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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 major hormone produced in the following areas of the adrenal cortex? - Zona reticularis
Antimicrobial agents
DHEA (androgens) Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Postinfectious GN
VSD

2. What complement factor deficiency leads to x Leukocyte adhesion deficiency with poor opsonization?
Stapedius muscle
Hepatitis E
C1 - C2 - or C4 deficiency
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)

3. Name the antidote - Methyl alcohol
Ethyl alcohol
Cytochrome c
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.
Superior and anterior

4. Do the PO2 peripheral chemoreceptors of the carotid body contribute to the normal drive for ventilation?
Nystagmus and ataxia
IL-5. It also stimulates eosinophil proliferation.
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.
Erythromycin

5. Which streptococcal species is associated with dental caries and infective endocarditis in patients with poor oral hygiene?
Hydrolysis
Streptococcus viridans
The rate of Beta- oxidation
Volkmann's contracture

6. What are the four Ds of niacin deficiency?
Plasmodium vivax
Myelofibrosis with myeloid metaplasia
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death
It is rare with normal grief; however - it is relatively common in depression

7. What three cells are essential for T- cell maturation?
Thymic epithelial cells - dendritic cells - and macrophages
Increase enzyme concentrations
Class IV
Goodpasture syndrome

8. What chronic systemic inflammatory disease commonly seen in women aged 20 to 50 is a progressive - symmetric arthritis affecting the hands - wrists - knees - and ankles that improves with increased activity?
Graves disease
S phase
Coagulative
Rheumatoid arthritis

9. What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
Sacrococcygeal teratoma
Streptomycin
Osteitis fibrosa cystica (von Recklinghausen disease)
HIV

10. What syndrome is characterized by sweating - insomnia - nausea - diarrhea - cramps - delirium - and general restlessness secondary to MAOI and SSRI in combination?
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.
Dominant temporal lobe
Metastatic
Goodpasture syndrome

11. Name the compartment of the mediastinum associated with the following thoracic structures: Splanchnic nerves
Posterior
Cystic fibrosis
ACh - histamine - and gastrin
H 1

12. What is the second leading cause of death in children aged 1 to 14 in the United States?
Fluconazole
Testicular lymphoma
Cancer
Plasmodium vivax

13. What is the most common one? - Bladder tumor
Negative
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
1. Glycine 2. Aspartate 3. Glutamine
Transitional cell carcinoma

14. Name the lung measurement based on the following descriptions: x Additional volume that can be expired after normal expiration
Duchenne muscular dystrophy
Expiratory reserve volume (ERV)
Somatic motor neurons
Hypercortisolism (Cushing syndrome)

15. What are the three carboxylase enzymes that require biotin?
Viral meningitis
Chronic rejection
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Streptococcus pneumoniae

16. Is seen in TB.
>10 mm
Monocytosis
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)

17. What two factors result in the apex of the lung being hypoperfused?
GH and prolactin are produced by acidophils; all others are by basophils.
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.
greater
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.

18. What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Filiform papillae
Pasteurella multocida
Seasonal affective disorder (treat with bright light therapy)

19. What is the name of the monoclonal antibody used in the treatment of Crohn disease and rheumatoid arthritis?
Infliximab
H 1
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Bell pad

20. What are the four ways to down - regulate the immune system?
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Mikulicz syndrome
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti - Ab

21. Which carcinoma
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Vaginismus; it is the female counterpart of premature ejaculation.
Glutamine and aspartate
Fructose; both glucose and galactose are actively absorbed via secondary active transport.

22. Are the following conditions associated with a negative or positive nitrogen balance? - Pregnancy
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
Clostridium tetani
Positive
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.

23. Are the following responses associated with histamines H1 or H2 receptor activation? - Bronchial smooth muscle activity
Proencephalon
H 1
Somatomedins
Temporal lobe

24. What is the term for having fantasies or dressing in female clothes for sexual arousal by heterosexual men?
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Blastomyces dermatitidis
An elevated serum osteocalcin level
Transvestite fetishism

25. What Ig is responsible for activation of complement - opsonization - and ADCC and is actively transported across the placenta?
IgG
Lingual nerve of CN V3
Lentigo maligna melanoma
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain

26. What happens to capillary oncotic pressure with dehydration?
Klebsiella pneumoniae
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
Oncotic pressure increases because of the removal of water.
Adenovirus

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

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28. What is the size of a positive PPD test for the following? (Reactive) x Healthy suburban male without any medical illnesses
Vaginismus; it is the female counterpart of premature ejaculation.
Rhombencephalon
>15 mm
Muscle spindles

29. In what compartment of the thigh is the profundus femoris artery found?

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30. In the water deprivation test - does a patient with reduced urine flow have primary polydipsia or diabetes insipidus?
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
Thymus gland. (Thymus gland is essential for T cell maturation.)
Postinfectious GN

31. What Freudian psyche component is described as x The conscience - morals - beliefs (middle of the road)?
Bronchial asthma (eosinophil membranes)
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
Superego
Hypervariable region (three per light chain; three per heavy chain)

32. What happens to free hormone levels when the liver decreases production and release of binding proteins?
Purkinje cell is the fastest - and the AV node is the slowest.
Lactose must be present and glucose must be absent
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Cytochrome a/a3

33. What are the three microscopic pathologic changes seen in Alzheimer's disease?
Ventral posteromedial nucleus
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
The pH of CSF is 7.33 - acidotic.
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons

34. What is the term for the difference between the highest and the lowest score in a population?
Gonococcus
Insulinoma
Kl
Range

35. What is the most common site for implantation of the blastocyst?
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
Osteosarcoma
Cystadenocarcinoma
On the superior body of the posterior wall of the uterus

36. Describe the organism based on the following information: x Beta - Hemolytic Streptococcus; positive cAMP test; hydrolyzes hippurate
Kartagener's syndrome (also known as immotile cilia syndrome) -------------------------------------------------------------------------------
Residual volume (RV)
Streptococcus agalactiae
give a warning

37. Can you tell which drug is more toxic based on therapeutic indices alone?
Meclizine
No - therapeutic indices can tell which drug is safer - not more toxic.
Vibrio parahaemolyticus
The liver (in the mitochondria)

38. What is the most common one? - Congenital heart defect in adults
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
ASD
Basal ganglia
Subacute combined degeneration - Which is bilateral below the level of the lesion.

39. What enzyme catalyzes the rate - limiting step in heme synthesis?
d - ALA synthase
Parkinson disease
Endometrial cancer
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.

40. Name the type of mutation: New codon specifies a different AA
The vaccine contains 23 capsular polysaccharides.
Avidity (more than one binding site)
Missense
Microglial cells

41. What is the most common opportunistic infection of the CNS in HIV?
Trichophyton
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
Toxoplasmosis
Teratoma (dermoid cyst)

42. According to Freud - what facet of the psyche represents the internalized ideals and values of one's parents?
Hypotonic - because NaCl is reabsorbed in the salivary ducts
Superego
GABA - quantitatively
Ascending limb

43. What disorder is due to a deficiency in the enzyme glucocerebrosidase?
HPV
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
Gaucher disease
Glanzmann syndrome

44. What is the major cell membrane sterol found in fungi?
The fasciculus cuneatus
CN IX - X - and XII CN XI arises from the cervical spinal cord.
Ergosterol
Previous suicide attempt

45. What is the most common one? - Benign breast tumor in females less than 35 years old
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)
Fibroadenoma
Methionine (start) and tryptophan are the only two AAs with only one codon.
1. Liver 2. Muscle 3. Adipose tissue

46. Name three products of HIV's pol gene.
Propranolol
The parasympathetic nervous system
Orotic acid (purine metabolism)
Protease - integrase - and reverse transcriptase

47. Name the antidote - Opioids
Anterior tibial artery
Atrial contraction Atrial - Contraction - Venous
Naloxone - naltrexone
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade

48. What is the rate - limiting step of the following? - Fatty acid synthesis
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
Multiple sclerosis
Distal convoluted tubules
Acetyl CoA carboxylase

49. What Vi - encapsulated gram - negative motile anaerobic rod that produces H2S is associated with enteric fever - gastroenteritis - and septicemia?
Absolute refractory period is due to voltage inactivation of sodium channels.
Thymus gland. (Thymus gland is essential for T cell maturation.)
Rapid efflux of potassium
Salmonella typhi

50. Prolactin levels can serve as a rough indicator of...
Enterococcus (Streptococcus faecalis)
During REM sleep
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
overall dopamine activity