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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 CNs arise from x The midbrain?
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
CN III and IV
CD16 and CD56
Buerger disease (thromboangiitis obliterans)

2. What is the most widely used class of antidepressants?
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum
SSRIs
Glucuronidation

3. Are used in combination with estrogens to decrease the risk of endometrial cancer.
Temporal lobe
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
Acetaminophen
Progestins

4. Can a physician commit a patient?
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Beta2- Adrenergic agents
Coxsackie A
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.

5. What is the term for the strength of the association between Ags and Abs?
Avidity. There is a positive correlation between valence numbers and avidity.
M- cells
Repaglinide
Superoxide dismutase - glutathione peroxidase - catalase

6. What variant of polyarteritis nodosa is associated with bronchial asthma - granulomas - and eosinophilia?
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.)
Arch of the aorta
Churg - Strauss syndrome
Thymidylate synthase

7. Name the most common type or cause - Nephrotic syndrome in children
Lipoid nephrosis
Labioscrotal swelling
Echinococcus multilocularis
Haemophilus influenzae type B

8. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Ventral root?
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
Vitamin D
Inactivated
Motor

9. What operant conditioning therapy or modification is described as x Providing the person with information regarding his or her internal responses to stimuli with methods of controlling them?
Lung and bronchus cancer
Glucokinase
Biofeedback
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

10. In what compartment of the thigh is the profundus femoris artery found?

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11. Describe the organism based on the following information: x Alpha - Hemolytic Streptococcus; lysed by bile; sensitive to Optochin
C3a - C4a - and C5a
Radial Immuno Diffusion (RID) for Ig levels.
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Pneumococcus (Streptococcus pneumoniae)

12. What protozoal parasite results in dysentery with blood and pus in the stool - is transmitted via fecal - oral route - is diagnosed by cysts or trophozoites in the stool - and forms liver abscesses and inverted flask - shaped lesions in the large int
Progestin
Ganciclovir
Volkmann's contracture
Entamoeba histolytica (treat with metronidazole)

13. How many mature sperm are produced by one type B spermatogonium?
Medial midbrain (Weber's) syndrome
Four
Congenital heart disease
CD21; it is a complement receptor for cleaved C3

14. Are bactericidal.
Tetracyclines
GnRH
Adipose tissue
Peyer's patch

15. What is found in the R group if the AA is acidic? Basic?
Vitamin A is responsible for vision and epithelial health.
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
Mycoplasma pneumoniae
Secondary erectile disorder (Male erectile disorder is the same as impotence.)

16. What estrogen - producing tumor of the female genital tract is characterized by Call - Exner bodies?
Parvovirus (it is the only ssDNA virus)
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
Granulosa cell tumor of the ovary

17. What cells of the thyroid gland secrete calcitonin?
Hypotonic - because NaCl is reabsorbed in the salivary ducts
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
Parafollicular C cells
Resistance decreases as resistors are added in parallel.

18. Which hepatitis B serology markers
PRPP aminotransferase
Effective dose for 50% of drug takers (median effective dose)
Hematoxylin
HBcAb IgM

19. What three structures increase the surface area of the GI tract?
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Escherichia coli
White muscle; short term too

20. Name the compartment of the mediastinum associated with the following thoracic structures: IVC
Aortic insufficiency
Middle
Ulnar and radial arteries (ulnar is the main supplier)
Arch of the aorta

21. What paraphilia is defined as x Having sex with cadavers?
Gain of hypotonic fluid (water intoxication or hypotonic saline)
Opsonization
Merkel cells (Merkel's tactile cells)
Necrophilia

22. Which benzodiazepine has the longest half - life?
Flurazepam
well - fed and fasting
Acute glomerulonephritis
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.

23. What is the only CN to arise from the dorsal surface of the midbrain?
Aschoff bodies of rheumatic fever
ASD
Schwannoma
CN IV

24. Match the pulmonary end capillary blood levels.
Ethyl alcohol
Generalized anxiety disorder
Lung cancer
The alveolar PO2 and PCO2 levels

25. A 30-year - old woman goes to your office with bilateral multiple breast nodules that vary with menstruation and have cyclical pain and engorgement. What is your diagnosis?
Conduction aphasia
Live vaccines
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Atropine and 2- PAM (pralidoxime)

26. What ovarian carcinoma is characterized by psammoma bodies?
Albendazole
Hirschsprung's disease (colonic gangliosus)
Gynecomastia
Cystadenocarcinoma

27. What is the term for the number of new events occurring in a population divided by the population at risk?
Hemochromatosis
Incidence rate
HPV serotypes 1 and 4
Papillary carcinoma of the thyroid

28. How many days prior to ovulation does LH surge occur in the menstrual cycle?
Displacement
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
In men it is prostate cancer - and in women it is breast cancer.
1 day prior to ovulation

29. What is the function of white rami communicantes?
Tensor tympani
Gout
Ventral lateral nucleus
They are preganglionic sympathetic axons. They are white because they are myelinated.

30. What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
Uroporphyrinogen I synthetase
Areas 1 - 2 - and 3
Myasthenia gravis
Accuracy (think of it as all the trues - because they are the ones correctly identified)

31. What antitubercular agent causes loss of red - green visual discrimination?
0.2
Periaortic lymph nodes
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
Ethambutol

32. What is flat - circumscribed nonpalpable pigmented change up to 1 cm?
Physostigmine
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
Macule (e.g. - a freckle)
Isolation of affect

33. What cells of the retina see in black and white and are used for night vision?
CN VII and VIII
Rods
Type I hypersensitivity (anaphylactic)
Acral - lentiginous melanoma

34. What is the most common one? - Tumor in men aged 15 to 35
The rectouterine pouch (of Douglas)
Aldolase B deficiencies are treated by eliminating fructose from the diet.
Cestodes
Testicular tumors

35. What Brodmann area is associated with x Frontal eye fields?
Hypnozoite
Mode
Area 8
Increase enzyme concentrations

36. Is the bound form or free form of a lipid - soluble hormone responsible for the negative feedback activity?
Gout
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Thyroid hormones are necessary for conversion of carotene to vitamin A.
Free form determines hormone activity and is responsible for the negative feedback loop.

37. What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur - humerus - and tibia?
Chronic alcoholic
Aedes mosquito
Beta- Hydroxybutyrate
Caisson disease

38. What are the three branches of the celiac trunk?
Repolarization is from base to apex and from epicardium to endocardium.
C5- C9
S phase
The left gastric - splenic - and common hepatic arteries

39. All primary oocytes in females are formed By What age?
They are all formed by the fifth month of fetal life.
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Superior and middle

40. Are the following responses associated with histamines H1 or H2 receptor activation? - Pain and pruritus
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Serocystadenocarcinoma
H 1
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.

41. What is the most common one? - Skin tumor in the United States
Phase 1
Obesity - DM - HTN - multiparity - early menarche - and late menopause
Mesencephalon
Basal cell carcinoma

42. What pancreatic islet cell tumor is associated with hypoglycemia - sweating - hunger - confusion - and increased C- peptide levels?
Phase III. It is considered the definitive test.
Insulinoma
Fibrocystic change of the breast
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)

43. Why isn't the incidence of a disease decreased when a new treatment is initiated?
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Idiotypes
Chromosome 19

44. Name the type of hypersensitivity reaction based on the following properties - IgG or IgM Abs against a specific target cell or tissue; complement - dependent or ADCC.
Corynebacterium diphtheriae
Liver
Muscles of the internal eye
Type II hypersensitivity (cytotoxic)

45. There is a strong ________ between IQ and academic achievement.
Metronidazole
positive correlation
Prostatic carcinoma
Nonsense

46. What cell of the male reproductive system produces testosterone?
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
Renin
Eosinophils

47. What is the major stimulus for cell division in chondroblasts?
IGF-1
Peutz - Jeghers syndrome
Primary follicle (in the white pulp)
Oncotic pressure increases because of the removal of water.

48. Should information flow from the patient to the family or vice versa?

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49. What segment of the gastrointestinal tract lacks villi - has crypts - and actively transports sodium out of its lumen?
Seminoma
Primase
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Large intestine. Water is passively removed from the lumen.

50. Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade?
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Chief cells
Oxygen
Resistance of the system increases. (Remember - when resistors are connected in a series - the total of the resistance is the sum of the individual resistances.)

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USMLE Step 1 Prep

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