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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 tremor that occurs during movements and is absent while the person is at rest?
Calcium oxylate
Negative reinforcement
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e. - pill rolling) is seen in basal ganglia lesions.
Medial meniscus

2. What area of the brain serves as the major sensory relay center for visual - auditory - gustatory - and tactile information destined for the cerebral cortex - cerebellum - or basal ganglia?
Ascaris lumbricoides
Maxillary artery
Fading
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)

3. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x cyclin D
Stranger anxiety
Neisseria meningitides
Mantle cell lymphoma
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see - can't wee - can't kick with your knee

4. Name the phase of the ventricular muscle action potential based on the following information: x Fast channels open - then quickly close - and sodium influx results in depolarization
Ulnar nerve
Phase 0
5 years old
IQ

5. What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?
Dilation of afferent arteriole
Chromosome 15
Pneumocystis carinii
Volvulus

6. What is the DOC for severe infections with Sporothrix - Mucor - Histoplasma - Cryptococcus - Candida - and Aspergillus?
Amphotericin B
Bipolar disorder (manic - depressive disorder)
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
Sheehan syndrome

7. A marfanoid patient presents with tearing retrosternal chest pain radiating to her back. What is your first diagnosis?
Rifampin
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.
Yes. The only civil liberty they lose is the freedom to come and go as they please.
Incidence rate

8. When is the surface tension the greatest in the respiratory cycle?
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Yolk sac tumor
GnRH pulsatile infusion
Internal 3' - 5' PDE bonds

9. What area of the small intestine is characterized by Peyer's patches?
Ileum
Thymus gland. (Thymus gland is essential for T cell maturation.)
Libman - Sacks endocarditis
Emphysematous bleb

10. Blood and its vessels form During What embryonic week?
Rhabdomyoma
Aldehyde dehydrogenase
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.
Third week; they are derived from the wall of the yolk sac.

11. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Dysphoria - irritability - musical and visual abilities decreased
Liver - kidney - and GI epithelium
Interval scale (a ruler - for example)
Nondominant temporal lobe
B cells; macrophages and dendritic cells are nonspecific.

12. Circulating levels of what hormone cause the cervical mucus to be thin and watery - allowing sperm an easier entry into the uterus?
Escherichia coli
Renin
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
Estrogen

13. What is the antidote for organophosphate ingestion?
Clozapine
Atropine and 2- PAM (pralidoxime)
Streptococcus viridans
Infiltrating ductal carcinoma

14. What apoprotein on HDL activates lecithin - cholesterol acyltransferase (LCAT)?
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
Papillary carcinoma of the thyroid
Paroxysmal nocturnal hemoglobinuria
apo A-1

15. What tract is responsible for voluntary refined movements of distal extremities?
Corticospinal tract
Renal failure
Meiosis I; disjunction with centromere splitting occurs during meiosis II.
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors

16. Name the compartment of the mediastinum associated with the following thoracic structures: Thymus
Superior and anterior
Bunyavirus
Mitochondria
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate

17. In what stage of psychosexual development - according to Freud - do children resolve the Oedipus complex?
Metastatic
17- alpha - Hydroxylase deficiency
Familial hypercholesterolemia
Latency stage (6-12 years)

18. What are the adult remnants of the following structures? - Left umbilical vein
Pseudomonas
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.
Ligament teres
Hemangioblastoma

19. What CN nucleus receives auditory information from both ears via the cochlear nuclei?
Secondary lysosome (think of the primary as inactive and secondary as active)
Left homonymous hemianopsia
Secondary hypocortisolism (pituitary)
Superior olivary nucleus

20. Are the quadrate and caudate lobes of the liver functionally part of the left or right lobe?
Chromosome 17
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.

21. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Psychosocial and environmental problems (stressors)?
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Axis IV
Depression
They are all formed by the fifth month of fetal life.

22. What component of the ETC is inhibited by the following? - Oligomycin
Anticentromere Abs
Permanent
Rhombencephalon
Fo/F1 complex

23. What is the most common one? - Bone disorder in the United States
Galactitol
Osteoporosis
The courts. These are legal - not medical terms.
Metaproterenol and albuterol

24. What component of the inner ear x Contains endolymph and responds to head turning and movement?
Semicircular duct
Glycogen phosphorylase
Viruses
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.

25. What is the neurotransmitter at the K- receptor?
Parvovirus B 19
HTN
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
Dynorphin

26. What cytoplasmic pathway produces NADPH and is a source of ribose 5- phosphate?
Cirrhosis
HMP shunt
Gout
Stable

27. What does failure of PaO2 to increase with supplemental O2 indicate?
Pulmonary shunt (i.e. - pulmonary embolism)
Herpesvirus
The sensory limb is via CN IX - and the motor limb is from CN X.
Pearson correlation

28. What type of symptoms in schizophrenia are associated with x Dopamine receptors?
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.
Amyl nitrate - sodium nitrate - or sodium thiosulfate

29. How many pairs of spinal nerves are associated with x Lumbar vertebrae?
2 to 4 hours
Sarcoidosis
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
No CHO - AA - ketones - or peptides are left in the tubular lumen.

30. What are the two precursors of heme?
Phase III. It is considered the definitive test.
LTB4
positive correlation
Glycine and succinyl - CoA

31. Name the structure that enters or exits the following foramina: x Foramen ovale
Simple diffusion; it does not use protein - mediated transport
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
The energy of activation (Ea)
CN V3 and the lesser petrosal nerve

32. What Brodmann area is associated with x Primary visual cortex?
Area 17
Rhombencephalon
Bronchogenic carcinoma
Compliance; the more compliant a lung is - the easier it is to inflate.

33. What embryonic structure forms the following adult structures? - Median umbilical ligament
Urachus
Moving objects - along with large bright objects with curves and complex designs.
Ventral posterolateral nucleus
The CD4 T cell; the APC is the first cell in the immune response.

34. Name the most common cause - Blindness worldwide
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
Epidermophyton
Chlamydia trachomatis
IgG

35. What component of the ETC is inhibited by the following? - CO
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
1. ADP 2. PG 3. TXA2
Cytochrome a/a3
Chordae tendineae

36. What four factors affect diffusion rate?
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
Mitral valve stenosis
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe
Cohort studies determine incidence and causality - not prevalence.

37. What gram - positive rod is distinguished by its tumbling motility?
HBeAb
Listeria
Neuroblastoma
Giardia lamblia (treat with metronidazole)

38. Is Dubin - Johnson or Rotor syndrome associated with black pigmentation of the liver?
Turner syndrome
The interposed nucleus
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.

39. Which CNs are found in the midline of the brainstem?
HPV infection
Riedel thyroiditis
Diabetes mellitus
CN I - II - III - VI - and XII Add 1 + 1 = 2 - 1 + 2 = 3 - 1 + 2 + 3 = 6 - 1 + 2 + 3 + 6 = 12

40. What embryonic structure forms the adult male structure? - Epididymis - ductus deferens - seminal vesicle - and ejaculatory duct
EF-2 and GTP
REM and stage 4 sleep; they decrease.
Mesonephric duct
Staphylococcus aureus

41. What is the term for a deficiency or absence of sexual fantasies or desires?
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
Specific rate (e.g. - men aged 55-60)
Hypoactive sexual desire disorder
Ventral lateral nucleus

42. Which one of the cerebellar peduncles is mainly responsible for outgoing (efferent) information?
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
Shaping (successive approximation)
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.

43. Which type of hepatitis is a picornavirus?
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
Helicobacter pylori - Which is also associated with an increased risk of gastric carcinoma
GP IIb and IIIa receptors
Hepatitis A (infectious)

44. What intrauterine deficiency leads to failure to thrive - mental retardation - motor incoordination - and stunted growth?
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
hCG can be detected in the blood by day 8 and in the urine by day 10.
Iodine - resulting in congenital hypothyroidism
The vestibulo - ocular reflex

45. What is the DOC for the treatment of the late phase response in an asthmatic attack?
Direct pathway; a good example is Parkinson's disease.
C1 - C2 - or C4 deficiency
Corticosteroid
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.

46. Which three factors cause the release of epinephrine from the adrenal medulla?
Listeria monocytogenes
Areas 41 and 42
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
Thyroid gland

47. In What area of the GI tract does iron get absorbed?
Duodenum
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
Jejunum (upper)

48. What antiviral agents inhibit neuraminidases of influenza A and B?
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
Zanamivir and oseltamivir
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Histidine

49. What a1- agonist is used to treat paroxysmal atrial tachycardia with hypotension?
Metaraminol (a1 - Beta1 )
Placental alkaline phosphatase
Succinyl CoA
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.

50. HIV's capsid - core nucleocapsid - and matrix proteins are products of what structural gene?
gag gene
Middle meningeal artery
Calcium influx secondary to slow channel opening
The conversion of tyrosine to dopamine in the cytoplasm

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USMLE Step 1 Prep

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