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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 are the five AAs that are both ketogenic and glucogenic?
Kupffer cells
Antisocial
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
Mitral (bicuspid) valve

2. From Where is the energy for gluconeogenesis derived?
HBsAg and HBeAg
Beta- Oxidation of fatty acids
Magnesium ammonium phosphate (struvite)
Collecting ducts - which make them readily permeable to water reabsorption.

3. What is the term for failure of the testes to descend into the scrotum?
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma
Positive sense RNA means it can serve as mRNA and therefore has 5'-3' polarity
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.

4. Name the structure that enters or exits the following foramina: x Optic canal
Zero - order elimination
Gardnerella vaginalis
Carbamazepine
CN II and ophthalmic artery

5. What is the key issue surrounding teenagers' maturation?
Epinephrine
Formation of an identity through issues of independence and rebellion; they define who they are.
Secondary hypocortisolism (pituitary)
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.

6. What condition results in the following CSF results? - Opening pressure 250 mm H2O; WBCs 250 (90% lymphocytes); glucose 35; protein 100
The alveolar PO2 and PCO2 levels
HMG CoA synthase
TB meningitis
Nystagmus and ataxia

7. 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.
Invariant chain
Type III
C3a - C4a - and C5a
Marfan syndrome

8. What vector is associated with malaria?
N- formyl - methionine LTB4 C5a IL-8
Anopheles mosquito
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
The basilar artery is formed at the pontomedullary junction.

9. What is the renal compensation mechanism for acidosis?
Aortic insufficiency
Temporal arteritis
Production of HCO3- - shifting the reaction to the left and thereby decreasing H+
Melanosis coli

10. What is the lymphatic drainage of the pelvic organs?
Glucokinase
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
Internal iliac nodes
NSAIDs

11. In What area of the brain can an excess of dopamine lead to psychotic symptoms?
Mesocortical area
Spironolactone
Confounding bias
Splitting

12. What rare vasculitis has the following characteristics: males aged 40 to 60; affecting small arteries and veins; involving nose - sinuses - lungs - and kidneys; C- ANCA and autoantibodies against proteinase 3?
Tropomyosin
>15 mm
Kayser - Fleischer ring
Wegener granulomatosis

13. What is the rate - limiting step of the following? - Fatty acid synthesis
Toxic dose for 50% of drug takers (median toxic dose)
Dapsone
The bifurcation of the abdominal aorta
Acetyl CoA carboxylase

14. What branch off the vertebral artery supplies x The cerebellum and the dorsolateral part of the medulla?
PICA
Osteitis fibrosa cystica (von Recklinghausen disease)
Langerhans cells (found in the stratum spinosum)
Pulmonary alveolar macrophages

15. How are resistance and length related regarding flow?
Superior and posterior
eIF-2 in the P site
Clostridium perfringens
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.

16. What antiviral agent is used to treat RSV - influenza A and B - Lassa fever - and hantavirus and as an adjunct to IFN- in hepatitis C?
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
Round and ovarian ligaments
Ribavirin
Listeria monocytogenes

17. What is the only enzyme in the body that uses N-5- methyl folate?
Homocysteine methyl transferase
Pirenzepine
Coxsackie B
transcription

18. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x et
Parvovirus B 19
Neutrophils - eosinophils - and basophils
MEN II and III syndromes
By causing rebound insomnia and decrease in REM sleep

19. Do the following structures pick up stain from hematoxylin or eosin? - RBCs
Acute cystitis
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
Eosin
Labile

20. A complete opposite expression of your inward feeling (e.g. - arguing all the time with someone you are attracted to when your feelings are not known)
Primary hyperaldosteronism (Conn syndrome)
Anaerobes
Reaction formation
Proto - oncogenes

21. What phobia is described as the fear of open spaces?
As sample size increases - the lower the chance of error.
Topoisomerase I (Relaxase)
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Agoraphobia. It also means having a sense of humiliation or hopelessness.

22. What is the most common site for implantation of the blastocyst?
IgE
They are all formed by the fifth month of fetal life.
Misoprostol
On the superior body of the posterior wall of the uterus

23. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Pancreas
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
Left atrium
GP IIb and IIIa receptors
Stable

24. What are the two reasons for megaloblastic anemia with elevated MCV?
Vitamin B12 deficiency and folate deficiency
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)
First pharyngeal groove; all others degenerate.

25. What is the only dsRNA virus?
Dihydrofolate reductase
EBV
Reovirus
Positive reinforcement

26. What is the term to describe a man who has x Used to be able to achieve an erection but now cannot?
Cytochrome a/a3
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
Left abducens nerve

27. Outburst to cover up true feelings (emotion is covered - not redirected).
Gonads
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
Cytochrome a/a3
Acting out

28. What component of the trigeminal nuclei x Receives sensory input (all but pain and temperature) from the face - scalp - dura - and the oral and nasal cavities?
Abs to HBsAg
Pyruvate carboxylase
Spinal trigeminal nucleus
Schizoid

29. Name the associated chromosomal translocation - Follicular lymphoma
Hapten; if it is coupled with a carrier - it may become immunogenic.
Rhombencephalon
Chromosome 14 - 18
Histoplasma capsulatum

30. Name at least three causes of metastatic calcification.

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31. Is the pH of CSF acidotic - alkalotic - or neutral?
Pneumotaxic center (short - fast breaths)
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Beta2- integrins
The pH of CSF is 7.33 - acidotic.

32. What direction does RNA polymerase move along the template strand of DNA during transcription?

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33. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Telencephalon
Prolactin
Proencephalon
Melanin
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.

34. What antifungal agent is used in the treatment of androgen receptor - positive cancers?
T3
Ketoconazole
Afterload
Second M PITS for pharyngeal pouch derivatives

35. Is digoxin or digitoxin renally eliminated?
Renal cell carcinoma
Antigenic determinant (epitope)
Parietal cells (Remember - they secrete HCl - too.)
Digoxin is renally eliminated; digitoxin is hepatically eliminated.

36. Indicates the patient has active pulmonary disease.
Galactoside permease
A positive PPD skin test
Dependent
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.

37. Which CNS ACh receptor or receptors are excitatory? Inhibitory?
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)

38. Name the insulin preparation based on the peak effect and duration of action - Peak - 8 to 16 hours; duration - 24 to 36 hours
Bladder carcinoma
O2
GH deficiency
Ultralente

39. Irreversible ototoxicity is associated with which loop diuretic?
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Escherichia coli and Pseudomonas sp.
Ethacrynic acid
The mouth

40. What is the term for the amount of blood in the ventricle after maximal contraction?
Prostate and lung cancer - respectively
Opsonization
Residual volume
Shortens

41. Ophthalmic artery is a branch of What artery?
Internal carotid artery
Listeria monocytogenes
Reserpine
Increase (5- HT and dopamine levels do the same)

42. In what stage of sleep is it easiest to arouse a sleeping individual?
Early collecting duct
During REM sleep
This is the triad of renal cell carcinoma
The raphe nuclei

43. What nerve lesion presents with ape or simian hand as its sign?
Median nerve lesion
Dysmetria; this is seen in a finger - to - nose test.
Reovirus
Nicotinic acid - because its side effects include hyperuricemia and exacerbation of ulcers.

44. Name the antidote - Mercury
Polyarteritis nodosa
Dimercaprol - penicillamine
Stable
INF- gamma

45. Are the following conditions associated with a negative or positive nitrogen balance? - Uncontrolled DM
Negative
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Dendrites receive information - whereas axons send information.
With arteriolar constriction both the flow and pressure downstream decrease.

46. What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
Hyaluronic acid (all sulfates bind to the core protein)
Kimmelstiel - Wilson disease
100% - with about 20% remaining positive after 1 year
It decreases insulin secretion.

47. Can advance directives be oral?
The lateral vestibular nucleus
Yes
Adenovirus
well - fed and fasting

48. What skin type on the palms and soles is characterized by the absence of hair follicles and presence of stratum lucidum?
Ego dystonic
Concentration gradient
Thick skin
Breast cancer

49. At What three sites can the HMP shunt enter into glycolysis?
Renal cell carcinoma
Tetany
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
wave

50. What causes the lysis of RBCs by oxidizing agents in a G-6- PD deficiency?
Leiomyoma
PRPP aminotransferase
Mitochondria
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.