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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? - Site for colonic diverticula
Sigmoid colon
Libman - Sacks endocarditis
Type I hypersensitivity (anaphylactic)
Sphingomyelin (lecithin also - but it is not a sphingolipid)

2. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebellum
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
Pulmonary shunt (i.e. - pulmonary embolism)
Rhombencephalon
Gonads

3. What term describes the volume of plasma From which a substance is removed over time?
Clearance
Atropine and 2- PAM (pralidoxime)
1. Short attention span 2. Impulsivity 3. Hyperactivity
T cells - not B cells

4. What embryonic structure forms the adult female structures? - Glans clitoris - corpus cavernosus - and spongiosum
Vesicle (e.g. - poison ivy)
Penicillin V
Phallus
Internal carotid artery

5. What percentage of children born to HIV- positive mothers will test positive for HIV at birth?
100% - with about 20% remaining positive after 1 year
18 years old (except if emancipated)
Semicircular duct
CN X

6. What blood disorder is a side effect of metformin?
Hemophilia B
The CD4 T cell; the APC is the first cell in the immune response.
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
HMG CoA reductase

7. With What three enzymes is thiamin pyrophosphate (TPP) associated?
The tsetse fly
Niemann - Pick and Tay- Sachs diseases
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -
Ductus epididymis - Which is lined by pseudostratified epithelium with stereocilia.

8. Why is there a decrease in the production in epinephrine when the anterior pituitary gland is removed?
Week four - and they remain dormant there until puberty.
Edinger - Westphal nucleus (via CN III)
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Systematic desensitization

9. Which shuttle is used to bring fatty acyl CoA from the cytoplasm for ketogenesis?
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Alzheimer disease
Carnitine acyl CoA transferase II
Affinity (one of each)

10. What limb of the internal capsule is not supplied by the middle cerebral artery?
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
Acute CO poisoning
Serocystadenocarcinoma
Posterior compartment of the thigh - tibial nerve

11. Which class of antiarrhythmics blocks sodium channels?
Class 1 (1A - 1B - and 1C)
Chromosome 11p
Low molecular weight heparin (LMWH)
Thiogalactoside transacetylase

12. What is the most common one? - Intraspinal tumor
Antidigoxin Fab fragments
Pedophilia
Native Americans
Ependymoma

13. What mineral - via excessive depositions in the liver - causes hemochromatosis?
DNA polymerase - d
de Quervain thyroiditis
Iron (Fe)
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.

14. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Denies being blind - cortical blindness

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15. Which class of antiarrhythmics are calcium channel blockers?
CN VII and VIII
Parietal cells (Remember - they secrete HCl - too.)
Pasteurella multocida
Class IV

16. What is the DOC for the following protozoal infections? - Giardiasis
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
Metronidazole
Middle meningeal artery
Hemophilia A

17. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
rRNA
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
Glycogen phosphorylase
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.

18. Name the aphasia based on these characteristics: x Lesion in Brodmann area 22; impaired comprehension; incoherent rapid - fluent speech; verbal paraphrasias; trouble repeating statements

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19. What structure or structures cross the diaphragm at x T10 level?
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
Permanent
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
Cyanide

20. What would be the result if an Ab were cleaved with pepsin?

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21. What is the role of the negative charge on the filtering membrane of the glomerular capillaries?
The negative charge inhibits the filtration of protein anions.
Viruses
K1 capsule
Hepatitis C

22. Circulating levels of what hormone cause the cervical mucus to be thin and watery - allowing sperm an easier entry into the uterus?
Norm reference (i.e. - 75% of the students in the class will pass)
Being awake
Estrogen
Glycogen synthase

23. What is the second arrested stage of development in the female reproductive cycle?
Succinylcholine
Mitochondria
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Kidney

24. What are the genetic variants of a molecule within members of the same species?
Clostridium tetani
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
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Allotypes

25. What stage of male development is characterized by the following LH and testosterone levels? - Decreased testosterone production is accompanied by an increase in LH production.
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Carbamoyl phosphate synthetase I
Aged adult
Aedes mosquito

26. Name the structure that enters or exits the following foramina: x Stylomastoid foramen
Isoniazid
Osler nodes
Sadism
CN VII

27. What Brodmann area is associated with x Primary auditory cortex?
Areas 41 and 42
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies
Kayser - Fleischer rings
Copper

28. What prokaryotic positioning enzyme in translation is blocked by the following? - Tetracycline
GnRH pulsatile infusion
Hgb F
EF- Tu and EF- Ts of the 30S ribosomal subunit
Urinary 17- OH steroids

29. What ovarian carcinoma is characterized by psammoma bodies?
Rhinovirus and hepatitis A virus
Cystadenocarcinoma
Hepatitis A (infectious)
Four Ms and a U 1. Median 2. Medial antebrachial 3. Medial pectoral 4. Medial brachial cutaneus 5. Ulnar

30. Which M- protein strain of Streptococcus pyogenes is associated with acute glomerulonephritis?
M12 strains
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
Probenecid
Hematoxylin

31. What are the two ketogenic AAs?
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
Leucine and lysine
IgG4
1. Sweat glands 2. Arterioles 3. Veins

32. What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
Kimmelstiel - Wilson disease
3 years old
Microsporum

33. What potentially lethal side effect of clozapine should be monitored with frequent blood drawing?
5 years old
All are lactose fermenters except Yersinia and Proteus.
CN XII
Agranulocytosis; approximately 2% develop this side effect.

34. What AR disorder of copper metabolism can be characterized by Kayser - Fleischer rings - decreased ceruloplasmin levels - and increased urinary copper excretion and tissue copper levels?
1. Liver 2. Muscle 3. Adipose tissue
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Oblique fissure
Premature ejaculation

35. Where is the greatest venous PO2 in resting tissue?
HMG CoA reductase
Yes. The only civil liberty they lose is the freedom to come and go as they please.
Renal circulation
Diphyllobothrium latum

36. What vascular tumor associated with von Hippel - Lindau syndrome involves the cerebellum - brainstem - spinal cord - and retina?
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
Lactulose
Hypersegmented neutrophils
Hemangioblastoma

37. What GnRH analog is used as a repository form of treatment in prostatic cancer?
Repression
Leuprolide
DiGeorge syndrome
Pregnancy

38. Caf
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
After the latent period
Neurofibromatosis
CN VII and VIII

39. What is defined as a general estimate of the functional capacities of a human?
Chromosome 15
Adulthood
IQ
Succinyl CoA synthetase

40. Are more Abs produced in a primary or a secondary immune response?
Type III hypersensitivity reaction
Pernicious anemia
More Ab is produced in less time in a secondary immune response (shorter lag period).
Parasites

41. What are the four functions of saliva?
Malassezia furfur (treat with selenium sulfide)
Purkinje cell is the fastest - and the AV node is the slowest.
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Finasteride

42. What is the term for RBC fragments?
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.
IgA
Positive
Schistocytes

43. What ocular ganglion is affected if the pupil on the affected side sluggishly responds to light with normal accommodation?
The Beta- subunit; remember - the a - subunit is nonspecific.
Collecting ducts - which make them readily permeable to water reabsorption.
Ciliary ganglion producing a tonic pupil
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.

44. What class of drugs are the DOCs for peptic ulcer disease - Zollinger - Ellison syndrome - and gastroesophageal reflux disease?
Mentally disabled
Proton pump inhibitors
1. Propranolol 2. Timolol 3. Carteolol
It forms a germinal tube at 37

45. What is the most common one? - Site for an ectopic abdominal pregnancy
de Quervain thyroiditis
Papillary carcinoma
Western blot
The rectouterine pouch (of Douglas)

46. What is the rate - limiting step of the following? - Fatty acid synthesis
Acetyl CoA carboxylase
Conidia
Phenytoin
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.

47. Name the associated chromosomal translocation - CML
Hypnozoite
Chromosome 9 - 22 (Philadelphia chromosome)
Chromosome 15
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

48. What is the renal compensation mechanism for acidosis?
AT II
Production of HCO3- - shifting the reaction to the left and thereby decreasing H+
Minor
Isolation of affect

49. What is the tetrad of tetralogy of Fallot?
Sleep latency
VSD - RVH - overriding aorta - and pulmonary stenosis
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
Xenograft

50. There is a strong ________ between IQ and academic achievement.
positive correlation
Sadism
Lateral compartment of the leg - superficial peroneal nerve
Measles (rubeola)

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USMLE Step 1 Prep

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