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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. Which medication requires an acidic gastric pH for activation to form a protective gel - like coating over ulcers and GI epithelium?
The basilar artery is formed at the pontomedullary junction.
Type II pneumocytes
Sucralfate
Superior vena cava

2. What drug blocks intragranular uptake of NE?
Log - kill hypothesis (follows first order kinetics)
Prophase of meiosis I (between 12th and 22nd week in utero)
Reserpine
Achondroplasia

3. What are the rules of 2 for Meckel diverticulum?
a - and Beta- chains are on most T cells.
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors
Psoriasis - ankylosing spondylitis - inflammatory bowel disease - and Reiter's syndrome
1. Cough 2. Coryza 3. Conjunctivitis

4. What oxygen - dependent killing enzyme requires hydrogen peroxide and halide (Cl -) to produce hypochlorous acid?
Myeloperoxidase
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
The short arm of chromosome 6
Ordinal scale (e.g. - faster/slower - taller/shorter)

5. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x PSA and prostatic acid phosphatase
Mesencephalic nucleus
Prostate cancer
IL-4 - IL-10 - and IL-13
Duchenne muscular dystrophy (Remember - Becker's is slower in progress - less severe - later in onset - and lacks cardiac involvement.)

6. From What aortic arch are the following structures derived?
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
Common and internal carotid arteries
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
GABA and glutamic acid

7. What GI pathology is associated with a positive string sign - an increase in the number of bloody stools - RLQ pain - skip lesions - terminal ileum most commonly affected - occurrence in women more than men - and an increased thickness of the bowel?
Lower lobe
Turner syndrome
Crohn disease
CHF - cirrhosis - and nephrosis

8. What limb of the internal capsule is not supplied by the middle cerebral artery?
embranoproliferative glomerulonephritis (MPGN)
The conversion of tyrosine to dopamine in the cytoplasm
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
P24

9. What disorder causes joint stiffness that worsens with repetitive motion - crepitus - effusions - and swelling and commonly affects the knees - hips - and spine?
Transference. When it is from the physician to the patient it is called countertransference.
Carnitine acyl CoA transferase II
Osteoarthritis
Puberty

10. What Brodmann area is associated with x Somatosensory association cortex?
Glucose -6- phosphatase
Krukenberg tumor
Microglia
Areas 5 and 7

11. Name the AD disease associated with chromosome 15 in which the patient has long extremities - lax joints - pigeon chest - and posterior mitral leaflet prolapse and is prone to developing dissecting aortic aneurysm.
Paget disease of the breast
Marfan syndrome
Eisenmenger syndrome - which can also occur with any left - to - right shunt
No. Remember - tests do not diagnose - they confirm or refute your diagnosis. Also - diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI - elevated cardiac enzymes consistent with MI - and ST segment elevati

12. What large - spore - forming - gram - positive anaerobic rod is associated with infections due to puncture wounds and trauma?
ASD
Site 2
Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle.
Clostridium tetani

13. What cell surface marker do all T cells have?
CD3
Medial compartment of the thigh - obturator nerve
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
Glutamate

14. Why is the base of the lung hyperventilated when a person is standing upright?
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.
C2 deficiency
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Endometrial cancer

15. What is the most common one? - Primary malignant tumor of the lungs
Adenocarcinoma (30% to 35%)
Superego
Chromaffin cells (adrenal medulla)
Dapsone

16. Name the associated chromosome - Neurofibromatosis type 2
Glyceraldehyde dehydrogenase
Chromosome 22q
IgG3
Minocycline

17. Name the compartment of the mediastinum associated with the following thoracic structures: IVC
Taenia saginata
Middle
Testicular tumors
Aldolase B deficiencies are treated by eliminating fructose from the diet.

18. What two forces affect movement of ions across a membrane?
The lateral vestibular nucleus
IgG
Concentration force and electrical force
Tryptophan

19. What commonly encountered overdose produces headache - tinnitus - respiratory alkalosis - metabolic acidosis - confusion - vomiting - and tachypnea?
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
ASA (salicylate)
Coxsackie B
Avidity (more than one binding site)

20. Would a G- C or an A- T rich dsDNA sequence have a higher melting point? Why?
Regular insulin
Intermediate part of the hemispheres
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)

21. A Japanese man has weight loss - anorexia - early satiety - epigastric abdominal pain - and a palpable left supraclavicular lymph node. On endoscopy you find a large - irregular ulcer with elevated margins on the lesser curvature of the stomach. What
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).
Gastric carcinoma
No. It is abnormal only if it interferes with normal sexual or occupational function.
Membranoproliferative glomerulonephritis (MGN)

22. At What three sites can the HMP shunt enter into glycolysis?
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.
Burkitt lymphoma
Bile pigments and bile salts

23. Which three aminoglycosides have vestibular toxicity?
Wernicke's aphasia
1. Streptomycin 2. Gentamicin 3. Tobramycin
Superior and posterior
Gout

24. What antiviral agent blocks the attachment and penetration of influenza A virus?
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
CCK stimulates the pancreas to release amylase - lipase - and proteases for digestion.
Amantadine
Laminin

25. At what stage of cognitive development (according to Piaget) do children x Have abstract thinking?
Clofazimine
Duodenum
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
Formal operations (> 12 years)

26. Where in the GI tract does the reabsorption of bile salts take place?
Motor nucleus of CN V
Bile salts are actively reabsorbed in the distal ileum.
The inner cortex (paracortex) contains the T cells - so it is considered the thymic - dependent area.
Protein A

27. What is the site of action of the following? - Loop diuretics
Squamous cell carcinoma
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
Tetany
Ascending limb

28. Name five causes for zero - order metabolism.
Zero correlation
Gardnerella vaginalis
1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity
>10 mm

29. Which dimorphic fungus is found as hyphae with nondescript conidia in rotting wood in the Upper Great Lakes - Ohio - Mississippi - eastern seaboard of the United States - and southern Canada?
IgE
Intrinsic factor (IF)
Urogenital sinus
Blastomyces dermatitidis

30. What happens to plasma concentration of a drug if there is a large volume of distribution?
The larger the volume of distribution - the lower the plasma concentration of a drug.
The myotatic reflex is responsible for the tension present in all resting muscle.
Oxazepam - temazepam - and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation - not via the cytochrome p450 system.
Lesch - Nyhan syndrome

31. A patient goes to the ER with abdominal cramps - vomiting - diarrhea - and sweating less than 24 hours after eating potato salad at a picnic; What is the most likely responsible organism?
Staphylococcus aureus
Succinylcholine
Follicular phase
Erythromycin

32. Name the most common type or cause - Pulmonary HTN in children
Insulin
VSD
Taenia saginata
Acute toxic or viral nephrosis

33. Name the DNA virus x Linear dsDNA; nuclear envelope; icosahedral; replicates in the nucleus
Elongation factor - G and GTP
H 1
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
Herpes virus

34. What neuroleptic agent causes retinal deposits - hypotension - and torsades de pointes?
Thioridazine
Norm reference (i.e. - 75% of the students in the class will pass)
Echinococcus multilocularis
Haemophilus ducreyi

35. What enzyme is inhibited by sulfonamides?
Conn syndrome (primary hyperaldosteronism)
Dihydropteroate synthetase
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
Id (pleasure principle)

36. What complex is needed for propionyl CoA carboxylase?
Biotin - ATP - and CO2
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.
Pulmonary shunt (i.e. - pulmonary embolism)
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.

37. What blotting technique uses the following for analysis? - Protein
RSV
The carotid sinus is a pressure - sensitive (low) receptor - while the carotid body is an oxygen - sensitive (low) receptor. (Remember 'Sinus Pressure').
Langerhans cells
Western blot

38. What wave is the cause of the following venous pulse deflections? - The rise in right atrial pressure secondary to blood filling and terminating when the tricuspid valves opens
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
V wave
Inspiratory capacity
extrapyramidal dysfunction

39. What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?
The Fc region of IgG and C3b
Excision endonuclease - which removes thiamine dimers from DNA
Alendronate
Atropine - 2- PAM (pralidoxime)

40. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Polycyclic aromatic hydrocarbons
Bronchogenic carcinoma
Mean corpuscular hemoglobin concentration (MCHC)
Isoleucine - leucine - and valine
Pons

41. Which acid - fast rod is an obligate intracellular parasite?
Mycobacterium leprae
Beta- Oxidation of fatty acids
Squamous cell carcinoma
G-6- PD deficiency

42. What is the name of the process that ensures that each B cell produces only one heavy- chain variable domain and one light chain?
The conus medullaris terminates at the level of the second lumbar vertebra.
Basophilic stippling
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
Klebsiella pneumoniae

43. If the ratio of a substance's filtrate and plasma concentrations are equal - What is that substance's affect on the kidney?
Raloxifene
Third week; they are derived from the wall of the yolk sac.
MGN
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.

44. What small gram - positive - non - spore - forming rod is a facultative intracellular parasite that grows in the cold and is associated with unpasteurized milk products?
Listeria monocytogenes
Id
Dorsal motor nucleus of CN X
Schwannoma

45. Circulating levels of what hormone cause the cervical mucus to be thin and watery - allowing sperm an easier entry into the uterus?
Hepatic glycogen phosphorylase
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
Estrogen
Medial nuclear group (limbic system)

46. What are the most common causes of osteomyelitis x Overall?
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Head of the pancreas
Staphylococcus aureus
JC virus

47. What CNs are responsible for the sensor and motor components of the light reflex?
Oxytocin
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Gonococcus
Pneumococcus

48. What are the two MCC of acute epididymitis in males? - Less than 35 years old
Neisseria gonorrhoeae and Chlamydia trachomatis
M
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors
Secondary hypoparathyroidism (vitamin D toxicity)

49. How many pairs of spinal nerves exit from the spinal cord?
Infliximab
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Aspartate and carbomoyl PO4
31 pairs

50. What is the most common form of elderly abuse?
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
In men it is prostate cancer - and in women it is breast cancer.
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation