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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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? - Eye tumor in children
Retinoblastoma
7 to 14 days
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Rhabdovirus

2. What vitamin deficiency produces homocystinuria and methylmalonic aciduria?
Are inactivated vaccines available in the United States
External abdominal oblique
Squamous cell carcinoma (skin - lung) and angiosarcoma of the liver
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)

3. What embryonic structure forms the adult female structures? - Labia majora
IDL
Volvulus
Mesolimbic system
Labioscrotal swelling

4. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 23/2n
There are no valves and no smooth muscle in the walls of the veins in the face.
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Breast cancer
Secondary spermatocyte

5. What is the name of the B cell - rich area of the spleen?
Succinylcholine
Eosin
GLUT 4
Primary follicle (in the white pulp)

6. What is the ratio of pulmonary to systemic blood flow?
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.
Adhesions and hernias
Hirschsprung disease (aganglionic megacolon)

7. What is the term for diffusion of water across a semipermeable or selectively permeable membrane?
Hyperacute rejection
Osmosis; water will diffuse from higher to lower water concentrations.
Lente or NPH insulin (neutral protamine Hagedorn insulin)
Alcohol abuse

8. What DNA viral disease is associated with aplastic crisis in patients with sickle cell anemia?
Parvovirus B-19
T cells - B cells - and macrophages
Bactericidal
Systemic lupus erythematosus

9. What water - soluble - vitamin deficiency is associated with cheilosis and magenta tongue?
Head of the pancreas
Nondominant parietal lobe
Coagulative
Riboflavin (B2)

10. What artery turns into the dorsalis pedis when it crosses the extensor retinaculum?
Anterior tibial artery
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Copper
Gonads

11. Based on operant conditioning - What type of reinforcement is described when x Removing a stimulus stops a behavior?
Extinction
Enkephalins
BPH
Neurofibromatosis

12. What antiepileptic agent has SIADH as a side effect?
Hypoparathyroidism
G2 phase
Carbamazepine
Albumin

13. Name the cluster C personality disorder: x Orderly - inflexible - perfectionist; makes rules - lists - order; doesn't like change - has a poor sense of humor - and needs to keep a routine
Pyruvate carboxylase
Obsessive - compulsive
Henoch - Sch
ACh receptor

14. What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
Marrow failure - cancer - and leukemia
Nodes of Ranvier
Renal plasma flow (decrease flow - increase FF)
Amnesia. (The person is aware of the memory loss.)

15. Lucid interval
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
Fibrinoid necrosis
Epidural hematoma
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord

16. What cystic swelling of the chorionic villi is the most common precursor of choriocarcinoma?
Hydatidiform mole
Heroin
During REM sleep
Phase 3

17. Are salivary secretions hypertonic - hypotonic - or isotonic?
Direct fluorescent Ab test
Hypotonic - because NaCl is reabsorbed in the salivary ducts
Dominant parietal lobe (Gerstmann's syndrome)
IgM

18. What enzyme catalyzes the reversible oxidative deamination of glutamate and produces the TCA cycle intermediate a - ketoglutarate?
Constipation and miosis
Protamine sulfate
0.21; it is a fancy way of saying 21% of the air is O2.
Glutamate dehydrogenase

19. Name the eukaryotic DNA polymerase based on the following information: x Replicates mitochondrial DNA
First - pass effect
DNA polymerase -?
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.
G0 phase

20. From What do catalase - superoxide dismutase - and glutathione peroxidase defend the cell?
Production of oxygen free radicals
Afterload
Systematic desensitization
PTH

21. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 46/4n
Primary spermatocyte
Bitemporal heteronymous hemianopsia
Listeria monocytogenes
CN II and ophthalmic artery

22. Name the antidote - Carbon monoxide (CO)
Cushing's ulcers
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
Oxygen
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)

23. Which virus is the MCC of a cold in the summer and fall? Winter and spring?
In men it is prostate cancer - and in women it is breast cancer.
The bifurcation of the abdominal aorta
Sj
Rhinoviruses for summer and fall; coronaviruses for winter and spring

24. What nerve or nerves supply general sensation and taste to the posterior third of the tongue?
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
CN XI and X
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Scavenger receptor (SR- B1)

25. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Agraphia - acalculia - finger agnosia - right - left disorientation

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26. What virus produces koilocytic cells on a Papanicolaou (Pap) smear?
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
HPV
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
Mast cells

27. Oxidation of Hgb forms what bodies in patients with G-6- PD deficiency?
Lithium
Pseudomonas aeruginosa
Heinz bodies
Superego

28. What form of penicillin is stable in acid environments?
Omega -3; linoleic is omega -6
Poxvirus
Penicillin V
Streptococcus pneumoniae

29. What organism is associated with the following types of diarrhea? Rice water stools
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
Vibrio cholera
Lesser curvature of the antrum of the stomach
Foramen of Monro

30. Name these immature defense mechanisms: x Inability to remember a known fact (aware of forgetting)
N- Acetylcysteine
Dependent
Blocking
Conidia

31. What hormone - produced by the granulose cell - stimulates the endometrium to enter the proliferative phase?
Brain abscess
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
Rho (D) immune globulin (RhoGAM) - an anti - RhD IgG antibody - prevents generation of RhD- specific memory B cells in the mother.
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.

32. How many bronchopulmonary segments are on the right lung? Left lung?
There are 10 bronchopulmonary segments on the right and 8 on the left.
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.
Streptokinase

33. What is the vector for Chagas disease?
Nucleus pulposus
Bisphosphonates
CN III
The reduviid bug

34. What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Terbinafine
Gastric cancer
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
Blood clots

35. What is the most common one? - Pituitary tumor
Cones (C for color and cones)
Chromophobe adenoma
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
Biotin. Avidin is found in raw egg whites.

36. What CN is associated with the sensory innervation of x Nasopharynx?
Staphylococcus
Substantia nigra
rRNA
Maxillary division of CN V and glossopharyngeal nerves

37. How many milliliters of O2 per milliliter of blood?
Pancreatic cancer
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
In the medulla; all the other structures are cortical.
0.2

38. Name the DNA virus: x Linear dsDNA; naked; replicates in the nucleus
Adenovirus
Clozapine
Cyanocobalamin (B12)
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.

39. Thyroid _____ is a measure of its function.
Chromosome 5q21
Nigrostriatal pathways (basal ganglia)
Size
Superior and middle

40. What enzyme of purine synthesis is inhibited by allopurinol and 6- mercaptopurine?
Mesothelioma and bronchogenic carcinoma
IgG
PRPP aminotransferase
Langerhans cells

41. What is the DOC for hyperprolactinemia?
Pyelonephritis
Pergolide
Alendronate
Protease - integrase - and reverse transcriptase

42. What is the term for the speckled appearance of the iris in patients with Down syndrome?
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
Aortic stenosis
Short - chain fatty acids
Brushfield spots

43. What lower extremity nerve is described by the following motor loss? - Loss of adduction of the thigh
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
Obturator nerve
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.

44. In What type of circuit is the total resistance always less than that of the individual resistors?
Direct fluorescent Ab test
Type II hypersensitivity (cytotoxic)
Parallel circuit
ACL

45. What commonly encountered overdose produces headache - tinnitus - respiratory alkalosis - metabolic acidosis - confusion - vomiting - and tachypnea?
2 - 4- Dinitrophenol
Parvovirus (it is the only ssDNA virus)
ASA (salicylate)
Peau d'orange

46. What term is described as the prestretch on the ventricular muscle at the end of diastole?
Preload (the load on the muscle in the relaxed state)
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.
Pneumocystis carinii
TAT (Thematic apperception test)

47. Name the most common cause - Croup
Zanamivir and oseltamivir
Salmeterol
Parainfluenza virus
Mycoplasma pneumoniae

48. What branch of the immune system is acquired in response to an Ag?
Ventricular fibrillation (V fib)
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.
Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.

49. What are the top three causes of infant mortality?
Middle
Chromosome 11 - 22
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
Stapes artery

50. What AA is a precursor of the following substances? - GABA
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency
Glutamate
Childhood
Protamine sulfate

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USMLE Step 1 Prep

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