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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 MCC of inherited mental retardation?
Rotavirus
N- formyl - methionine LTB4 C5a IL-8
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.
Down syndrome

2. What is the only DNA virus that has the reverse transcriptase enzyme?
Gain of hypotonic fluid (water intoxication or hypotonic saline)
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.
Entamoeba histolytica (treat with metronidazole)
Hepadnavirus

3. How many caf
extrapyramidal dysfunction
At least six
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.

4. Name the end product or products: x Fatty acid oxidation
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Epispadia
Mesencephalon
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting).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

5. Why should opioid analgesics be avoided for patients with head trauma?
Median nerve
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone - whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
Crossover study

6. Which trematode is associated with bladder carcinoma in Egypt and Africa?
Chromosome 15
Biofeedback
Schistosoma haematobium
Transvestite fetishism

7. Are bactericidal.
Hypotonia (rag doll appearance)
Tetracyclines
Arterial PCO2 levels are proportional to cerebral blood flow.
mRNA

8. Is an anti - HAV IgG Ab associated with immunization or recent infection?
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Spleen
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.

9. What does failure of PaO2 to increase with supplemental O2 indicate?
Scrofula
Pulmonary shunt (i.e. - pulmonary embolism)
Allotypes
Cocaine

10. What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin?
Cortisol levels increase. Lymphocyte levels decrease in sleep - deprived individuals.
Increases
Pneumococcus (Streptococcus pneumoniae)
Griseofulvin

11. What cell transports IgA - is secreted by plasma cells - and is in Peyer's patches to the gastrointestinal lumen?
Accommodation
Ipratropium
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
M- cells

12. What component of the ETC is inhibited by the following? - Oligomycin
Fo/F1 complex
Hairy cell leukemia
MEN I (or Wermer syndrome)
Haemophilus ducreyi

13. What bactericidal agents are resistant to Beta- lactamases and are used to treat in - hospital life - threatening infections?
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
Anemia
Imipenem and meropenem

14. Name the area of the cerebral cortex with the function described: x Initiation and control of movements
Juxtaglomerular (JG) cell
HBcAb IgM
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
Basal ganglia

15. What lysosomal enzyme is deficient in x Gaucher's disease?
Cyproheptadine
Glucocerebrosidase
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
Insulinoma

16. What is the major pulmonary side effect of
P24
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament
Respiratory depression
Middle cerebral artery

17. What pancreatic islet cell tumor is associated with MEN I syndrome?
Hgb F
Gastrinoma
Ependymal cells
Transketolase and transaldolase. The reactions they catalyze are reversible.

18. A urethral swab of a patient shows gram - negative diplococci in PMNs; what organism do you diagnose?
Adrenal medulla
Meningioma
H2PO4- (dihydrogen phosphate)
Neisseria gonorrhoeae

19. T cells can recognize - bind - and internalize...
unprocessed Ags
HHV 8
Sinus venosus
5HT1D

20. What area of the hypothalamus is responsible for recognizing an increase in body temperature and mediates the response to dissipate heat?
Anterior hypothalamic zone; lesions here result in hyperthermia.
Blastomyces dermatitidis
They prevent mast cell degranulation.
Right vagus innervates the SA node and the left vagus innervates the AV node

21. What are the three major functions of secretory IgA?
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
Glucose -6- phosphatase
Chromosome 19

22. What disorder causes joint stiffness that worsens with repetitive motion - crepitus - effusions - and swelling and commonly affects the knees - hips - and spine?
Being awake
Transposons
CN X
Osteoarthritis

23. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH
Hapten (not immunogenic)
1. Liver 2. Kidney 3. Pituitary gland (via 5'- deiodinase enzyme)
Pituitary hypogonadism
IF

24. What vitamin is a component of the enzymes fatty acid synthase and acyl CoA?
Convergence
None; it degenerates.
The time it takes ACh to diffuse to the postjunctional membrane
Pantothenic acid

25. What is the term for repetitive actions blocking recurring bad thoughts?
secondary immune response
Superior and posterior
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
Site 2

26. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
ELISA. It detects anti - p24 IgG.
Vesicular stomatitis virus
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.
The T- test (used when comparing two groups)

27. After fertilization - what cells of the corpus luteum x Secrete estrogen?
Class 1 (1A - 1B - and 1C)
Phosphorylation of mannose residues
Uric acid
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.

28. What is the triad of fat embolism?
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
LTB4
Nystagmus and ataxia

29. What viruses are associated with Cowdry type A intranuclear inclusions?
Splitting
Positive
Herpes virus I and II
Gerstmann's syndrome; spoken language is usually understood.

30. What happens to the lung if the intrapleural pressure exceeds lung recoil?
The lung will expand; also the opposite is true.
Proencephalon
HPV
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.

31. What would be the result if an Ab were cleaved with papain?
Job syndrome
There would be two Fab and Fc regions.
Paroxysmal nocturnal hemoglobinuria
GLUT 2

32. What attaches the cusps of the valves to the papillary muscles in the heart?
Chordae tendineae
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
CD21; it is a complement receptor for cleaved C3
Prevalence increases.

33. What are the four muscles of mastication?
Epispadia
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Arginine
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid

34. What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?
Because they do not block D2A receptors - they are antagonists of 5HT2 receptors.
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.
Osteosarcoma

35. What deep cerebellar nuclei receive Purkinje cell projections in x The vermis?
The fastigial nucleus
Reverse transcriptase
Glycine/arginine
Ampicillin and amoxicillin

36. What type of scale is graded into equal increments - showing not only any difference but how much?
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
Glossopharyngeal nerve
Interval scale (a ruler - for example)

37. At the base of the lung - What is the baseline intrapleural pressure - and what force does it exert on the alveoli?
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
Superoxide dismutase - glutathione peroxidase - catalase
Being a white male
Chromosome 11 - 22

38. Which virus is treated with the monoclonal antibody palivizumab?
S2 - S3 - S4
Mild (50-70)
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
RSV

39. Name the macrophages by location: x Lungs
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Marfan syndrome
Alveolar macrophages
SITS

40. What enzyme catalyzes the rate - limiting step in gluconeogenesis?
Streptococcus pneumoniae
Marijuana
Fructose -1 - 6- bisphosphatase
Pneumocystis carinii

41. What two viruses are associated with Reye's syndrome?
Varicella virus and influenza virus
ATP production
Hypotonia (rag doll appearance)
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.

42. Do the following structures pick up stain from hematoxylin or eosin? - Collagen
Hypertrophic scar
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
Superior
Eosin

43. Marriage ______ a child less than 17 years old.
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
emancipates
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia
Intellectualization

44. What is the effect of insulin on protein storage?
Ampulla
Primary hyperparathyroidism
Rhombencephalon
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.

45. What myeloid disorder is characterized by increased hematocrit - blood viscosity - basophils - and eosinophils; intense pruritus; and gastric ulcers due to histamine release from basophils - increased LAP - and plethora?
0157:H7
Superior vena cava
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)
Phase I

46. What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Stroke volume
GLUT 4
Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle.
Thoracic splanchnic fibers

47. What is the most common one? - Renal cell cancer type
Clear cell
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Autosomal recessive
Waldenstr

48. What determines the rate of a reaction?
The energy of activation (Ea)
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
Low interstitial free Ca2+ concentrations
G0 phase

49. What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
Osteogenesis imperfecta
Muscles of the internal eye
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
Psoas major

50. What hormone is activated in adipose tissue when blood glucose levels decrease?
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
6 weeks 10 weeks
Hemiballismus
Hormone - sensitive lipase