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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 form of renal tubular reabsorption is characterized by low back leaks - high affinity of a substance - and easy saturation? It is surmised that the entire filtered load is reabsorbed until the carriers are saturated - and then the rest is excret
A transport maximum (Tm) system
Glucose -6- phosphatase
HBsAb IgG
Fibrinous exudates

2. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH decreased - Ca2+ increased - Pi increased
Type I pneumocytes
Lactulose
Secondary hypoparathyroidism (vitamin D toxicity)
80S ribosomes (because they are eukaryotic)

3. Progesterone has __________ activities.
Thermogenic
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
Knee
T wave

4. What molecule that is needed to trigger T cell activation is noncovalently linked to TCR?
Proencephalon
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Tetany

5. Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia?
Total lung capacity (TLC)
Lead poisoning
d - Tubocurarine
Spinal trigeminal nucleus

6. What glycoprotein in the HIV virus is used for fusion?
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.
Bactericidal
Superior and posterior
GP41

7. What are the three stimuli that result in the reninangiotensin - aldosterone secretion?
Francisella tularensis
DNA polymerase - a
Major
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells

8. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Osmolarity
300 mOsm/L
H 2
Gout
Scleroderma

9. What connects the lateral ventricles to the third ventricle?
Foramen of Monro
90% of benign myxomas arise within the left atrium near the fossa ovalis.
S phase
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)

10. What is the primary target for the action of glucagon?
Glutamate
Are live attenuated vaccines available in the United States
Liver (hepatocytes)
Yolk sac tumor

11. What CNs are responsible for the sensor and motor components of the light reflex?
Eosinophils
Residual volume (RV)
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Squamous cell carcinoma

12. What fungus is seen as colored cauliflower lesions?
Chromomycosis
Pseudomonas aeruginosa
Bernard - Soulier syndrome
The bifurcation of the abdominal aorta

13. What is the most common opportunistic infection of the CNS in HIV?
Meningocele All except occulta cause elevated - fetoprotein levels.
Opposite the second upper molar tooth
Toxoplasmosis
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12

14. Name the most common cause - A cold in the winter and summer
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
Lateral compartment of the leg - superficial peroneal nerve
Listeria monocytogenes
Coronavirus

15. What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Chromosome 14 - 18
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Ependymoma

16. What form of Plasmodium species affects the liver?
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
Cytochrome b/c1
Hypnozoite
1. ADP 2. PG 3. TXA2

17. What receptor is in the smooth muscle cells of the small bronchi - is stimulated during inflation - and inhibits inspiration?
Estriol
The number of Ags that the Ab can bind
Nicotinic acid - because its side effects include hyperuricemia and exacerbation of ulcers.
Stretch receptors prevent overdistension of the lungs during inspiration.

18. Name the most common type or cause - Cellular injury
Hypoxia
Insulinoma
Null hypothesis (what you hope to disprove)
Group A Beta- hemolytic streptococci

19. What is the term for new made - up words?

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20. How much of a vessel must be stenosed to cause sudden cardiac death?
Eisenmenger syndrome - which can also occur with any left - to - right shunt
To provide attachment between contiguous cells and to maintain a semipermeable barrier
M- cells
More than 75% of the vessel

21. What is the amount in liters and percent body weight for the following compartments? - Vascular fluid
Necrophilia
Stable
Permanent
4.7 L - 5% of body weight

22. What is the most common one? - Solid tumor in the body
Ventral lateral nucleus
Nephroblastoma
RBCs
Clonidine

23. What is the most common one? - Benign lesion that affects the breast
Negative
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Fibrocystic change of the breast
Fusobacterium

24. Senile plaques
Reverse transcription
Constipation and miosis
C3 deficiency
Alzheimer disease

25. How many days before the first day of menstrual bleeding is ovulation?
Liver
PGD2 - PGE2 - and PGF 2
14 days in most women (Remember - the luteal phase is always constant.)
Recovery and death

26. What is the pyrimidine intermediate that joins PRPP (5- Phosphoribosyl -1- Pyrophosphate)?
Axillary nerve and posterior humeral artery
Pulmonary alveolar macrophages
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
Orotic acid (purine metabolism)

27. What class of drugs are the DOCs for peptic ulcer disease - Zollinger - Ellison syndrome - and gastroesophageal reflux disease?
Pterygopalatine ganglion (I remember this as the only ganglion left.)
Proton pump inhibitors
1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity
Macula densa

28. What syndrome is associated with gastrin - producing islet cell tumor resulting in multiple intractable peptic ulcers?
Clindamycin
Asparagine
apo A-1
Zollinger - Ellison syndrome

29. What CN is associated with the x Fifth pharyngeal arch?
None; it degenerates.
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Splenic flexure

30. Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
Ribavirin
M 2
Nodular sclerosis

31. Which class of antihypertensives produces angioedema - hyperkalemia - and a dry cough?
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
ACE inhibitors (the - pril agents)
Primary hyperaldosteronism (Conn syndrome)

32. What two compensatory mechanisms occur to reverse hypoxia at high altitudes?
Increase in erythropoietin and increase in 2 - 3- BPG - also called 2 - 3- diphosphoglycerate (2 - 3- P2Gri) (increase in glycolysis)
IgE
Endometrial cancer
Pasteurella multocida

33. Name the antidote - Digoxin
HTN
Salmeterol
Estriol
Antidigoxin Fab fragments

34. What four factors shift the Hgb - O2 dissociation curve to the right? What is the consequence of this shift?
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
TB meningitis
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.
Accidents

35. What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
Berry aneurysm
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Operant conditioning (reinforcement is after a response)

36. What is the precursor of all sphingolipids?
Maxillary artery
Gardnerella vaginalis
Ceramide
CN III - IV - and VI

37. What embryonic structure forms the following adult structures? - External genitalia
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Disulfiram
Phallus - urogenital folds - and labioscrotal swellings
Borrelia recurrentis

38. Are necessary for normal menstrual cycles.
Trimethoprim
Thyroid hormones
Ankylosing spondylitis
CD3

39. Name the DNA virus: x Linear dsDNA; naked; replicates in the nucleus
Adenovirus
Aldehyde dehydrogenase
Osteoarthritis
Subclavian vein

40. What motile - gram - negative spiral bacillus with flagella is oxidase positive - urease positive - and associated with gastritis - peptic ulcer disease - and stomach cancer?
N- formyl - methionine LTB4 C5a IL-8
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Helicobacter pylori
Left homonymous hemianopsia

41. If a mother delivers a Rho - positive baby - she should receive...
IL-5. It also stimulates eosinophil proliferation.
False - positive rate
enveloped
Rho-immunoglobin

42. Describe What type of fluid is either gained or lost with the following changes in body hydration for the ECF volume - ICF volume - and body osmolarity - respectively: x ECF - decrease; ICF - decrease; body: increase
Epinephrine
Blastoconidia
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
Lipoid nephrosis

43. What is the major hormone produced in the following areas of the adrenal cortex? - Zona glomerulosa
Poliomyelitis; it is a bilateral LMN lesion.
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Chromosome 15 - 17
Venlafaxine. (It also has a mild dopaminergic effect.)

44. Where are the preganglionic neuron cell bodies - the CNS or the PNS?
They are in the grey matter of the CNS.
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
Vimentin
Puborectalis

45. Name the antimicrobial agent whose major side effect is listed - Grey baby syndrome
gamma and delta chains
Transcription factor IID
Chloramphenicol
Cushing's ulcers

46. What cell surface marker do all T cells have?
Arnold - Chiari malformation type 2
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.
Silent
CD3

47. What component of the trigeminal nuclei x Receives sensory input (all but pain and temperature) from the face - scalp - dura - and the oral and nasal cavities?
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Spinal trigeminal nucleus
Internal carotid artery

48. What type of muscle is characterized by no myoglobin - anaerobic glycolysis - high ATPase activity - and large muscle mass?
White muscle; short term too
Th2 cells
Malpighian layer (made up of the stratum basale and stratum spinosum)
Urinary trigone

49. What causes the lysis of RBCs by oxidizing agents in a G-6- PD deficiency?
TAT (Thematic apperception test)
Celiac sprue (gluten - sensitive enteropathy)
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.
The larger the volume of distribution - the lower the plasma concentration of a drug.

50. Prolactin levels can serve as a rough indicator of...
Type IV hypersensitivity (cell - mediated)
overall dopamine activity
Ligament of Treitz
Pneumococcus