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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. How many acetyl CoAs per glucose enter into the TCA cycle?
Arsenic
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
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
Trazodone

2. Activates the histidine operon.
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
Histidine
VLDL
Hypothyroidism. (TSH levels must be monitored.)

3. What are the adult remnants of the following structures? - Left umbilical vein
Negative
Huntington's chorea. (Death in 15-20 years - often via suicide.)
The anterior nucleus of the thalamus
Ligament teres

4. What infection is associated with ring - enhancing lesions seen on computed tomography (CT) of the brain in an HIV- positive individual?
Glucagon
White muscle; short term too
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)

5. What cell type is commonly elevated in asthma?
Anemia of chronic disease
Negative
Ligamentum arteriosum
Eosinophil

6. At which three sites in the body is T4 converted to T3?

7. What virus is associated with the Norwalk agent?
Calicivirus
Neuroleptic malignant syndrome is a potentially life - threatening condition Which is treated with symptomatic support - bromocriptine - and dantrolene.
Benign nevus (mole)
Effective dose for 50% of drug takers (median effective dose)

8. Name the area of the cerebral cortex with the function described: x Skill - based memory - verbal recall - balance - refined voluntary movements
Chromosome 21
HHV 8
Cerebellum
Desipramine

9. How do the corticobulbar fibres of CN VII differ from the rest of the CNs?
Paget disease (osteitis deformans)
Vitamin B6
Proud flesh
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c

10. What disorder is characterized by a depressed mood and a loss of interest or pleasure for more than 2 years?
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT - which means warfarin - extrinsic - PT; heparin - intrinsic - PTT)
Cleft palate
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
Niemann - Pick and Tay- Sachs diseases

11. What enzyme is deficient in congenital erythropoietic porphyria?
Carcinoid tumor
Hypervariable region
Uroporphyrinogen III cosynthase
G-6- PD deficiency

12. What is the DOC for the following protozoal infections? - Amebiasis
Metronidazole
Acute cystitis
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
Rhombencephalon

13. What two pathologic conditions occur when the gut does not return to the embryo?
Omphalocele and gastroschisis
Ampulla of the fallopian tube
Clear cell
Fungi

14. The closure of what valve indicates the beginning of the isovolumetric relaxation phase of the cardiac cycle?
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
Graves disease
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
Cocaine - induced coronary ischemia

15. Name the compartment of the lower extremity and the nerve based on its movements - Flex the hip and extend the knee
Carcinoid tumor
Anterior compartment of the thigh - femoral nerve
PRPP aminotransferase
The hallmarks of LMN lesion injury are absent or decreased reflexes - muscle fasciculations - decreased muscle tone - and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget - LMN lesions are ipsilateral at the level of the

16. 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
Metastatic
Median nerve
ATP production
Varicella virus and influenza virus

17. Name the most common cause - Blindness worldwide
Flea - bitten kidney (can also be seen in pyelonephritis)
Superior and posterior
Constrictor pupillae and ciliary muscles
Chlamydia trachomatis

18. What large - diameter vessel has the smallest cross - sectional area in systemic circulation?
Western blot
Convergence
Periaortic lymph nodes
The aorta

19. What oral hypoglycemic agent stimulates pancreatic Beta- cell release of insulin and is given just prior to meals because of its short half - life?
Repaglinide
Candida
Minoxidil (orally and topically - respectively!)
Digoxin is renally eliminated; digitoxin is hepatically eliminated.

20. Name the B- cell CD marker: x Required for class switching signals from T cells
One day after the LH surge and 2 days after the estrogen peak.
Chromosome 13
CD40
Gonads

21. Homer - Wright rosettes
Dopamine
well - fed and fasting
Neuroblastoma
Duchenne muscular dystrophy

22. How many pairs of spinal nerves are associated with x Coccygeal vertebrae?
Protamine sulfate
Id (pleasure principle)
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
refuse

23. Which bacteria are associated with the following pigment production? - Pyocyanin (blue - green)
Pseudomonas aeruginosa
IgG
HPV infection
Complex 4

24. What two factors result in the apex of the lung being hypoperfused?
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.
Hypoglycemia for secretion and hyperglycemia for inhibition
Prolactinoma
Gaucher disease

25. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH ?
NE
Ampulla of the fallopian tube
GnRH constant infusion
Public speaking (Remember: stage fright)

26. What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
Amanita phalloides
Ampulla
Quaternary structure
Proportionate mortality rate

27. Name the correct artery - The left recurrent laryngeal nerve passes around it.
Degenerates
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
HMG CoA reductase
Arch of the aorta

28. On the venous pressure curve - What do the following waves represent? - C wave?
Ventricular contraction Atrial - Contraction - Venous
For males it's prostate cancer - and for females it's breast cancer.
Riboflavin (B2) deficiency
Asparagine

29. What genus is known as the smallest free living bacteria? (hint: has no cell wall and has sterols in the membrane)
Mycoplasma
Hyperplasia
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.
HHV 6

30. What form of diabetes insipidus is due to an insufficient amount of ADH for the renal collecting ducts?
Propionic acid
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available - but the renal collecting ducts are impermeable to its actions.
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)
Acetyl CoA carboxylase

31. What follicular cell possesses FSH receptors and converts androgens into estradiol?
Granulosa cells
Lesch - Nyhan syndrome
Beta- Blockers
Buffers (remember that buffers are best when they are used in a pH range near its pK)

32. A patient can ______ a feeding tube.
Pertussis toxin
Ungated potassium channel
Left homonymous hemianopsia
refuse

33. What type of chromatin is transcriptionally inactive?
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
An increase in serum glucose levels
Bunyavirus
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)

34. What female follicular cell is under LH stimulation and produces androgens from cholesterol?
Infection
G1 phase; G2 and S phase are diploid (2N).
Ulnar nerve
Theca cell

35. Why is O2 content depressed in anemic patients?
Acetyl CoA (pyruvate to acetyl CoA)
PGE 1 - PGI 2 (most potent) - and TXA 2
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
C1 - C2 - or C4 deficiency

36. At the end of each round of Beta- oxidation - What is released?
Complex I
Acetyl CoA - FADH2 - and NADH
Serum 25- hydroxy- vitamin D (25- OH- D)
Autosomal dominant

37. What ring is a weblike narrowing of the gastroesophageal junction?
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)
Pseudomonas aeruginosa
Schatzki ring
T3 increases both heart rate and cardiac output by increasing the number of Beta - receptors and their sensitivity to catecholamines.

38. To differentiate central from nephrogenic diabetes insipidus - after an injection of ADH - which will show a decreased urine flow?
Central. Remember - there is a deficiency in ADH production in the central form.
Renal plasma flow (decrease flow - increase FF)
Cilia
Viruses

39. What is the name of the superficial subcutaneous fascia of the abdomen containing fat?

40. What CNs are affected if there is a lesion in x The upper pons?
Pirenzepine
Sarcoplasmic reticulum
CN V
Area 8

41. Which IL is associated with increases of IgG and IgE?
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
In the dorsal horn of the spinal cord on the primary afferent neurons
IL-4
Patau syndrome (trisomy 13)

42. Name the structure that enters or exits the following foramina: x Internal auditory meatus
Middle
CN VII and VIII
Purine nucleoside phosphorylase
Enterobius vermicularis

43. Used in the treatment of barbiturate overdose.
Teratoma (dermoid cyst)
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Humerus with ulna (major) and radius (minor)
Flumazenil

44. What small gram - positive - non - spore - forming rod is a facultative intracellular parasite that grows in the cold and is associated with unpasteurized milk products?
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
Hapten; if it is coupled with a carrier - it may become immunogenic.
Listeria monocytogenes
Griseofulvin

45. What is the relationship between ventilation and PCO2 levels?
Toxoplasmosis
Primary follicle (in the white pulp)
Single - strand DNA binding protein
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.

46. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Euphoria - delusions - thought disorders - Wernicke's aphasia - auditory hallucinations (Hint: the lesion is in the left hemisph
Dominant temporal lobe
Early distal tubule
Conidia
Rheumatoid arthritis

47. What bacterium is diagnosed using the Dieterle silver stain?
Legionella
Hemosiderin
Plasmodium malariae
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)

48. In What trimester is the fetus most vulnerable to congenital rubella syndrome?
Major
The first trimester
Ostium secundum defects
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)

49. How can you differentiate vitamin K from vitamin C deficiency by bleeding time and PT levels?
Erythema marginatum
When it crosses the teres major
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.
1. Clavulanic acid 2. Sulbactam 3. Tazobactam

50. What happens to the resistance of the system when a resistor is added in a series?
Ego syntonic
hnRNA
Resistance of the system increases. (Remember - when resistors are connected in a series - the total of the resistance is the sum of the individual resistances.)
Osteosarcoma