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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 splanchnic carries preganglionic parasympathetic fibers that innervate the hindgut and the pelvic viscera?
4 years old
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
Medial pontine syndrome
Pelvic splanchnics (They all begin with P.)

2. What vitamin deficiency causes a glove - and - stocking neuropathy seen in alcoholics?
Crohn disease
Pyridoxine (B6) deficiency
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Residual volume

3. Name the structure that enters or exits the following foramina: x Foramen ovale
Tay- Sachs disease
3 to 4 days
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
CN V3 and the lesser petrosal nerve

4. Name the most common cause - A cold in the winter and summer
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
Preductal (infantile)
Coronavirus
Occipital lobe

5. What percentage of the bone marrow must be composed of blast for leukemia to be considered?
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)
Eosinophilic exudates
At least 30% blast in the bone marrow
Thick skin

6. Bloody tap on lumbar puncture
Glanzmann syndrome
Rickets prior to fusion - osteomalacia if the deficiency occurs after epiphyseal fusion.
Subarachnoid hemorrhage
Granulosa cell tumor of the ovary

7. What is the term for recurrent and persistent pain before - after - or during sexual intercourse?
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Frameshift
Nystagmus and ataxia
Amygdala; it helps imprint an emotional response in memory.

8. Is excretion greater than or less than filtration for net secretion to occur?
IgM
Citrate - via the citrate shuttle
Excretion is greater than filtration for net secretion to occur.
Hyperplasia

9. All spore formers are...
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.
gram positive
Acarbose

10. What is the term for RBC remnants of nuclear chromatin in asplenic patients?
Folate deficiency (very common in the elderly)
Fluconazole
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase
Howell - Jolly bodies

11. What is the costliest health care problem in the United States?
Molluscum contagiosum
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Alcohol and its related problems cost the country approximately $100 billion a year.
Labile

12. What is the only way to increase maximum velocity (Vmax)?
Zanamivir and oseltamivir
Increase enzyme concentrations
Estrone
Premature ejaculation

13. Name the phase of the eukaryotic cell cycle: x Period of cellular growth (translation and transcription) after DNA synthesis
G2 phase (gap 2)
Bitemporal heteronymous hemianopsia
Residual volume
Pedophilia

14. What three PGs are potent platelet aggregators?
Blood
Wernicke's encephalopathy
PGE 1 - PGI 2 (most potent) - and TXA 2
Testosterone

15. Why is there an increase in prolactin if the hypothalamic - pituitary axis was severed?
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed - thereby increasing the secretion of prolactin.
Alcohol consumption
Acute tubular necrosis

16. Can correct mistakes - whereas RNA polymerases lack this ability.
Hematogenous
Rotavirus
Amanita phalloides
DNA polymerases

17. Where are the tonsillar tissues?

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18. Damage to what nerve will give you winged scapula?
Pseudomonas aeruginosa
Arginine
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
Chi - square.

19. Describe the organism based on the following information: x Beta - Hemolytic Streptococcus; positive cAMP test; hydrolyzes hippurate
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Streptococcus agalactiae
Neuroblastoma
IL-4 - IL-10 - and IL-13

20. What enzyme deficiency results in darkening of the urine when exposed to air?
Infrapatellar bursa
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
VIPoma
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.

21. What Brodmann area is associated with x Somatosensory association cortex?
11- Beta - Hydroxylase deficiency results in excess production of 11- deoxycorticosterone - a weak mineralocorticoid. It increases BP - Na+ - and ECF volume along with production of adrenal androgens.
Type III
Areas 5 and 7
Hydrolysis

22. How far below ideal body weight are patients with anorexia nervosa?
Axis III
Rickets prior to fusion - osteomalacia if the deficiency occurs after epiphyseal fusion.
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.
At least 15%

23. In an adrenergic nerve terminal - Where is dopamine converted to NE? By what enzyme?
Carbamazepine
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
Osteoma
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.

24. What is the most common one? - Acquired GI emergency of infancy
Chromosome 11p
Massive influx of calcium
Adhesions and hernias
Necrotizing enterocolitis

25. What are the three characteristics of autoregulation?
Lente or NPH insulin (neutral protamine Hagedorn insulin)
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Asbestosis
Proencephalon

26. What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
The venae recta maintain the gradient via countercurrent flow.
Anxiety disorders; for men it is substance abuse.
Intraductal papilloma
Fixed interval

27. The probability that a person with a negative test result is truly disease free refers to what value?
Sexual aversion disorder
Negative predictive value
Disorganized schizophrenia
Being a white male

28. The lack of dopamine production in the substantia nigra leads to the ______________ - characteristically seen in patients with Parkinson's disease.
Emphysema
extrapyramidal dysfunction
Secondary lysosome (think of the primary as inactive and secondary as active)
Mitosis

29. What ocular muscle x Depresses and abducts the eyeball?
Chromosome 11p
Superior Oblique (CN IV) (LR6 SO4)3
First - pass effect
Ileum

30. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Months to years after transplantation; gradual onset of HTN - oliguria - and azotemia; seen as intimal fibrosis of the blood vessels and in
impermeable to water
Kl
Chronic rejection
Helicase (requires ATP for energy)

31. What follicular cell possesses FSH receptors and converts androgens into estradiol?
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia
Truncus arteriosus
Granulosa cells
The liver (in the mitochondria)

32. What area of the lymph node contains germinal centers?
Heinz bodies
The outer cortex contains most of the germinal centers and therefore also most B cells.
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
Ulcerative colitis

33. What is the term for nonneoplastic abnormal proliferation of cell size - shape - and cellular organization?
Plasmodium vivax
Dysplasia
SSRIs
The rate of infusion

34. Why is the apex of the lung hypoventilated when a person is standing upright?
Type II hypersensitivity (cytotoxic)
Vitamin D
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.

35. What form of renal tubular reabsorption is characterized by high back leak - low affinity for substance - and absence of saturation and is surmised to be a constant percentage of a reabsorbed filtered substance?
Orbitomedial frontal lobe
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol
Epidermophyton
Gradient - time system

36. What rare vasculitis has the following characteristics: males aged 40 to 60; affecting small arteries and veins; involving nose - sinuses - lungs - and kidneys; C- ANCA and autoantibodies against proteinase 3?
Streptococcus agalactiae
Wegener granulomatosis
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases
Secondary hypocortisolism (pituitary)

37. What cell of the duodenum contains high concentrations of lysozymes and has phagocytic activity?
Lateral rectus (CN VI) (LR6 SO4)3
Osteoma
Paneth cells
Meningocele All except occulta cause elevated - fetoprotein levels.

38. What protein carries free fatty acids to the liver?
Albumin
Right and left pulmonary arteries and the ductus arteriosus
Flutamide
Posterior

39. What form of depression is due to abnormal metabolism of melatonin?
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
Basophilic stippling
Seasonal affective disorder (treat with bright light therapy)

40. What is the term for the ability of a test to measure something consistently?

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41. What condition results from a deficiency in the enzyme hexosaminidase A?
Class II
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Potter facies
Tay- Sachs disease

42. At what vertebral level does the common carotid artery bifurcate?
Secondary lysosome (think of the primary as inactive and secondary as active)
Stratum lucidum
EF-1 and GTP
C4 (the upper border of the thyroid cartilage)

43. What is the term for a schizophrenic episode lasting longer than 30 days with full return to former functioning capacity?
Courvoisier's law
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)

44. What organism is commonly associated with a cellulitis from an animal bite?
Free - unprocessed Ag
Pasteurella multocida
HBc Ab
Phenylalanine hydroxylase

45. What paraphilia is defined as x Deriving sexual pleasure from other peoples' pain?
Carnitine acyltransferase - I
Ego
Sadism
Basophilic stippling

46. What syndrome is associated with the following brainstem lesions? - AICA or superior cerebellar artery occlusion - resulting in ipsilateral limb ataxia - ipsilateral facial pain and temperature loss - contralateral loss of pain and temperature to the
Congenital heart disease
Water soluble
Ulnar nerve
Lateral pontine syndrome

47. Name the muscle type based on the histological features: x Actin and myosin in sarcomeres; striated; uninuclear; gap junctions; troponin:calcium binding complex; T tubules and SR forming dyadic contacts; voltage - gated calcium channels
PALS
Cardiac muscle
Clostridium perfringens
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.

48. Which CHO is independently absorbed from the small intestine?
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
PGD2 - PGE2 - and PGF 2
Legionella (think air conditioners)
Omphalocele and gastroschisis

49. What two substances stimulate Sertoli cells?
FSH and testosterone
3' end. Phosphate (PO4) is at the 5' end.
Hyperplasia
GH- producing adenoma

50. What happens to the following during skeletal muscle contraction? - Sarcomere
S phase
Shortens
Paget disease (osteitis deformans)
Enterokinase