USMLE Step 1 Prep

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. How many codons code for AAs? How many for termination of translation?
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.
Dihydropteroate synthetase
The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
Salmeterol


2. Name the compartment of the mediastinum associated with the following thoracic structures: Phrenic nerve
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
Herpesvirus
Range
Superior and middle


3. What is the most common one? - Form of vasculitis
Chemotaxis
Temporal arteritis
SER
They are in the grey matter of the CNS.


4. What hormone is characterized by the following renal effects? - Calcium excretion - phosphate excretion
Hepatitis E
Rickets prior to fusion - osteomalacia if the deficiency occurs after epiphyseal fusion.
Calcitriol
robenecid - a uricosuric agent


5. What disease has a genetically low level of UDPglucuronate transferase - resulting in elevated free unconjugated bilirubin?


6. What happens to NE levels in x Major depression?
Mild (50-70)
Conidia
Yes. The only civil liberty they lose is the freedom to come and go as they please.
Decrease (5- HT and dopamine levels do the same)


7. What organ functions to keep blood glucose levels normal through both well - fed and fasting states and produces ketones in response to increased fatty acid oxidation?
Sadism
Liver
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Test - retest reliability


8. Name the compartment of the mediastinum associated with the following thoracic structures: Ascending aorta
Middle
Neisseria meningitides
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.


9. What is the most common one? - Type of hernia seen in males more than 50 years old
Supraspinatus and infraspinatus
Direct; in males less than 50 years old indirect hernias are the most common type.
Bile pigments and bile salts
Adenine and guanine


10. Which of the following is not a risk factor for cholesterol gallstones: pregnancy - OCP use - female gender - hemolytic anemia - cirrhosis - and obesity? (May be more than one answer.)
Posterior compartment of the thigh - tibial nerve
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Primary hypoaldosteronism (Addison's disease)
Right vagus innervates the SA node and the left vagus innervates the AV node


11. Name the most common type or cause - Right heart failure
Inferior Oblique (CN III) (LR6 SO4)3
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.
IgG
Left heart failure


12. Name the form of spina bifida - Meninges project through a vertebral defect
The cat
Meningocele All except occulta cause elevated - fetoprotein levels.
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
First pharyngeal groove; all others degenerate.


13. Can you tell which drug is more toxic based on therapeutic indices alone?
Hypertension
HTLV-1
No - therapeutic indices can tell which drug is safer - not more toxic.
CD8+ T cells


14. Is nystagmus defined by the fast or slow component?
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Macula densa
Rotavirus


15. How many base pairs upstream is the prokaryotic TATA box promoter?
PKU
Nodular melanoma
The fasciculus cuneatus
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.


16. What is the most common one? - Type of PUD
Eosin
The urea cycle
unprocessed Ags
Duodenal ulcers (4 times as common as gastric)


17. Although the CSF normally contains 0 to 4 lymphocytes or monocytes - the ___________ is always considered abnormal.
Metronidazole
presence of PMNs
TAT (Thematic apperception test)
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)


18. What is the most common one? - Primary malignant tumor of the female genital tract in the United States
Adenocarcinoma of the cervix
RNA polymerase III
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Xenograft


19. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - aggression - inability to learn new material - and memory problems
Transmembrane potential (an absolute number)
Cirrhosis
Limbic system
Low interstitial free Ca2+ concentrations


20. Name the most common type or cause - Lobar pneumonia
Thyroid hormones
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)
Corticosteroid
Streptococcus pneumoniae


21. Name the insulin preparation based on the peak effect and duration of action - Peak - 8 to 12 hours; duration - 18 to 24 hours
Mycoplasma pneumoniae
Lente or NPH insulin (neutral protamine Hagedorn insulin)
Respiratory depression
Aedes (the same for yellow fever)


22. What is the most common one? - Primary CNS tumor in adults
Glioblastoma multiforme
Squamous cell carcinoma
A low - resistance system is formed by resistors added in parallel.
LTB4


23. Which antimicrobial agent is used with pyrimethamine to treat toxoplasmosis?
Left atrial myxoma
Basal cell carcinoma
Clindamycin
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)


24. What is the term for vitamin D deficiency prior to epiphyseal fusion?
Rickets prior to fusion - osteomalacia if the deficiency occurs after epiphyseal fusion.
Ampulla of the fallopian tube
Pancreas and colon
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino


25. What organ is responsible for the elimination of excess nitrogen from the body?
Sucralfate
The kidneys excrete the excess nitrogen from the body as urea in the urine.
Complex I
Anopheles mosquito


26. What four substances increase the rate of gluconeogenesis?
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
Transudative; exudative has the opposite values and has an elevated cellular content.
Psoas major
Left ventricle and tip of right ventricle


27. What happens to the tonicity of the urine with increased ADH secretion?
Astrocytoma
C1 through C4
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Menses


28. Which organism releases endotoxins prior to cell death?
Good Samaritan Law. (Physicians are not required to stop and help.)
Malignancy
Alcohol abuse
Neisseria meningitidis


29. What are the two factors that affect alveolar PCO2 levels?
Translation
Metabolic rate and alveolar ventilation (main factor)
Lysine and tyrosine
CD16 and CD56


30. What are the pharmacologic effects seen sexually with x Beta- Blockers?
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
Diphenhydramine
embranoproliferative glomerulonephritis (MPGN)
Impotence


31. What bonds are broken by exonucleases?


32. What is the DOC for hyperprolactinemia?
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.
Bridging veins draining into the sagittal sinus
EF-2 and GTP
Pergolide


33. Name the macrophages by location: x CNS
Neutrophils - eosinophils - and basophils
Microglial cells
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
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?


34. Name the eukaryotic DNA polymerase based on the following information: x Replicates mitochondrial DNA
Concentration gradient
Clavicle - acromion - and glenoid fossa of the scapula and the humerus
DNA polymerase -?
Langerhans cells (found in the stratum spinosum)


35. What are known as jumping genes?
RSV
Metronidazole
Transposons
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet


36. What are the five components of portal HTN?
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
Anterior compartment (it's the blood supply to the posterior compartment)
Diphyllobothrium latum
Mode


37. What AD disease is associated with chromosome 4p; does not present until the person is in his or her 30s; and involves atrophy of the caudate nucleus - dilatation of the lateral and third ventricles - and signs of extrapyramidal lesions?
Negative selection. This helps to prevent autoimmune diseases.
Huntington disease
Tyramine
The odontoid process of C2


38. What type of hemostasis in an intravascular space consists of fibrin - platelets - RBCs - and WBCs?
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Thrombus
Decreases
Clofazimine


39. What two vessels in fetal circulation have the highest PO2 levels?
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.
Metastatic carcinomas
Umbilical vein and ductus venosus (80%)
Left colic - superior rectal - and sigmoidal arteries


40. What two areas of the skin do not contain sebaceous glands?
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Social learning theory
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
Negative


41. What aneurysm of the circle of Willis is associated with polycystic kidney disease?
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
Gout
Berry aneurysm
SSRIs


42. Why are clozapine and olanzapine unlikely to result in EPS effects?
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Because they do not block D2A receptors - they are antagonists of 5HT2 receptors.
Primary erectile disorder


43. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH ?
Seasonal affective disorder (treat with bright light therapy)
Primary hypogonadism (postmenopausal women)
Raynaud's phenomenon
H2PO4- (dihydrogen phosphate)


44. What follicular cell possesses FSH receptors and converts androgens into estradiol?
Granulosa cells
Hepadnavirus
catalase - negative
Ulnar nerve


45. Which bacteria are associated with the following pigment production? - Yellow pigmentation
Staphylococcus aureus
transcription
Recovery and death
Voltage - gated potassium channels


46. What malignant tumor of the trophoblast causes high levels of hCG and may occur after a hydatidiform mole - abortion - or normal pregnancy?
Leiomyoma
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.
Gilbert's syndrome


47. Which is the conditioned response - the conditioned stimulus - the unconditioned response - the unconditioned stimulus in this case? A patient has blood withdrawn and faints. The next time she goes to have blood taken - she faints at the sight of the
Vancomycin
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting). The needle is part of the blood - drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in th
Metanephros
The resistance increases 16- fold.


48. What family do the following viruses belong to? - Hantavirus
Medial pontine syndrome
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
Bunyavirus
Adenosine deaminase (ADA) deficiency


49. What type of bias is it when the sample population is not a true representative of the population?
Pantothenic acid
Selection bias
VSD - RVH - overriding aorta - and pulmonary stenosis
Down syndrome (it is slightly more common than fragile X syndrome.)


50. Name the antidote - Digoxin
Antidigoxin Fab fragments
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
Glucagon and epinephrine
Helicobacter pylori - Which is also associated with an increased risk of gastric carcinoma