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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 the compartment of the mediastinum associated with the following thoracic structures: Vagus nerve
Posterior
HBcAb IgM - HBV- DNA - HBeAg - HBsAg
Celecoxib
Rhabdomyoma

2. What thyroid enzyme is needed for oxidation of I- to I'?
Repolarization is from base to apex and from epicardium to endocardium.
Reinforcement
Atropine and 2- PAM (pralidoxime)
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell

3. Is there a difference between mathematical and clinical steady states? If so - What are their values (half - lives)?
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
Succinylcholine and halothane (Treatment is with dantrolene.)
There is a difference; it takes about 7 to 8 half - lives to reach mathematical steady state and 4 to 5 half - lives to reach clinical steady state.
Foramen of Winslow

4. What organelles make ATP - have their own dsDNA - and can synthesize protein?
Humerus with ulna (major) and radius (minor)
DNA polymerase - d
Mitochondria
ydroxyproline

5. Is it acceptable to lie - even if it protects a colleague from malpractice?
Caisson disease
T and B- cells belong to the adaptive branch - whereas PMNs - NK cells - eosinophils - macrophages - and monocytes belong to the innate branch.
Subclavian vein
No - it is never acceptable to lie.

6. What type of random controlled test is least subjective to bias?
Double - blind study. It is the most scientifically rigorous study known.
Large segment deletions
Sinus venosus
Amantadine

7. What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ?
Depolarization (i.e. - Na+ influx)
Aminophylline
Functions of hepatocytes
Streptokinase

8. Is T3 or T4 responsible for the negative feedback loop on to the hypothalamus and anterior pituitary gland?
CN XII
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.
LVEDV and LVEDP (left ventricular end - diastolic volume and end - diastolic pressure - respectively)
Extinction

9. Name the type of graft described by these transplants: x From one site to another on the same person
Remember the mnemonic PAM SMIDT P - (hyper) Parathyroid/ Paget disease A - Addison's disease M - Milk - alkali syndrome/metastatic cancer S - Sarcoidosis M - Multiple myeloma I - Immobilization/idiopathic D - Vitamin D intoxication T - Tumors
PALS (Parietolateral lymphocytic sheath)
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
Autograft

10. What enzyme is needed to activate the following reactions? - Procarboxypeptidase to carboxypeptidase
Case control studies cannot assess incidence or prevalence - but they can determine causal relationships.
Trypsin
Free form determines hormone activity and is responsible for the negative feedback loop.
Ulcerative colitis

11. What is the term for the copper corneal deposits found in Wilson's disease?
Kayser - Fleischer rings
Pedophilia
Hypertrophy
Plasmodium malariae

12. What paraphilia is defined as x Deriving sexual pleasure from other peoples' pain?
Sadism
Osteoporosis
Low molecular weight heparin (LMWH)
H2PO4- (dihydrogen phosphate)

13. In which form of emphysema - panacinar or centriacinar - is the effect worse in the apical segments of the upper lobes?
Aminophylline
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
Burr cells (echinocytes)
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes

14. Why are patients with Chronic Granulomatous Disease not prone to develop infections from catalase - negative bacteria?
1. Sweat glands 2. Arterioles 3. Veins
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
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
Lung cancer

15. Name the antidote - Arsenic
Cytochrome a/a3
Nodes of Ranvier
Dimercaprol - D- penicillamine
Gastrinoma

16. What muscle acts in all ranges of motion of the arm?
The rate of infusion
From age 5 onward IQ stabilizes.
Deltoid
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.

17. What is the name for failed recanalization of the duodenum resulting in polyhydramnios - bile - containing vomitus - and a distended stomach?
CN V
Duodenal atresia
Temporal lobe
PRPP aminotransferase

18. What is the term to describe the inability to feel any pleasant emotions?
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
RNA polymerase I
Anhedonia
Herpesvirus

19. What DNA viral disease is associated with aplastic crisis in patients with sickle cell anemia?
A gene (a rather simple definition but accurate)
Multiple myeloma
Parvovirus B-19
Cholesterolosis

20. Name the macrophage based on its location: x Connective tissue macrophages
Pergolide
It increases Ca2+ excretion from the kidney and increases bone mineralization.
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.
Histiocytes

21. What Ig is associated with ADCC for parasites?
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Borrelia recurrentis
IgE
Doxacurium

22. Name the phase of the eukaryotic cell cycle: x Cells cease replicating (i.e. - nerve cell)
G0 phase
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
Left atrial myxoma

23. What triggers phase 4 of the action potential in a ventricular pacemaker cell?
Tamoxifen
Decreasing potassium conductance - which results in increased excitability
12 to 16 weeks (in response to mother's face)
CD21; it is a complement receptor for cleaved C3

24. Which trematode is associated with bladder carcinoma in Egypt and Africa?
Albumin
Type III
Mentally disabled
Schistosoma haematobium

25. What is the only vein in the body with a high O2 content?
Carbamazepine
Dominant parietal lobe (Gerstmann's syndrome)
Supraspinatus and infraspinatus
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.

26. What is the label given to an individual whose IQ is x Below 69
Hemochromatosis
Decrease (5- HT and dopamine levels do the same)
Mentally disabled
Pulmonary infections

27. Which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida?
Carbamazepine
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
Myasthenia gravis
Eosinophil chemotactic factor A

28. What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
Marrow failure - cancer - and leukemia
Alcoholism
Carbamazepine
Cohort studies determine incidence and causality - not prevalence.

29. How many pairs of spinal nerves are associated with x Sacral vertebrae?
Missense
Rectum
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.

30. What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1?
Hyperkalemia
Dimercaprol - penicillamine
Lisch nodules
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.

31. Which organism causes trench fever?
Rochalimaea quintana (now called Bartonella quintana)
Graves disease
Thrombus
Chemotaxis

32. What endotoxin receptor is the best marker for macrophages?
Primary hypoaldosteronism (Addison's disease)
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
CD4+ T cells (helper)
CD14

33. What is the most common one? - Viral cause of myocarditis
Coxsackie B
Bronchogenic carcinoma
Leiomyoma (fibroids)
The DCML system. (Remember - everything but pain and temperature.)

34. What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting - fissuring - and oozing?
Paget disease of the breast
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
REM latency; normally it is about 90 minutes.

35. What area of the small intestine is characterized by Peyer's patches?
LC4 - LD4 - and LE 4
Mural infarct
Ileum
1. Liver 2. Muscle 3. Adipose tissue

36. What benign bone tumor is associated with Gardner syndrome?
They prevent mast cell degranulation.
At least 15%
Osteoma
Cardiac muscle

37. Has no underlying pathology.

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38. What complement factor deficiency leads to x Hereditary angioedema?
C1 inhibitor (C1- INH)
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
Area 17
Postinfectious GN

39. Leading to gallstones and steatorrhea.
Median nerve
Between the renal arteries and at the bifurcation of the abdominal aorta
Pancreatic delta - cell tumors inhibit CCK secretion
Secondary lysosome (think of the primary as inactive and secondary as active)

40. A migrating myoelectric complex is a propulsive movement of undigested material of undigested material from the stomach to the small intestine to the colon. During a fast - What is the time interval of its repeats?
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
CD19

41. What is the major hormone produced in the following areas of the adrenal cortex? - Zona reticularis
Right - sided valves
1. Big 2. Bilateral 3. Berry aneurysm
2 and 5HT3 receptors
DHEA (androgens) Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

42. What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
Fitz - Hugh - Curtis syndrome
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
Beta- Blockers
The pulsatile release of GnRH

43. What three cephalosporins can produce disulfiram - like reactions?
Velocity is inversely related to cross - sectional area.
Ependymal cells
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
1. Cefamandole 2. Cefoperazone 3. Moxalactam

44. What type of potential is characterized as being an all - or - none response - propagated and not summated?
Action potential
Infection
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
All are lactose fermenters except Yersinia and Proteus.

45. What type of membrane is characterized as being permeable to water only?
1. Tinea coli 2. Haustra 3. Epiploic appendages
Hemangioma (benign)
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
Tidal volume (VT)

46. What classical conditioning therapy or modification is described as x Pairing noxious stimuli to an inappropriate behavior?
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Axon hillock
Expiratory reserve volume (ERV)
Aversive conditioning

47. Which leukotriene is chemotactic for neutrophils?
LTB4
ACE inhibitors (the - pril agents)
Sigma factor
Chromosome 11p

48. Have no GI tract They absorb nutrients from the host's GI tract.
Cestodes
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)
Areas 5 and 7
2 and 5HT3 receptors

49. What is the term for hyphae with constrictions at each septum that are commonly seen in Candida albicans?
Pseudohyphae
Pedophilia
Down syndrome (trisomy 21)
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.

50. What is the greatest component of lung recoil?
Melanoma
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Alcoholics Anonymous
Surface tension; in the alveoli - it is a force that acts to collapse the lung.