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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 first branch of the abdominal artery?
HBcAb IgM
Inferior phrenic artery
HPV infection
Two - way ANOVA. It allows the test to check several variables at the same time.

2. What three Beta- blockers are used in the treatment of glaucoma?
Ipsilateral loss below the level of the lesion
Negative
Glutamate
1. Propranolol 2. Timolol 3. Carteolol

3. What malabsorption syndrome produces abdominal distention - bloating - flatulence - diarrhea - steatorrhea - and weight loss shortly after eating bread products?
Central. Remember - there is a deficiency in ADH production in the central form.
Thymine
Celiac sprue (gluten - sensitive enteropathy)
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)

4. What level of mental retardation is characterized by x Needing a highly structured environment with constant supervision?
Profound (I.Q. range < 20)
Breast cancer
Internal carotid artery
Acetyl CoA and propionyl CoA (in odd chain fatty acids)

5. What nerve supplies general sensation to the anterior two - thirds of the tongue?
Lateral fissure (fissure of Sylvius)
Lingual nerve of CN V3
IgA
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.

6. The ophthalmic artery is a branch of what vessel?
Ribavirin
Reiter syndrome
Internal carotid artery
Gonads

7. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ increased - Pi decreased
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
Desipramine
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
Primary hyperparathyroidism

8. What cancer of the male genitourinary system is associated with osteoblastic bony metastasis?
Scleroderma
Decreases
Prostatic carcinoma
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.

9. In What trimester is the fetus most vulnerable to congenital rubella syndrome?
Type IV hypersensitivity (cell - mediated)
The first trimester
Riboflavin (B2)
Serum 25- hydroxy- vitamin D (25- OH- D)

10. What AA is a precursor of the following substances? - Serotonin
Streptococcus agalactiae and Escherichia coli
Tryptophan
As the isotype is switched - the Ab specificity does not change because it does not affect the variable chains.
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells

11. What syndrome results if the enzyme ?-1- iduronidase is deficient? L- iduronate sulfatase deficiency?
Psoas major
Fourth M PITS for pharyngeal pouch derivatives
Hurler syndrome and Hunter syndrome - respectively
Metronidazole

12. What is the most abundant neuron in the cerebellum?
Poliomyelitis; it is a bilateral LMN lesion.
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
Doxycycline
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)

13. What disorder is associated with spider angiomas - palmar erythema - gynecomastia - testicular atrophy - encephalopathy - abnormalities in clotting factors - and portal HTN?
Cirrhosis
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Nasal polyps - rhinitis - and aspirin hypersensitivity
Flumazenil

14. What disease results in a failure of neural crest cells to migrate to the myenteric plexus of the sigmoid colon and rectum?

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15. What bacterium is responsible for woolsorter's disease?
Bacillus anthracis
Lente insulin and either NPH or protamine zinc insulin (PZI)
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Sexual aversion disorder

16. What term describes senseless repetition of words or phrases?
Paneth cells
Verbigeration
Valproic acid
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)

17. What X- linked recessive disorder that is due to an abnormality in the dystrophin gene - has onset by age 5 with progressive proximal muscle weakness - calf pseudohypertrophy - and elevated CPK levels?

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18. What is the most potent NMJ blocker and also has no cardiovascular side effects?
Doxacurium
Sexual aversion disorder
Parasympathetics (parasympathetics point - sympathetics shoot)
1. ADP 2. PG 3. TXA2

19. In Parkinson's disease - What area of the basal ganglia has a decreased amount of dopamine?
Smooth muscle
Enkephalin
Substantia nigra
REM sleep. Nightmares are frightening dreams that we recall.

20. What is the term for the negative resting membrane potential becoming more negative?
Hyperpolarization (i.e. - K+ influx)
Streptococcus pneumoniae
Graves disease
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)

21. What assay is used to identify MHC class I molecules?
Excess lead
Microcytotoxic assay
Azithromycin
Mesencephalon

22. Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
Single - strand DNA binding protein
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Fourth M PITS for pharyngeal pouch derivatives
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent

23. Name the T- cell CD marker: x Interacts with MHC class I molecules
Selection bias
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti - Ab
CD8
Medial nuclear group (limbic system)

24. What is the term for a benign melanocytic tumor associated with sun exposure that presents as tan - to - brown colored and has sharply defined well - circumscribed borders?
Saccule and utricle
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Tidal volume (VT)
Benign nevus (mole)

25. What are the five tissues in which glucose uptake is insulin independent?
Massive influx of calcium
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
NADPH - O2 - and cytochrome b5
Gradient - time system

26. With a decrease in arterial diastolic pressure - what happens to x TPR?
Decreases
Ergosterol
Staphylococcus
Tetracycline

27. What is the major hormone produced in the following areas of the adrenal cortex? - Zona glomerulosa
pI (isoelectric point)
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Diazoxide
Osteosarcoma

28. What cells of the thyroid gland secrete calcitonin?
The JG cells
Left colic - superior rectal - and sigmoidal arteries
Parafollicular C cells
Schizotypal

29. Is cigarette smoking associated with transitional cell carcinoma of the bladder?
PKU
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Ratio scale
Gain of hypotonic fluid (water intoxication or hypotonic saline)

30. What antimuscarinic is used as an inhalant for asthma?
Erythema marginatum
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)
After the latent period
Ipratropium

31. Are resistant to the effects of aminoglycosides.
Anaerobes
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Somatoform pain disorder
Clostridium botulinum

32. What area of the spleen consists of splenic cords of Billroth and phagocytoses RBCs?
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
Red pulp (Remember - Red pulp and RBCs begin with R.)
CN X
Coxiella burnetii

33. What is the most common one? - Female genital tract malignancy resulting in death
Ovarian cancer
Axillary nerve and posterior humeral artery
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
False - negative rate

34. ______________ that slow bacterial growth are bactericidal.
For males it's prostate cancer - and for females it's breast cancer.
An increase in serum glucose levels
Antimicrobial agents
Metronidazole

35. What small gram - positive - non - spore - forming rod is a facultative intracellular parasite that grows in the cold and is associated with unpasteurized milk products?
1. Iliocostalis 2. Longissimus 3. Spinalis ('I Love Science' muscles)
Lateral fissure (fissure of Sylvius)
Listeria monocytogenes
Alanine cycle

36. What is the major muscle used in the relaxed state of expiration?
Encapsulated bacteria
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
Physostigmine
Reiter syndrome

37. Name the DNA virus: x Partially dsDNA circular; enveloped; virion - associated polymerases; has RNA intermediate; replicates in the nucleus
Mural infarct
Hepatic adenomas
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
Hepadnavirus

38. What is the term to describe the increase in organ size due to the increase in cell size and function?
Mean corpuscular hemoglobin (MCH)
G0 phase
Hypertrophy
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.

39. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 and int -2
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
nef and tat genes
In the first and second bronchi
Melanoma - cancer of the stomach and bladder

40. Name the type of hypersensitivity reaction based on the following properties - Reaction - mediated by sensitized T- cells
Type IV hypersensitivity (cell - mediated)
Transketolase and transaldolase. The reactions they catalyze are reversible.
Succinate dehydrogenase
Rhombencephalon

41. What is the start codon - and What does it code for in eukaryotes? Prokaryotes?
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.
Frontal eye field (Brodmann area 8)
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.
Thalassemia minor

42. Ensures emancipation.
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
Molindone
Pregnancy
Stable angina

43. What is an elevated - fluid - filled cavity between skin layers up to 0.5 cm?
Polycystic kidney disease of childhood
Mycoplasma
Rate of absorption
Vesicle (e.g. - poison ivy)

44. A mother takes her 2- week - old infant to the ER because the baby regurgitates and vomits after eating and has peristaltic waves visible on the abdomen and a palpable mass in the right upper quadrant. What is your diagnosis?
HHV-8
Pyloric stenosis
Bile pigments and bile salts
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.

45. Is the following description characteristic of competitive or noncompetitive antagonists: parallel shift to the right on a dose - response curve - complete reversibility with increase of the dose of the agonist drug - and capacity to decrease the pot
Competitive antagonist
Insulin
Copper
Volume of distribution is decreased when a large percentage of drug is protein bound.

46. What hormone excess produces adrenal hyperplasia?
ACTH
Interferons
Escherichia coli
ASD

47. In high altitudes - What is the main drive for ventilation?
0157:H7
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Stercobilin
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.

48. Name the compartment of the mediastinum associated with the following thoracic structures: Brachiocephalic vein
The odontoid process of C2
The myotatic reflex is responsible for the tension present in all resting muscle.
Resistance increases as resistors are added to the circuit.
Superior

49. What acid - base disturbance is produced from vomiting?
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.
Missense
Metronidazole
Four high energy bonds - two from ATP in AA activation and two from GTP

50. Are the following major or minor Jones criteria of rheumatic fever? - Subcutaneous nodules
Unconjugated (indirect)
Breast
Major
Thiamine and folate