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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 for increased iron deposition resulting in micronodular cirrhosis - CHF - diabetes - and bronzing of the skin?
Type III hypersensitivity (immune complex)
Hemochromatosis
Streptococcus viridans
No. Prions are infectious proteins - so antibiotics are useless.

2. What type of correlation is defined as x Two variables with no linear relation to one another?
ater flows from a low - solute to high - solute concentrations.
Hydroxyproline (breakdown product of collagen)
The small subunit (40S) binds first.
Zero correlation

3. What two AAs act as excitatory transmitters in the CNS - generating EPSPs?
Trypsin
C5a
C1 through C4
Glutamine and aspartate

4. What is the term for the number of individuals who have an attribute or disease at a particular point in time?
Prevalence rate
Ependymoma
Rapid efflux of potassium
Bronchioloalveolar carcinoma

5. Why are eukaryotes unable to perform transcription and translation at the same time like prokaryotes?
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Validity (remember - reliability is necessary but not the only thing needed for validity)
Left atrial myxoma

6. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Alkylating agents
Leukemias and lymphomas
Dynorphin
CSF
One - and it provides the energy for mechanical contraction.

7. What is the term given to arthropod - borne viruses?
Axon hillock
The inner membrane of the mitochondria (cristae)
Incidence rate
Arboviruses (bunyavirus - flavivirus - and togavirus)

8. With What three enzymes is thiamin pyrophosphate (TPP) associated?
Mural infarct
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -
Osteogenesis imperfecta
They innervate skeletal muscle.

9. What vessel is lacerated in an epidural hematoma?
Osteoclasts
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Middle meningeal artery
Displacement

10. What is the name of the process in which cells migrate toward an attractant along a concentration gradient?
Squamous cell carcinoma
Transketolase and transaldolase. The reactions they catalyze are reversible.
Axis V
Chemotaxis

11. What cytokine do Th1 cells secrete to inhibit Th2 cell function?
Sarcoplasmic reticulum
INF- gamma
Uric acid
None; it degenerates.

12. What are the adult remnants of the following structures? - Left umbilical vein
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.
Constipation and miosis
Ligament teres
Because creatinine is filtered and a small amount is secreted

13. What cytokines do Th2 cells secrete to inhibit Th1 cell function?
IL-4 - IL-10 - and IL-13
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
Antisocial personality
ATP/ADP Translocase

14. What embryonic structure forms the adult female structures? - Urinary bladder - urethra - greater vestibular glands - vagina
Prader - Willi syndrome and Angelman syndrome - respectively
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.
Urogenital sinus
Histidine - because of the imidazole ring found in the R group - is basic.

15. For what disease are SS- A(Ro) - SS- B(La) - and R- ANA diagnostic markers?
HPVs 16 and 18
Allotypes
Low molecular weight heparin (LMWH)
Sj

16. What is the only way to increase O2 delivery in the coronary circulation?
Increased erection and libido
Repaglinide
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
Chromosome 4p

17. What triad consists of endothelial injury - changes in laminar flow - and hypercoagulation?
Viral meningitis
Virchow triad - associated with the formation of a thrombus.
Degenerates
Escherichia coli

18. The 'tea - and - toast' diet is classically associated with what cause of megaloblastic anemia?
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
The carotid sinus reflex
Uric acid
Folate deficiency (very common in the elderly)

19. How does sympathetic stimulation to the skin result in decreased blood flow and decreased blood volume? (Hint: what vessels are stimulated - and how?)
Ganciclovir
An increase in serum glucose levels
PR interval
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.

20. What type of jaundice is seen in Dubin - Johnson syndrome?
Conjugated (direct) hyperbilirubinemia - a transport defect
SSRIs
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
Candida

21. Name the insulin preparation based on the peak effect and duration of action - Peak - 0.3 to 2 hours; duration - 3 to 4 hours
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
Dysplasia
Pyridoxine
Lispro insulin

22. Should you refer a patient to a form of folk medicine even if you don't believe in it?

23. What area of the brain is linked to emotion and movement?
Mesolimbic system
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
CN XI and X
Excess estradiol in the blood

24. What rate is indicated by 1- sensitivity?
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
Phallus
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
False - negative rate

25. What is the term for neurologic signs consistent with a cerebrovascular accident but lasting 24 hours with full recovery?
Mitral insufficiency
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
Transient ischemic attack
Serocystadenoma

26. What is the term for excessive amounts of granulation tissue that can block re - epithelialization and wound healing?
Clozapine
Fixation (arrested development)
Proud flesh
Menses. (Ovulation occurs 14 days before the beginning of menses.)

27. Is encapsulated.
Medullary carcinoma of the thyroid
Gonococcus
Increased secretion of GH postpuberty leading to acromegaly.
The left is a branch of the aortic arch - while the right is a branch of the brachiocephalic trunk.

28. What is the major Ab of the primary immune response?
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
7 to 14 days
Central. Remember - there is a deficiency in ADH production in the central form.
IgM

29. Clue cells are associated with which organism that causes vaginal discharge?
Sensory
Preoperational (2-6 years)
Gardnerella vaginalis
Gastric carcinoma

30. What type of chromatin is transcriptionally inactive?
Diazoxide
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
igantism
Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle.

31. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Metencephalon
Rhombencephalon
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get
Subarachnoid hemorrhage
absorption

32. Which parasitic organism - when it crosses the placenta - results in intracerebral calcifications - chorioretinitis - microcephaly - hydrocephaly - and convulsions?
Rheumatoid arthritis
Liver
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
Toxoplasma gondii

33. What protein causes fibrinolysis?
The biofeedback model is based on the parasympathetic nervous system.
Left atrium
Plasmin
HPV serotypes 16 - 18 - 31 - and 33

34. What restriction endonuclease site is destroyed in sickle Beta- globin allele?
Depolarization is from apex to base and from endocardium to epicardium.
Staphylococcus aureus
MstII; changing codon 6 (from A to T) destroys the restriction site.
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.

35. Name the type of exudate - given the following examples - Rickettsial infection
Craniopharyngioma
Radial Immuno Diffusion (RID) for Ig levels.
CN V
Hemorrhagic exudates

36. Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium?
Type III hypersensitivity reaction
Zafirlukast
Papovavirus
Carbamazepine

37. How many pairs of spinal nerves are associated with x Cervical vertebrae?
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Early collecting duct
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive - compulsive disorder and learning disabilities.

38. What Brodmann area is associated with x Primary auditory cortex?
Areas 41 and 42
Basophilic stippling
ll
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

39. Via what cell surface receptor does HDL cholesterol from the periphery enter hepatoceles?
Scavenger receptor (SR- B1)
Ea (activation energy)
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels

40. What tetracycline is associated with hepatotoxicity?
Chlortetracycline
CN IX - X - and XI; sigmoid sinus
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle

41. What nerve is associated with the following functions? - Flex the wrist and digits - pronate the wrist and the LOAF (Lumbricales - Opponens pollicis - Abductor pollicis brevis - Flexor pollicis brevis) muscles of the hand
Curling ulcers (think curling iron = burn)
Cohort studies determine incidence and causality - not prevalence.
Median nerve
Obsessive - compulsive

42. 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
rRNA
Cancer
Medial pontine syndrome
It increases Ca2+ excretion from the kidney and increases bone mineralization.

43. What is the primary method of nonverbal communication of emotional states?
Disulfiram
Facial expression (the second is vocal intonation)
CD16 and CD56
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.

44. What statistical method do you use when analyzing x Cohort studies?
The sandfly
TAT (Thematic apperception test)
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)

45. Kayser - Fleischer rings
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
As the standard deviation increases - the greater the chance of error.
Wilson disease
Chromosome 5q21

46. What is the bioactive form of thyroid hormone?
Cardiac output
Heinz bodies
T3
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)

47. What paraphilia is defined as x Deriving sexual pleasure from being abused or in pain?
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns
Ductus epididymis - Which is lined by pseudostratified epithelium with stereocilia.
Masochism
G-6- PD deficiency

48. What is the most common one? - Type of hernia seen in males more than 50 years old
Down syndrome (it is slightly more common than fragile X syndrome.)
Gangrenous necrosis
Adenovirus
Direct; in males less than 50 years old indirect hernias are the most common type.

49. Which thalamic nucleus receives auditory input from the inferior colliculus?
CD8+ T cells (cytotoxic) Remember - 8
MGB
>10 mm
Meckel diverticulum

50. What acid - base disturbance is produced from vomiting?
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
The pH of CSF is 7.33 - acidotic.