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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 muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.
M 2
Proximal tubule

2. What are the three naked RNA viruses?
Escherichia coli
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)

3. In prokaryotes - What is the term for a set of structural genes that code for a select group of proteins and the regulatory elements required for the expression of such gene?
Helicobacter pylori
Membranous glomerulonephritis
Operon
Yolk sac tumor

4. Name the thalamic nucleus based on its input and output - Input from inferior colliculus; output to primary auditory cortex
MGB (think EARS)
CN III
Autoimmune hemolytic anemia
Trypanosoma cruzi

5. How does L- tryptophan affect sleep?
2 and 5HT3 receptors
Chromosome 11p
Common and internal carotid arteries
It increases REM and total sleep time.

6. What form of poisoning is associated with bitter almond - scented breath?
Malignant mesothelioma
Courvoisier's law
Cyanide
REM sleep. Remember - awake brain in a sleeping body.

7. What cells of the epidermis - derived from the neural crest - act as mechanoreceptors?

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8. What type of membrane channel opens in response to depolarization?
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
Voltage - gated channel
CD16 and CD56
Aldehyde dehydrogenase

9. What two viruses are associated with Reye's syndrome?
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti - Ab
Repression
Varicella virus and influenza virus
Osteoma

10. What purine base is contained in inosine monophosphate?
Choriocarcinomas and trophoblastic tumors
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
Silicosis - Coal worker's pneumoconiosis is synonymous with black lung disease - an upper lobe occupational disorder
Marfan syndrome

11. What CNs are responsible for the sensor and motor components of the light reflex?
Left homonymous hemianopsia
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Postductal coarctation of the aorta (adult)
Areas 44 and 45

12. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x CDK4
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
LC4 - LD4 - and LE 4
Melanoma
Bitemporal heteronymous hemianopsia

13. What is the term for the load on a muscle in the relaxed state?
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell
CN I
Preload. It is the load on a muscle Prior to contraction.
Chromosome 9 - 22 (Philadelphia chromosome)

14. What happens to plasma concentration of a drug if there is a large volume of distribution?
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.
The larger the volume of distribution - the lower the plasma concentration of a drug.
Chylomicrons
CD4+T cells

15. WBC casts in the urine
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
Arch of the aorta and right subclavian artery
Uricosuric
Acute pyelonephritis

16. Where is the cupola of the lung in relation to the subclavian artery and vein?
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
Streptococcus pneumoniae

17. 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.
Marfan syndrome
GERD
Estrogen use
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)

18. What antifungal agent is activated by fungal cytosine deaminase to form 5- FU?
Proencephalon
The death of a spouse. The higher the score - the greater the risk of developing an illness in the next 6 months.
EF- G of the 50S subunit
Flucytosine

19. As what AAs do muscles send nitrogen to the liver?
Repaglinide
Major
Calcium oxalate
Alanine and glutamine

20. Are reabsorbed in the gallbladder.
Bile pigments and bile salts
Conus arteriosus of the right ventricle and right and left auricles
Flocculonodular lobe (one of my favorite words in all of medicine!)
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries

21. What are the three carboxylase enzymes that require biotin?
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
Severe (range 20-34)
Ulcerative colitis

22. Which hepatitis B serology markers
Stimulus control
EBV
Squamous cell carcinoma
HBcAb IgM

23. What complement factor deficiency leads to x Leukocyte adhesion deficiency with poor opsonization?
Null hypothesis (what you hope to disprove)
Embolism
Carbonic anhydrase
C1 - C2 - or C4 deficiency

24. What area of the brain acts as the center for ipsilateral horizontal gaze?
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
Clindamycin
PPRF
Chromosome 3p

25. What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?
Azathioprine
Major
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
The anterior nucleus of the thalamus

26. Are the following responses associated with histamines H1 or H2 receptor activation? - Pain and pruritus
H 1
CD40
Avoidant
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)

27. What AR disease involves a defect in AA 508 on chromosome 7 - causing a defect in Cl - transportation that leads to recurrent pulmonary infections and an increase in viscid mucoid secretions along with pancreatic insufficiencies?
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
Menses. (Ovulation occurs 14 days before the beginning of menses.)
Medial rectus (CN III) (LR6 SO4)3
CD19

28. What drug - if given during pregnancy - would cause the uterus to exhibit signs of progesterone withdrawal and induce an abortion?
RU 486
Urogenital folds
Intellectualization
Kayser - Fleischer ring

29. What syndrome is described by a lesion in the angular gyrus (area 39) resulting in alexia - agraphia - acalculia - finger agnosia - and right - left disorientation?

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30. What body fluid preferentially breaks down esters?
Ego syntonic
Confidence interval. It is a way of admitting estimation for the population.
Blood
Toxoplasmosis

31. What is the function of the basal ganglia?
Conus arteriosus of the right ventricle and right and left auricles
Unconjugated (indirect)
Initiate and manage gross skeletal muscle movement control
Urinary trigone

32. Name the lung measurement based on the following descriptions: x Maximal volume that can be expired after maximal inspiration
Vital capacity (VC)
Bacteria
Frontal lobe
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.

33. Name the MCC - Pneumonia in a patient with atypical bird exposure and hepatitis
Chlamydia psittaci
A transport maximum (Tm) system
Recovery and death
Posterior

34. Based on operant conditioning - What type of reinforcement is described when x Removing a stimulus reinforces a behavior?
H 2
Negative reinforcement
Invariant chain
Resistance increases as resistors are added to the circuit.

35. Which protein prevents internal binding of self proteins within an MHC class II cell?
IL-3 (3 face down is an M)
Metronidazole
Cauda equina
Invariant chain

36. What somatomedin serves as a 24- hour marker of GH secretion?
Amyotrophic lateral sclerosis (Lou Gehrig's disease) is a LMN lesion at the level of the lesion and UMN lesion below the level of the lesion.
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.
Formal operations (> 12 years)
IGF-1 (somatomedin C)

37. What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb - containing area?
Target cell
Hepadnavirus
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
Haemophilus influenzae type B

38. From what pharyngeal groove is the external auditory meatus derived?
Removal of the ileum
At least six
Mast cells
First pharyngeal groove; all others degenerate.

39. What variant of polyarteritis nodosa is associated with bronchial asthma - granulomas - and eosinophilia?
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
EBV
Churg - Strauss syndrome

40. What chronic inflammatory WBC is associated with IgE- mediated allergic reactions and parasitic infections?
CD3
Listeria monocytogenes
Eosinophils
Bronchiectasis

41. Unconsciously forgetting(forgetting that you forgot something!)
Medial compartment of the thigh - obturator nerve
Repression
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
TB meningitis

42. With what stage of sleep is enuresis associated?
HIV and poxvirus
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
The vaccine contains 23 capsular polysaccharides.
Primary hypothyroidism (Low T4 has a decreased negative feedback loop - resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release - respectively.)

43. Name the correct artery - The right recurrent laryngeal nerve passes around it.
Sphingomyelin
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
Right brachiocephalic artery
Melanoma - cancer of the stomach and bladder

44. What splanchnic carries preganglionic parasympathetic fibers that innervate the hindgut and the pelvic viscera?
Ovarian fibroma
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Minocycline
Pelvic splanchnics (They all begin with P.)

45. Which three organisms cause heterophilic negative mononucleosis?
CMV - Toxoplasma gondii - and Listeria
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
Minoxidil (orally and topically - respectively!)
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.

46. At what vertebral levels does the aortic arch begin and end?
Protein A
Phosphofructokinase -1 and costs 1 ATP
Transketolase and transaldolase. The reactions they catalyze are reversible.
It both begins and ends at T4 (sternal angle [of Louis]).

47. What are the three surrogate criteria?

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48. What type of spore is defined as an asexual budding daughter yeast cell?
Blastoconidia
Regression
ACE inhibitors (the - pril agents)
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.

49. What nerve is associated with the following functions? - Flex the shoulder - flex the elbow - and supinate the elbow
Musculocutaneous nerve
Beta2- Adrenergic agents
Motor nucleus of CN V
Thyroid hormones

50. What is the DOC for the following protozoal infections? - Pneumocystis carinii pneumonia
Trimethoprim/sulfamethoxazole (TMP- SMX)
Early collecting duct
2 ATPs - via the amino acyl tRNA synthase enzyme
Alzheimer disease