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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. Name the macrophage based on its location: x Lung macrophages
Allograft
Pulmonary alveolar macrophages
Depolarization is from apex to base and from endocardium to epicardium.
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.

2. Mallory bodies
Stibogluconate
Lateral pontine syndrome
Chronic alcoholic
Size

3. What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
The splenic vein
Id
Hypertrophy

4. Name the lung measurement based on the following descriptions: x Additional air that can be taken in after normal inspiration
Simple diffusion; it does not use protein - mediated transport
Inspiratory reserve volume (IRV)
Mumps and influenza virus
Hurler syndrome and Hunter syndrome - respectively

5. What ocular muscle x Abducts the eyeball and is involved in horizontal conjugate gaze?
Both
Lateral rectus (CN VI) (LR6 SO4)3
Valence
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.

6. What area of the nephron is sensitive to the effects of ADH?
Nasal polyps - rhinitis - and aspirin hypersensitivity
Collecting ducts - which make them readily permeable to water reabsorption.
Vitamin E
Breast cancer

7. What parasite found in raw fish can produce vitamin B12 deficiency?
Proud flesh
Pregnancy
Arthroconidia with hyphae
Diphyllobothrium latum

8. What mineral deficiency involves blood vessel fragility?
Areas 44 and 45
Superior gluteal nerve
Copper deficiency
Thiamine

9. What is the name of the regulatory protein that covers the attachment site on actin in resting skeletal muscle?
Mesencephalic nucleus
Simon focus
Tropomyosin
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.

10. Name the valve abnormality based on the following criteria: x Systolic murmur - increased preload and afterload - decreased aortic pulse pressure and coronary blood flow
Aortic stenosis
Musculophrenic and superior epigastric arteries
A gene (a rather simple definition but accurate)
Multiple sclerosis

11. What is the term for nonneoplastic abnormal proliferation of cell size - shape - and cellular organization?
Lead poisoning
Gastrinoma
Legionella (think air conditioners)
Dysplasia

12. What is the label given to an individual whose IQ is x 110 to 119
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
High average
IgG4
Pernicious anemia (secondary to a lack of vitamin B12 absorption)

13. What myeloid disorder is characterized by dry bone marrow aspirations - splenomegaly - leukoerythroblastosis - teardrop RBCs - and hyperuricemia due to increased cell turnover?
Outside the cell
Myelofibrosis with myeloid metaplasia
C1 - C2 - or C4 deficiency
Marijuana

14. The most frequent number occurring in a population is what?
Mode
AT II
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
Global aphasia

15. Name the phase of the eukaryotic cell cycle: x Cells cease replicating (i.e. - nerve cell)
Giant cell tumor of the bone
G0 phase
Skeletal muscle
CD19

16. What lipoprotein is formed if an IDL particle acquires cholesterol from a HDL particle?
LDL
Down syndrome (it is slightly more common than fragile X syndrome.)
Caplan syndrome
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.

17. Are excitatory neurotransmitters in the CNS.
Left heart failure
Diacylglycerols and phosphatidic acid
GABA and glutamic acid
Moving objects - along with large bright objects with curves and complex designs.

18. What is the most common one? - Tumor in individuals exposed to asbestos
Bronchogenic carcinoma
External abdominal oblique
Mesencephalon
Flea - bitten kidney (can also be seen in pyelonephritis)

19. HIV's capsid - core nucleocapsid - and matrix proteins are products of what structural gene?
Dihydrofolate reductase
4.7 L - 5% of body weight
3' end. Phosphate (PO4) is at the 5' end.
gag gene

20. Are contraindicated in patients who present to the hospital with CHF.
Palindrome
Beta- Blockers
At 8 to 9 years of age. Prior to this age they view death as a form of punishment.
Cancer

21. Without ADH the collecting duct would be...
Right coronary artery
Filtration is greater than excretion for net reabsorption to occur.
impermeable to water
Calcium influx secondary to slow channel opening

22. Name the macrophage based on its location: x Bone macrophages
Osteoclasts
Chloramphenicol
Invasive ductal carcinoma
Necrophilia

23. Name these cluster A personality disorders: x Baseline mistrust; carries grudges; afraid to open up; uses projection as defense mechanism; lacks hallucinations or delusions
Paranoid
HBcAb and HBeAb. You see the antibodies c and e.
Chromosome 13
Glutamate dehydrogenase

24. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Denial of illness - hemineglect - construction apraxia (can't arrange matchsticks)
Nondominant parietal lobe
Stratum spinosum
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Ergosterol

25. What Ag is needed to diagnose an infectious patient with hepatitis B?
HBeAg
Clearance
Imipenem and meropenem
Succinyl CoA synthetase

26. Oxidation of Hgb forms what bodies in patients with G-6- PD deficiency?
Common and internal carotid arteries
Heinz bodies
Arcuate line
Raloxifene

27. What is the most important determinant of drug potency?
Labetalol
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)
The affinity of the drug for its receptor
Positive sense RNA means it can serve as mRNA and therefore has 5'-3' polarity

28. Name the 10 retroperitoneal organs.
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.
Bronchogenic carcinoma
Schistosoma have separate males and females.

29. The clearance of what substance is the gold standard of GFR?
Hypersegmented neutrophils
Neuroblastoma
Lung cancer
Inulin

30. The nucleus is the site of...
Pulmonary alveolar macrophages
Squamous cell carcinoma (skin - lung) and angiosarcoma of the liver
Benign nevus (mole)
transcription

31. What are the three main functions of surfactant?
robenecid - a uricosuric agent
Cirrhosis
Mean corpuscular hemoglobin concentration (MCHC)
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

32. What is the most widely used class of antidepressants?
H 1
SSRIs
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.
The thyroid gland

33. Which type of hepatitis is a calicivirus?
Hepatitis E (enteric)
Gardner syndrome
7 to 14 days
Uric acid

34. What area of the brain is responsible for emotion - feeding - mating - attention - and memory?
Mural infarct
The limbic system
Hodgkin lymphoma
No. It is abnormal only if it interferes with normal sexual or occupational function.

35. What area of the female reproductive tract is lined by stratified squamous epithelium rich in |glycogen?
The vagina
First - pass effect
Progestins
Ribonucleotide reductase

36. What is associated with prolonged lithium use?
IgA
Hypothyroidism. (TSH levels must be monitored.)
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes

37. What complement factor deficiency leads to x Leukocyte adhesion deficiency with poor opsonization?
Mixed (both cholesterol and calcium)
C1 - C2 - or C4 deficiency
Breast and lung cancer - respectively.
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).

38. What three vitamin deficiencies are associated with homocystinemia?
Middle cerebral artery
Intussusception
Folate - vitamin B12 - and vitamin B6
Ultraviolet B (UVB) sunlight

39. How many days prior to ovulation does LH surge occur in the menstrual cycle?
Dysplasia
1 day prior to ovulation
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
Insulin

40. What component of an ECG is associated with the following? - Ventricular depolarization
Previous suicide attempt
QRS complex
Quinolones
Hypochondriasis (they will begin with 'I think I have...')

41. What color do fungi stain with PAS? Silver stain?
Hot pink with PAS and grey to black with silver stain
Picornaviridae
Courvoisier's law
Homeodomain proteins

42. What are the five terminal branches of the facial nerve?
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
2.0 or greater
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)
Avoidant

43. Name these mature defense mechanisms: x Preparing for an upcoming event
Anticipation
S phase
Compliance; the more compliant a lung is - the easier it is to inflate.
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)

44. What is the most common one? - Testicular tumor in infants and children
Diethylcarbamazine
Yolk sac tumor
Cefuroxime and cefaclor
Chromosome 8 - 14

45. In regard to motor development during infancy - choose the motor response that happens first - Proximal or distal progression
Glutamine
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
Proximal to distal progression
CD3

46. What is the most common one? - Type of ASD
Decreases
A right CN V lesion results in weakened muscles of mastication - and the jaw deviates to the right.
Methanol
Ostium secundum defects

47. From what pharyngeal pouch is the following structure derived? - Superior parathyroid gland and ultimobranchial body of the thyroid
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
Tropomyosin
Fourth M PITS for pharyngeal pouch derivatives
Linoleic acid and linolenic acid

48. What disease is seen in the 20- to 40-year - old age group - is more prevalent in women than men - involves diarrhea with or without bloody stools - starts in the rectum and ascends without skipping areas - includes pseudopolyps - and has a thickness
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
REM and stage 4 sleep; they decrease.
Ulcerative colitis
Sublimation

49. What disorder is associated with loss of polarity - anaplasia - pleomorphism - discohesiveness - increase in the nuclear:cytoplasmic ratio - hyperchromasia - and increase in the rate of mitosis?
Haemophilus influenzae type B
Prostate and lung cancer - respectively
Malignancy
Valence

50. Do the following structures pick up stain from hematoxylin or eosin? - Calcium
Hematoxylin
Parvovirus B-19
Atropine with pralidoxime
Patients with unilateral cerebellar lesions fall toward the side of the lesion.