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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 stromal tumor in males is characterized histologically with crystalloids of Reinke?
Gonads
Paroxysmal nocturnal hemoglobinuria
Vmax
Leydig cell tumor

2. 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.
Type II hypersensitivity (cytotoxic)
Benign lentigo
CD4
Truncus arteriosus

3. Under resting conditions - What is the main determinant of cerebral blood flow?
Unipolar disorder (major depression)
Right - sided valves
Arterial PCO2 levels are proportional to cerebral blood flow.
Lateral collateral ligament

4. What bacterium is a gram - negative - oxidase - positive aerobic rod that produces a grapelike odor and pyocyanin pigmentation?
Corynebacterium diphtheriae
Visceral pleura
Pseudomonas aeruginosa
Appendix (second is terminal ileum)

5. What is the most common primary diagnosis resulting in an office visit for males? For females?
Neuroblastoma
Albendazole
For males - HTN; for females - pregnancy.
LC4 - LD4 - and LE 4

6. What is the pentad of TTP?

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7. What vascular injury may result from a supracondylar fracture of the femur?
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
Yes
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.

8. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Polycyclic aromatic hydrocarbons
Ataxia - telangiectasia
Average
ll
Bronchogenic carcinoma

9. What is the term for transverse bands on the fingernails seen in patients with chronic arsenic poisoning?
Mees lines
Impotence
Intellectualization
C1 inhibitor (C1- INH)

10. Name the antimicrobial agent whose major side effect is listed - Hemolytic anemia
Stage 3 and 4
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Nitrofurantoin
Reverse transcriptase

11. What happens to intrapleural pressure when the diaphragm is ontracted during inspiration?
Allograft
Intrapleural pressure decreases (becomes more negative).
C5- C9
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)

12. What is the most common one? - Malignant tumor in women
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
Breast
Voyeurism
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.

13. What type of healing occurs in a clean surgical incision?
Thalassemia minor
Primary intention
gram positive
Dysmetria; this is seen in a finger - to - nose test.

14. Which drug is used to treat respiratory depression associated with an overdose of opioids?
Ulcerative colitis
Naloxone or naltrexone
Enterobius vermicularis
Chromosome 5q21

15. Name the aphasia based on these characteristics: x Both Broca's and Wernicke's areas damaged by lesion in the presylvian speech area; trouble repeating statements; poor comprehension with telegraphic speech
Phase 3
Succinyl CoA synthetase
Global aphasia
Hematoxylin

16. Name the MCC of death - In diabetic individuals
The folding of an AA chain
MI
HHV 6
Trimethoprim

17. Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
The urine becomes hypertonic because of water reabsorption in the collecting duct.
It decreases insulin secretion.
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol

18. Name the type of mutation: x New codon specifies for a stop codon
Sciatic nerve
Excess estradiol in the blood
Nonsense
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.

19. What immunologic syndrome is due to a pharyngeal pouch 3 and 4 failure?

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20. What is the most common one? - Tumor in individuals exposed to asbestos
Rapidly progressive glomerulonephritis (RPGN)
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
Hepatoma and nonseminomatous testicular germ cell tumors
Bronchogenic carcinoma

21. Is there a difference between mathematical and clinical steady states? If so - What are their values (half - lives)?
CD3
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
Hypervariable region
There is a difference; it takes about 7 to 8 half - lives to reach mathematical steady state and 4 to 5 half - lives to reach clinical steady state.

22. What is the vector for yellow fever?
CN V
Papillary carcinoma of the thyroid
Glutamate
Aedes mosquito

23. In which syndrome does a person present with intentionally produced physical ailments with the intent to assume the sick role?
Prostatic carcinoma
Bunyavirus
M
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.

24. What are the primary neurotransmitters at the following sites? - Brainstem cells
Methanol (wood alcohol)
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
Serotonin
Allelic exclusion. It is to ensure that one B cell produces only one Ab.

25. Name the structure that enters or exits the following foramina: x Carotid canal
Internal carotid artery and sympathetic plexus
Lipid - soluble hormones are considered slow - acting hormones.
It both begins and ends at T4 (sternal angle [of Louis]).
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

26. What is the leading cause of preventable premature death and illness in the United States?
Ventral anterior nucleus
Smoking
Aspartate transcarbamylase
Stretch receptors prevent overdistension of the lungs during inspiration.

27. What Ab is an indication of low transmissibility for hepatitis?
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
HBeAb
Voltage - gated channel
Cryptococcus

28. What is the only Plasmodium that is quartan?
Glutamine
At birth (reflex)
Clostridium perfringens
Plasmodium malariae; the others are tertian.

29. What is the term for headaches - inability to concentrate - sleep disturbances; avoidance of associated stimuli; reliving events as dreams or flashbacks following a psychologically stressful event beyond the normal range of expectation?
They innervate LMNs.
C5a
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
Chromosome 15 - 17

30. What hormone - produced by Sertoli cells - if absent would result in the formation of internal female structures?
IF
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.
ELISA. It detects anti - p24 IgG.
Muscle glycogen phosphorylase

31. How many ATPs are generated per acetyl coenzyme A (CoA)?
Calcitriol
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
Indirect or unconjugated
For males it's prostate cancer - and for females it's breast cancer.

32. What is the function of the basal ganglia?
Stapedius muscle
Initiate and manage gross skeletal muscle movement control
Minoxidil (orally and topically - respectively!)
Axis III

33. What ssDNA virus must make dsDNA before it makes mRNA?
Parvovirus (it is the only ssDNA virus)
EF- G of the 50S subunit
Hgb F
Pseudogout

34. When a drug is administered orally and enters into portal circulation - it undergoes hepatic metabolism. What is the name of this effect?
Isotypes
7 years old
First - pass effect
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).

35. Lucid interval
Huntington disease
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
Epidural hematoma
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.

36. Which centrally acting a2- adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Areas 44 and 45
Uracil
Paramyxovirus
Clonidine

37. What X- linked recessive disorder is characterized by hyperuricemia - spastic cerebral palsy - mental retardation - and self - mutilation?
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
Waterhouse - Friderichsen syndrome
Addition (They are mutually exclusive.)
Lesch - Nyhan syndrome

38. Name the associated chromosomal translocation - Adult familial polyposis
Ketamine
Breast and lung cancer - respectively.
Liver - kidney - and GI epithelium
Chromosome 5 - 21

39. What two Abs are used to diagnose Hashimoto's thyroiditis?
Antithyroglobulin and antimicrosomal Abs
Antigenic determinant (epitope)
Arcuate line
REM

40. What class of heparin is active against factor Xa and has no effect on PT or PTT?
A right CN V lesion results in weakened muscles of mastication - and the jaw deviates to the right.
Serum 25- hydroxy- vitamin D (25- OH- D)
Low molecular weight heparin (LMWH)
Medial medullary syndrome

41. What mineral - via excessive depositions in the liver - causes hemochromatosis?
PALS (Parietolateral lymphocytic sheath)
Puberty
Succinyl CoA
Iron (Fe)

42. Name the end product or products: x Fatty acid oxidation
Follicular adenoma
Stratum lucidum
Myelofibrosis with myeloid metaplasia
Acetyl CoA and propionyl CoA (in odd chain fatty acids)

43. From What aortic arch are the following structures derived?
Common and internal carotid arteries
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Site 2
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.

44. What two factors cause PTH to be secreted?
Ch
Lateral pontine syndrome
Phenytoin
A decrease in Ca2+ and an increase in PO4

45. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Alkylating agents
Primary hypothyroidism (Low T4 has a decreased negative feedback loop - resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release - respectively.)
Leukemias and lymphomas
S2 - S3 - S4
The pH of CSF is 7.33 - acidotic.

46. In which region of the lung are 75% of the pulmonary infarcts seen?
Lower lobe
Red blood cell distribution width index (RDW)
Superior
Opposite the second upper molar tooth

47. What AD syndrome involves 1000 or more edematous polyps - most commonly affects the colorectal area - and is associated with chromosome 5q21?
Proencephalon diencephalon derivative
Familial polyposis coli
Axis I
Euchromatin - the dark stuff in the nucleus on an electron microscope image.

48. You would not prescribe __________ for a patient with gout who is an overexcretor of uric acid.
Heroin
Hematogenous
Class III
Probenecid

49. What form of hemophilia is X- linked recessive and due to a deficiency in factor VIII?
Area 22 and occasionally 39 and 40
Postinfectious GN
Chromosome 15
Hemophilia A

50. What DNA virus is associated with exanthem subitum (roseola)?
HHV 6
Turner syndrome
M- cells
C4 (the upper border of the thyroid cartilage)