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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 drug blocks glucose uptake - leading to decreased formation of ATP and resulting in immobilization of the parasite?
Albendazole
Bile salts are actively reabsorbed in the distal ileum.
Adrenarche
The cat

2. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Mucosal epithelium
Labile
Eosinophil
reflexes
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)

3. What is the name of demyelination of the corticospinal tract and the dorsal column in the spinal cord due most commonly to a vitamin B12 deficiency?
Hematogenous
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Mesencephalon
Psammoma bodies

4. What type of correlation is defined as x One variable that diminishes in the presence of the other?
Negative correlation
Empyema
Compliance (think of it as distensibility)
Test - retest reliability

5. What is the fastest - conducting fiber of the heart? Slowest conduction fiber in the heart?
ASA (salicylate)
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
PGE 1 - PGI 2 (most potent) - and TXA 2
Purkinje cell is the fastest - and the AV node is the slowest.

6. Could an overdose with either zolpidem or zaleplon be reversed with flumazenil?
Yes - because they both activate the BZ1- receptors - which can be reversed by flumazenil.
1. Short attention span 2. Impulsivity 3. Hyperactivity
Testicular tumors
Visceral pleura

7. What are the three C's of measles?
Ephedrine
1. Cough 2. Coryza 3. Conjunctivitis
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.
By asking a patient to close the eyes while standing with feet together

8. What part of the heart forms x Apex?
Diphyllobothrium latum
Mitral valve prolapse
Tip of the left ventricle
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.

9. What fungus is seen as colored cauliflower lesions?
Chromomycosis
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Radial nerve and the profunda brachii artery

10. Name the structure that enters or exits the following foramina: x Stylomastoid foramen
Cohort studies determine incidence and causality - not prevalence.
Osteoblasts (Remember - they modulate the function of osteoclasts.)
Intussusception
CN VII

11. Why isn't the incidence of a disease decreased when a new treatment is initiated?
Glanzmann syndrome
Femoral nerve
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
Gonorrhea

12. What two sugars can be used to produce cerebrosides?
Streptococcus pneumoniae
Glucose and galactose
Klatskin tumor
Pituitary adenoma

13. Name the antimicrobial agent whose major side effect is listed - Teratogenicity
Metronidazole
Enkephalin
Calcitriol
These are the gross pathologic changes associated with Alzheimer's disease.

14. What phase of the cell cycle are the following antineoplastic agents specific for? - Alkylating agents
CD3
The otic ganglion. (These fibers are carried in CN IX. Remember it like this: the - oti - is in both otic ganglion and parotid gland.)
IgG
G0 phase

15. Name the cluster B personality disorder: x Criminal behavior; lacking friends - reckless - and unable to conform to social norms
Transverse abdominis
Secondary lysosome (think of the primary as inactive and secondary as active)
Antisocial
Spermatid

16. What happens to O2 affinity with a decrease in p50?
VLDL
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma

17. What is the venous and arterial stretch receptors' function regarding the secretion of ADH?
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.
AML- M3
Hepatitis A
Sympathetic chain ganglion

18. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x Ki - ras
Thymic epithelial cells - dendritic cells - and macrophages
Orotic acid (purine metabolism)
ASD
Pancreas and colon

19. Who is responsible for passing on mitochondrial DNA genetic disorders?
Mitochondria - linked disorders are always inherited from the mother.
1. Decrease alpha -1 activity 2. Increase Beta -2 activity 3. Increase ACh levels
Vitreous humor
Foramen of Winslow

20. What encephalitis is associated with the JC virus?
Progressive multifocal leukoencephalopathy
A decrease in Ca2+ and an increase in PO4
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
Umbilical vein and ductus venosus (80%)

21. What type of Ag do T cells recognize?
Processed antigenic peptides bound in the groove of the MHC molecule
Hemangioma (benign)
Teeth grinding is associated with stage 2 sleep.
Median nerve

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

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23. What is the most common one? - Cardiac pathology in patients with SLE
Libman - Sacks endocarditis
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
PGE 1 - PGI 2 (most potent) - and TXA 2
Rotavirus

24. Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
Onion skinning
Chromosome 18
Dantrolene
Ristocetin

25. What excitatory fibers arise from the inferior olivary nuclei on the contralateral side of the body?
Mebendazole
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
Small to medium - sized cerebral vessels
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.

26. How do delusions - illusions - and hallucinations differ?
It is rare with normal grief; however - it is relatively common in depression
Proximal to distal progression
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
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.

27. Name the DNA virus: x ssDNA; naked; icosahedral; replicates in the nucleus
Constrictor pupillae and ciliary muscles
Parvovirus
Thymic epithelial cells - dendritic cells - and macrophages
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.

28. Ventral rami of what cervical nerves constitute the phrenic nerve?
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.
C3 - C4 - and C5 keep the diaphragm alive!
Angiosarcoma of the liver
Plasmodium malariae

29. What syndrome is due to anti - GBM Abs directed against the lung and kidneys?
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
Goodpasture syndrome
LH
Puborectalis

30. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Thalamus
Proencephalon
Zonula occludens (tight junctions)
Yes - it decreases fat and muscle uptake of glucose - thereby increasing blood glucose levels.
Hyperventilation - which decreases CO2 - shifting the reaction to the left and decreasing H+

31. What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ?
Isovolumetric contraction
Axis I
Aminophylline
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.

32. Which anticonvulsant is also used in the treatment of bipolar disorder and for migraine headaches?
An increase in serum glucose levels
Phenylalanine hydroxylase
Valproic acid
Spironolactone (binds to aldosterone receptors)

33. What female pathology is associated with endometrial glands and stroma outside the uterus commonly affecting the ovaries as chocolate cysts?
Pseudohyphae
Obsessive - compulsive
Endometriosis
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.

34. Where does Beta - oxidation of very long chain fatty acids begin?
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.
Tensor tympani
Outside the cell
Parasympathetics (parasympathetics point - sympathetics shoot)

35. If the AV difference is positive - is the substance extracted or produced by the organ?
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.
Areas 5 and 7
Masochism
4 years old

36. Name the compartment of the mediastinum associated with the following thoracic structures: Aortic arch
Superior
Incidence rate
Proencephalon
Southern blot

37. What type of test asks a patient to draw a scene - attempting to find out the individual's unconscious perceptions in his or her life?
competency
Stibogluconate
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.
The subclavian artery

38. Name these mature defense mechanisms: x Preparing for an upcoming event
Prader - Willi syndrome and Angelman syndrome - respectively
Anticipation
Increased GABA levels decrease the likelihood of learned helplessness.
Ascending limb

39. What specifies how accurately the sample values and the true values of the population lie within a given range?
Cefuroxime and cefaclor
28 L - 40% of body weight
Confidence interval. It is a way of admitting estimation for the population.
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord

40. What are the three characteristics of autoregulation?
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Alveoli; they are part of the respiratory portion.
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
Thermogenic

41. Circulating levels of what hormone in men is responsible for the negative feedback loop to the hypothalamus and the anterior pituitary gland regulating the release of LH?
5- hydroxyindoleacetic acid (5- HIAA)
Testosterone
Mitosis
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.

42. What disorder of aldosterone secretion is characterized by x Decreased total body sodium - ECF volume - plasma volume - BP - and pH; increased potassium - renin - and AT II activity; no edema?

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43. What inflammatory bowel disorder is continuous - with extensive ulcerations and pseudopolyps - and is associated with HLA- B27?
Supraspinatus and infraspinatus
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
Ulcerative colitis
Transient ischemic attack

44. Name the aphasia based on these characteristics: x Nonfluent speech - telegraphic and ungrammatical; lesion in Brodmann's area 44; unimpaired comprehension

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45. What is the lymphatic drainage of the pelvic organs?
Cancer of the lung - stomach - colon - and breast
Internal iliac nodes
Purine nucleoside phosphorylase
Propionibacterium acnes

46. Which organism causes trench fever?
Duodenum
Arnold - Chiari malformation type 2
Rochalimaea quintana (now called Bartonella quintana)
Schwannoma

47. Name the associated chromosome - Down syndrome
The zygote divides mitotically; only germ cells divide meiotically.
Chromosome 21
Left atrium and tip of the right atrium
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.

48. If a mother delivers a Rho - positive baby - she should receive...
Filovirus
Rho-immunoglobin
Pedophilia
Urogenital sinus

49. Can be secreted.
Luteal phase
B- cell Ag receptors
Sarcoplasmic reticulum
Ipratropium

50. If the occurrence of one event had nothing to do with the occurrence of another event - How do you combine their probabilities?
G0 phase
Since they are independent events - their probabilities would be multiplied.
Chronic alcoholic
Nephrotoxicity