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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 topoisomerase makes ssDNA cuts - requires no ATP - relaxes supercoils - and acts as the swivel in front of the replication fork?
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Glossopharyngeal nerve
hCG
Topoisomerase I (Relaxase)

2. What is the most common one? - Cancer of the esophagus in the world
Squamous cell carcinoma
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
Leydig cell tumor
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain

3. What organism is associated with the following types of diarrhea? Rice water stools
Hepatitis - with or without necrosis
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
Intussusception
Vibrio cholera

4. What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency - glucocorticoid deficiency - and an excess of adrenal androgens?
Ephedrine
Glucose -6- phosphatase
Proton pump inhibitors
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.

5. Is irreversible
Bioavailability
Dendrites receive information - whereas axons send information.
Pneumococcus
Ag - Ab binding

6. What component of the corneal reflex is lost in a CN VII deficit?
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Eaton - Lambert syndrome
Motor aspect
SER

7. With which CN are preganglionic parasympathetic axons arising from the Edinger - Westphal nucleus associated?
Propranolol
CN III
Ulnar nerve
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.

8. What happens to prevalence as incidence increases?
Prevalence increases.
Urogenital folds
The inner cortex (paracortex) contains the T cells - so it is considered the thymic - dependent area.
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva

9. The 'tea - and - toast' diet is classically associated with what cause of megaloblastic anemia?
Campylobacter jejuni
Alcoholics Anonymous
1. Skin 2. Liver 3. Kidney
Folate deficiency (very common in the elderly)

10. What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia - tetany - and T- cell deficiency?
Fanconi - like syndrome
Arsenic - thorotrast - and vinyl chloride
Dyslexia
DiGeorge syndrome

11. 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?
IgM
Specificity (it deals with the healthy)
Dorsal motor nucleus of CN X
Effective dose for 50% of drug takers (median effective dose)

12. What lower extremity nerve is described by the following motor loss? - Loss of knee extension - weakened hip flexion
Femoral nerve
The death of a spouse. The higher the score - the greater the risk of developing an illness in the next 6 months.
8 weeks (response to a face)
Berylliosis

13. Where is ADH synthesized?
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
Mesonephric duct
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
Prostate cancer

14. What obligate extracellular fungus is silver stain - positive and is associated with pneumonia in patients with AIDS?
Pneumocystis carinii
Herpes I
Carbidopa and benserazide
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.

15. What disease is associated with the HLA- DR2 and HLA- DR3 alleles
Systemic lupus erythematosus
Mycoplasma
EBV
Prolactinoma

16. What is the only enzyme in the body that uses N-5- methyl folate?
Necrophilia
Transmembrane potential (an absolute number)
Homocysteine methyl transferase
Wernicke's encephalopathy

17. Which organism causes multiple infections by antigen switching?
Borrelia recurrentis
a - Methyldopa (Guanabenz or clonidine is also used.)
Prostate cancer
No - therapeutic indices can tell which drug is safer - not more toxic.

18. 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
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
Primary hyperaldosteronism (Conn syndrome)
Atelectasis

19. What syndrome is characterized by dynein arm abnormality resulting in chronic sinusitis - recurrent pulmonary infections - and infertility?

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20. What are the three carboxylase enzymes that require biotin?
Stranger anxiety
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland

21. What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?
Supraspinatus and infraspinatus
Osteosarcoma
Clear cell
Plasmodium vivax

22. Is excretion greater than or less than filtration for net secretion to occur?
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Excretion is greater than filtration for net secretion to occur.
Berger disease (IgA nephropathy)
Leukemias

23. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Midbrain
Direct pathway; a good example is Parkinson's disease.
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Mesencephalon

24. What mineral deficiency in children is associated with poor growth and impaired sexual development?
The pH of CSF is 7.33 - acidotic.
The primitive streak grows caudal to rostral.
Suprachiasmatic nucleus
Zinc (Zn) deficiency

25. What autoimmune syndrome is characterized by keratoconjunctivitis - corneal ulcers - xerostomia - and an increased risk of high - grade B- cell lymphomas? What two Ab tests are used in making the diagnosis?
Sj
Acute toxic or viral nephrosis
NADPH oxidase
CD40

26. Name the hepatitis virus based on the following information - Enveloped DNA hepadnavirus
Fluconazole
HBsAb IgG
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
Hepatitis B

27. What components of the coagulation cascade are affected by estrogen?
Estradiol
Pelvic splanchnics (They all begin with P.)
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Hepatitis E

28. The opening of what valve indicates the termination of isovolumetric relaxation phase of the cardiac cycle?
Site 3
Trypsin
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
Measles (rubeola)

29. By What age should children be able to draw the following figures? - Cross
Eosinophilic exudates
RNA polymerase III
Concrete operations (6-12 years)
4 years old

30. What percentage of cardiac output flows through the pulmonary circuit?
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
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.
Ketamine
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)

31. What are the two essential fatty acids?
Constipation and miosis
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet
Linoleic acid and linolenic acid
Birds

32. Where do the primordial germ cells arise?
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
Laminin
From the wall of the yolk sac
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.

33. What viral infection is associated with black vomit?
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone - whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
Yellow fever (flavivirus)
Areas 41 and 42
Flow cytometric analysis

34. Which type of cerebral herniation is associated with CN III palsy?
HTN
Transtentorial (uncal)
Beryllium
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.

35. Name the associated chromosome - Albinism
Chromosome 11p
Salmeterol
Sciatic nerve
Gonads

36. What is the term for the same results achieved again on testing a subject a second or third time?
Test - retest reliability
Itraconazole
Parkinson disease
Ventromedial nucleus; lesions here result in obesity.

37. What cancer of the male genitourinary system is associated with osteoblastic bony metastasis?
Ethambutol
Insulinoma
Prostatic carcinoma
Coronary circulation

38. What is the most common one? - Proliferative abnormality of an internal organ
Amnesia. (The person is aware of the memory loss.)
Roth spots
BPH
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.

39. In a skeletal muscle fiber - the interior of the T- tubule is...
Sensory
Guillain - Barr
Extracellular
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.

40. What is the most common one? - Cardiac tumor of infancy
Rhabdomyoma
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
Laminin

41. What normochromic - normocytic AD anemia has splenomegaly and increased osmotic fragility?
Adenosine deaminase (ADA) deficiency
Left coronary artery
Hereditary spherocytosis
Thyroarytenoid muscles

42. What bactericidal agent is the DOC for MRSA - enterococci - and Clostridium difficile?
Glutamine
nef and tat genes
DiGeorge's syndrome
Vancomycin

43. What is the term for the strength of the association between Ags and Abs?
Increased androgen secretion at puberty drives the increased GH secretion.
Avidity. There is a positive correlation between valence numbers and avidity.
Mumps and influenza virus
CN XI - vertebral arteries

44. Name the most common type or cause - Panhypopituitarism
Spermatid
Unstable (crescendo) angina
Sheehan syndrome
Cleft palate

45. What diseases are associated with the HLA- B27 allele

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46. What direction does the primitive gut rotate? What is its axis of rotation?
Factors II - VII - IX - and X and proteins C and S.
The gut rotates clockwise around the superior mesenteric artery.
Cell - mediated immunity
Spinal trigeminal nucleus

47. Which hepatitis B serology markers
HBcAb IgG and HBsAb IgG
Brain abscess
Nephrotoxicity
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration

48. What form of bilirubin can cross the blood - brain barrier?
Initiate and manage gross skeletal muscle movement control
Unconjugated free bilirubin
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland
Increased leukocyte alkaline phosphatase (LAP)

49. What is the function of the basal ganglia?
Metaproterenol and albuterol
Initiate and manage gross skeletal muscle movement control
Trypsin
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.

50. How does ceasation of barbiturate use affect sleep?
Bender Visual Motor Gestalt Test
Reverse transcriptase
By causing rebound insomnia and decrease in REM sleep
Polyarteritis nodosa