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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 most common one? - Primary CNS tumor in adults
M
Primary hyperparathyroidism
Glioblastoma multiforme
Fibrocystic change of the breast

2. Is the bound form or free form of a lipid - soluble hormone responsible for the negative feedback activity?
Metastatic carcinomas
Free form determines hormone activity and is responsible for the negative feedback loop.
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major
The triad of respiratory depression - pinpoint pupils - and coma in an IV drug abuser suggests opioid overdose (e.g. - heroin) - and you should give naloxone.

3. Which nicotinic receptor antagonist is inactivated to laudanosine?
Type III hypersensitivity (immune complex)
Atracurium
Midazolam
Constrictor pupillae and ciliary muscles

4. What is the most common causative organism of acne vulgaris?
Ligamentum venosum
antiemetic
Propionibacterium acnes
Crossover study

5. What is the most common one? - Malignant tumor of the breast
Axis V
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
Invasive ductal carcinoma
Uricosuric

6. In which quadrant is breast cancer most commonly found?
Upper outer quadrant (left more than right)
TCR
LTC4 and LTD4
Pulse pressure

7. What antiepileptic agent has SIADH as a side effect?
Remember the mnemonic PAM SMIDT P - (hyper) Parathyroid/ Paget disease A - Addison's disease M - Milk - alkali syndrome/metastatic cancer S - Sarcoidosis M - Multiple myeloma I - Immobilization/idiopathic D - Vitamin D intoxication T - Tumors
Membrane conductance (think conductance = channels open)
Carbamazepine
Pterygopalatine ganglion (I remember this as the only ganglion left.)

8. What disease has a genetically low level of UDPglucuronate transferase - resulting in elevated free unconjugated bilirubin?

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9. What are the two best indices of left ventricular preload?
Ticlopidine or clopidogrel
LVEDV and LVEDP (left ventricular end - diastolic volume and end - diastolic pressure - respectively)
To provide attachment between contiguous cells and to maintain a semipermeable barrier
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.

10. What complement factor deficiency leads to x Leukocyte adhesion deficiency with poor opsonization?
C1 - C2 - or C4 deficiency
2 - 4- Dinitrophenol
IgA
Chromosome 19

11. What are the three mechanisms of action for atrial natriuretic peptide's diuretic and natriuretic affects?
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts
Triazolam
G-6- PD deficiency; pyruvate kinase deficiency is second.
Prinzmetal variant angina

12. What syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use?
Eaton - Lambert syndrome
VSD
The small subunit (40S) binds first.
Sj

13. At what stage of sleep is GH output elevated?
Stage 4
Inulin
Sheehan syndrome
IF-2 of the 30S subunit

14. What AA is a precursor of the following substances? - Serotonin
Brucella and Listeria (has tumbling motility)
Tryptophan
Rapid efflux of potassium
28 L - 40% of body weight

15. What area of the posterior aspect of the eye has no photoreceptors?
Lysine and tyrosine
Chief cells
The optic disk is the blind spot.
Adenocarcinoma

16. What disorder is described as having x Unconscious symptoms with unconscious motivation?
Foscarnet
Eisenmenger syndrome - which can also occur with any left - to - right shunt
Dihydrotestosterone
Somatoform disorder

17. What is the DOC for CMV retinitis?
Bioavailability
Urinary 17- OH steroids
Ganciclovir
Decreases

18. What DNA virus is associated with heterophile - negative mononucleosis?
Average
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
Macula densa
Somatization disorder

19. What three AAs are used to synthesize the purine ring?
Folic acid deficiency
IgA
The portal tract of the liver lobule
1. Glycine 2. Aspartate 3. Glutamine

20. What family do the following viruses belong to? - Hantavirus
Albinism
Palms - up before palms - down maneuvers
Hemiazygous vein
Bunyavirus

21. What result occurs because of the negative alveolar pressure generated during inspiration?
Marrow failure - cancer - and leukemia
Because creatinine is filtered and a small amount is secreted
O2 has a higher driving force but is only one - twenty- fourth as soluble as CO2. CO 2 has a very small partial pressure difference across the alveolar membrane (47-40 = 7 mmHg) - but it is extremely soluble and therefore diffuses readily across the
Air flows into the respiratory system.

22. What are the pharmacologic effects seen sexually with x Serotonin?
Inhibited orgasm
The stomach
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Foramen of Winslow

23. What is the most common condition leading to an intracerebral bleed?
HTN
The Beta -2- microglobin. It is the separately encoded Beta - chain for class I Ags.
Urachus
Goodpasture syndrome

24. What is the main mechanism for exchange of nutrients and gases across a capillary membrane?
Western blot
Streptokinase
Phase 4
Simple diffusion; it does not use protein - mediated transport

25. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CA-125
Ovarian cancer
Renin secretion
Major basic protein
Stretch receptors prevent overdistension of the lungs during inspiration.

26. Name the most common type or cause - Sudden cardiac death
Hepatic adenomas
Sporothrix schenckii
Ventricular fibrillation (V fib)
Round and ovarian ligaments

27. Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade?
G-6- PD
Vanillylmandelic acid (VMA)
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)

28. What is defined as a general estimate of the functional capacities of a human?
Mitral stenosis
Methylphenidate (Ritalin)
t the end of the PCT 25% of Na+ - Cl - - K+ is left
IQ

29. Paranoid and catatonic schizophrenia are good...
Outside the cell
prognostic predictors
Cancer
Maxillary artery

30. What segment of the nephron has the highest concentration of inulin? Lowest concentration of inulin?

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31. What type of muscle is characterized by no myoglobin - anaerobic glycolysis - high ATPase activity - and large muscle mass?
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
White muscle; short term too
Median nerve
Estrone

32. What type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea?
Papillary carcinoma of the thyroid
Gonococcus
Streptococcus viridans
Hgb F

33. What is the most abundant neuron in the cerebellum?
Visceral pleura
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
IgG4
Stage 3 and 4

34. What medication is used to help alcoholics avoid relapse by decreasing glutamate receptor activity?
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
School phobia
Fusobacterium
Cestodes

35. What is the effect of T3 on the glucose absorption in the small intestine?
Intermediate part of the hemispheres
Female pseudohermaphrodite
Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine.
Respiratory depression

36. How many ATPs per glucose are produced by pyruvate dehydrogenase?
Palindrome
Adipose tissue
Goodpasture disease
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)

37. What organism would you suspect in a patient with diarrhea after eating rice?
Gonads
Repolarization is from base to apex and from epicardium to endocardium.
Bacillus cereus
Cleft palate

38. What component of the vascular system is most sensitive to the effects of calcium channel blockers?
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
Premature ejaculation
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
Arterioles

39. Based on operant conditioning - What type of reinforcement is described when x Removing a stimulus reinforces a behavior?
Buffers (remember that buffers are best when they are used in a pH range near its pK)
IgM
Negative reinforcement
Cervical neoplasia

40. Which gram - negative diplococcus ferments maltose?
Ipsilateral flaccid paralysis
Meningococcus (Gonococcus does not)
RU 486
Streptomycin

41. What antidepressant - which recently was approved for general anxiety disorder - inhibits the reuptake of NE and 5- HT?
Venlafaxine. (It also has a mild dopaminergic effect.)
Hypoactive sexual desire disorder
Clostridium perfringens
Amyl nitrate - sodium nitrate - or sodium thiosulfate

42. With what disease do you see IgA deposits in small vessels of the skin and the kidneys?
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.
Henoch - Sch
Lung cancer
Malignancy

43. What are the four chemotactic agents?
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
Primary hypogonadism (postmenopausal women)
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides

44. What is the main factor determining GFR?
4.7 L - 5% of body weight
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)

45. What are the four effects of suckling on the mother?
Lung cancer
Helicase (requires ATP for energy)
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion

46. What operant conditioning therapy or modification is described as x Stopping the reinforcement that is leading to an undesired behavior?
Hormone - sensitive lipase
H 2
Extinction
Allelic exclusion. It is to ensure that one B cell produces only one Ab.

47. What is the most common one? - Benign tumor of the breast
a1- Receptors
Fibroadenoma
Insulin
Stibogluconate

48. With what stage of sleep are bruxisms associated?
HMP shunt
Enkephalin
Teeth grinding is associated with stage 2 sleep.
Volume of distribution is decreased when a large percentage of drug is protein bound.

49. Name the B- cell CD marker: x Required for class switching signals from T cells
Vital capacity (VC)
Thiamine and folate
Posterior compartment of the leg - tibial nerve
CD40

50. What is the most common one? - Subtype of Hodgkin lymphoma
Nodular sclerosis
Temporal lobes
Varicocele
Phase I