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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 is the most common one? - Melanoma in dark - skinned persons
Shortens
Norm reference (i.e. - 75% of the students in the class will pass)
secondary immune response
Acral - lentiginous melanoma

2. Name the most common cause - A cold in the spring and fall
Rhinovirus
Severe (range 20-34)
Intrinsic factor (IF)
Gain of hypertonic fluid (mannitol or hypertonic saline)

3. What vitamin is needed for the production of heme?
Bladder carcinoma
11- Beta - Hydroxylase deficiency results in excess production of 11- deoxycorticosterone - a weak mineralocorticoid. It increases BP - Na+ - and ECF volume along with production of adrenal androgens.
Operon
Pyridoxine (B6)

4. What operant conditioning therapy or modification is described as x Stopping the reinforcement that is leading to an undesired behavior?
Extinction
Being a female physician increases the risk of suicide nearly four times the general population.
Bladder cancer
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.

5. Name the phase of the eukaryotic cell cycle: x Period of cellular growth (translation and transcription) after DNA synthesis
Skeletal muscles
GERD
G2 phase (gap 2)
Trypsin

6. Name the following descriptions associated with bacterial endocarditis: x Painless hyperemic lesions on the palms and soles
Acarbose
Caseous necrosis
Janeway lesions
Hormone - sensitive lipase

7. What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
Red muscle
Neutropenia - splenomegaly - and rheumatoid arthritis
Vitamin B12 deficiency and folate deficiency

8. What is the term for pelvic inflammatory disease of the fallopian tubes?
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
Seminoma
Salpingitis
Stranger anxiety

9. What is the name of depression and mania alternating within a 48- to 72- hour period?
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Rapid cycling bipolar disorder
Erythema nodosum
Group A Beta- hemolytic streptococci

10. If you report a suspected case of child abuse and are wrong - are you protected from legal liability?
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
An internal elastic lamina
Histiocytes
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.

11. Curschmann spirals
Epinephrine
Bronchial asthma (whorled mucous plugs)
Roth spots
Severe combined immunodeficiency disease

12. What organelles make ATP - have their own dsDNA - and can synthesize protein?
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
Variable ratio If it is based on time - it is an interval - and if it is based on the number of responses - it is a ratio.
Mitochondria
overall dopamine activity

13. What mineral is required for cross - linking of collagen molecules into fibrils?
p -53
Secondary spermatocyte
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
Lead

14. What disease is associated with the HLA- A3 allele
Third week
Primary Hemochromatosis
Affinity (one of each)
Bladder cancer

15. What three cells are essential for T- cell maturation?
Bone deposition increases with increased Ca2+ or PO 4- concentrations - whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
Foramen of Winslow
Thymic epithelial cells - dendritic cells - and macrophages
T3 increases both heart rate and cardiac output by increasing the number of Beta - receptors and their sensitivity to catecholamines.

16. What operant conditioning therapy or modification is described as x Removing a reinforcement (without the patient knowing) gradually over time to stop a condition?
Ewing sarcoma
Rhinovirus and hepatitis A virus
Fading
Iron deficiency anemia

17. Name the most common type or cause - Meningitis in renal transplantation patients
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Listeria monocytogenes
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
HPVs 16 and 18

18. What is the primary target for the action of glucagon?
Left atrium and tip of the right atrium
Liver (hepatocytes)
Chief cell adenoma (80%)
Coxsackie A

19. What type of pleura is adherent to the surface of the organ?
Atrial contraction Atrial - Contraction - Venous
Visceral pleura
Duodenum
Squamous cell carcinoma

20. Name the cluster B personality disorder: x Grandiose sense of self - importance; demands constant attention; fragile self - esteem; can be charismatic
14 days
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.
Narcissistic
Acetyl CoA carboxylase

21. What is the tetrad of tetralogy of Fallot?
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
Left ventricle and tip of right ventricle
VSD - RVH - overriding aorta - and pulmonary stenosis
No CHO - AA - ketones - or peptides are left in the tubular lumen.

22. With which DNA virus are Guarnieri bodies associated?
Flow cytometric analysis
Variola (smallpox)
The subclavian artery
Down syndrome (trisomy 21)

23. What type of jaundice is seen in Rotor's syndrome?
Formation of an identity through issues of independence and rebellion; they define who they are.
Yolk sac tumor
Pseudogout
Conjugated (direct) hyperbilirubinemia

24. What are the three stages that children aged 7 months to 5 years go through when they are separated from a primary caregiver for a long time?
1. Protest 2. Despair 3. Detachment
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon

25. Do the following structures pick up stain from hematoxylin or eosin? - Calcium
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
Hematoxylin
Previous suicide attempt
Dopamine antagonists

26. Name the hepatitis virus based on the following information - Enveloped DNA hepadnavirus
Monocytosis
Hepatitis B
NSAIDs
Streptococcus viridans

27. What muscle of the middle ear is innervated by the mandibular division of CN V?
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
Epinephrine
Tensor tympani
Ribozymes

28. According to Freud - what facet of the psyche represents the internalized ideals and values of one's parents?
VSD - RVH - overriding aorta - and pulmonary stenosis
Paranoid
Superego
Thymus gland. (Thymus gland is essential for T cell maturation.)

29. What statistical test compares the means of many groups (>2) of a single nominal variable by using an interval variable?
Convergence
Tetracyclines
Stratum spinosum
One - way ANOVA

30. What are the strongest determinants of gender identity?
G2 phase
1. Decrease alpha -1 activity 2. Increase Beta -2 activity 3. Increase ACh levels
Parental assignment and culture (not biology)
Familial polyposis coli

31. What protein allows Mycoplasma to attach to the respiratory epithelium?
Pseudomonas
Ulcerative colitis
P1 protein
Glioblastoma multiforme

32. What limb of the internal capsule is not supplied by the middle cerebral artery?
Squamous cell carcinoma
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
Hyperplasia
Sarcoplasmic reticulum

33. What is the name of violent projectile movements of a limb resulting from a lesion in the subthalamic nuclei of the basal ganglia?
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Hemiballismus
Medullary carcinoma of the thyroid
Vancomycin

34. Name the most common type or cause - Painless hematuria
18 years old (except if emancipated)
Renal cell carcinoma
Tyramine
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.

35. What intrauterine deficiency leads to failure to thrive - mental retardation - motor incoordination - and stunted growth?
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Impaired ejaculation
Iodine - resulting in congenital hypothyroidism
Middle cerebral artery

36. Where is the lesion that produces these symptoms when a patient is asked to look to the left? Neither eye can look left with a slow drift to the right
Temporal lobes
Left abducens nucleus or right cerebral cortex
Histiocytosis X
Cervical neoplasia

37. What three cephalosporins can produce disulfiram - like reactions?
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Escherichia coli
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.
Buffers (remember that buffers are best when they are used in a pH range near its pK)

38. What syndrome causes inability to concentrate - easy distractibility - apathy - and regression to an infantile suckling or grasping reflex?
Isoniazid
Afterload
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.
Frontal lobe syndrome (lesion in the prefrontal cortex)

39. Can committed mentally ill patients refuse medical treatment?
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
The urea cycle
External 3' - 5' PDE bonds
Yes. The only civil liberty they lose is the freedom to come and go as they please.

40. What is the most common one? - Thyroid cancer
Pneumocystis carinii
Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.
Superior and posterior
Papillary carcinoma

41. What is the PO2 of aortic blood in fetal circulation?
Mycosis fungoides (cutaneous T- cell lymphoma)
Yes - because they both activate the BZ1- receptors - which can be reversed by flumazenil.
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
60%

42. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 46/2n (divide mitotically)
CSF
Spermatogonia (type B)
Valine
Mitosis

43. A urethral swab of a patient shows gram - negative diplococci in PMNs; what organism do you diagnose?
p -53
Short - chain fatty acids
Neisseria gonorrhoeae
Third week

44. What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
Prolactin
HIV
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
Gastrin - releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)

45. Where is tropocollagen aggregated to form a collagen fibril?
Outside the cell
Papule
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
Aversive conditioning

46. What is the MCC of the following meningitides? - In neonates to 3 months of age
Streptococcus agalactiae and Escherichia coli
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
Serocystadenoma

47. What is the term for the unidirectional attraction of cells toward a chemical mediator released during inflammation?
Second M PITS for pharyngeal pouch derivatives
Chemotaxis
Vitamin E
MEN IIa (or Sipple syndrome)

48. What parasitic infection is associated with cholangiocarcinoma?
Clonorchis sinensis
Allotypes
Granulosa/thecal cell tumor of the ovary
H 2

49. What embryonic structure forms the adult female structures? - Ovary - follicles - rete ovarii
Gonads
Duodenal atresia
Primary hypoaldosteronism (Addison's disease)
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.

50. Name the antidote - Warfarin
Pseudomonas aeruginosa
Vitamin K
Voltage - gated calcium channel
Parvovirus B 19