach - colon - and breast
The raphe nuclei
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.

33. What are the primary neurotransmitters at the following sites? - Postganglionic sympathetic neurons
NE
Menstruation
Breast cancer
The inner membrane of the mitochondria (cristae)

34. What phase of the cell cycle are the following antineoplastic agents specific for? - Alkylating agents
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
LTB4
G0 phase
Sulfonamides

35. What malignant tumor of the skin is associated with Birbeck granules?
Anterior wall of the first part of the duodenum
Unipolar disorder (major depression)
Histiocytosis X
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.

36. Hereditary angioneurotic edema (AD) produces local edema in organs (e.g. - GI - skin - respiratory tract). What enzyme deficiency causes increased capillary permeability due to a release of vasoactive peptides?
Contralateral loss below and bilateral loss at the level of the lesion
Hepatitis A
Leiomyoma (fibroids)
C1 esterase inhibitor (C1INH)

37. What Beta- blocker is also a membrane stabilizer?
Tidal volume (VT)
PGE 1 - PGI 2 (most potent) - and TXA 2
Coxiella burnetii
Propranolol

38. What is the term for increased iron deposition resulting in micronodular cirrhosis - CHF - diabetes - and bronzing of the skin?
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
Hemochromatosis
>15 mm
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)

39. What is the name of the postganglionic parasympathetic ganglion that innervates x The lacrimal gland and oral and nasal mucosa?
Pterygopalatine ganglion (I remember this as the only ganglion left.)
Anemia
Excretion is greater than filtration for net secretion to occur.
Trimethoprim

40. What pneumoconiosis is associated with exposure to the following occupations or materials? - Miners - metal grinders - and sandblasters

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41. On what chromosome is the adenomatous polyposis coli gene?
Middle cerebral artery
Subthreshold potential
Chromosome 5q21
Hemiazygous vein

42. What are the four ways to increase TPR?
Clostridium botulinum
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels
Phallus
Jejunum (upper)

43. What is the term to describe jumping from one topic to the next without any connection?
Osteoclasts
Loose association
Catechol - O- methyl transferase (COMT)
Lateral collateral ligament

44. What is the term for the day after the LH surge in the female cycle?
Palms - up before palms - down maneuvers
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Penicillin G (benzylpenicillin)
Ovulation

45. What is the most common one? - Germ cell tumor in boys
Yolk sac tumor
IgA nephropathy
Gonads
Huntington disease

46. Which overdose carries a higher mortality rate - that of benzodiazepines or barbiturates?
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
Dihydrofolate reductase
HBsAg as its envelope

47. What is the main factor determining GFR?
G2 phase (gap 2)
Mild (50-70)
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
Alternative hypothesis (What is left after the null has been defined)

48. What facultative intracellular fungus is associated with hepatosplenomegaly?
Obese patients
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Isovolumetric contraction
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available - but the renal collecting ducts are impermeable to its actions.

49. Where does CHO digestion begin?
In the mouth with salivary a - amylase (ptyalin)
Nitroprusside
Carbonic anhydrase
Removal of the ileum

50. What syndrome has loss of deep tendon reflexes - muscle weakness - and ascending paralysis preceded by a viral illness?
Guillain - Barr
Carbonic anhydrase
Metaproterenol and albuterol
Down syndrome (trisomy 21)