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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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. Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it?
Chromosome 11p
The mouth
Paneth cells
Chromosome 19

2. Name the antidote - Arsenic
Agoraphobia. It also means having a sense of humiliation or hopelessness.
Dimercaprol - D- penicillamine
CO
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension

3. What classical conditioning therapy or modification is described as x Triage of a hierarchy of fears (from least to most) - then teaching muscle relaxation techniques in the presence of those fears until the subject is not afraid anymore?
Systematic desensitization
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major
Ethyl alcohol
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)

4. What is the term for nonneoplastic abnormal proliferation of cell size - shape - and cellular organization?
Cholesterolosis
Stibogluconate
Dysplasia
Type II error (beta error). (Remember it as saying something doesn't work when it does.)

5. What papillae are responsible for sweet taste?
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major
Affinity decreases; they are inversely proportional.
Metaplasia (usually to a more protective cell type)
Circumvallate papillae

6. What is the name of the spinal cord passing within the subarachnoid space and forming the spinal nerves that exit the lumbar and sacral foramina?
Cauda equina
Ulcerative colitis
Clostridium tetani
Mitral insufficiency

7. What diseases are associated with the HLA- DR3 allele
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
Vagus nerve
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
GP IIb and IIIa receptors

8. What nerve is associated with the following functions? - Flex the wrist and digits - pronate the wrist and the LOAF (Lumbricales - Opponens pollicis - Abductor pollicis brevis - Flexor pollicis brevis) muscles of the hand
14 L - 33% of body weight
One - way ANOVA
Median nerve
Eosin

9. What subunit of hCG is used to detect whether a patient is pregnant?
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
The Beta- subunit; remember - the a - subunit is nonspecific.
Edrophonium

10. What epidermal layer's function is to release lipids to act as a sealant?
Cortisol
Third M PITS for pharyngeal pouch derivatives
Stratum granulosum
Metanephros

11. What is the relationship between chance of error and x Sample size?
False - negative rate
Paramyxovirus
As sample size increases - the lower the chance of error.
Midazolam

12. What is the term for the strength of the association between Ags and Abs?
Toxoplasma gondii
Histiocytes
Nucleus pulposus
Avidity. There is a positive correlation between valence numbers and avidity.

13. Name the most common type or cause - Liver transplantation in adults
When it crosses the teres major
Orotic acid (purine metabolism)
Bacillus cereus
Alcoholic cirrhosis

14. Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery?
Metronidazole
Propofol
Schistocytes
Histidine

15. What AA is a precursor of the following substances? - Creatine
Wilms tumor
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Streptomycin
Glycine/arginine

16. What is the most common one? - Site for carcinoid tumors
Appendix (second is terminal ileum)
Protein A
Chromosome 18
Stibogluconate

17. What class of pharmaceuticals are inactive until they are metabolized to their active products?
Graves disease
CSF
Prodrugs
Direct fluorescent Ab test

18. What is the longest and most convoluted segment of the nephron?
Sciatic nerve
Specificity (it deals with the healthy)
PCT
Streptococcus agalactiae

19. Name the form of spina bifida - Meninges project through a vertebral defect
Cardiac output
Meningocele All except occulta cause elevated - fetoprotein levels.
Plasma cell (mature B lymphocyte)
Streptococcus viridans

20. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
Histoplasma capsulatum
The T- test (used when comparing two groups)
CN VI - VII - and VIII
Ethacrynic acid

21. What hormone is required for 1 - 25- dihydroxy- vitamin D (1 - 25- diOH- D) to have bone resorbing effects?
Varicella
Biotin. Avidin is found in raw egg whites.
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid
PTH

22. 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 - no change; body - no change
Ascaris lumbricoides
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Ependymoma
Budd - Chiari syndrome

23. What components of the coagulation cascade are affected by estrogen?
Dopamine
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
In the dorsal horn of the spinal cord on the primary afferent neurons
Methylene blue

24. Why is spermatogenesis decreased with anabolic steroid therapy?
Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone - produced by Leydig cells - is needed for spermatogenesis.
Prostatic carcinoma
Hirschsprung's disease (colonic gangliosus)
Histidine

25. Name the compartment of the mediastinum associated with the following thoracic structures: Pulmonary artery and veins
N- Acetylcysteine
PCT
From the wall of the yolk sac
Middle

26. What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
Amanita phalloides
Ceramide
Ergosterol
Molindone

27. Which medication requires an acidic gastric pH for activation to form a protective gel - like coating over ulcers and GI epithelium?
Vibrio cholera
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
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
Sucralfate

28. From What aortic arch are the following structures derived?
Degenerates
Clindamycin
IgG
Burr cells (echinocytes)

29. In the alveoli - what cell type is x responsible for producing surfactant?
Alveoli; they are part of the respiratory portion.
Type II pneumocytes
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
Treacher Collins syndrome

30. What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Test - retest reliability
Ligamentum venosum
Terbinafine
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.

31. What stage of sleep is associated with somnambulism?
Spironolactone
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Alzheimer disease
45XO

32. What disease is seen in children younger than 5 years of age and is characterized by X- linked recessive cardiac myopathies - calf pseudohypertrophy - lordosis - protuberant belly - an increase then a decrease in CPK - and death commonly in the secon
Duchenne muscular dystrophy
IgE
80S ribosomes (because they are eukaryotic)
Red blood cell distribution width index (RDW)

33. In which syndrome does a person present with intentionally produced physical ailments with the intent to assume the sick role?
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Intraductal papilloma
M
Transverse abdominis

34. What happens to the following during skeletal muscle contraction? - Sarcomere
Th2 cells
Leucine and lysine
Lisch nodules
Shortens

35. Which subset of MEN syndrome is associated with the following? - Medullary carcinoma of the thyroid - pheochromocytoma - and parathyroid adenomas (or hyperplasia)
Type 2
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>
MEN IIa (or Sipple syndrome)

36. What muscle type is characterized by low ATPase activity - aerobic metabolism - myoglobin - association with endurance - and small muscle mass?
Red muscle
Metronidazole
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember - it may be negative in the first week of the illness - so retest if you have a high index of suspicion.)
Gastric carcinoma

37. With What three enzymes is thiamin pyrophosphate (TPP) associated?
With arteriolar constriction both the flow and pressure downstream decrease.
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Selective erectile disorder
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -

38. There are no persistent infections with...
Gerstmann's syndrome; spoken language is usually understood.
Allotypes
naked viruses
P = .05; P < .05 rejects the null hypothesis

39. What is the respiratory compensation mechanism for metabolic alkalosis?
Physostigmine
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Supraoptic nuclei; lesions here result in diabetes insipidus.

40. What nerve lesion presents with ape or simian hand as its sign?
Median nerve lesion
Citrate - via the citrate shuttle
Ductus epididymis - Which is lined by pseudostratified epithelium with stereocilia.
Lente insulin and either NPH or protamine zinc insulin (PZI)

41. What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy?
Punishment
Celecoxib
GP120
ydroxyproline

42. Which carcinoma
Leydig cell tumor
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Metronidazole
Large segment deletions

43. What prostaglandin is associated with maintaining patency of the ductus arteriosus?
Phenylephrine
Papillary carcinoma of the thyroid
PGE (along with low oxygen tension)
C1 esterase inhibitor (C1INH)

44. What component of an ECG is associated with the following? - Atrial depolarization
env structural protein
Cocaine
P wave
Bipolar disorder (manic - depressive disorder)

45. Name the MCC of death - In patients with cystic fibrosis
Constriction of efferent arteriole
Because creatinine is filtered and a small amount is secreted
Pulmonary infections
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.

46. Name the B- cell CD marker: x Used clinically to count B cells in blood
CD19
Succinylcholine and halothane (Treatment is with dantrolene.)
Axis III
Malignancy

47. What family do the following viruses belong to? - California encephalitis
Uroporphyrinogen III cosynthase
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
Posterior compartment of the thigh - tibial nerve
Bunyavirus

48. What is the largest organ in the body?
Integument (skin and its derivatives)
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
Coagulative
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid

49. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Spinal nerve?
14 days
PDA
Both
Chlamydia psittaci

50. What structure or structures cross the diaphragm at x T8 level?
Imipenem and meropenem
Production of HCO3- - shifting the reaction to the left and thereby decreasing H+
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
Naloxone - naltrexone

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