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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. Name the insulin preparation based on the peak effect and duration of action - Peak - 8 to 12 hours; duration - 18 to 24 hours
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Cefuroxime and cefaclor
Gardnerella vaginalis
Lente or NPH insulin (neutral protamine Hagedorn insulin)

2. What is the drug of choice in treating a patient with hyperuricemia due to underexcretion of uric acid?
Mitral (bicuspid) valve
robenecid - a uricosuric agent
Scrofula
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)

3. What are the only two picornaviruses that do not lead to aseptic meningitis?
Primary hypercortisolism
Rhinovirus and hepatitis A virus
Staphylococcus saprophyticus
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive - compulsive disorder and learning disabilities.

4. What are the three branches of the inferior mesenteric artery?
A patent processus vaginalis
Left colic - superior rectal - and sigmoidal arteries
Minor
Ovulation

5. What form of endocarditis do patients with SLE commonly encounter?
Farnesyl pyrophosphate (FPP)
Libman - Sacks endocarditis
Being awake
Hemiazygous vein

6. Increases the risk of developing squamous cell carcinoma of the penis.
Visceral pleura
Humerus with ulna (major) and radius (minor)
robenecid - a uricosuric agent
HPV infection

7. What pharyngeal pouch and groove persist when a pharyngeal fistula is formed?
Phallus
Simon focus
Metaproterenol and albuterol
The second pharyngeal pouch and groove

8. What part of the heart forms x Apex?
Nephrotoxicity
Ticlopidine or clopidogrel
Tip of the left ventricle
Streptomycin

9. What is the name of the postganglionic parasympathetic ganglion that innervates x The papillary sphincter and ciliary muscle of the eye?
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Heroin
Streptococcus viridans

10. What results when the maxillary prominence fails to fuse with the medial nasal prominence?
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Desipramine
Cleft lip
Succinylcholine

11. What thyroid abnormality has the following? - TRH increased - TSH decreased - T4 decreased
Erythema nodosum
Filiform papillae
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).

12. What is associated with prolonged lithium use?
Mesencephalon
CD4+ T cells (helper)
Hypothyroidism. (TSH levels must be monitored.)
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.

13. What three cephalosporins can produce disulfiram - like reactions?
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Type IV hypersensitivity (cell - mediated)
Streptococcus viridans
Sphingosine

14. What disorder is associated with loss of polarity - anaplasia - pleomorphism - discohesiveness - increase in the nuclear:cytoplasmic ratio - hyperchromasia - and increase in the rate of mitosis?
Omphalocele and gastroschisis
Malignancy
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.

15. Can an acute MI be diagnosed only by looking at an ECG?
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
Chief cell adenoma (80%)
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
No. Remember - tests do not diagnose - they confirm or refute your diagnosis. Also - diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI - elevated cardiac enzymes consistent with MI - and ST segment elevati

16. What is the most common one? - Germ cell tumor in men
Seminoma
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.
Coronary circulation

17. What enzyme of the purine salvage pathway is deficient in the following? - SCID
Adenosine deaminase
The raphe nuclei
CD3
Jejunum (upper)

18. Name the valve abnormality based on the following criteria: x Systolic murmur - increased preload and afterload - decreased aortic pulse pressure and coronary blood flow
Aortic stenosis
PKU
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
The fasciculus cuneatus

19. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH decreased - Ca2+ decreased - Pi increased
Primary hypoparathyroidism
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)

20. What four conditions result in secondary hyperaldosteronism?
ACL
Left homonymous hemianopsia
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
CD19

21. Lacks glycerol kinase.
Increases
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
Rheumatic fever
Adipose tissue

22. What is the most common one? - Primary malignant tumor in the liver
Fungi
Occulta All except occulta cause elevated - fetoprotein levels.
Both Neisseria and Moraxella are gram - negative cocci.
Hepatocellular carcinoma

23. Name the laryngeal muscle described by the following: x Adducts the vocal ligaments - closes the air passageway during swallowing - and allows phonation
Chlortetracycline
Alcoholic cirrhosis
Lateral cricoarytenoid muscles
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)

24. What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
Myasthenia gravis
Transference. When it is from the physician to the patient it is called countertransference.
Tetany
Substituted judgment. It is made by the person who best knows the patient - not the closest relative.

25. In What tract does pain - temperature - and crude touch sensory information ascend to the postcentral gyrus of the parietal lobe?
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
Gonads
Spinothalamic tract (anterolateral system)
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.

26. What AA undergoes N- glycosylation?
Tropomyosin
ACh receptor
Asparagine
Trypanosoma cruzi

27. What is the major pulmonary side effect of
Increased androgen secretion at puberty drives the increased GH secretion.
Variable ratio If it is based on time - it is an interval - and if it is based on the number of responses - it is a ratio.
Ampulla
Respiratory depression

28. What component of the corneal reflex is lost in a CN VII deficit?
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Osteosarcoma
Motor aspect
Shigella

29. What CN is associated with the sensory innervation of x Nasopharynx?
1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors
Maxillary division of CN V and glossopharyngeal nerves
Breast
LTC4 and LTD4

30. What vitamin is a component of the enzymes fatty acid synthase and acyl CoA?
Pantothenic acid
3 to 4 days
Anticipation - associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.
The second pharyngeal pouch and groove

31. What region of the brain houses the central chemoreceptors responsible for control of ventilation?
The surface of the medulla
EF- Tu and EF- Ts of the 30S ribosomal subunit
Ascaris lumbricoides
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.

32. What tumor constitutes 40% of testicular tumors in children?
Areas 41 and 42
Teratoma
Cancer
Chromosome 14 - 18

33. What is the term for the type of pupil seen in neurosyphilis - and what ocular reflexes are lost?
False - positive rate
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
Conidia
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.

34. Which anticonvulsant is used in the treatment of bipolar disorder and neuropathic pain?
Gabapentin
Specific rate (e.g. - men aged 55-60)
Mikulicz syndrome
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c

35. What area of the posterior aspect of the eye has no photoreceptors?
The optic disk is the blind spot.
Acute tubular necrosis
Glycine/arginine
1. Posterior auricular vein 2. Posterior division of the retromandibular vein

36. What cell converts androgens to estrogens?
Granulosa cell
Superior
Enkephalins
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)

37. Lucid interval
The anterior nucleus of the thalamus
Epidural hematoma
Lysosomal a -1 - 4- glucosidase
Staphylococcus aureus

38. With What thoracic vertebra or vertebrae does rib 7 articulate?
Endometrial cancer
Leiomyoma
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.

39. What disease involves cold skin abscesses due to a defect in neutrophil chemotaxis and a serum IgE level higher than 2000?
Rapid efflux of potassium
Histamine
Job syndrome
Toxoplasma gondii

40. Is the following description characteristic of competitive or noncompetitive antagonists: parallel shift to the right on a dose - response curve - complete reversibility with increase of the dose of the agonist drug - and capacity to decrease the pot
Competitive antagonist
Prolyl and lysyl hydroxylases
Catatonic schizophrenia
Turner syndrome

41. Are the following responses associated with histamines H1 or H2 receptor activation? - Pain and pruritus
The vaccine contains 23 capsular polysaccharides.
H 1
Succinylcholine
Superego

42. What are the three rules governing a secondary immune response?
Epinephrine
Efficacy
1. Covalent bonding between the hapten and carrier 2. B- cell exposure to hapten twice 3. T- cell exposure to carrier twice
Giardia lamblia (treat with metronidazole)

43. What is the most common one? - Malignant tumor of the esophagus
Squamous cell carcinoma
Intercellular adhesion molecule (ICAM) 1
Leucine and lysine
Alanine cycle

44. What is the term to describe inability to recall the past and possible assumption of a completely new identity?
Fentanyl
Excess estradiol in the blood
Mitochondrial inheritance
Dissociative fugue. (Patients are unaware of memory loss.)

45. Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
Embolic
Major
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Short - chain fatty acids

46. What is the most common one? - Neoplastic tumor in the lungs
CN V2
Sucralfate
VSD
Metastatic carcinomas

47. What is the term for dilated veins within the spermatic cord?
Production of oxygen free radicals
Gluteus maximus
Multiple myeloma
Varicocele

48. What Freudian psyche component is described as x The urges - sex aggression - and 'primitive' processes?
Id (pleasure principle)
ACE inhibitors (the - pril agents)
Pancreatic cancer
IgA - IgD - IgE - IgG - and IgM

49. Stimulate hair cells at the base of the cochlea.
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
High - frequency sound waves
Serratus anterior
greater

50. Is an anti - HAV IgG Ab associated with immunization or recent infection?
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
Pyelonephritis
Secondary hypoparathyroidism (vitamin D toxicity)
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.