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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 is the epithelial cell lining the nasopharynx?
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.
Osteopetrosis (Albers - Sch
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.

2. What is the drug of choice in treating a patient with hyperuricemia due to underexcretion of uric acid?
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
robenecid - a uricosuric agent
Pyridoxine
Internal abdominal oblique

3. What two factors lead to the development of the bends (caisson disease)?
Aspiration pneumonia
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.

4. What three Beta- blockers are used in the treatment of glaucoma?
Rationalization
Chromosome 3p
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
1. Propranolol 2. Timolol 3. Carteolol

5. What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated?
Dystrophic calcification
Sj
2 and 5HT3 receptors
LTB4

6. What paraphilia is defined as x Deriving sexual pleasure from being abused or in pain?
Protamine sulfate
The pulsatile release of GnRH
Fixed ratio (rewards set behaviors)
Masochism

7. What is it called when levels of sex steroids increase - LH increases - and FSH increases?
GnRH pulsatile infusion
Gradient - time system
Proencephalon
The folding of an AA chain

8. What apoprotein on HDL activates lecithin - cholesterol acyltransferase (LCAT)?
apo A-1
CN X
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
Type IV hypersensitivity (cell - mediated)

9. What type of personality test is the Rorschach inkblot test - objective or projective?
Adipose tissue
Pulmonary infections
Medial umbilical ligaments
Projective test. Most tests with a wide range of possibilities for the answers are projective.

10. Why is hypothyroidism associated with night blindness?
Ungated potassium channel
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
Thyroid hormones are necessary for conversion of carotene to vitamin A.
Cryptococcus neoformans

11. What cardiac reflex is characterized by stretch receptors in the right atrium - afferent and efferent limbs via the vagus nerve - and increased stretch leading to an increase in heart rate via inhibition of parasympathetic stimulation?
Bainbridge reflex
Diphyllobothrium latum
Healing by secondary intention
Mebendazole

12. What is the term to describe the limited portion of an Ag that is recognized by an Ab?
Trichomonas vaginalis (treat with metronidazole)
Lactose must be present and glucose must be absent
Chromaffin cells (adrenal medulla)
Antigenic determinant (epitope)

13. What is the term for a substance secreted by a leukocyte in response to a stimulus?
Emphysematous bleb
ater flows from a low - solute to high - solute concentrations.
Unconjugated free bilirubin
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.

14. What transmural inflammatory bowel disease can be found from the mouth to anus - has noncaseating granulomas - is discontinuous (skip lesions) - and has a cobblestone appearance - thickening of the bowel wall - linear fissures - and aphthous ulcers w
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)
Crohn disease
Burr cells (echinocytes)
More Ab is produced in less time in a secondary immune response (shorter lag period).

15. What is the most common one? - Site of ischemia in the GI tract
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Splenic flexure
Achondroplasia
Ordinal scale (e.g. - faster/slower - taller/shorter)

16. What enzyme catalyzes the rate - limiting step in fatty acid synthesis?
The negative charge inhibits the filtration of protein anions.
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
Acetyl CoA carboxylase
Pyelonephritis

17. What modified smooth muscle cells of the kidney monitor BP in the afferent arteriole?
The JG cells
<2
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve
It decreases insulin secretion.

18. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Placental alkaline phosphatase
Seminoma
Heart disease
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.
Nodular sclerosis

19. All Proteus species are...
Fungi
Eosinophils
urease positive
Arginine

20. What growth factors are chondrogenic - working on the epiphyseal end plates of bone?
G0 phase
Foramen of Monro
Somatomedins (IGF-1)
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+

21. What are the two factors that affect alveolar PCO2 levels?
Sensitivity (it deals with the sick)
Metabolic rate and alveolar ventilation (main factor)
45XO
Previous suicide attempt

22. Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
1. Streptomycin 2. Gentamicin 3. Tobramycin
Conjugated (direct) hyperbilirubinemia - a transport defect
IL-5. It also stimulates eosinophil proliferation.

23. What AD syndrome involves 1000 or more edematous polyps - most commonly affects the colorectal area - and is associated with chromosome 5q21?
17- alpha - Hydroxylase deficiency
Familial polyposis coli
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)

24. What GnRH analog is used as a repository form of treatment in prostatic cancer?
Middle meningeal artery
Avidity. There is a positive correlation between valence numbers and avidity.
Leuprolide
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).

25. What is the bioactive form of thyroid hormone?
Internal carotid artery
Keloid
T3
Alanine and glutamine

26. Increases your risk factor for testicular cancer.
Being a white male
Autosomal recessive
Production of oxygen free radicals
Obsessive - compulsive

27. What form of anxiety - appearing at 6 months - peaking at 8 months - and disappearing by 1 year of age - is seen in the presence of unfamiliar people?
Stranger anxiety
Acetyl CoA carboxylase
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.

28. What term is defined as a patient unconsciously placing his or her thoughts and feelings on the physician in a caregiver or parent role?
Transference. When it is from the physician to the patient it is called countertransference.
Cholera toxin
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
C2 deficiency

29. What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
PDA
Proencephalon
Heroin
Kidney

30. What tumor is seen in the 2- to 4-year - old age group; does not cross the midline; has immature glomeruli - tubules - and stroma; and metastasizes late to the lungs?
Foramen of Winslow
Wilms tumor
Emphysematous bleb
Nephroblastoma

31. What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
Conjugated (direct) hyperbilirubinemia - a transport defect
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
The folding of an AA chain
Hemolytic uremic syndrome

32. What type of hormone is described as having intracellular receptors - being synthesized as needed - mostly bound to proteins - and having its activity determined by free hormone levels?
Affinity (one of each)
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).
Lipid - soluble hormones are considered slow - acting hormones.
Area 8

33. What is the rule of one - third regarding muscle type of the esophagus?
Staphylococcus aureus
Temporal lobes
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle

34. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Naphthylamine
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
Bladder cancer
A low - resistance system is formed by resistors added in parallel.
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism

35. What small gram - negative facultative intracellular rod is transmitted to human host by Dermacentor tick bite?
Seminoma
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
Francisella tularensis

36. What is the second arrested stage of development in the female reproductive cycle?
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Theca cell
Decreases

37. What is the only local anesthetic to produce vasoconstriction?
Cocaine
Osmosis; water will diffuse from higher to lower water concentrations.
Dilator pupillae muscle
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.

38. What three cells are essential for T- cell differentiation in the thymus?
Chromosome 15 - 17
von Gierke's disease
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
Dendritic cells - macrophages - and thymic epithelial cells

39. What do low levels of Ca2+ and PO4- along with neuromuscular irritability indicate?
HBc Ab
Ankylosing spondylitis
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)
Hypoparathyroidism

40. What is the rate - limiting step in the production of steroids?
Leydig cell tumor
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
The conversion of CHO to pregnenolone via the enzyme desmolase
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)

41. What large - spore - forming - gram - positive anaerobic rod is associated with infections due to puncture wounds and trauma?
Clostridium tetani
Propionibacterium acnes
Pyruvate carboxylase
Osler nodes

42. Which gram - negative diplococcus ferments maltose?
These are the gross pathologic changes associated with Alzheimer's disease.
Carbamazepine
Thoracic and sacral
Meningococcus (Gonococcus does not)

43. What is the term for a delay in the onset of normal IgG synthesis seen in the fifth to sixth month of life?
Excess estradiol in the blood
ACh
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
Prader - Willi syndrome and Angelman syndrome - respectively

44. What is the name of the major chemotactic agent released from x Bacteria?
Fibrinous exudates
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
F- Met - Peptides
Antidigoxin Fab fragments

45. What adrenergic receptors use inositol triphosphate (IP3) and diacylglycerol (DAG) for their second messenger system?
Purkinje cell is the fastest - and the AV node is the slowest.
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.
a1- Receptors
Early distal tubule

46. What encapsulated gram - negative - lactose - fermenting rod is associated with pneumonia in patients with alcoholism - diabetes - and chronic lung disease?
Trapezius and sternocleidomastoid
Wilms tumor
Gangrenous necrosis
Klebsiella pneumoniae

47. What are the adult remnants of the following structures? - Ductus venosus
Ligamentum venosum
Oxytocin
Arcuate line
PGE2

48. Name the compartment of the mediastinum associated with the following thoracic structures: Splanchnic nerves
ydroxyproline
Posterior
Proencephalon
Preload (the load on the muscle in the relaxed state)

49. What happens to the following during skeletal muscle contraction? - Actin and myosin lengths
Autosomal dominant
Rationalization
PRPP aminotransferase
No change in length

50. Name the most common cause - Croup
Myasthenia gravis
At birth (reflex)
Tinea favosa (favus)
Parainfluenza virus