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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 is the most common one? - Renal calculus type
unprocessed Ags
Calcium oxylate
Clonorchis sinensis
Superior

2. What are the two absolute requirements for the cytochrome P450 enzyme system?
Decreased REM sleep and REM rebound during withdrawal
Hydatidiform mole
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
NADPH and molecular O 2

3. Name the most common type or cause - Urethritis in a young - newly sexually active individual
It increases Ca2+ excretion from the kidney and increases bone mineralization.
Phase III. It is considered the definitive test.
Lipoprotein lipase
Staphylococcus saprophyticus

4. Name the macrophage based on its location: x Brain macrophages
Basophilic stippling
PALS
Lesser curvature of the antrum of the stomach
Microglia

5. What is the term for excessive amounts of granulation tissue that can block re - epithelialization and wound healing?
Superior and anterior
Proud flesh
Eclipse period
Clearance

6. Pseudorosettes
Pituitary hypogonadism
Ewing sarcoma
Klinefelter syndrome
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)

7. How are pulse pressure and compliance related?
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Metastatic calcification
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
Bipolar disorder (manic - depressive disorder)

8. What is the first membrane - bound Ig on B cell membranes?
During stage 3 and 4 (remember - it is called deep sleep.)
Cytochrome a/a3
IgM; IgD follows shortly thereafter.
Right nasal hemianopsia

9. How far below ideal body weight are patients with anorexia nervosa?
Cryptococcus neoformans
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
At least 15%
Candida albicans

10. A patient goes to the ER with signs and symptoms of biliary colic. Which opioid analgesic do you choose?
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.
5' deiodinase
Paroxysmal nocturnal hemoglobinuria
Mean corpuscular hemoglobin (MCH)

11. Being college educated increases a man's risk of having...
premature ejaculation
Paget disease of the breast
Dysplasia
Streptococcus pneumoniae

12. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol increased - ACTH increased
eEF-1
Secondary hypercortisolism (pituitary)
Postinfectious GN
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)

13. What type of potential is characterized as graded - decremental - and exhibiting summation?
Hematoxylin
Accidents
Subthreshold potential
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.

14. Bloody tap on lumbar puncture
Subarachnoid hemorrhage
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.
The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated.
Positive

15. Name the eukaryotic DNA polymerase based on the following information: x Synthesizes the lagging strand during replication
Beta- Oxidation of fatty acids
After the eclipse period
DNA polymerase - a
Parkinson's disease

16. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Percentage of Na+ - Cl - - K+ left in the lumen
Hyperkalemia
t the end of the PCT 25% of Na+ - Cl - - K+ is left
Good Samaritan Law. (Physicians are not required to stop and help.)
Elevated ASO titers and serum complement levels

17. Name the correct artery - The right recurrent laryngeal nerve passes around it.
Bioavailability
Right brachiocephalic artery
Alkaline phosphatase
TAT (Thematic apperception test)

18. Name the most common type or cause - Subacute bacterial endocarditis
Streptococcus viridans
Average
Eosinophil chemotactic factor A
Ganciclovir

19. How many attacks are needed over how much time before panic disorder is diagnosed?
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
Waterhouse - Friderichsen syndrome
T wave
Breast

20. What ribosomal subunit binds first to the mRNA strand?
IgD; IgM is also correct.
Lung and bronchus cancer
The small subunit (40S) binds first.
Free ionized Ca2+

21. Abs to what hepatitis B Ag provide immunity?
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
Abs to HBsAg
The alveolar PO2 and PCO2 levels
PGI2

22. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Concentration of CHO - AA - ketones - peptides
Serum 25- hydroxy- vitamin D (25- OH- D)
Left homonymous hemianopsia
IgA nephropathy
No CHO - AA - ketones - or peptides are left in the tubular lumen.

23. What disease with familial mental retardation produces large - everted ears and macro - orchidism?
Fragile X syndrome
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)

24. What drug blocks glucose uptake - leading to decreased formation of ATP and resulting in immobilization of the parasite?
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.
Burkitt lymphoma
emancipates
Albendazole

25. What is the most common one? - Intraspinal tumor
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
Pseudogout
Ependymoma
During REM sleep

26. Name the product or products of arachidonic acid: x Vasoconstriction and platelet aggregation produced by platelets
TXA2
Amygdala; it helps imprint an emotional response in memory.
Positive
Pseudomonas aeruginosa

27. What form of angina is characterized by x Coronary artery luminal narrowing - symptom occurrence during exertion - ST segment depression on ECG?
Lung cancer
Left colic - superior rectal - and sigmoidal arteries
Parallel circuit
Stable angina

28. Name the macrophage based on its location: x Lung macrophages
Rabies
Pulmonary alveolar macrophages
Facial expression (the second is vocal intonation)
Calcium oxylate

29. What is the vector for Chagas disease?
Proencephalon diencephalon derivative
Hypercortisolism (Cushing syndrome)
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
The reduviid bug

30. Name the antidote - Arsenic
They innervate skeletal muscle.
gag gene
Dimercaprol - D- penicillamine
Metronidazole

31. What AR disorder is due to a deficiency in glycoprotein IIb - IIIa - resulting in a defect in platelet aggregation?
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
Respiratory depression
Glanzmann syndrome
Coma - convulsions - and cardiotoxicity

32. What is the term for the degree to which a test measures what it is intended to measure?
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
Type II pneumocytes
Validity (remember - reliability is necessary but not the only thing needed for validity)
IL-8 (IL-1 and TNF- gamma also)

33. What happens to free hormone levels when the liver decreases production and release of binding proteins?
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Spermatogonia (type A)
Pubis - ilium - and ischium
Lesser curvature of the antrum of the stomach

34. What Freudian psyche component is described as x Reality - rationality - language basis?
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
Ostium secundum defects
Hemiballismus
Ego

35. When referring to a series circuit - what happens to resistance when a resistor is added?
Resistance increases as resistors are added to the circuit.
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.

36. Name the most common type or cause - Cyanotic heart disease
Tetralogy of Fallot
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
No change in length
The raphe nuclei

37. What is the term to describe the limited portion of an Ag that is recognized by an Ab?
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Antigenic determinant (epitope)
Waterhouse - Friderichsen syndrome

38. What are the five hormones produced by Sertoli cells?
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.
Substituted judgment. It is made by the person who best knows the patient - not the closest relative.
greater
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim

39. What are the two ketogenic AAs?
Phallic stage (4-6 years)
Afterload
Stage fright (discrete performance anxiety)
Leucine and lysine

40. Do the following structures pick up stain from hematoxylin or eosin? - Fibrin
Eosin
Nephrotoxic oxylate stones
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
Streptococcus agalactiae and Escherichia coli

41. Name five causes for zero - order metabolism.
Metformin
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Listeria monocytogenes
1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity

42. What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
LC4 - LD4 - and LE 4
Renal cell carcinoma
Ventral lateral nucleus
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.

43. What Brodmann area is associated with x Visual association cortex?
Demeclocycline
Areas 18 and 19
Superior
Effective dose for 50% of drug takers (median effective dose)

44. What CNs arise from x The pons?
Melanoma - cancer of the stomach and bladder
CN V - VI - VII - and VIII
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
Insulinoma

45. Using Laplace's relationship regarding wall tension - why is the wall tension in an aneurysm greater than in the surrounding normal blood vessel's wall?
Acetyl CoA carboxylase
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
Sinus venosus
Plasmodium malariae

46. What two vessels in fetal circulation have the highest PO2 levels?
Neurofibromatosis
Calcium oxalate
Umbilical vein and ductus venosus (80%)
Right ventricle

47. What stage of male development is characterized by the following LH and testosterone levels? - Decreased testosterone production is accompanied by an increase in LH production.
Emphysematous bleb
Aged adult
Ipratropium
Ampicillin and amoxicillin

48. What happens to prevalence as the number of long - term survivors increases?
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
First M PITS for pharyngeal pouch derivatives
Invariant chain
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.

49. What enzyme is deficient in hereditary protoporphyria?
Cerebral aqueduct
The energy of activation (Ea)
Ferrochelatase
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.

50. How do the corticobulbar fibres of CN VII differ from the rest of the CNs?
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
False - positive rate
The affinity of the drug for its receptor

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USMLE Step 1 Prep

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