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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 happens to affinity if you increase Km?
Tetralogy of Fallot
Direct fluorescent Ab test
Affinity decreases; they are inversely proportional.
Hemangioblastoma

2. In reference to membrane potential (Em) and equilibrium potential (Ex) - which way do ions diffuse?
Lactulose
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT - which means warfarin - extrinsic - PT; heparin - intrinsic - PTT)
IgD; IgM is also correct.

3. How is velocity related to the total cross - sectional area of a blood vessel?
Velocity is inversely related to cross - sectional area.
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.

4. Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
Posterior compartment of the leg - tibial nerve
Tensor tympani
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Single - strand DNA binding protein

5. In the alveoli - what cell type is x for gas exchange?
The left is a branch of the aortic arch - while the right is a branch of the brachiocephalic trunk.
Double - blind study. It is the most scientifically rigorous study known.
Type I pneumocytes
CN XII

6. Name the type of mutation: x Unequal crossover in meiosis with loss of protein function
Neisseria gonorrhoeae
Large segment deletions
The basilar artery is formed at the pontomedullary junction.
Left abducens nerve

7. What malignant bone tumor is associated with familial retinoblastoma?
Osteosarcoma
Pancreatic delta - cell tumors inhibit CCK secretion
Paracortex
Compliance (think of it as distensibility)

8. Mallory bodies
Stable
Cell - mediated immunity
Clostridium botulinum
Chronic alcoholic

9. What protein of the HIV virus does ELISA detect to determine whether a patient is HIV positive?
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages
Hairy cell leukemia
Mitochondria
P24

10. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Lateral ventricles
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)
Proencephalon
IGF-1 (somatomedin C)
ASA

11. What small - to medium - sized vasculitis is seen in a 35-year - old man who is a heavy smoker presenting with claudication symptoms in the upper and lower extremities?
Cohort studies determine incidence and causality - not prevalence.
14 days in most women (Remember - the luteal phase is always constant.)
Renal circulation
Buerger disease (thromboangiitis obliterans)

12. What fungus is seen as colored cauliflower lesions?
Pyridoxine (B6) deficiency
Diazepam is longest acting and midazolam is shortest acting.
Voltage - gated calcium channel
Chromomycosis

13. What are the pharmacologic effects seen sexually with x Neuroleptics?
Erectile dysfunction
Acute toxic or viral nephrosis
HTLV-1
S phase

14. What syndrome is characterized by the triad of renal tubular acidosis - nephrosis - and amino aciduria?
Toxoplasmosis
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Fanconi - like syndrome
Umbilical vein and ductus venosus (80%)

15. What type II hypersensitivity disorder is defined as x Autoantibodies directed against the TSH receptor?
Graves disease
Latissimus dorsi
Production of HCO3- - shifting the reaction to the left and thereby decreasing H+
ICF volume decreases when there is an increase in osmolarity and vice versa.

16. Where are the postganglionic neuron cell bodies - the CNS or the PNS?
The larger the volume of distribution - the lower the plasma concentration of a drug.
They are in ganglia in the PNS.
a -1 - 6 transferase
Chromosome 21

17. What component of an ECG is associated with the following? - Atrial depolarization
Medial umbilical ligaments
P wave
Arch of the aorta and right subclavian artery
Reliability (think of it as 'nice grouping' or 'precise')

18. What endotoxin receptor is the best marker for macrophages?
Adult polycystic kidney disease
Crohn disease
CD14
Stage fright (discrete performance anxiety)

19. What enzyme is essential for the conversion of CO2 to HCO3-?
Ligamentum arteriosum
Carbonic anhydrase
after abortion
Rhabdomyoma

20. Is excretion greater than or less than filtration for net secretion to occur?
Edinger - Westphal nucleus (via CN III)
Excretion is greater than filtration for net secretion to occur.
Pimozide
Stretch receptors prevent overdistension of the lungs during inspiration.

21. What bursa is inflamed in clergyman's knee?
The reduviid bug
Mumps
Infrapatellar bursa
Glioblastoma multiforme

22. What embryonic structure forms the adult male structure? - Epididymis - ductus deferens - seminal vesicle - and ejaculatory duct
Hepatitis A (infectious)
Dimercaprol - penicillamine
Mesonephric duct
Lymphoblastic lymphoma

23. What occurs when the lower esophageal sphincter fails to relax during swallowing due to abnormalities of the enteric nervous plexus?
Renshaw neuron
Achalasia
Volkmann's contracture
Caisson disease

24. What is the relationship between ventilation and PCO2 levels?
G1 phase (gap 1)
Herpesvirus
There would be a Fab' region; thus - it would still be able to participate in precipitation and agglutination.
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.

25. Name the compartment of the mediastinum associated with the following thoracic structures: Aortic arch
Superior
Transitional cell carcinoma
Normal values
Transvestite fetishism

26. What type of mortality rate is defined as the number of deaths x From a specific cause per all deaths?
Negative
Proportionate mortality rate
Anterior nuclear group (Papez circuit of the limbic system)
Supraspinatus and infraspinatus

27. Name the area of the cerebral cortex with the function described: x Speech; critical for personality - concentration - initiating and stopping tasks (do one thing and begin a new without completion of the first) - abstract thought - and memory and hi
Postinfectious GN
Severe (range 20-34)
Left homonymous hemianopsia
Frontal lobe

28. With what stage of sleep are night terrors associated?
Clozapine
Anterior hypothalamic zone; lesions here result in hyperthermia.
NREM sleep. Night terrors are dreams that we are unable to recall.
CD15 and CD30

29. Is marital satisfaction higher for couples with or without children?

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30. What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
Type II
Primary sclerosing cholangitis
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)
Terbinafine

31. What disease is seen in the 20- to 40-year - old age group - is more prevalent in women than men - involves diarrhea with or without bloody stools - starts in the rectum and ascends without skipping areas - includes pseudopolyps - and has a thickness
Janeway lesions
HMG CoA reductase
The CD4 T cell; the APC is the first cell in the immune response.
Ulcerative colitis

32. How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery?
The courts. These are legal - not medical terms.
AT II
Fanconi - like syndrome
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.

33. Where does most circulating plasma epinephrine originate?
CN IX - X - and XII
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Allopurinol
Glutamine

34. What is the most common one? - Congenital heart defect in adults
ASD
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
Alveolar dead space
Crigler - Najjar syndrome

35. What is the most common one? - Germ cell tumor in boys
Yolk sac tumor
Autograft
Saltatory conduction
Filovirus

36. From what pharyngeal groove is the external auditory meatus derived?
Riboflavin (B2)
First pharyngeal groove; all others degenerate.
External abdominal oblique
Foramen of Winslow

37. What is the DOC for esophageal candidiasis?
PCR
Fluconazole
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
Rhabdomyoma

38. Macro - ovalocytes in the peripheral blood smear are formed From what cell in the bone marrow?
Megaloblasts
Flow cytometric analysis
Fc portion of IgG - C3b - and mannose - binding proteins
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.

39. What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Streptococcus pyogenes
Hemolytic uremic syndrome
Terbinafine
Major basic protein

40. What vascular tumor associated with von Hippel - Lindau syndrome involves the cerebellum - brainstem - spinal cord - and retina?
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
Wegener granulomatosis
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
Hemangioblastoma

41. What hormone level increases in the first 3 hours of sleep?
Scleroderma
Opposite the second upper molar tooth
Eaton - Lambert syndrome
Prolactin

42. What type of chromatin is transcriptionally inactive?
Acting out
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
Internal carotid artery
Constipation and miosis

43. What antiepileptic agent has SIADH as a side effect?
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
P wave
Carbamazepine
Urinary 17- OH steroids

44. Name the GLUT transporter based on the following: x Found in liver and pancreatic Beta- cells
GLUT 2
Vitamin C
Uricosuric
Splenomegaly and anemia (with a high index of suspicion)

45. Is the Lac operon activated or inactivated in the presence of both glucose and lactose?
LTB4
Type III
GH deficiency
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.

46. What is the term for an increase in the number of cells in a tissue?
Ewing's sarcoma
Nodes of Ranvier
Hyperplasia
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.

47. Which hepatitis virus is in the Picornaviridae family?
Epidural hematoma
Hepatitis A
Goodpasture disease
Prostatic carcinoma

48. Setting up to be let down (it is unconscious; if conscious - you're just rude)
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Coxsackie B
Zonula occludens (tight junctions)
Passive - aggressive

49. In what form is excess folate stored in the body?
Bone deposition increases with increased Ca2+ or PO 4- concentrations - whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
Lac repressor protein
N-5- methyl THF
The notochord

50. As what compound do the carbons for fatty acid synthesis leave the mitochondria?
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).
Citrate - via the citrate shuttle
Rhabdovirus