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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 Freudian psyche component is described as x The conscience - morals - beliefs (middle of the road)?
Diacylglycerols and phosphatidic acid
apo A-1
Superego
Metronidazole

2. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol decreased - ACTH decreased
Secondary hypocortisolism (pituitary)
Glyceraldehyde dehydrogenase
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
The bifurcation of the abdominal aorta

3. What event signifies the first day of the menstrual cycle?
Rickets prior to fusion - osteomalacia if the deficiency occurs after epiphyseal fusion.
Onset of bleeding
Internal 3' - 5' PDE bonds
impermeable to water

4. 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.
Duchenne muscular dystrophy
Marfan syndrome
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
Primary hypogonadism (postmenopausal women)

5. What AA has a pKa of 13?
Afterload
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Mitosis
Arginine

6. What somatoform disorder is described as x La belle indiff
Tetralogy of Fallot
Red blood cell distribution width index (RDW)
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Conversion disorder

7. What somatoform disorder is described as x Having a F:M ratio of 20:1 - onset before age 30 - and having 4 pains (2 gastrointestinal - 1 sexual - 1 neurologic)?
Somatization disorder
Chlamydia trachomatis
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
Avidity. There is a positive correlation between valence numbers and avidity.

8. What are the rules of 10 regarding pheochromocytoma?
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland
Prolactin
Uric acid
Trichomonas vaginalis (treat with metronidazole)

9. Is GH considered a gluconeogenic hormone?
Yes - it decreases fat and muscle uptake of glucose - thereby increasing blood glucose levels.
The inner membrane of the mitochondria (cristae)
Xenograft
Yolk sac tumor

10. What is the primary method of nonverbal communication of emotional states?
The greater the myelination - the greater the conduction velocity.
IL-4 - IL-10 - and IL-13
Facial expression (the second is vocal intonation)
Formal operations (> 12 years)

11. What is the site of action of the following? - Aldosterone antagonists
Distal convoluted tubules
Buerger disease (thromboangiitis obliterans)
Cytochrome b/c1
Calicivirus

12. Which drug is used to treat opioid withdrawal - ADHD - and sometimes Tourette's syndrome?
Diphenhydramine
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
There are no valves and no smooth muscle in the walls of the veins in the face.
Clonidine

13. What are the five tissues in which glucose uptake is insulin independent?
Pyelonephritis
Osteoclasts
QRS complex
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa

14. Name the hypochromic microcytic anemia based on the following laboratory values - Normal iron - TIBC - percent saturation - and ferritin
Type 2
Chromosome 7
Thalassemia minor
M 2

15. T cells can recognize - bind - and internalize...
Major
unprocessed Ags
presence of PMNs
Atropine with pralidoxime

16. What somatoform disorder is described as x Unrealistic negative opinion of personal appearance - seeing self as ugly?
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Thalassemia minor
Indirect or unconjugated
Body dysmorphic disorder

17. What are the two reasons for megaloblastic anemia with elevated MCV?
Al - Anon
Vitamin B12 deficiency and folate deficiency
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
Labetalol

18. Are the following conditions associated with a negative or positive nitrogen balance? - Uncontrolled DM
Negative
Stratum corneum (keratinized)
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Extracellular

19. What three chemical agents are associated with angiosarcomas of the liver?
Arsenic - thorotrast - and vinyl chloride
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Fibrocystic change of the breast
Metaplasia (usually to a more protective cell type)

20. What drug that penetrates the blood - brain barrier is found in asthma preparations and used as a nasal decongestant?
Calcium oxylate
Enterobius vermicularis; the treatment is albendazole.
Ephedrine
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)

21. What is the MCC of the following endocarditis scenarios? - Post dental work
Streptococcus viridans
Yolk sac tumor
Streptococcus pneumoniae
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid

22. Which gram - negative diplococcus ferments maltose?
Treacher Collins syndrome
Meningococcus (Gonococcus does not)
Duchenne muscular dystrophy
The muscle's ATPase activity

23. Which benzodiazepine has the longest half - life?
Accommodation
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
Flurazepam
Raynaud's phenomenon

24. What type of hepatitis has the highest mortality rate among pregnant women?
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Hepatitis E
Terbinafine
Accommodation

25. The clearance of what substance is the gold standard of renal plasma flow?
1. Short attention span 2. Impulsivity 3. Hyperactivity
Preoperational (2-6 years)
Para - aminohippurate (PAH)
Hepatic adenomas

26. What is the most common site for an aneurysm in cerebral circulation?
Chromosome 8 - 14
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Tinea favosa (favus)

27. What ribosomal subunit binds first to the mRNA strand?
The small subunit (40S) binds first.
C5- C8 deficiency
6 weeks 10 weeks
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.

28. What are the growth factors released from the liver called?
Somatomedins
Pregnancy
Sympathetic chain ganglion
Dystrophic calcification

29. What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?
Syringomyelia
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
They innervate LMNs.
Desipramine

30. What CNs arise from x The pons?
Goodpasture syndrome
Third M PITS for pharyngeal pouch derivatives
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
CN V - VI - VII - and VIII

31. What foramen must be traversed for entry into the lesser peritoneal sac?
Foramen of Winslow
Are live attenuated vaccines available in the United States
1. VSD 2. ASD 3. PDA
Transference. When it is from the physician to the patient it is called countertransference.

32. What encapsulated group of nerve endings seen at the muscle - tendon junction responds to an increase in tension generated in that muscle? (This is dropping a box that is too heavy to carry.)
Axis II
The increased H+ moves intracellularly and is buffered by K+ leaving the cells - resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis - even though the serum
IgG
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.

33. Are antibiotics helpful in treating a disease caused by a prion?
Viral meningitis
No. Prions are infectious proteins - so antibiotics are useless.
VLDL
Squamous cell carcinoma

34. What nerve supplies taste sensation to the anterior two - thirds of the tongue?
Chorda tympani of CN VII
Avoidant
Goodpasture disease
Achalasia

35. What enzyme is blocked by methotrexate/ trimethoprim?
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.
Dihydrofolate reductase
No change in length
Denial

36. Which streptococcal species is associated with dental caries and infective endocarditis in patients with poor oral hygiene?
Krukenberg tumor
Infrapatellar bursa
Streptococcus viridans
ELISA screens and Western blot confirms the diagnosis.

37. What is the name of the superficial subcutaneous fascia of the abdomen containing fat?
Nonsense
HBcAb IgG and HBsAb IgG
Rhinovirus and hepatitis A virus
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)

38. What fructose metabolism enzyme is deficient in patients with vomiting - apathy - diarrhea - jaundice - proximal renal tubular acidosis - hypoglycemia - and hyperuricemia?
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.
Aldolase B deficiencies are treated by eliminating fructose from the diet.
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
Pterygopalatine ganglion (I remember this as the only ganglion left.)

39. What hormone is characterized by the following renal effects? - Calcium excretion - phosphate excretion
Posterior compartment of the thigh - tibial nerve
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse - hyperreflexia - spastic paralysis - increased muscle tone - and weakness are commonly seen in UMN lesions.
Calcitriol

40. Which hepatitis B serology markers
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
Elongation factor - G and GTP
HBcAb IgM - HBV- DNA - HBeAg - HBsAg
Systematic desensitization

41. What ring is a weblike narrowing of the gastroesophageal junction?
Schatzki ring
absorption
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
Live vaccines

42. What Ab is an indication of recurrent disease for hepatitis?
Simple diffusion; it does not use protein - mediated transport
Limbic system
HBc Ab
Actinomyces israelii

43. If you double the infusion rate of a drug - how long will it take to reach steady state?
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
Osteosarcoma

44. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x abl
Suppression
Autoimmune hemolytic anemia
CML and All
Pyruvate carboxylase

45. What are the two MCC of acute epididymitis in males? - Less than 35 years old
The odontoid process of C2
Megaloblasts
Neisseria gonorrhoeae and Chlamydia trachomatis
Four high energy bonds - two from ATP in AA activation and two from GTP

46. What somatoform disorder is described as x Preoccupied with illness or death - persisting despite reassurance - lasting longer than 6 months?
The venae recta maintain the gradient via countercurrent flow.
Hypochondriasis (they will begin with 'I think I have...')
Cauda equina
Stable angina

47. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol increased - ACTH decreased
Constipation and miosis
Cystadenocarcinoma
Primary hypercortisolism
Salpingitis

48. What cell of the duodenum contains high concentrations of lysozymes and has phagocytic activity?
Cleft palate
Paneth cells
Citrate - via the citrate shuttle
Internal iliac nodes

49. What neuropsychologic test shows nine designs to the patient - then asks for recall of as many as possible?
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
The pulsatile release of GnRH
Bender Visual Motor Gestalt Test
Accommodation

50. Based on operant conditioning - What type of reinforcement is described when x Removing a stimulus stops a behavior?
Head of the pancreas
Sporothrix schenckii
Inferior rectus (CN III) (LR6 SO4)3
Extinction

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