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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 name of the T cell - rich area of the lymph node?
Paracortex
Spectinomycin
Squamous cell carcinoma
Voltage - gated channel

2. What classical conditioning therapy or modification is described as x Triage of a hierarchy of fears (from least to most) - then teaching muscle relaxation techniques in the presence of those fears until the subject is not afraid anymore?
Kartagener's syndrome (also known as immotile cilia syndrome) -------------------------------------------------------------------------------
2 ATPs by oxidative phosphorylation
Systematic desensitization
Reiter syndrome

3. How many hydrogen bonds link A- T? C- G?
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
Clavicle - acromion - and glenoid fossa of the scapula and the humerus
Resistance decreases as resistors are added in parallel.
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.

4. By removing Na+ from the renal tubule and pumping it back into the ECF compartment - What does aldosterone do to the body's acid - base stores?
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Omega -3; linoleic is omega -6
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.
Hypotonia (rag doll appearance)

5. Per Freud - with What part of the unconscious are sex and aggression (instincts) associated?
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Spleen
Id
None; they are not formed until a girl reaches puberty.

6. What hormone is characterized by the following renal effects? - Calcium reabsorption - phosphate excretion
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Coarctation of the aorta
PTH
Emphysema

7. After traveling in a plane across the Atlantic Ocean - an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose?
Pentoxifylline
Areas 18 and 19
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
Pulmonary embolism due to a DVT; this is not absolute but a classic description.

8. What type of hormone is described as having intracellular receptors - being synthesized as needed - mostly bound to proteins - and having its activity determined by free hormone levels?
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.
Candida albicans
Lipid - soluble hormones are considered slow - acting hormones.
Proximal tubule

9. Males are more likely to develop _______ than females.
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Type III
Femoral hernias
Ganciclovir

10. What muscles make up the rotator cuff?
SITS
The liver (in the mitochondria)
Streptococcus viridans
Trichomonas vaginalis (treat with metronidazole)

11. What component of the ANS is responsible for dilation of the blood vessels in the erectile tissue of the penis - resulting in an erection?
Mean
Parasympathetics (parasympathetics point - sympathetics shoot)
Metaproterenol and albuterol
Macule (e.g. - a freckle)

12. What pancreatic islet cell tumor is associated with hypoglycemia - sweating - hunger - confusion - and increased C- peptide levels?
Paneth cells
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Ulcerative colitis
Insulinoma

13. What are the five terminal branches of the facial nerve?
Ventricular fibrillation (V fib)
JC virus
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)
1. ADP 2. PG 3. TXA2

14. What disorder causes joint stiffness that worsens with repetitive motion - crepitus - effusions - and swelling and commonly affects the knees - hips - and spine?
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
Turner syndrome
Intrinsic factor (IF)
Osteoarthritis

15. What type of correlation compares two ordinal variables?
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
Spearman correlation
Adenosine deaminase
P24

16. Schiller - Duval bodies
Yolk sac tumor
Nasal polyps - rhinitis - and aspirin hypersensitivity
Palindrome
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age

17. Name the hepatitis virus based on the following information - Naked capsid RNA calicivirus
Hepatitis E
Hypnozoite
The urea cycle
Lysosomal a -1 - 4- glucosidase

18. In biostatistics - What are the three criteria required to increase power?
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
1. Large sample size 2. Large effect size 3. Type I error is greater
Postductal coarctation of the aorta (adult)
Leydig cell tumor

19. What bedside test is used to differentiate a dorsal column lesion from a lesion in the vermis of the cerebral cortex?

20. What thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 increased
Class IV
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
Metaraminol (a1 - Beta1 )
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.

21. What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells - not a fixed number?
Streptococcus agalactiae (Group B Streptococcus - or GBS)
Increased androgen secretion at puberty drives the increased GH secretion.
Cervical neoplasia
Log - kill hypothesis (follows first order kinetics)

22. How many codons code for AAs? How many for termination of translation?
Toxic or viral hepatitis
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.
Ampulla
Ribonucleotide reductase

23. What are the three posttranscriptional modifications?

24. What hematologic malignancy is treated with the monoclonal antibody rituximab?
Proencephalon
Renin secretion
Mode
Non - Hodgkin lymphoma

25. All Proteus species are...
urease positive
Magnesium
Uroporphyrinogen I synthetase
Gangrenous necrosis

26. What stage of male development is characterized by the following LH and testosterone levels? - Both LH and testosterone levels drop and remain low.
Adrenarche
Infiltrating ductal carcinoma
Childhood
Altruism

27. What androgen receptor blocker is used in the treatment of prostatic cancer?
Flutamide
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
Tropomyosin

28. What enzyme catalyzes the rate - limiting step in fatty acid oxidation?
CN XI - vertebral arteries
Staphylococcus aureus
Carnitine acyltransferase - I
Areas 41 and 42

29.
prior to birthThe foramen ovale closes just...
The inner cortex (paracortex) contains the T cells - so it is considered the thymic - dependent area.
GP IIb and IIIa receptors
Choriocarcinomas and trophoblastic tumors

30. When does most of the NREM sleep (stage 3 and 4) occur - in the first or second half of sleep?
Osteosarcoma
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
8 to 25 hours
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.

31. What two substances stimulate Sertoli cells?
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)
FSH and testosterone
Stretch receptors prevent overdistension of the lungs during inspiration.
Ipsilateral flaccid paralysis

32. What is the most common one? - Helminth parasitic infection in the United States
Aldolase B deficiencies are treated by eliminating fructose from the diet.
Akathisia
Pneumococcus (Streptococcus pneumoniae)
Enterobius vermicularis

33. What substance found in eosinophils is toxic to parasitic worms?
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Major basic protein
Diacylglycerols and phosphatidic acid
Histidine

34. What case is known as 'let nature take its course'?
All (nearly 15-20 times the normal risk)
Postinfectious GN
Progestin
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.

35. What ribosomal subunit binds first to the mRNA strand?
The small subunit (40S) binds first.
They innervate LMNs.
CML and All
Purine nucleoside phosphorylase

36. Name the antidote - Atropine
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).
Physostigmine
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
Amyloidosis

37. What happens to extracellular volume with a net gain in body fluid?
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
GLUT 4
tRNA

38. What are the three main functions of surfactant?
0157:H7
Primary hypocortisolism (Addison's disease)
Lateral part of the hemispheres
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension

39. Name the macrophage based on its location: x Lung macrophages
Homocysteine methyl transferase and methylmalonyl CoA transferase
Nitrofurantoin
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Pulmonary alveolar macrophages

40. What component of the inner ear x Contains endolymph and gravity receptors monitoring linear acceleration and deceleration of the head - noting changes in head position?
Left: stomach - spleen - and left kidney; right: liver - duodenum - and right kidney
Stranger anxiety
Utricle and saccule
Clostridium botulinum

41. What benign bone tumor is associated with Gardner syndrome?
Kidney
Metastatic carcinoma
Osteoma
Eclipse period

42. Megaloblastic anemia and thrombocytopenia are signs of what vitamin deficiency?
The fast component is directed toward the affected side of a cerebellar lesion.
Decreased REM sleep and REM rebound during withdrawal
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
Folic acid deficiency

43. What hormone - produced by Sertoli cells - if absent would result in the formation of internal female structures?
IF
Parietal cells (Remember - they secrete HCl - too.)
Akathisia
Metaproterenol and albuterol

44. Name the cluster B personality disorder: x In a constant state of crisis - promiscuous - unable to tolerate anxiety- causing situations - afraid of being alone - and having intense but brief relationships
Borderline
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.
Streptococcus pneumoniae
Humor

45. What is the most common opportunistic infection of the CNS in HIV?
Lymphoblastic lymphoma
Toxoplasmosis
Brucella
Complex I

46. What cell in the heart has the highest rate of automaticity?
Zileuton
Finasteride
Transposons
SA node; it is the reason it is the primary pacemaker of the heart.

47. What is the term for the unidirectional attraction of cells toward a chemical mediator released during inflammation?
Eisenmenger's syndrome
Chemotaxis
Staphylococcus saprophyticus
Menses

48. What syndrome is described as bilateral lesions of the amygdala and the hippocampus resulting in placidity - anterograde amnesia - oral exploratory behavior - hypersexuality - and psychic blindness?
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
Arch of the aorta
Kl
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.

49. How many pairs of spinal nerves are associated with x Cervical vertebrae?
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
GABA and glutamic acid
Secondary hypercortisolism (pituitary)
Streptococcus viridans

50. Name the cluster C personality disorder: x Orderly - inflexible - perfectionist; makes rules - lists - order; doesn't like change - has a poor sense of humor - and needs to keep a routine
Allotypes
Obsessive - compulsive
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
Amanita phalloides