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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 term is described as the prestretch on the ventricular muscle at the end of diastole?
Pseudohyphae
Preload (the load on the muscle in the relaxed state)
CN IX and X
Molindone

2. What hormone causes contractions of smooth muscle - regulates interdigestive motility - and prepares the intestine for the next meal?
Testosterone
CMV - Toxoplasma gondii - and Listeria
Left homonymous hemianopsia
Motilin

3. What nerve and artery could be affected in a midshaft humeral fracture?
Cleft lip
Nonsense
Radial nerve and the profunda brachii artery
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts

4. Which prophylactic asthmatic agent is an antagonist of LTD4?
Zafirlukast
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Biotin - ATP - and CO2
The placenta

5. After a longstanding left - to - right shunt reverses - causing cyanosis - and becomes a right - to - left shunt - What is it termed?

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6. What vitamin deficiency causes a glove - and - stocking neuropathy seen in alcoholics?
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Pyridoxine (B6) deficiency
Chi - square.
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament

7. Name the antidote - Atropine
Homeodomain proteins
Wilms tumor
Physostigmine
Dimorphic

8. What phase of the cell cycle are the following antineoplastic agents specific for? - Cisplatin
G0 phase
Hydralazine - isoniazid - and procainamide (HIP)
The stapedius muscle
Pasteurella multocida

9. What two vitamins are inactivated when they come in contact with acetaldehyde?
Mikulicz syndrome
INF- gamma
Adenine and guanine
Thiamine and folate

10. If the family member of a patient asked you to withhold information - would you?
For the USMLE Step 1 the answer is no - but if the information would do more harm than good - withhold. This is very rare but it does occur.
B- cell Ag receptors
Prevalence increases. (Incidence does not change.)
Testicular lymphoma

11. What fat - soluble vitamin is connected to selenium metabolism?
Vitamin E
Elevated ASO titers and serum complement levels
Separation anxiety
robenecid - a uricosuric agent

12. What is the primary target for the action of glucagon?
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Liver (hepatocytes)
1. Big 2. Bilateral 3. Berry aneurysm
To provide attachment between contiguous cells and to maintain a semipermeable barrier

13. What two AAs do not have more than one codon?
Mycoplasma
Right atrium
Methionine (start) and tryptophan are the only two AAs with only one codon.
Embolism

14. Name the lipoprotein based on the following characteristics - apo E
IDL
A gene (a rather simple definition but accurate)
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Acute CO poisoning

15. What are the four ways to increase TPR?
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Stretch receptors prevent overdistension of the lungs during inspiration.
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels

16. What is the most common form of inherited dwarfism?
IGF-1 (somatomedin 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
Achondroplasia
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.

17. What toxin ADP- ribosylates via Gs protein to increase cAMP?
Integrase
A patent processus vaginalis
Cholera toxin
ASA

18. Has no underlying pathology.

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19. Name the neurotransmitter at the neuromuscular junctions for all of the voluntary muscles in the body.
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
ACh; think about the ANS.
Preductal (infantile)
The rate of Beta- oxidation

20. Name these narcissistic defense mechanisms: x Not allowing reality to penetrate because afraid of becoming aware of painful aspect of reality.
Denial
Eosin
Primary intention
The energy of activation (Ea)

21. What is the term for the negative resting membrane potential becoming more negative?
Hyperpolarization (i.e. - K+ influx)
Southern blot
GP41
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

22. What enzyme is blocked by 5- FU?
Beta2- integrins
Thymidylate synthetase
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Lead poisoning

23. What form of antimicrobial therapy is best for an immunocompromised patient?
IF and GTP (eIF for eukaryotes)
Bactericidal
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.

24. What virus is associated with the Norwalk agent?
Calicivirus
Secondary hypercortisolism (pituitary)
Frameshift
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.

25. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Third ventricle
Dihydropteroate synthetase
Proencephalon
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.
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.

26. What is the only neuroleptic that does not cause an increase in weight or appetite?
Secondary hypoparathyroidism (vitamin D toxicity)
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.
Superior and posterior
Molindone

27. What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Escherichia coli and Pseudomonas sp.
Thoracic splanchnic fibers
Imipenem and meropenem
Thymidylate synthase

28. Do not have MHC class I Ags on their surface.
RBCs
Primary hyperparathyroidism
Hereditary spherocytosis
Flumazenil

29. What is the most common genetic cause of mental retardation?
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
Diverticulosis
Down syndrome (it is slightly more common than fragile X syndrome.)
Kimmelstiel - Wilson disease

30. What AD disease is associated with chromosome 4p; does not present until the person is in his or her 30s; and involves atrophy of the caudate nucleus - dilatation of the lateral and third ventricles - and signs of extrapyramidal lesions?
Huntington disease
Axon hillock
AML- M3
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.

31. 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.
Iatrogenesis
Burkitt lymphoma
For males it's prostate cancer - and for females it's breast cancer.

32. What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?
Mesonephric duct
Prolactin
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Filiform papillae

33. Name the most common type or cause - Nonorganic pneumoconiosis
Left atrial myxoma
1. Large sample size 2. Large effect size 3. Type I error is greater
Afterload
Asbestosis

34. What a1- agonist - not inactivated by catechol - O- methyl transferase (COMT) - is used as a decongestant and for treatment of paroxysmal atrial tachycardia?
C1 - C2 - or C4 deficiency
Cohort studies determine incidence and causality - not prevalence.
Phenylephrine
CD3

35. What prokaryotic positioning enzyme in translation is blocked by the following? - Tetracycline
CN VII and VIII
EF- Tu and EF- Ts of the 30S ribosomal subunit
eIF-2 in the P site
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.

36. What CNs arise from x The medulla?
Sphingosine
Yolk sac tumor
Albumin
CN IX - X - and XII CN XI arises from the cervical spinal cord.

37. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Spinal nerve?
Both
Griseofulvin
Yolk sac tumor
Free ionized Ca2+

38. What is the term for thymic induction of T cells with high - affinity Ag receptors for self that are programmed to undergo apoptosis?
Gain of hypertonic fluid (mannitol or hypertonic saline)
Hydroxyproline
Left colic - superior rectal - and sigmoidal arteries
Negative selection. This helps to prevent autoimmune diseases.

39. What disorder is described as having x Conscious symptoms with unconscious motivation?
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Factitious disorder
At the end of the PCT 25% of the original volume is left

40. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF normal - capillary pressure ?
Entamoeba histolytica
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
Between the renal arteries and at the bifurcation of the abdominal aorta
Dilation of afferent arteriole

41. Inhibition of peripheral aromatic amino acid decarboxylase and increased CNS availability of L- dopa are results of what drug used in the treatment of Parkinson's disease?
Good Samaritan Law. (Physicians are not required to stop and help.)
Carbidopa and benserazide
Coronary circulation
Eosin

42. What type of cell surface projection lies on the lateral surface of cells closest to the apex and acts to seal off the outside environment from the rest of the body?
Melanocytes
emancipates
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
Zonula occludens (tight junctions)

43. What percentage of nephrons is cortical?
Peyer's patch
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Vaginismus; it is the female counterpart of premature ejaculation.
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.

44. Name the B- cell CD marker: x Required for class switching signals from T cells
Reverse transcriptase
Chromosome 11p
CD40
HBsAg as its envelope

45. What rapidly progressive and aggressive T- cell lymphoma affects young males with a mediastinal mass (thymic)?
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
Lymphoblastic lymphoma
Total ventilation (minute ventilation or minute volume)
IgA

46. What blotting technique uses the following for analysis? - Protein
DiGeorge's syndrome
Chromosome 11 - 22
Thymus - independent Ags
Western blot

47. There are no central ___ receptors.
School phobia
HIV and poxvirus
Axon hillock
O2

48. What two forces affect movement of ions across a membrane?
Concentration force and electrical force
G0 phase
Sphingomyelin (lecithin also - but it is not a sphingolipid)
Molindone

49. What is the MCC of the following meningitides? - In military recruits
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age
RNA polymerase II
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Neisseria meningitides

50. What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?
Onion skinning
Nitrates
Niacin (B3)
1. VSD 2. ASD 3. PDA