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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 term to describe homosexuals who x Are uncomfortable with their own person and disagree with their sense of self?
Ego dystonic
There would be two Fab and Fc regions.
Selenium (Se)
Pontocerebellar angle syndrome

2. What bile pigment is formed by the metabolism of bilirubin by intestinal bacteria - giving stool its brown color?
Stercobilin
Niacin (B3)
Francisella tularensis
ACh receptor

3. What is the only Rickettsia that is stable in the environment?
Creutzfeldt - Jakob's disease. Patients first develop vague somatic complaints and anxiety - rapidly followed by dysarthria - myoclonus - ataxia - and choreoathetosis.
Chlamydia
Coxiella burnetii
Area 8

4. What form of dementia is characterized by onset at age 40 to 50 - rapid progression - infection by a prion - and death within 2 years?

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5. What CNs arise from x The medulla?
CN IX - X - and XII CN XI arises from the cervical spinal cord.
Integument (skin and its derivatives)
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.

6. Describe the organism based on the following information: x Beta - hemolytic Streptococcus sensitive to bacitracin
Ewing sarcoma
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Streptococcus pyogenes
Look for broken blood vessels in the baby's eyes.

7. Has no underlying pathology.

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8. Name the type of exudate - given the following examples - Meningococcal infection
Respiratory depression
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Purulent exudates
tRNA

9. What is the term of the viral growth period when no viruses can be found intracellularly?
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Positive
The vestibulo - ocular reflex
Eclipse period

10. What happens to NE levels in x Major depression?
Hemochromatosis
Decrease (5- HT and dopamine levels do the same)
Entamoeba histolytica
Rhombencephalon

11. Which of the following
An internal elastic lamina
VLDL
Fat necrosis
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.

12. Name these immature defense mechanisms: x Psychic feelings converted to physical symptoms
Edrophonium
Metastatic
Fourth M PITS for pharyngeal pouch derivatives
Somatization

13. What protective covering adheres to the spinal cord and CNS tissue?
Pia mater
HMG CoA synthase
Renin secretion
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.

14. What cell type of the epidermis functions as antigen - presenting cells?
Superior
Langerhans cells (found in the stratum spinosum)
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
Chromosome 5 - 21

15. What three CNs are associated with conjugate eye movements?
Decreases
Left atrial myxoma
rRNA
CN III - IV - and VI

16. Can be secreted.
B- cell Ag receptors
Posterior
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.
Pons

17. What are the three carboxylase enzymes that require biotin?
Proportionate mortality rate
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
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
Pyruvate - acetyl CoA - and propionyl CoA carboxylase

18. What type of mortality rate is defined as the number of deaths x From a specific cause per population?
Cause - specific mortality rate
Acute toxic or viral nephrosis
A low - resistance system is formed by resistors added in parallel.
Vitamin B12 deficiency and folate deficiency

19. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Cardiac muscle
Stretch receptors prevent overdistension of the lungs during inspiration.
5 years old
Permanent
V wave

20. What happens to intracellular volume when there is an increase in osmolarity?
Hepatic adenomas
Chromosome 21
ICF volume decreases when there is an increase in osmolarity and vice versa.
Ventricular fibrillation (V fib)

21. What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
Vitamin K
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Nondominant temporal lobe

22. What form of poisoning is associated with bitter almond - scented breath?
Chromosome 19
Cyanide
These are the gross pathologic changes associated with Alzheimer's disease.
Crude mortality rate

23. What is the tumor at the bifurcation of the right and left hepatic ducts?
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.
Klatskin tumor
PCR
Sertoli cell

24. Which class of antiarrhythmics are calcium channel blockers?
Class IV
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
CN IV
Achondroplasia

25. Which class of antihypertensives is used in the treatment of BPH?
a - Blockers (- zosins)
CN IX - X - and XII
Round and ovarian ligaments
Conn syndrome (primary hyperaldosteronism)

26. Is a marker for increased bone formation.
Dystrophic calcification
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)
An elevated serum osteocalcin level

27. What happens to the following during skeletal muscle contraction? - I band
Shortens
CD21; it is a complement receptor for cleaved C3
PALS
Brain abscess

28. What Ig is associated with mast cell and basophil binding?
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
Area 4
gag gene

29. Fixing impulses by acting out the opposite of an unacceptable behavior
Coronary circulation
Undoing
Mitosis
Meckel diverticulum

30. What is the term for chronic necrotizing pulmonary infections resulting in permanent airway dilation and associated with Kartagener syndrome?
Both
Large segment deletions
B- cell Ag receptors
Bronchiectasis

31. What is the most common one? - Route for infectious arthritis
Parafollicular C cells
The hallmarks of LMN lesion injury are absent or decreased reflexes - muscle fasciculations - decreased muscle tone - and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget - LMN lesions are ipsilateral at the level of the
Pheochromocytoma
Hematogenous

32. What is the neurotransmitter at the
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Increased GABA levels decrease the likelihood of learned helplessness.
Beta- Endorphin

33. Panic attacks can be induced by __________ or carbon dioxide.
Staphylococcus aureus
Constipation and miosis
Temporal arteritis
hyperventilation

34. What two AAs have a pKa of 4?
Increased erection and libido
The resistance increases 16- fold.
Aspartic acid and glutamic acid
Childhood

35. What statistical method do you use when analyzing x Case control studies?
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
Odds ratio. (Case control studies deal with prevalence.)
Thiabendazole
Since they are independent events - their probabilities would be multiplied.

36. What are the strongest determinants of gender identity?
Parental assignment and culture (not biology)
Breast
Clostridium botulinum
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.

37. Is used to detect Abs in a patient?
Direct fluorescent Ab test
Rheumatic fever
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
Combined metabolic and respiratory acidosis

38. What is the signal to open the voltage - gated transmembrane potassium channels?
Asbestosis
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.
Type II
Skeletal muscle

39. What bonds are broken by endonucleases?

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40. Are the following parameters associated with an obstructive or restrictive lung disorder: decreased FEV1 - FVC - peak flow - and FEV1/FVC; increased TLC - FRC - and RV?
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.
SITS
There are no valves and no smooth muscle in the walls of the veins in the face.

41. The ophthalmic artery is a branch of what vessel?
Rheumatic fever
Chromosome 15
Internal carotid artery
IL-4

42. Name the ventricular muscle membrane channel: x Closed at rest; depolarization causes channels to open slowly
Voltage - gated calcium channel
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Reaction formation
Duodenal ulcer

43. What virus is associated with both nasopharyngeal carcinoma and Burkitt lymphoma?
The liver (in the mitochondria)
EBV
Methylation of bacterial DNA
Oblique fissure

44. What disorder of aldosterone secretion is characterized by x Increased total body sodium - ECF volume - plasma volume - BP - and pH; decreased potassium - renin and AT II activity; no edema?
Primary hyperaldosteronism (Conn syndrome)
The respiratory system
Cefamandole - cefoperazone - and moxalactam
Reserpine

45. Can incidence - prevalence - and cause and effect be assessed in x Cross - sectional studies?
Cross - sectional studies determine prevalence - not incidence or cause and effect.
Transtentorial (uncal)
Aldehyde dehydrogenase
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly

46. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Benzenes
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Protamine sulfate
Stibogluconate
Leukemias

47. What primary acid - base disturbance is caused by a loss in fixed acid forcing the reaction to shift to the right - thereby increasing HCO3- levels?
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
Hematogenous
Azathioprine

48. Name the RNA subtype based on the following: x RNA molecules with enzymatic activity
Ribozymes
Hashimoto thyroiditis
Bainbridge reflex
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.

49. At what vertebral level does the common carotid artery bifurcate?
Hepatitis A
Aspartame
C4 (the upper border of the thyroid cartilage)
Enterohemorhagic Escherichia coli

50. What diagnosis ensues from finding well - demarcated erythematous plaques with silvery scales on the knees - elbows - and scalp along with nail bed pitting and discoloration?
Median (think of it as the halfway point)
Eosinophil chemotactic factor A
Psoriasis
Ganciclovir