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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. 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)
Sublimation
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Average
Elongation factor - G and GTP

2. What disorder is described as having x Conscious symptoms with unconscious motivation?
Factitious disorder
Plasmodium malariae
Masochism
Upper outer quadrant (left more than right)

3. What parasympathetic nucleus is found on the floor of the fourth ventricle and supplies preganglionic fibers innervating the terminal ganglias of the thorax - foregut - and midgut?
Dorsal motor nucleus of CN X
Squamous cell carcinoma (skin - lung) and angiosarcoma of the liver
Dihydrotestosterone
Production of oxygen free radicals

4. What are the three components to the asthma triad?
IgG
Trypsin
Nasal polyps - rhinitis - and aspirin hypersensitivity
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)

5. What happens to free hormone levels when the liver decreases production and release of binding proteins?
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
RNA polymerase I
CD14

6. What enzyme found in a cholinergic synapse breaks down ACh? What are the byproducts?
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
Trypanosoma cruzi
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
Pregnancy

7. Which medication used in the treatment of bipolar disorder decreases the release of T 4 from the thyroid gland?
Axis II
Lithium
Interval scale (a ruler - for example)
Alcoholic cirrhosis

8. Name the cluster C personality disorder: x Orderly - inflexible - perfectionist; makes rules - lists - order; doesn't like change - has a poor sense of humor - and needs to keep a routine
Obsessive - compulsive
Al - Anon
2 to 4 hours
Dependent

9. What modified smooth muscle cells of the kidney monitor BP in the afferent arteriole?
EBV
The JG cells
Biofeedback
Psoas major

10. At what vertebral level does the trachea bifurcate?
Fibrous pericardium
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
IL-8 (IL-1 and TNF- gamma also)
Prophase of meiosis I (between 12th and 22nd week in utero)

11. Name the most common cause - Croup
Parainfluenza virus
Site 2
Volume of distribution is decreased when a large percentage of drug is protein bound.
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.

12. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x Ki - ras
Metronidazole
Pancreas and colon
Metabolic rate and alveolar ventilation (main factor)
Choriocarcinomas and trophoblastic tumors

13. What happens to the tonicity of the urine with increased ADH secretion?
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Pancreas and colon

14. Place in order from fastest to slowest the rate of gastric emptying for CHO - fat - liquids - and proteins.
Residual volume (RV)
The carotid sinus reflex
Erectile dysfunction
Liquids - CHO - protein - fat

15. What is the anatomic positioning of the right and left gastric nerve plexus of the esophagus as they pass through the diaphragm?
Carbamazepine
Proencephalon
Hemochromatosis
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)

16. What malabsorption syndrome produces abdominal distention - bloating - flatulence - diarrhea - steatorrhea - and weight loss shortly after eating bread products?
CD40
Celiac sprue (gluten - sensitive enteropathy)
Bronchogenic carcinoma
Herpes virus

17. What is the most common one? - Tumor on sun - exposed sites
Virchow triad - associated with the formation of a thrombus.
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
Basal cell carcinoma
Tolcapone and entacapone

18. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Fibroblasts
Diazoxide
Stable
Ketamine
Epinephrine

19. What is the rate - limiting step in a conduction of a NMJ?
Hemochromatosis
The time it takes ACh to diffuse to the postjunctional membrane
EF-2 and GTP
Biotin. Avidin is found in raw egg whites.

20. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Agraphia - acalculia - finger agnosia - right - left disorientation

21. What vitamin deficiency can result in high - output cardiac failure?
LH
Riedel thyroiditis
Thiamine
Pyruvate - acetyl CoA - and propionyl CoA carboxylase

22. Being college educated increases a man's risk of having...
premature ejaculation
Dihydrofolate reductase
GABA and glutamic acid
Sphingomyelin (lecithin also - but it is not a sphingolipid)

23. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Northern blot
Hypervariable region
H 1
Type II hypersensitivity reaction

24. What is the term for a complete aversion to all sexual contact?
Bladder cancer
12 days after ovulation
GLUT 2
Sexual aversion disorder

25. What structure of the knee is described thus? - Prevents adduction
Lateral collateral ligament
Factitious disorder
Mean corpuscular hemoglobin concentration (MCHC)
They are all formed by the fifth month of fetal life.

26. What stage of male development is characterized by the following LH and testosterone levels? - Both LH and testosterone levels drop and remain low.
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.
Childhood
C3a - C4a - and C5a
90% as HCO3- - 5% as carbamino compounds - and 5% as dissolved CO2

27. To What does aldose reductase convert galactose?
Mitochondria - linked disorders are always inherited from the mother.
Galactitol
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)

28. Under resting conditions - What is the main determinant of cerebral blood flow?
Arterial PCO2 levels are proportional to cerebral blood flow.
Ventricular fibrillation (V fib)
Proline and lysine
Cones (C for color and cones)

29. What are the three reasons for the effectiveness of the blood - brain barrier?
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Pompe's disease
Borderline
Aortic stenosis

30. What is the only Ig that crosses the placenta?
Paneth cells
IgG
Phase I
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)

31. What is the term for recurrent and persistent pain before - after - or during sexual intercourse?
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
Testicular lymphoma
Stranger anxiety
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.

32. An 80-year - old woman presents to you with right - sided temporal headache - facial pain and blurred vision on the affected side - and an elevated ESR. Your diagnosis?
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
Inhibin - m
Melanoma
Temporal arteritis (giant cell arteritis)

33. Do the following structures pick up stain from hematoxylin or eosin? - Cytoplasm
Chromosome 11p
Epidural hematoma
Eosin
Afterload

34. What is the term for a substance secreted by a leukocyte in response to a stimulus?
Primitive ventricle
Frontal lobe
Varicella
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.

35. Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
naked viruses
The short arm of chromosome 6
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.
Phase 4

36. What syndrome results if the enzyme ?-1- iduronidase is deficient? L- iduronate sulfatase deficiency?
8 to 25 hours
Filiform papillae
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
Hurler syndrome and Hunter syndrome - respectively

37. What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
Heroin
CD19
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)

38. Name the hepatitis virus based on the following information - Enveloped RNA flavivirus
Hepatitis C
Intermediate part of the hemispheres
Inspiratory reserve volume (IRV)
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.

39. What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?
Churg - Strauss syndrome
Ergotamines
Pseudogout
The folding of an AA chain

40. What nematode is known as whipworms? What is the treatment?
Voltage - gated channel
Trichuris trichiura is treated with albendazole.
Expressive aphasia
Serum 25- hydroxy- vitamin D (25- OH- D)

41. What cerebral vessel size is affected in patients with vascular dementia?
Leydig cell tumor
Small to medium - sized cerebral vessels
Validity (remember - reliability is necessary but not the only thing needed for validity)
HPVs 16 and 18

42. What is the most common one? - Helminthic parasite worldwide
Leptospira
Ascaris lumbricoides
Axis III
Prevalence increases.

43. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Naphthylamine
Indirect or unconjugated
Leukemias and lymphomas
Bladder cancer
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)

44. What cells of the adrenal gland are neural crest derivatives?
Chromaffin cells (adrenal medulla)
Pseudomonas aeruginosa
Asbestosis and silicosis
Reverse transcriptase

45. What neuroleptic agent is also considered to be an antihistamine?
Risperidone
Erythema marginatum
Cushing's ulcers
Ankylosing spondylitis

46. Name the antimicrobial agent whose major side effect is listed - Cartilage abnormalities
Quinolones
Multiple myeloma
Sphingosine
Streptokinase

47. When a person goes from supine to standing - what happens to the following? - Cardiac output
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
Acute rejection
Concentration force and electrical force

48. Anhedonia - lack of motivation - feelings of worthlessness - decreased sex drive - insomnia - and recurrent thoughts for at least 2 weeks - representing a change from previous level of function - describes what disorder?
Acute cystitis
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Unipolar disorder (major depression)

49. What is the term for having fantasies or dressing in female clothes for sexual arousal by heterosexual men?
Transvestite fetishism
The carotid sinus reflex
Transient ischemic attack
The poly(A) site on the DNA

50. A patient can ______ a feeding tube.
refuse
Valproic acid
Subscapularis
Heart rate determines the diastolic interval - and contractility determines the systolic interval.