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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. Name the most common type or cause - Nephritic syndrome in adults
Huntington's chorea. (Death in 15-20 years - often via suicide.)
Membrane conductance (think conductance = channels open)
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
MGN

2. What is the venous and arterial stretch receptors' function regarding the secretion of ADH?
CD8+ T cells (cytotoxic) Remember - 8
Class 1 (1A - 1B - and 1C)
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.
Zona fasciculata and zona reticularis

3. What nerve is associated with the following functions? - Supinate the wrist - extend the wrist and digits - extend the shoulder and elbow
Ventral anterior nucleus
Alcohol and its related problems cost the country approximately $100 billion a year.
Radial nerve
Merkel cells (Merkel's tactile cells)

4. Name the most common type or cause - Viral pneumonia leading to death
The folding of an AA chain
Adenocarcinoma
RSV
Hematoxylin

5. What type of personality test is the Rorschach inkblot test - objective or projective?
Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone - produced by Leydig cells - is needed for spermatogenesis.
Projective test. Most tests with a wide range of possibilities for the answers are projective.
Duodenal atresia
The mouth

6. How many base pairs upstream is the prokaryotic TATA box promoter?
von Gierke's disease
Renal cell carcinoma
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Hyperacute rejection

7. In MHC class II molecules - what chain blocks access to the peptide - binding groove during transportation within the cell - ensuring that the MHC class II- peptide complex is transported to the surface?
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
Resistance decreases as resistors are added in parallel.

8. What subunit of hCG is used to detect whether a patient is pregnant?
Dantrolene
Third week
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling
The Beta- subunit; remember - the a - subunit is nonspecific.

9. What area of the brain acts as the center for ipsilateral horizontal gaze?
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.
G2 phase (gap 2)
Acetyl CoA carboxylase
PPRF

10. What syndrome is associated with the following brainstem lesions? - Contralateral corticospinal and medial lemniscus tract deficits and an ipsilatera medial strabismus secondary to a lesion in CN VI
Selective erectile disorder
In men it is prostate cancer - and in women it is breast cancer.
Metaphase II
Medial pontine syndrome

11. Metformin is contraindicated in ________ because of weight gain as its side effect.
Obese patients
Homocysteine methyl transferase
Osteoblast (Remember - blasts make - clasts take)
Polycystic ovary disease (Stein - Leventhal syndrome)

12. Name three opsonins.
Candida albicans
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.
Fc portion of IgG - C3b - and mannose - binding proteins
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.

13. What are the primary neurotransmitters at the following sites? - Postganglionic sympathetic neurons
Bacillus cereus
NE
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme

14. Can advance directives be oral?
Osteoblasts (Remember - they modulate the function of osteoclasts.)
Yes
Granulosa cell tumor of the ovary
CD15 and CD30

15. Name the T- cell CD marker: Is a costimulatory molecule in T cell activation
CD28
Dimercaprol - D- penicillamine
Hepatitis - with or without necrosis
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.

16. Name the GLUT transporter based on the following: x Found in most tissues - including brain and RBCs
GLUT 3 and 4
Sorbitol (resulting in cataracts)
CD14
Moderate (35-49)

17. Can a patient refuse life - saving treatment for religious reasons?

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18. Name the Plasmodium species based on the following information:Persistent hypnozoite liver stage with relapses; blood smear shows amoeboid trophozoites with oval - jagged infected RBCs; 48- hour fever spike pattern
Arnold - Chiari malformation type 2
ACTH
Plasmodium ovale
0.21; it is a fancy way of saying 21% of the air is O2.

19. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Alkylating agents
Liver
Leukemias and lymphomas
Duodenum
Aortic insufficiency

20. What embryonic structure forms the adult male structure? - Epididymis - ductus deferens - seminal vesicle - and ejaculatory duct
Proximal to distal progression
Diazepam is longest acting and midazolam is shortest acting.
Mesonephric duct
Chronic alcoholic

21. What mineral is an important component of the enzyme xanthine oxidase?
Neonatal respiratory distress syndrome (NRDS)
Because it is the largest vessel and has the highest velocity in systemic circulation
Molybdenum (Mb)
Prokaryotes. Polycistronic and prokaryotes both start with P.

22. Which virus is treated with the monoclonal antibody palivizumab?
RSV
Gonads
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
The alveolar PO2 and PCO2 levels

23. What are the three components to the asthma triad?
Nasal polyps - rhinitis - and aspirin hypersensitivity
Fibrous pericardium
Virchow triad - associated with the formation of a thrombus.
Primitive ventricle

24. What enzyme is deficient in the following glycogen storage disease? - Hers' disease
Aortic stenosis
Hepatic glycogen phosphorylase
Flurazepam
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.

25. What nucleus supplies the preganglionic parasympathetic fibers to the ciliary ganglion?
The aorta
Primary hypercortisolism
Edinger - Westphal nucleus (via CN III)
The vestibulo - ocular reflex

26. Name the valve abnormality based on the following criteria: x Systolic murmur - increased preload and afterload - decreased aortic pulse pressure and coronary blood flow
Aortic stenosis
None; they are the storage sites for ADH and oxytocin.
Succinyl CoA synthetase
Zanamivir and oseltamivir

27. What is the most common one? - Form of arthritis
Ungated channels
Operant conditioning (reinforcement is after a response)
Small cell carcinoma (oat cell)
Osteoarthritis

28. What bactericidal agents are resistant to Beta- lactamases and are used to treat in - hospital life - threatening infections?
Imipenem and meropenem
Lateral rectus (CN VI) (LR6 SO4)3
total body water
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)

29. What operant conditioning therapy or modification is described as x Reinforcing successive attempts that lead to the desired goal (gradual improvement)?
Paroxysmal nocturnal hemoglobinuria
Shaping (successive approximation)
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Dihydrofolate reductase

30. Name the MCC of death - In neonates
Chromosome 18
HPV
Intraductal papilloma
Neonatal respiratory distress syndrome (NRDS)

31. What is the most important determinant of drug potency?
G-6- PD deficiency
The affinity of the drug for its receptor
First - pass metabolism and acid lability
Intussusception

32. What is the main factor determining GFR?
Iron (Fe)
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
H1 histones
Reovirus

33. What is the only anesthetic that causes cardiovascular stimulation?
Agglutination test
Ketamine
Body dysmorphic disorder
Bernard - Soulier syndrome

34. What is the major inorganic component of bone?
Hepatitis A (infectious)
Hydroxyapatite
Treacher Collins syndrome
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.

35. In what layer of the epidermis is melanin transferred from melanocytes to keratinocytes?
Lentigo maligna melanoma
Stratum spinosum
Fluconazole
The conversion of tyrosine to dopamine in the cytoplasm

36. What size ribosomes do fungi have?
Chlamydia
80S ribosomes (because they are eukaryotic)
Conus arteriosus of the right ventricle and right and left auricles
Magnesium

37. What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
Histrionic
Amanita phalloides
PGE (along with low oxygen tension)
Carnitine acyl CoA transferase II

38. What is the term for ventilation of unperfused alveoli?
Alveolar dead space
CN III
Menses
Factors II - VII - IX - X - and proteins C and S

39. What happens to affinity if you increase Km?
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
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
Coprophilia
Affinity decreases; they are inversely proportional.

40. What is the term for the load a muscle is trying to move during stimulation?
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)
Dihydrofolate reductase
Afterload
Serous exudates

41. Name three purine bases that are not found in nucleic acids.
Aedes (the same for yellow fever)
C5a
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
VIPoma

42. What is the antidote for organophosphate ingestion?
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.
Hepatitis B
The basilar artery is formed at the pontomedullary junction.
Atropine and 2- PAM (pralidoxime)

43. Are the following major or minor Jones criteria of rheumatic fever? - Subcutaneous nodules
Major
Amiloride
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Proencephalon

44. What CNs arise from x The pons?
Somatomedins (IGF-1)
G-6- PD
Riedel thyroiditis
CN V - VI - VII - and VIII

45. What is the most common one? - Bladder tumor
Unstable (crescendo) angina
Concrete operations (6-12 years)
Transitional cell carcinoma
Left atrial myxoma

46. On the right lung the ___________ divides the middle from the inferior lobe and the horizontal fissure further divides the middle from the upper lobe. On the left the oblique divides the superior from the inferior lobe.
Anaerobes
Oblique fissure
Leuprolide
Mast cells

47. What substrate builds up in Tay- Sachs disease?
Naloxone - naltrexone
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Healing by secondary intention

48. Where is most of the body's Ca2+ stored?
Multiple myeloma
Pompe's disease
Merkel cells (Merkel's tactile cells)
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.

49. What small coagulase - positive - gram - negative rod with bipolar staining is a facultative intracellular parasite resulting in buboes?
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
Large segment deletions
Yersinia pestis
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.

50. Where are the tonsillar tissues?

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