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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. T3 increases bone ossification through synergistic effect with what hormone?
Proencephalon
GH
Ciliary ganglion
G-6- PD deficiency

2. Are white rami preganglionic or postganglionic fibers?
Parvovirus B-19
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Hirschsprung disease
Preload (the load on the muscle in the relaxed state)

3. What is the MCC of the following endocarditis scenarios? - Post dental work
Preload. It is the load on a muscle Prior to contraction.
Streptococcus viridans
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
CD16 and CD56

4. Name the muscle type based on the histological features: x Actin and myosin in sarcomeres; striated; uninuclear; gap junctions; troponin:calcium binding complex; T tubules and SR forming dyadic contacts; voltage - gated calcium channels
Hemangioblastoma
CD14
Cardiac muscle
K1 capsule

5. What is the term for a substance secreted by a leukocyte in response to a stimulus?
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
Turcot syndrome
Birds
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T

6. What DNA virus is associated with exanthem subitum (roseola)?
Chlamydia psittaci
McArdle's syndrome
HHV 6
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade

7. What fungus is urease positive?
Nasopharynx
Cryptococcus
Rhabdovirus
Estradiol

8. What renal side effect is commonly seen in patients taking lithium?
Nonsense
Melanosis coli
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
Ventral anterior nucleus

9. What mixed a - antagonists are used for patients with pheochromocytoma?
Astrocytoma
Phentolamine and phenoxybenzamine
Crude mortality rate
First pharyngeal groove; all others degenerate.

10. What paraphilia is defined as x Deriving sexual pleasure from being abused or in pain?
INF- gamma
Masochism
Thiabendazole
Lipoid nephrosis

11. What organelle is responsible for ribosomal RNA synthesis?
Marfan syndrome
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
Fragile X syndrome
FSH and testosterone

12. Where do sperm go for maturation?
Ductus epididymis - Which is lined by pseudostratified epithelium with stereocilia.
Avidity (more than one binding site)
Myasthenia gravis
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.

13. What AA has a pKa of 13?
REM latency; normally it is about 90 minutes.
Haemophilus ducreyi
Chromosome 18
Arginine

14. Which anticonvulsant is also used in the treatment of bipolar disorder and for migraine headaches?
Valproic acid
Ferritin
Severe combined immunodeficiency disease
Effective dose for 50% of drug takers (median effective dose)

15. What personality disorder affects 75% of the prison population?
Antisocial personality
Hyperkalemia
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
Bridging veins draining into the sagittal sinus

16. What class of antimicrobial agents should be avoided in patients with a history of GPDH deficiency?
TXA2
RSV
Sulfonamides
Pompe's disease

17. Cowdry type A bodies
Isograft
Borrelia recurrentis
Herpesvirus
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.

18. Name the phase of the eukaryotic cell cycle: x Period of cellular growth (translation and transcription) before DNA synthesis
Chi - square.
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
G1 phase (gap 1)
Medulla blastoma

19. Name the RNA subtype based on the following: x Only type of RNA that is translated
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
Acute cystitis
mRNA
CMV; remember - EBV is associated with heterophile - positive mononucleosis.

20. What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.
ater flows from a low - solute to high - solute concentrations.
Ventral lateral nucleus
GERD

21. What is the size of a positive PPD test for the following? (Reactive) x Patient with AIDS
Avidity. There is a positive correlation between valence numbers and avidity.
Methanol (wood alcohol)
>5 mm
Constipation and miosis

22. What are the six substances that promote the secretion of insulin?
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
Berry aneurysm

23. What syndrome is characterized by the triad of renal tubular acidosis - nephrosis - and amino aciduria?
Biotin - ATP - and CO2
Fanconi - like syndrome
HHV 6
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.

24. Anatomical and alveolar dead spaces together constitute what space?
Unconjugated free bilirubin
Parasympathetics (parasympathetics point - sympathetics shoot)
Physiologic dead space is the total dead space of the respiratory system.
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.

25. What are the four characteristics of all protein - mediated transportation?
Radial nerve
Proton pump inhibitors
Aged adult
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero - order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than i

26. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x CDK4
A right CN V lesion results in weakened muscles of mastication - and the jaw deviates to the right.
Melanoma
Brucella and Listeria (has tumbling motility)
Simon focus

27. In What three areas of the body are sympathetics the predominant tone?
Head of the pancreas
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood
1. Sweat glands 2. Arterioles 3. Veins
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes

28. Name the macrophage based on its location: x Epidermal macrophages
Expressive aphasia
Langerhans cells
Early distal tubule
CHF - cirrhosis - and nephrosis

29. Reinke crystals
80S ribosomes (because they are eukaryotic)
Squamous cell carcinoma
Chromosome 3p
Leydig cell tumor

30. What is the most common one? - Testicular tumor in men over 50 years old
There would be two Fab and Fc regions.
Testicular lymphoma
Subarachnoid hematoma
Both

31. What disorder is associated with jaundice - white stools - and dark urine due to biliary duct occlusion secondary to incomplete recanalization?
H 1
Extrahepatic biliary atresia
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
Enterohemorhagic Escherichia coli

32. Is splenomegaly more commonly associated with intravascular or extravascular hemolysis?
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.
Urogenital folds
Cortisol - a 21- carbon steroid - has a - OH group at position 17.

33. The clearance of what substance is the gold standard of GFR?
Positive correlation
Inulin
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.
Hirschsprung disease (aganglionic megacolon)

34. What is the term for pelvic inflammatory disease of the fallopian tubes?
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.
GnRH constant infusion
Salpingitis
Ticlopidine or clopidogrel

35. Do the following structures pick up stain from hematoxylin or eosin? - Calcium
Systemic lupus erythematosus
Hematoxylin
Alzheimer disease
GLUT 2

36. In eukaryotes - What transcription factor binds to the TATA box before RNA polymerase II can bind?
Carbamazepine
Transcription factor IID
Calicivirus
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

37. What paraphilia is defined as x A male rubbing his genitals on a fully clothed female to achieve orgasm?
Niemann - Pick disease
Case fatality rate
Frotteurism
Thrush

38. What is the term for the proportion of a drug that reaches systemic circulation?
Amyotrophic lateral sclerosis (Lou Gehrig's disease) is a LMN lesion at the level of the lesion and UMN lesion below the level of the lesion.
Superior
Crohn disease
Bioavailability

39. What AR CNS disorder presents early in childhood with gait ataxia - loss of deep tendon reflexes - impaired vibratory sensation - hand clumsiness - and loss of position sense?
Stage fright (discrete performance anxiety)
Legionella
The fast component is directed toward the affected side of a cerebellar lesion.
Friedreich ataxia

40. What cell type of the body or fundus of the stomach secretes pepsinogen?
Phenylephrine
Chief cells
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
HHV 8

41. What is the formula to calculate IQ?
Bulla
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age
Oncotic pressure increases because of the removal of water.
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death

42. Name the associated chromosome - Huntington disease
Glycogen phosphorylase
Cardiac muscle
Femoral hernias
Chromosome 4p

43. What HIV structural gene produces GP120 and GP41?
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Cytosine
env structural protein
Guanethidine and bretylium

44. What phase of Food and Drug Administration approval tests x The safety in healthy volunteers?
Phase I
Pseudomonas
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Phase 0

45. How do the corticobulbar fibres of CN VII differ from the rest of the CNs?
Rabies
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
Crude mortality rate
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia

46. What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
Hemolytic uremic syndrome
Streptococcus viridans
Medulla blastoma
Leiomyoma

47. What disorder is associated with decreased platelet count - prolonged PT and PTT - decreased fibrinogen - and increased fibrin split products (D- dimers)?
Coxsackie B
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)
Disseminated intravascular coagulation (DIC)
Bacillus cereus

48. How many milliliters of O2 per milliliter of blood?
0.2
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
CN V - VI - VII - and VIII
Class III

49. What bilateral AR disorder seen in infancy as progressive renal failure has multiple small cysts at right angles to the cortical surface?
Polycystic kidney disease of childhood
Escherichia coli
Left ventricle and auricle of left atrium
Tibial nerve

50. What Brodmann area is associated with x Wernicke's area?
Staphylococcus aureus
EF- G of the 50S subunit
Area 22 and occasionally 39 and 40
Hematoxylin