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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. After fertilization - what cells of the corpus luteum x Secrete progesterone?
Somatization disorder
Atropine and 2- PAM (pralidoxime)
Transferrin
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.

2. What non - spore - forming gram - positive aerobic rod produces bull neck - sore throat with pseudomembranes - myocarditis - and sometimes respiratory obstructions?
From the wall of the yolk sac
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Hepatitis A (infectious)
Corynebacterium diphtheriae

3. What reflex - seen in lesions of the corticospinal tract - is an extension of the great toe with fanning the of remaining toes?
Compliance; the more compliant a lung is - the easier it is to inflate.
Reverse transcriptase
Middle meningeal artery
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse - hyperreflexia - spastic paralysis - increased muscle tone - and weakness are commonly seen in UMN lesions.

4. What CNs are affected if there is a lesion in x The upper medulla?
Terminal ileum
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
CN IX - X - and XII
Type IV collagen

5. What is the term for the appearance of the kidney in malignant hypertension (it has petechiae on its surface)?
Projective test. Most tests with a wide range of possibilities for the answers are projective.
Bile salts are actively reabsorbed in the distal ileum.
Penicillin G (benzylpenicillin)
Flea - bitten kidney (can also be seen in pyelonephritis)

6. Name the B- cell CD marker: x Required for class switching signals from T cells
Saccule and utricle
Beta- Galactosidase
CD40
Passive - aggressive

7. What three cells are essential for T- cell differentiation in the thymus?
2 ATPs - via the amino acyl tRNA synthase enzyme
Flea - bitten kidney (can also be seen in pyelonephritis)
Dendritic cells - macrophages - and thymic epithelial cells
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.

8. Are associated with poststreptococcal GN.
Complex I
Elevated ASO titers and serum complement levels
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.

9. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x CDK4
Bronchogenic carcinoma
Vaginismus; it is the female counterpart of premature ejaculation.
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Melanoma

10. Which direction is air flowing when the intra - alveolar pressure is zero?
Membrane conductance (think conductance = channels open)
IgM; IgD follows shortly thereafter.
Prophase of meiosis I (between 12th and 22nd week in utero)
When the intra - alveolar pressure equals zero - there is no airflow.

11. What enzyme is deficient in the following glycogen storage disease? - Pompe's disease
Antimicrobial agents
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Lysosomal a -1 - 4- glucosidase
The vaccine contains 23 capsular polysaccharides.

12. Which one of the cerebellar peduncles is mainly responsible for outgoing (efferent) information?
Enterohemorhagic Escherichia coli
Anxiety disorders; for men it is substance abuse.
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.
Rhinoviruses for summer and fall; coronaviruses for winter and spring

13. If the pH is more acidic than the pI - does the protein carry a net positive or net negative charge?
They block the midcycle surge of LH.
Achondroplasia
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.
Conduction aphasia

14. A motor lesion to the right CN V results in deviation of the jaw to which side?
A right CN V lesion results in weakened muscles of mastication - and the jaw deviates to the right.
Staphylococcus aureus
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
Methionine (start) and tryptophan are the only two AAs with only one codon.

15. Name the most common type or cause - Reversible HTN in the United States
Alcohol abuse
Autoimmune hemolytic anemia
Negative
Dantrolene

16. What family do the following viruses belong to? - California encephalitis
Celiac sprue (gluten - sensitive enteropathy)
Bunyavirus
Ulnar nerve
Dopamine levels rise with waking; dopamine is associated with wakefulness.

17. Which of the following
Cystadenocarcinoma
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
Ovarian fibroma
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.

18. Which organism causes trench mouth?
Fusobacterium
Hairy cell leukemia
Ethacrynic acid
Kupffer cells

19. How does ventricular depolarization take place - base to apex or vice versa?
Vitelline fistula
Haemophilus influenzae type B
Bordetella pertussis
Depolarization is from apex to base and from endocardium to epicardium.

20. What is the name for failure of the allantois to close - resulting in a urachal fistula or sinus?
Patent urachus
Free - unprocessed Ag
Toxic or viral hepatitis
Intellectualization

21. Name the hypochromic microcytic anemia based on the following laboratory values - Increased iron - decreased TIBC - increased percent saturation - increased ferritin
Volume of distribution is decreased when a large percentage of drug is protein bound.
Sideroblastic anemia
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
Lung cancer

22. At the level of rib 6 - the internal thoracic artery divides into What two arteries?
Hypercortisolism (Cushing syndrome)
Musculophrenic and superior epigastric arteries
Streptococcus pneumoniae
Papillary carcinoma of the ovary

23. What two AAs do not have more than one codon?
Methionine (start) and tryptophan are the only two AAs with only one codon.
Cryptococcus
Antithyroglobulin and antimicrosomal Abs
Superior

24. What is the term for the point on a scale that divides the population into two equal parts?
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Listeria
Fusobacterium
Median (think of it as the halfway point)

25. What direction does the primitive gut rotate? What is its axis of rotation?
nef and tat genes
The gut rotates clockwise around the superior mesenteric artery.
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
Serotonin

26. Blood and its vessels form During What embryonic week?
Third week; they are derived from the wall of the yolk sac.
Hepatitis A (infectious)
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
The stomach

27. In what pathway of the basal ganglia do lesions result in hyperactive cortex with hyperkinetic - chorea - athetosis - tics - and dystonia?
Indirect pathway (Tourette syndrome for example)
Gynecomastia
Medial umbilical ligaments
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse

28. What thyroid abnormality has the following? - TRH increased - TSH increased - T4 decreased
Primary hypothyroidism (Low T4 has a decreased negative feedback loop - resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release - respectively.)
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.
Obsessive - compulsive
Look for broken blood vessels in the baby's eyes.

29. What paraphilia is defined as x Deriving sexual pleasure from other peoples' pain?
Sadism
IGF-1 (somatomedin C)
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).
Adenovirus

30. In what stage of sleep is it easiest to arouse a sleeping individual?
Libman - Sacks endocarditis
Prostate cancer
During REM sleep
Vitamin E

31. What topoisomerase makes ssDNA cuts - requires no ATP - relaxes supercoils - and acts as the swivel in front of the replication fork?
Childhood
Topoisomerase I (Relaxase)
MGN
>10 mm

32. What syndrome causes inability to concentrate - easy distractibility - apathy - and regression to an infantile suckling or grasping reflex?
Limbic system
Frontal lobe syndrome (lesion in the prefrontal cortex)
Functions of hepatocytes
Bronchiectasis

33. Name the DNA virus: x ssDNA; naked; icosahedral; replicates in the nucleus
Cerebellum
Rationalization
Parvovirus
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.

34. How many milliliters of O2 per milliliter of blood?
Epstein - cardiac anomaly of the tricuspid valve
The primitive streak grows caudal to rostral.
0.2
IgE

35. The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?
Phosphofructokinase -1 and costs 1 ATP
Androgen - binding protein
Cytochrome a/a3
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.

36. What is the term for drug removal per unit of time in a given volume of blood?
Thymus gland. (Thymus gland is essential for T cell maturation.)
Clearance
Premature ejaculation
Superior and posterior

37. Name the compartment of the mediastinum associated with the following thoracic structures: Left common carotid artery
Libman - Sacks endocarditis
Secondary hypercortisolism (pituitary)
Somatization disorder
Superior

38. What are the three naked RNA viruses?
Primary erectile disorder
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)
Metaraminol (a1 - Beta1 )
Very superior (<2.5% of the population)

39. How many mature sperm are produced by one type B spermatogonium?
Mycoplasma
S phase
Four
Myelofibrosis with myeloid metaplasia

40. What type of mortality rate is defined as the number of deaths x From a specific cause per number of persons with the disease?
Superior
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
Medial compartment of the thigh - obturator nerve
Case fatality rate

41. Is most of the coronary artery blood flow during systole or diastole?
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
12 days after ovulation
Seminoma
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries

42. Is CO2 a perfusion - or diffusion - limited O2 gas?
Metaraminol (a1 - Beta1 )
Gastric carcinoma
Ticlopidine or clopidogrel
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse

43. What are the most common causes of osteomyelitis x In drug addicts?
Mitral valve stenosis
Pseudomonas
HHV-8
ELISA. It detects anti - p24 IgG.

44. At high doses aspirin has ________ properties.
Systemic lupus erythematosus
Uricosuric
Pseudomonas aeruginosa
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.

45. What glycolytic enzyme has a high Vmax - high Km - and low affinity for glucose?
Cytosine
Cleft palate
The vermis
Glucokinase

46. What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?
Uroporphyrinogen III cosynthase
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Melasma
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.

47. Will a unilateral lesion in the spinothalamic tract result in a contralateral or ipsilateral loss of pain and temperature?
Ischemic
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.
Folic acid deficiency
1. Decrease alpha -1 activity 2. Increase Beta -2 activity 3. Increase ACh levels

48. The first area to be oxygenated in the liver.
Rabies
Superoxide dismutase - glutathione peroxidase - catalase
The portal tract of the liver lobule
Pirenzepine

49. In men - At What embryonic week do the primordial germ cells migrate to the indifferent gonad?
Purine nucleoside phosphorylase
Smooth muscle
Week four - and they remain dormant there until puberty.
Zonula occludens (tight junctions)

50. Based on operant conditioning - What type of reinforcement is described when x Removing a stimulus stops a behavior?
Serocystadenocarcinoma
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Extinction
Metronidazole