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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 are the three characteristics of autoregulation?
Primary spermatocyte
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Creatinine
Ungated channels

2. Name the most common type or cause - Hypothyroidism in the United States
Tibial nerve
Dihydrofolate reductase
Iatrogenesis
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.

3. What is the first epidermal layer without organelles and nuclei
Dendritic cells - macrophages - and thymic epithelial cells
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Stratum lucidum
Phallus

4. What is the triad of Reiter syndrome?

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5. Name the associated chromosomal translocation - Acute promyelocytic leukemia (M3)
Hirschsprung disease (aganglionic megacolon)
Chromosome 15 - 17
CN XII
Tetanospasmin (also called tetanus toxin)

6. Which form of emphysema is associated with an alpha1- antitrypsin deficiency?
Escherichia coli and Pseudomonas sp.
Phase 1
Waldenstr
Panacinar

7. Name the most common cause - A cold in the spring and fall
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
NADPH oxidase
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.
Rhinovirus

8. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Percentage of original filtered volume left in the lumen
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Acebutolol and Pindolol
At the end of the PCT 25% of the original volume is left
Valence

9. What is the term for the strength of the association between Ag and an Ab?
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
Lipid - soluble hormones are considered slow - acting hormones.
Graves disease
Affinity (one of each)

10. What component of the inner ear x Contains endolymph and responds to head turning and movement?
CN VII
Transference. When it is from the physician to the patient it is called countertransference.
Semicircular duct
Leiomyoma

11. In skeletal muscle ________ is an active event.
Somatization disorder
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
relaxation
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)

12. What element is needed for the proper alignment of tropocollagen molecules?
Reye syndrome
Primary hypoaldosteronism (Addison's disease)
Copper (Cu+)
Positive reinforcement

13. HIV's capsid - core nucleocapsid - and matrix proteins are products of what structural gene?
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.
Aspiration pneumonia
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
gag gene

14. Name the compartment of the mediastinum associated with the following thoracic structures: Aortic arch
Treacher Collins syndrome
C1 - C2 - or C4 deficiency
Superior
Brain - spleen - and kidney

15. What is the most common one? - Primary malignant tumor of the ovary
Nonsense
Glutamate dehydrogenase
HMP shunt
Serocystadenocarcinoma

16. What is the most common one? - Malignant tumor of the esophagus
The negative charge inhibits the filtration of protein anions.
Because it is the largest vessel and has the highest velocity in systemic circulation
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
Squamous cell carcinoma

17. What splanchnic carries preganglionic parasympathetic fibers that innervate the hindgut and the pelvic viscera?
In the mouth with salivary a - amylase (ptyalin)
Pelvic splanchnics (They all begin with P.)
Superior vena cava
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.

18. 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
Absolute refractory period is due to voltage inactivation of sodium channels.
Left abducens nucleus or right cerebral cortex
Vitreous humor
Clonidine

19. What form of estrogen is of placental origin?
Estriol
HGPRT
Ovarian cancer
The primitive streak grows caudal to rostral.

20. What naturally occurring substances mimic the effects of opioids?
Spironolactone
Enkephalins
Nominal scale (categorical - e.g. - male or female)
Basal cell carcinoma

21. Name the most common type or cause - Hematuria
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)
Odds ratio. (Case control studies deal with prevalence.)
Infection
Staphylococcus aureus

22. What chromosome is autism linked to?
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
Chromosome 15
Inferior Oblique (CN III) (LR6 SO4)3
Mesothelioma and bronchogenic carcinoma

23. Does REM deprivation interfere with performance on simple tasks?
By causing rebound insomnia and decrease in REM sleep
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
Polycystic ovary disease (Stein - Leventhal syndrome)
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.

24. What syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use?
C1 inhibitor (C1- INH)
Spironolactone
Dystrophic calcification
Eaton - Lambert syndrome

25. What is the term to describe how easily a vessel stretches?
Bainbridge reflex
Compliance (think of it as distensibility)
Varicella
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva

26. What are the five components of portal HTN?
Arch of the aorta and right subclavian artery
Seminoma
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
Broca's aphasia

27. Name the type of graft described by these transplants: x From one species to another
Emphysematous bleb
Type I hypersensitivity (anaphylactic)
Because they do not block D2A receptors - they are antagonists of 5HT2 receptors.
Xenograft

28. Name the compartment of the mediastinum associated with the following thoracic structures: Esophagus
Hypertrophy
Superior and posterior
Stretch receptors prevent overdistension of the lungs during inspiration.
Action potential

29. What germ cell tumor is seen in the 15- to 35-year - old age group - peaks when the person is 35 years of age - and is a bulky mass that spreads via the lymphatic system?
Acute CO poisoning
N-5- methyl THF
Seminoma
They prevent mast cell degranulation.

30. Name the MCC - Epiglottitis in an unvaccinated child
External abdominal oblique
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Haemophilus influenzae type B
IgG

31. Methylating uracil produces what pyrimidine base?
Chloramphenicol
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
Rhombencephalon
Thymine

32. Is cigarette smoking associated with transitional cell carcinoma of the bladder?
Prader - Willi syndrome and Angelman syndrome - respectively
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Giant cell tumor of the bone

33. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Pineal gland
The DCML system. (Remember - everything but pain and temperature.)
Functional residual capacity (FRC)
LVEDV and LVEDP (left ventricular end - diastolic volume and end - diastolic pressure - respectively)
Proencephalon diencephalon derivative

34. In which region of the lung are 75% of the pulmonary infarcts seen?
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
Mallory- Weiss syndrome
Lower lobe
Meningomyelocele All except occulta cause elevated - fetoprotein levels.

35. What is the name of the postganglionic parasympathetic ganglion that innervates x The parotid gland?
The conversion of CHO to pregnenolone via the enzyme desmolase
LTB4
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
The otic ganglion. (These fibers are carried in CN IX. Remember it like this: the - oti - is in both otic ganglion and parotid gland.)

36. What four substances increase the rate of gluconeogenesis?
Spermatid
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Cervical neoplasia
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP

37. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Labetalol
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
Contralateral loss below and bilateral loss at the level of the lesion

38. What is the only Plasmodium that is quartan?
Niemann - Pick disease
ATP production
Plasmodium malariae; the others are tertian.
Medial medullary syndrome

39. What is the term for a congenital absence of the ganglionic cells of the Auerbach and Meissner plexus in the rectum and sigmoid colon?
Metaplasia (usually to a more protective cell type)
Filiform papillae
Hirschsprung disease (aganglionic megacolon)
Opposite the second upper molar tooth

40. What connects the lateral ventricles to the third ventricle?
Foramen of Monro
Silent
Carnitine acyl CoA transferase II
Radial nerve and the profunda brachii artery

41. Where are the tonsillar tissues?

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42. What phase of Food and Drug Administration approval tests x The efficacy and occurrence of side effects in large group of patient volunteers?
Foramen of Monro
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Phase III. It is considered the definitive test.
Taenia saginata

43. What is the difference between a Ghon focus and a Ghon complex?
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
Apneustic center (deep breathing place)
Brucella and Listeria (has tumbling motility)

44. What Staphylococcus aureus protein inhibits phagocytosis?
Protein A
Chromosome 15q
1. Streptomycin 2. Gentamicin 3. Tobramycin
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.

45. In a ventricular pacemaker cell - what phase of the action potential is affected by ACh?
Proencephalon
G0 phase
Enkephalin
Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance - taking longer to reach threshold and slowing the rate of firing.

46. In what stage of sleep is GH secreted?
Thoracic and sacral
Stages 3 and 4 (NREM)
Clozapine
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)

47. Regarding the Lac operon - for What do the following genes code? - A gene
Ethambutol
Galactoside permease
Thiogalactoside transacetylase
After the eclipse period

48. Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?
PGI 2
Eosin
Chromosome 6
Procainamide

49. What type of random controlled test is least subjective to bias?
Axon hillock
Arginine
Double - blind study. It is the most scientifically rigorous study known.
It both begins and ends at T4 (sternal angle [of Louis]).

50. What is the most common cause of vitamin B6 deficiency?
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
Isoniazid treatment
Bladder cancer
Osler nodes