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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 two forces affect movement of ions across a membrane?
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
Tetracycline
Concentration force and electrical force
Dimercaprol - D- penicillamine

2. At the level of rib 6 - the internal thoracic artery divides into What two arteries?
RBCs
Unconjugated free bilirubin
H 2
Musculophrenic and superior epigastric arteries

3. Name the lung measurement based on the following descriptions: x Additional volume that can be expired after normal expiration
CN V
Allopurinol
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Expiratory reserve volume (ERV)

4. 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
Median nerve
antiemetic
Sympathetic nervous system
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)

5. Are the following major or minor Jones criteria of rheumatic fever? - Subcutaneous nodules
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Brushfield spots
Major
Sympathetic chain ganglion

6. How does cell diameter affect the conduction velocity of an action potential?
competency
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
The greater the cell diameter - the greater the conduction velocity.

7. What ribosomal subunit sizes do eukaryotic cells have?
Major
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.
Medial collateral ligament
Lisch nodules

8. If no fertilization occurs - How many days after ovulation does the corpus luteum begin to degenerate?
12 days after ovulation
de Quervain thyroiditis
5HT1D
Tibial nerve

9. All primary oocytes in females are formed By What age?
After the eclipse period
They are all formed by the fifth month of fetal life.
3 ATPs by oxidative phosphorylation
Misoprostol

10. What are the three most common sites for left - sided heart embolisms to metastasize?
HBcAb IgG and HBsAb IgG
Phallus
Brain - spleen - and kidney
Third week; they are derived from the wall of the yolk sac.

11. What is the most potent stimulus for glucagon secretion? Inhibition?
Hypoglycemia for secretion and hyperglycemia for inhibition
S phase
Valence
Enterohemorhagic Escherichia coli

12. What is the most common form of inherited dwarfism?
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
HBcAb IgG - HBV- DNA - HBeAg - HBsAg
CD4+T cells
Achondroplasia

13. What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficile - ischemia - Staphylococcus - Shigella - or Candida infection?
McArdle's syndrome
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.
Pseudomembranous colitis
Ependymoma

14. What three cephalosporins are eliminated via biliary mechanisms?
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
Osteosarcoma
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.

15. What cell type in the bone is responsible for bone deposition?
Osteoblast (Remember - blasts make - clasts take)
NADPH and molecular O 2
HBsAg as its envelope
Id (pleasure principle)

16. What happens to cortisol levels in sleep - deprived individuals?
Allograft
Cortisol levels increase. Lymphocyte levels decrease in sleep - deprived individuals.
GnRH constant infusion
Trichophyton

17. What type of GN - associated with celiac disease and dermatitis herpetiformis - has mesangial deposits of IgA - C3 - properdin - IgG - and IgM?
Prostatic carcinoma
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
Berger disease (IgA nephropathy)
Streptococcus agalactiae

18. What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
Excision endonuclease - which removes thiamine dimers from DNA
Coagulative necrosis

19. Name the type of exudate - given the following examples - Uremic pericarditis
Mumps
Bacillus cereus
Fibrinous exudates
Sarcoidosis

20. Which hepatitis B Ag correlates with infectivity and viral proliferation?
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
Atracurium
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
HBeAg

21. If inserting a needle to perform a pleural tap or insertion of a chest tube - do you use the inferior or the superior border of a rib as your landmark? Why?
Methionine (start) and tryptophan are the only two AAs with only one codon.
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Benign nevus (mole)

22. What facultative intracellular fungus is associated with hepatosplenomegaly?
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
GnRH constant infusion
IgG
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.

23. What is the reservoir for the togavirus?
Birds
2.0 or greater
Selective erectile disorder
Berylliosis

24. What is the costliest health care problem in the United States?
Ungated potassium channel
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
Alcohol and its related problems cost the country approximately $100 billion a year.
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)

25. Name the cerebral vessel associated with the following vascular pathologies - Subarachnoid hemorrhage
Mallory- Weiss syndrome
Increases
Berry aneurysm in the circle of Willis
Sorbitol (resulting in cataracts)

26. What hormone is secreted by the placenta late in pregnancy - stimulates mammary growth during pregnancy - mobilizes energy stores from the mother so that the fetus can use them - and has an amino acid sequence like GH?
Beta- Oxidation of fatty acids
Flocculonodular lobe (one of my favorite words in all of medicine!)
Extrahepatic biliary atresia
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)

27. What type of bias is it when the information is distorted because of the way it is gathered?
Diffuse proliferative GN
Griseofulvin
Measurement bias
Cocaine - induced coronary ischemia

28. A 70-year - old man complains of urinary urgency - nocturia - hesitancy - postvoid dribbling - urinary retention - and a PSA result of 6.5 ng/mL. What is your diagnosis?
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result) - these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease - when obstructive symptoms begin to occur.
Actually - yes. You should encourage your patient to try other forms of medicine as long as they are not contraindicated with the patient's preexisting illness. You must be able to accept the health beliefs of your patients - even if you don't agree.
Ulnar nerve
Resistance of the system increases. (Remember - when resistors are connected in a series - the total of the resistance is the sum of the individual resistances.)

29. What ovarian disease involves psammoma bodies?
It forms a germinal tube at 37
NREM sleep. Remember awake body - sleeping brain
Serocystadenocarcinoma
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.

30. What are the five K
Chromium (Cr)
Muscle glycogen phosphorylase
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.

31. What is the site of action of cholera toxin?
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
HMG CoA reductase
Phase 2
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.

32. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Epidermis
IGF-1 (somatomedin C)
Ego
Nephrotoxic oxylate stones
Labile

33. What is the MCC of the following meningitides? - In those 12 months to 6 years of age
Area 6
Haemophilus influenzae type B
Prostate and lung cancer - respectively
Dantrolene

34. What antiviral agent for ganciclovir - resistant infections has limited utility because of its nephrotoxic side effect?
Histiocytosis X
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
Foscarnet
Agglutination test

35. Neurofibrillary tangles
IgG4
17- alpha - Hydroxylase deficiency
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Alzheimer disease

36. Name the antidote - Cyanide
Amyl nitrate - sodium nitrate - or sodium thiosulfate
Superior and posterior
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
Tetracyclines

37. If a patient asks you a question and you do not know the answer - do you tell a white lie or simply not respond?
Left atrium and tip of the right atrium
CD16 and CD56
Absolutely not! Answer any question you are asked.
CN XI and X

38. What enzyme - induced by insulin and activated by apo C- II - is required for chylomicron and VLDL metabolism?
Lipoprotein lipase
Reiter syndrome
IgG
Hepadnavirus

39. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Nitrosamines
IgG
Purine nucleoside phosphorylase
Gastric cancer
Lateral cricoarytenoid muscles

40. What virus causes hoof - and - mouth disease?
Minor
Vesicular stomatitis virus
Hepatitis C
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.

41. 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.
Syphilitic
Chromosome 19
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.

42. What antiviral agents inhibit neuraminidases of influenza A and B?
The fastigial nucleus
reflexes
Zanamivir and oseltamivir
Invariant chain

43. What is the primary predisposing factor for vascular dementia?
Liver
Somatic motor neurons
Hypertension
The Beta- subunit; remember - the a - subunit is nonspecific.

44. What type of crystals are associated with gout?
All are lactose fermenters except Yersinia and Proteus.
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
Monosodium urate crystals
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.

45. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Osmolarity
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
300 mOsm/L
Bcl -2

46. Increases your risk factor for testicular cancer.
The energy of activation
Being a white male
Stercobilin
Basal cell carcinoma

47. Which type of cerebral herniation is associated with CN III palsy?
Transtentorial (uncal)
The biofeedback model is based on the parasympathetic nervous system.
Metronidazole
Cryptococcus

48. Name the type of necrosis - Seen as dead tissue with coagulative necrosis
Rhabdomyoma
Papillary carcinoma
Gangrenous necrosis
BPH

49. What muscle of the middle ear is innervated by the mandibular division of CN V?
Streptococcus viridans
Menses
GnRH pulsatile infusion
Tensor tympani

50. WBCs in the urine
Acute cystitis
Poststreptococcal GN
Labile
Ulnar to radial progression