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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 DOC for the following protozoal infections? - Pneumocystis carinii pneumonia
Arterial PCO2 levels are proportional to cerebral blood flow.
Generalized anxiety disorder
Trimethoprim/sulfamethoxazole (TMP- SMX)
Temporal arteritis (giant cell arteritis)

2. Which benzodiazepine is most commonly used IV in conscious sedation protocols?
Midazolam
Ipsilateral flaccid paralysis
At least 5 lobes
Zero correlation

3. What viral infection is known to cause intracerebral calcifications?
Double - blind study. It is the most scientifically rigorous study known.
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
Glioblastoma multiforme

4. What is the size of the prokaryotic ribosome?
Inactivated
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
Occulta All except occulta cause elevated - fetoprotein levels.
G2 phase

5. Which class of antiarrhythmics blocks sodium channels?
Thiazide diuretics
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Class 1 (1A - 1B - and 1C)
The folding of an AA chain

6. Name the type of necrosis - Soft - friable - cottage - cheese appearing; characteristically seen in TB
Caseous necrosis
Oxytocin
The muscle's ATPase activity
Social learning theory

7. Name the bony articulations of the following sites. Be specific. Elbow
Humerus with ulna (major) and radius (minor)
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
The rate of infusion
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis

8. What urinary metabolite is increased in patients with carcinoid syndrome?
5- hydroxyindoleacetic acid (5- HIAA)
Disseminated intravascular coagulation (DIC)
Phallic stage (4-6 years)
1 day prior to ovulation

9. The elimination of the unfertilized egg. In females - meiosis II is incomplete unless fertilization takes place.
Bladder cancer
Citrate - via the citrate shuttle
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Menses

10. What statistical method do you use when analyzing x Case control studies?
PKU
The poly(A) site on the DNA
Odds ratio. (Case control studies deal with prevalence.)
Primary Hemochromatosis

11. Name the thalamic nucleus based on its input and output - Input from globus pallidus and substantia nigra; output to primary motor cortex
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Pick's disease
Ventral anterior nucleus
The left gastric - splenic - and common hepatic arteries

12. 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
Hypertension
Glanzmann syndrome
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)

13. What is the most common one? - Kidney stone type
CD8+ T cells
Calcium oxalate
Erythema nodosum
Increase (5- HT and dopamine levels do the same)

14. Do the following structures pick up stain from hematoxylin or eosin? - Bacteria
Microglial cells
Hematoxylin
Boutonni
The urine becomes hypertonic because of water reabsorption in the collecting duct.

15. What IL down - regulates cell mediated immunity?
apo B-48
Paroxysmal nocturnal hemoglobinuria
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
IL-10

16. What is the degree to which two measures are related? Does it imply causation?
Correlation. No - correlation does not imply causation.
Schizotypal
Primary Hemochromatosis
N- formyl - methionine LTB4 C5a IL-8

17. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Eukaryotic cell; 3 to 10 microns; 80S ribosomes; chitinous cell wall; ergosterol in cell membrane; replicate via cytokinesis with mitosis and meio
Serocystadenocarcinoma
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.
Superior Oblique (CN IV) (LR6 SO4)3
Fungi

18. What muscle of the middle ear is innervated by CN VII?
GLUT 2
Labetalol
Aspiration pneumonia
The stapedius muscle

19. What is the most common one? - Malignant tumor in the bone of teenagers
HIV
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
CN IV
Osteosarcoma

20. What muscles insert in or on the intertubercular groove of the humerus?

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21. What peripheral chemoreceptor receives the most blood per gram of weight in the body?
Estrone
<2
The carotid body - which monitors arterial blood directly
Vancomycin

22. What type of hemostasis in an intravascular space consists of fibrin - platelets - RBCs - and WBCs?
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors
Hepatitis C
Bronchioloalveolar carcinoma
Thrombus

23. What purine base is contained in inosine monophosphate?
Intrapleural pressure decreases (becomes more negative).
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
GnRH pulsatile infusion
env structural protein

24. Can incidence - prevalence - and cause and effect be assessed in x Cross - sectional studies?
Cross - sectional studies determine prevalence - not incidence or cause and effect.
ACL
IL-3 (3 face down is an M)
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)

25. What histone binds two nucleosomes together?
ACh
1. Big 2. Bilateral 3. Berry aneurysm
Dihydrofolate reductase
H1 histones

26. HIV's capsid - core nucleocapsid - and matrix proteins are products of what structural gene?
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
gag gene
Hematoxylin

27. Is suicidal ideation a component of normal grief?
It is rare with normal grief; however - it is relatively common in depression
Succinate dehydrogenase
Major
Prader - Willi syndrome and Angelman syndrome - respectively

28. What is the only glycosaminoglycan (GAG) that binds to the linker portion of the proteoglycan?
Staphylococcus aureus (but they are more prone to salmonella infections)
The resistance increases 16- fold.
Wegener granulomatosis
Hyaluronic acid (all sulfates bind to the core protein)

29. Name the most common type or cause - Acute bacterial endocarditis
C3b
The resistance will decrease one - sixteenth of the original resistance.
Staphylococcus aureus
The greater the myelination - the greater the conduction velocity.

30. If the radius of a vessel doubles - what happens to resistance?
The resistance will decrease one - sixteenth of the original resistance.
Duodenal atresia
Distal convoluted tubules
Selegiline

31. Acts as the vertebral body of C1 allowing lateral rotation of the head. The first cervical vertebra has no vertebral body.
The odontoid process of C2
Antigenic determinant (epitope)
Unconjugated free bilirubin
Temporal arteritis

32. What are the primary neurotransmitters at the following sites? - Postganglionic sympathetic neurons
The carotid sinus is a pressure - sensitive (low) receptor - while the carotid body is an oxygen - sensitive (low) receptor. (Remember 'Sinus Pressure').
IgA
NE
Hydatidiform mole

33. What pancreatic islet cell secretes glucagons?
HTN
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood
alpha - Cells; glucagon has stimulatory effects on - cells and inhibitory effects on - cells.
Correlation. No - correlation does not imply causation.

34. In what disease do you see horseshoe kidneys - rockerbottom feet - low - set ears - micrognathia - and mental retardation?
Uracil
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Lateral medullary (Wallenberg's) syndrome
Edward syndrome (trisomy 18)

35. The gallbladder functions to...
produce bile
Vibrio vulnificus
Red blood cell distribution width index (RDW)
Anterior hypothalamic zone; lesions here result in hyperthermia.

36. With an increase in arterial systolic pressure - what happens to x Vessel compliance?
Increased leukocyte alkaline phosphatase (LAP)
2 ATPs by oxidative phosphorylation
Decreases
Keloid

37. What complement factor deficiency leads to x Hereditary angioedema?
Osler nodes
C1 inhibitor (C1- INH)
Bronchial asthma (whorled mucous plugs)
Gout

38. Name the antidote - Mercury
Dimercaprol - penicillamine
Alveolar macrophages (dust cells)
The first trimester
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation

39. What ethnic group has the highest adolescent suicide rate?
unprocessed Ags
Native Americans
Because creatinine is filtered and a small amount is secreted
Size

40. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Type II hypersensitivity reaction
Herpes II
Wiskott - Aldrich syndrome
Coma - convulsions - and cardiotoxicity

41. What is the term for the total volume of air moved in and out of the respiratory system per minute?
D- Penicillamine
Phase 1
Common peroneal nerve
Total ventilation (minute ventilation or minute volume)

42. What are the first signs of overdose from phenobarbitals?
Primary hypocortisolism (Addison's disease)
Nystagmus and ataxia
Vibrio cholera
Progestin

43. Ventral rami of what cervical nerves constitute the phrenic nerve?
Aedes (the same for yellow fever)
Acting out
Squamous cell carcinoma of the lung
C3 - C4 - and C5 keep the diaphragm alive!

44. What form of nephritic syndrome is associated with celiac sprue and Henoch - Sch
Filiform papillae
IgA nephropathy
Insulinoma
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion

45. What group of eukaryotic regulatory proteins has a major factor in controlling the gene expression embryonically?
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.
Processed antigenic peptides bound in the groove of the MHC molecule
Hypertrophy
Homeodomain proteins

46. If a peripheral blood smear shows schistocytes - reticulocytes - and thrombocytopenia - is it more commonly seen in patients with ITP or TTP?
Transient ischemic attack
Escherichia coli
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
Somatization disorder

47. What type of cell can never leave the lymph node?
Menses
Proencephalon
Clarke's nucleus
Plasma cell

48. What stage of sleep is associated with somnambulism?
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Protamine sulfate
Fragile X syndrome
DHEA (androgens) Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

49. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Hematopoietic cells
Maxillary artery
Liver
C1 esterase inhibitor (C1INH)
Labile

50. The blood stored in the systemic veins and the pulmonary circuit are considered part of the...
Cardiac output
Bile salts are actively reabsorbed in the distal ileum.
Lithium
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.