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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. Are white rami preganglionic or postganglionic fibers?
7 years old
Prolactinoma
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.

2. What condition results from a deficiency in the enzyme hexosaminidase A?
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland
Kupffer cells
Tay- Sachs disease
Primitive ventricle

3. Name the product or products of arachidonic acid: x Chemotactic for neutrophils
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland
LTB4
AT II
Catalase - negative bacteria secrete H2O2 as a byproduct (remember - catalase breaks down H2O2) - allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase - positive bacterial infect

4. Per Freud - with What part of the unconscious are sex and aggression (instincts) associated?
IgA
Id
Histiocytosis X
As sample size increases - the lower the chance of error.

5. What disorder of aldosterone secretion is characterized by x Increased total body sodium - ECF volume - plasma volume - BP - and pH; decreased potassium - renin and AT II activity; no edema?
Pseudomonas
Conjugated (direct) hyperbilirubinemia
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.
Primary hyperaldosteronism (Conn syndrome)

6. What is the most common one? - Tumor in individuals exposed to asbestos
Bronchogenic carcinoma
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
Medial compartment of the thigh - obturator nerve
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).

7. What are the growth factors released from the liver called?
Cryptococcus
Paramyxovirus
Somatomedins
Achalasia

8. What is found in the R group if the AA is acidic? Basic?
Kupffer cells
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
Burr cells (echinocytes)

9. Which way does the Hgb - O2 dissociation curve shift in patients with CO poisoning?
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.
Schistocytes
VIPoma
Small cell cancer of the lung

10. Are bactericidal.
Smooth muscle
Tetracyclines
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.

11. What subtype of schizophrenia is characterized by x Childlike behaviors - unorganized speech and behaviors - poor grooming - incongruous smiling and laughter - and the worst prognosis?
M3 (promyelocytic leukemia)
Disorganized schizophrenia
Polycystic ovaries
Size

12. What MHC class functions as a target for elimination of abnormal host cells?
Escherichia coli
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells
Punishment
Aspartate and carbomoyl PO4

13. What disorder of bone remodeling results in thick - weak bones and is associated with high - output cardiac failure?
Circumvallate papillae
By causing rebound insomnia and decrease in REM sleep
Stable
Paget disease (osteitis deformans)

14. Lewy bodies
Duodenum
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)
Parkinson disease
MEN II and III syndromes

15. Name four chemotactic factors for neutrophils.
Klebsiella pneumoniae
Pneumocystis carinii
Aminophylline
N- formyl - methionine LTB4 C5a IL-8

16. Fixing impulses by acting out the opposite of an unacceptable behavior
Undoing
Hemosiderin
The subclavian artery
Chloramphenicol

17. What are the adult remnants of the following structures? - Foramen ovale
extrapyramidal dysfunction
Beta- Hydroxybutyrate
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern - my senior resident asked me this question more times than I would like to remember.)
Fossa ovale

18. Name the antimicrobial agent whose major side effect is listed - CN VIII damage (vestibulotoxic)
Adulthood
Diazepam is longest acting and midazolam is shortest acting.
Rabies
Aminoglycosides

19. What operant conditioning therapy or modification is described as x Stopping the reinforcement that is leading to an undesired behavior?
Ventromedial nucleus; lesions here result in obesity.
TB meningitis
Sphingomyelin
Extinction

20. What virus lies dormant in the x Sensory ganglia of S2 and S3?
Herpes II
Nitroprusside
ll
Chromosome 20q (deficiency in adenosine deaminase)

21. What is the volume of distribution (increased or decreased) of a drug when a large percentage is protein bound?
Left atrium and tip of the right atrium
Vanillylmandelic acid (VMA)
Antisocial
Volume of distribution is decreased when a large percentage of drug is protein bound.

22. What is the amount in liters and percent body weight for the following compartments? - Interstitial fluid
Nondominant temporal lobe
1. The child poses an imminent danger to self or others. 2. The child is unable to self - care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety e
9.3 L - 15% of body weight
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe

23. What disorder is characterized by autoantibodies to IF?
GABA and glutamic acid
Pernicious anemia
Erythema nodosum
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases

24. After a longstanding left - to - right shunt reverses - causing cyanosis - and becomes a right - to - left shunt - What is it termed?

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25. What childhood pathology involves anterior bowing of the tibia - epiphyseal enlargements - and costochondral widening - with the endochondral bones being affected?
Rickets
Site 2
Transtentorial (uncal)
Sporothrix schenckii

26. What is the venous and arterial stretch receptors' function regarding the secretion of ADH?
Chromosome 11p
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.
MGB (think EARS)

27. What hormone - produced by Sertoli cells - if absent would result in the formation of internal female structures?
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
Reticulocyte
IF
Sporozoites

28. What AA is broken down into N2O - causing an increase in cyclic guanosine monophosphate (cGMP) of smooth muscle - hence vasodilation?
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia
Blastomyces dermatitidis
Arginine

29. Name these mature defense mechanisms: x Converting an unacceptable impulse to a socially acceptable form (Hint: it is the most mature of all defense mechanisms)
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Multiple myeloma
Sublimation
Asbestosis and silicosis

30. Where are the lowest resting PO2 levels in a resting individual?
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
Hypervariable region (three per light chain; three per heavy chain)
Trapezius and sternocleidomastoid
Coronary circulation

31. Is the bound form or free form of a lipid - soluble hormone responsible for the negative feedback activity?
The sandfly
Spearman correlation
Glucosyl cerebroside
Free form determines hormone activity and is responsible for the negative feedback loop.

32. What substance is secreted by parietal glands and is required for life?
Hydroxyproline
Bone deposition increases with increased Ca2+ or PO 4- concentrations - whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
Intrinsic factor (IF)
CMV retinitis and HSV-2

33. What is the relationship between ventilation and PCO2 levels?
1. VSD 2. ASD 3. PDA
RES(Reticular endothelial system)
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
Pia mater

34. Name the most common type or cause - Chancre
Haemophilus ducreyi
Congenital heart disease
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Pseudomonas aeruginosa

35. Name the type of necrosis - Soft - friable - cottage - cheese appearing; characteristically seen in TB
Zoophilia
Bronchogenic carcinoma
Decreasing potassium conductance - which results in increased excitability
Caseous necrosis

36. What AA is a precursor of the following substances? - GABA
Glutamate
Muscles of the internal eye
Creutzfeldt - Jakob's disease. Patients first develop vague somatic complaints and anxiety - rapidly followed by dysarthria - myoclonus - ataxia - and choreoathetosis.
Lac repressor protein

37. What type of correlation compares two ordinal variables?
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Renin secretion
Spearman correlation
Astrocytes

38. What Brodmann area is associated with x Somatosensory association cortex?
Areas 5 and 7
An elevated serum osteocalcin level
Abs to HBsAg
After the eclipse period

39. In regard to motor development during infancy - choose the motor response that happens first - Palms up or down
Increased androgen secretion at puberty drives the increased GH secretion.
Palms - up before palms - down maneuvers
Transferrin
True hermaphrodism

40. Name the associated chromosomal translocation - Adult familial polyposis
Clearance
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
Chromosome 5 - 21
Aminoglycosides

41. Name the ventricular muscle membrane channel: x Always open
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Ungated potassium channel
Afterload
IgA

42. What form of continuous DNA - used in cloning - has no introns or regulatory elements?
cDNA - when it is made from mRNA
Female pseudohermaphrodite
Microcytotoxic assay
Sigma factor

43. What protein allows Mycoplasma to attach to the respiratory epithelium?
P1 protein
Ischemia
Ovulation
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain

44. What ocular ganglion is affected if the pupil on the affected side sluggishly responds to light with normal accommodation?
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
Ciliary ganglion producing a tonic pupil
Agoraphobia. It also means having a sense of humiliation or hopelessness.
Cohort studies determine incidence and causality - not prevalence.

45. What congenital small bowel outpouching is a remnant of the vitelline duct?
Acute cystitis
Excretion is greater than filtration for net secretion to occur.
1. ADP 2. PG 3. TXA2
Meckel diverticulum

46. What vasculitis affects a 30-year - old Asian female having visual field deficits - dizziness - decreased blood pressure - and weakened pulses in the upper extremities?
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.
Takayasu arteritis (medium - size to large vessels)
Lead
Wiskott - Aldrich syndrome

47. What pattern of genetic transmission is characterized by no transmission from M - maternal inheritance - and the potential for the disease to affect both sons and daughters of affected F?
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Relative refractory period
Mitochondrial inheritance
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.

48. What organ must metastasize for carcinoid heart disease to occur?
de Quervain thyroiditis
Rifampin
Masochism
Liver

49. Do the following structures pick up stain from hematoxylin or eosin? - Nuclei
Skin - liver - and kidneys
HBeAb
Obese patients
Hematoxylin

50. What is the drug of choice for penicillin - resistant gonococcal infections?
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
Adenosine deaminase (ADA) deficiency
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
Spectinomycin