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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. How do delusions - illusions - and hallucinations differ?
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
Inhibin - m
Hydrolysis
Acetoacetate - acetone - and Beta- hydroxybutyrate

2. Name the antimicrobial agent whose major side effect is listed - Grey baby syndrome
Chloramphenicol
Nissl substances; there is a great deal of RER in neuron cell bodies - indicating high protein synthesis.
Inferior Oblique (CN III) (LR6 SO4)3
Being single

3. What is the most common one? - Tumor on sun - exposed sites
Negative
Basal cell carcinoma
The short arm of chromosome 6
1. Tinea coli 2. Haustra 3. Epiploic appendages

4. What mineral - via excessive depositions in the liver - causes hemochromatosis?
Iron (Fe)
pK (think of it as where half is base and half is acid)
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)
Hexosaminidase A

5. Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism?
Fibrinoid necrosis
Physiologic antagonism
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.
Metronidazole

6. Innervate the striated muscle of the bulbospongiosus and ischiocavernous muscles and result in ejaculation of semen.
Courvoisier's law
Somatic motor neurons
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.
Keloid

7. 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 - increase; ICF - decrease; body - increase
Gain of hypertonic fluid (mannitol or hypertonic saline)
Medial pontine syndrome
urease positive
Caplan syndrome

8. What is the site of action for carbonic anhydrase inhibitors?
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
Hgb F
Proximal tubule
Hepatitis B

9. What are the three exceptions to the rule of codominant gene expression?
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
Increased secretion of GH postpuberty leading to acromegaly.
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.

10. What cytokines do Th2 cells secrete to inhibit Th1 cell function?
Thymidylate synthetase
Nissl substances; there is a great deal of RER in neuron cell bodies - indicating high protein synthesis.
Series circuit
IL-4 - IL-10 - and IL-13

11. What is the most common one? - Pancreatic islet cell tumor
S phase
Arthroconidia with hyphae
Osteogenesis imperfecta
Insulinoma

12. What encapsulated gram - negative - lactose - fermenting rod is associated with pneumonia in patients with alcoholism - diabetes - and chronic lung disease?
Folate deficiency (very common in the elderly)
Klebsiella pneumoniae
Microglia (Microglia and mesoderm both begin with M)
Jejunum (upper)

13. What is the vector of African sleeping sickness?
The tsetse fly
Glioblastoma multiforme
Stable
Flucytosine

14. Rheumatic fever most commonly follows pharyngeal infections with what bacteria?
Group A Beta- hemolytic streptococci
HMG CoA synthase
Methanol (wood alcohol)
Oxytocin

15. What is the most common chromosomal disorder?
Kayser - Fleischer rings
Arginine
Down syndrome
1. Tinea coli 2. Haustra 3. Epiploic appendages

16. What nerves carry the sensory and motor components of the blink reflex?
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.
Glucokinase
The outer cortex contains most of the germinal centers and therefore also most B cells.
Hypercortisolism (Cushing syndrome)

17. What artery travels with the following veins? - Small cardiac vein
Left colic - superior rectal - and sigmoidal arteries
Right coronary artery
Osteoma
Conjugated (direct) hyperbilirubinemia

18. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol decreased - ACTH increased

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19. What enzyme catalyzes the covalent bonding of the AA's carboxyl group to the 3' end of tRNA?
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.
Alanine and glutamine
a - Blockers (- zosins)
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)

20. In skeletal muscle ________ is an active event.
relaxation
Osteocyte
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
Look for broken blood vessels in the baby's eyes.

21. What is the vector for Chagas disease?
Minoxidil (orally and topically - respectively!)
The reduviid bug
Cystadenocarcinoma
Lac repressor protein

22. What are the first intermediate hosts for trematodes?
Snails
Carbidopa and benserazide
Friedreich ataxia
Right brachiocephalic artery

23. 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
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Metaplasia (usually to a more protective cell type)
CN VI - VII - and VIII
The Fc region of IgG and C3b

24. Outburst to cover up true feelings (emotion is covered - not redirected).
No - therapeutic indices can tell which drug is safer - not more toxic.
Acting out
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.
The conversion of tyrosine to dopamine in the cytoplasm

25. Name the AD disease associated with chromosome 15 in which the patient has long extremities - lax joints - pigeon chest - and posterior mitral leaflet prolapse and is prone to developing dissecting aortic aneurysm.
Marfan syndrome
Filiform papillae
Mitral insufficiency
Schistosoma have separate males and females.

26. Regarding the Lac operon - for What do the following genes code? - Z gene
Beta- Galactosidase
nef and tat genes
Uroporphyrinogen III cosynthase
Plasmodium malariae

27. What is the name of the process in which cells migrate toward an attractant along a concentration gradient?
Hypoglycemia for secretion and hyperglycemia for inhibition
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
Chemotaxis

28. What hematologic agent is used in the treatment of intermittent claudication because it decreases blood viscosity and increases RBC membrane flexibility and stability?
Chief cell adenoma (80%)
Phase I
Pentoxifylline
positive correlation

29. What is the DOC for the treatment of the late phase response in an asthmatic attack?
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
Cell - mediated immunity
Ethyl alcohol
Corticosteroid

30. What highly undifferentiated aggressive CNS tumor of primordial neuroglial origin develops in children and is associated with pseudorosettes?
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)
competency
Succinylcholine and halothane (Treatment is with dantrolene.)
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)

31. What is the term to describe a man who has x The ability to have an erection sometimes and other times not?
Kinesins. Dynein generates retrograde transportation of information.
Hemosiderin
Decrease (5- HT and dopamine levels do the same)
Selective erectile disorder

32. At What age does a child develop x Endogenous smile?
At birth (reflex)
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Chromosome 15
Nephroblastoma

33. What structure or structures cross the diaphragm at x T12 level?
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12
Atrial contraction Atrial - Contraction - Venous
3 years old
Anticipation - associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.

34. What somatoform disorder is described as x Unrealistic negative opinion of personal appearance - seeing self as ugly?
Gluteus maximus
Body dysmorphic disorder
Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine.
Hepatocellular carcinoma

35. What is the term for drug removal per unit of time in a given volume of blood?
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed - thereby increasing the secretion of prolactin.
Clearance
Mitral valve prolapse
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.

36. With what stage of sleep are nightmares associated?
Double - blind study. It is the most scientifically rigorous study known.
Osteosarcoma
Alanine cycle
REM sleep. Nightmares are frightening dreams that we recall.

37. What are the adult remnants of the following structures? - Right and left umbilical arteries
Staphylococcus
1. Glycine 2. Aspartate 3. Glutamine
MGN
Medial umbilical ligaments

38. What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex- mediated; and is seen as lumpy- bumpy subepithelial deposits?
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.
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Postinfectious GN

39. What AA is a precursor of the following substances? - NAD
Pseudomonas aeruginosa
Tryptophan
Concrete operations (6-12 years)
Acetoacetate - acetone - and Beta- hydroxybutyrate

40. What muscle or muscles are innervated by the following nerves? - Upper subscapularis nerve
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
Subscapularis
Primary hypogonadism (postmenopausal women)
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12

41. What happens to dopamine levels when we awaken?
Dopamine levels rise with waking; dopamine is associated with wakefulness.
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
In the JG cells of the kidney
Urogenital folds

42. How many pairs of spinal nerves are associated with x Coccygeal vertebrae?
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
Parvovirus (it is the only ssDNA virus)
Lateral pontine syndrome
Argyll Robertson pupils

43. Which two antipsychotic drugs create a high risk for developing extrapyramidal syndrome (EPS) side effects?
Flurazepam
The negative charge inhibits the filtration of protein anions.
Schistosoma have separate males and females.
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)

44. Which sedative - hypnotic is contraindicated for patients taking warfarin?
CN III and IV
Chloral hydrate
Negative
Excess lead

45. Name the compartment of the mediastinum associated with the following thoracic structures: Thymus
Superior and anterior
14 days in most women (Remember - the luteal phase is always constant.)
Dynorphin
Hypersegmented neutrophils

46. What form of antimicrobial therapy is best for an immunocompromised patient?
Diacylglycerols and phosphatidic acid
Splenomegaly and anemia (with a high index of suspicion)
Hemiballismus
Bactericidal

47. What operant conditioning therapy or modification is described as x Reinforcing successive attempts that lead to the desired goal (gradual improvement)?
Stapes artery
Intrinsic factor (IF)
Shaping (successive approximation)
Catatonic schizophrenia

48. Which type of hepatitis is a picornavirus?
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Renal plasma flow (decrease flow - increase FF)
Hepatitis A (infectious)
Right coronary artery

49. Does being a female physician increase or decrease the risk of suicide?
Arnold - Chiari malformation type 2
Being a female physician increases the risk of suicide nearly four times the general population.
Lateral fissure (fissure of Sylvius)
Seasonal affective disorder (treat with bright light therapy)

50. Movement disorders are associated with what dopamine pathway (What part of the brain)?
Nigrostriatal pathways (basal ganglia)
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
Salpingitis
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)