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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. Why isn't the incidence of a disease decreased when a new treatment is initiated?
Glucuronidation
D- Penicillamine
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).
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet

2. Based on the onset of the symptoms - how are bacterial conjunctivitis from Neisseria and Chlamydia differentiated?
Stable
Terminal bronchioles. (No gas exchange occurs here.)
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.
PGI2

3. What is the drug of choice in treating a patient with hyperuricemia due to underexcretion of uric acid?
gamma and delta chains
In the mouth with salivary a - amylase (ptyalin)
Phosphofructokinase -1 and costs 1 ATP
robenecid - a uricosuric agent

4. Dopamine antagonists are...
Subacute bacterial endocarditis
antiemetic
Hematogenous
The alveolar PO2 and PCO2 levels

5. Eating fava beans can produce the Mediterranean type of what deficiency?
Ethyl alcohol
G-6- PD deficiency
Estriol
Chromosome 9 - 22 (Philadelphia chromosome)

6. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x cyclin D
GH deficiency
Chromaffin cells (adrenal medulla)
Right medial longitudinal fasciculus
Mantle cell lymphoma

7. What is the first membrane - bound Ig on B cell membranes?
GP120
Hypoxia
IgM; IgD follows shortly thereafter.
Thymine (B1)

8. Do the following structures pick up stain from hematoxylin or eosin? - RBCs
Eosin
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
Gastric carcinoma
Chromosome 15 - 17

9. What is the term for a congenital absence of the ganglionic cells of the Auerbach and Meissner plexus in the rectum and sigmoid colon?
Metanephros
Copper
Succinylcholine
Hirschsprung disease (aganglionic megacolon)

10. What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria?
Spironolactone
Bcl -2
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.
LTB4

11. A chronic alcohol abuser goes to the ER with weakness - a sore - beefy red tongue - loss of vibration and position sense - arm and leg dystaxia - elevated levels of methylmalonic acid in the urine - and anemia with an MCV above 105 fL. What is your d
Meiosis I; disjunction with centromere splitting occurs during meiosis II.
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working - you will see an increased reticulocyte count on the peripheral smear in about 5 days.
Pernicious anemia
Narcissistic

12. What right - to - left shunt occurs when only one vessel receives blood from both the right and left ventricles?
Wilms tumor
Persistent truncus arteriosus
Saccule and utricle
Clostridium perfringens

13. What is the leading cause of primary hyperparathyroidism?
Fourth M PITS for pharyngeal pouch derivatives
Chief cell adenoma (80%)
Chemotaxis
Blastomyces dermatitidis

14. After traveling in a plane across the Atlantic Ocean - an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose?
Glioblastoma multiforme
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
Trimethoprim/sulfamethoxazole (TMP- SMX)
Gametocytes

15. Prevents restriction endonuclease from cutting its own chromosomes.
C5- C8 deficiency
IL-10
Crohn disease
Methylation of bacterial DNA

16. How many days prior to ovulation does LH surge occur in the menstrual cycle?
Escherichia coli
The urea cycle
Tetany
1 day prior to ovulation

17. How many bases upstream is the eukaryotic TATA box promoter?
Insulin
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
At least 30% blast in the bone marrow
Integrase

18. What ocular muscle x Abducts the eyeball and is involved in horizontal conjugate gaze?
Anterior compartment of the leg - deep peroneal nerve
3 months of symptoms in 2 consecutive years
Calcium oxalate
Lateral rectus (CN VI) (LR6 SO4)3

19. Name the correct artery - The left recurrent laryngeal nerve passes around it.
Integument (skin and its derivatives)
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
Ampulla
Arch of the aorta

20. Which serotypes of HPV are associated with plantar warts?
Occipital lobe
The conversion of CHO to pregnenolone via the enzyme desmolase
Ulcerative colitis
HPV serotypes 1 and 4

21. What form of renal tubular reabsorption is characterized by high back leak - low affinity for substance - and absence of saturation and is surmised to be a constant percentage of a reabsorbed filtered substance?
Hirschsprung disease (aganglionic megacolon)
Reovirus
Gradient - time system
Hemophilia A

22. What muscle keeps the stapes taut against the oval window?
Stapedius muscle
6 weeks 10 weeks
Medial compartment of the thigh - obturator nerve
Multiple myeloma

23. What is the name of depression and mania alternating within a 48- to 72- hour period?
LTC4 and LTD4
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.
Rapid cycling bipolar disorder
Leydig cell tumor

24. What diseases are associated with HLA- DR4
Sj
Hydroxyapatite
Hypertrophy
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)

25. Which drug is used to treat opioid withdrawal - ADHD - and sometimes Tourette's syndrome?
Clonidine
With arteriolar constriction both the flow and pressure downstream decrease.
Shortens
Cause - specific mortality rate

26. What branch off the vertebral artery supplies x The ventrolateral two - thirds of the cervical spinal cord and the ventrolateral part of the medulla?
Anterior spinal artery
Effective dose for 50% of drug takers (median effective dose)
Pneumococcus (Streptococcus pneumoniae)
Pancreatic cancer

27. Which antimicrobial agent is used with pyrimethamine to treat toxoplasmosis?
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.
Clindamycin
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.
Intercellular adhesion molecule (ICAM) 1

28. Which major cell type is found in the red pulp of the spleen?
A gene (a rather simple definition but accurate)
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Terminal ileum
RBCs. That is why it is called red pulp.

29. Name the most common type or cause - Hematologic cause of papillary necrosis
LTB4
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
Areas 5 and 7
Sickle cell disease

30. What color do fungi stain with PAS? Silver stain?
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Hot pink with PAS and grey to black with silver stain
Folic acid deficiency
Major

31. What is the most common one? - Liver tumor
Minimal change disease
Gastrin - releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)
Oblique fissure
Metastatic carcinoma

32. What metal poisoning produces microcytic anemia with basophilic stippling?
Both
Lead poisoning
Hepatoma and nonseminomatous testicular germ cell tumors
Decreases

33. What is the size of a positive PPD test for the following? (Reactive) x Recent immigrant from India
Axillary nerve and posterior humeral artery
Herpes virus I and II
>10 mm
Ependymal cells

34. Name three opsonins.
IgA nephropathy
Fc portion of IgG - C3b - and mannose - binding proteins
Superego
overall dopamine activity

35. What happens to the Ab specificity when class switching occurs in mature B cells?
EF- Tu or EF- ts and GTP
As the isotype is switched - the Ab specificity does not change because it does not affect the variable chains.
Galactose and glucose
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function

36. What neuronal cell bodies are contained in the intermediate zone of the spinal cord? (T1- L2)
G2 phase
Preganglionic sympathetic neurons
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.)
Lactulose

37. What is the name for the following RBC indices? - The coefficient of variation of the RBC volume
Nonsense
Pyelonephritis
Free ionized Ca2+
Red blood cell distribution width index (RDW)

38. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF ? - capillary pressure ?
Avidity (more than one binding site)
Areas 18 and 19
Constriction of efferent arteriole
CHF - cirrhosis - and nephrosis

39. How many carbons do estrogens have?
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
Stibogluconate
Ischemic
The respiratory system

40. What cell in chronic inflammation is derived from blood monocytes?
Macrophages
Iron deficiency anemia
Rhombencephalon
Hydrostatic pressure of the glomerular capillaries (promotes filtration)

41. What is the first Ab a baby makes?
It both begins and ends at T4 (sternal angle [of Louis]).
IgM
The Beta -2- microglobin. It is the separately encoded Beta - chain for class I Ags.
Common peroneal nerve

42. What is pumped from the lumen of the ascending loop of Henle to decrease the osmolarity?
NADPH oxidase
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
Osteoarthritis
Pulmonary infections

43. What Ig is associated with mast cell and basophil binding?
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
igantism
Lipoid nephrosis
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.

44. How is sleep affected in a person with alcohol intoxication?
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
H 2
Decreased REM sleep and REM rebound during withdrawal
Peyer's patch

45. What is the first branch of the abdominal artery?
Type III hypersensitivity reaction
Farnesyl pyrophosphate (FPP)
Erythema multiforme
Inferior phrenic artery

46. What peripheral chemoreceptor receives the most blood per gram of weight in the body?
Ketamine
The carotid body - which monitors arterial blood directly
Social learning theory
Hypotonia (rag doll appearance)

47. Name the antidote - Copper
Positive correlation
D- Penicillamine
Coxsackie B
Raloxifene

48. In What type of circuit is the total resistance always less than that of the individual resistors?
Extrahepatic biliary atresia
Microsporum
Carbamoyl phosphate synthetase I
Parallel circuit

49. What structure of the knee is described thus? - Prevents adduction
Silicosis - Coal worker's pneumoconiosis is synonymous with black lung disease - an upper lobe occupational disorder
Lateral collateral ligament
Marrow failure - cancer - and leukemia
C5a

50. Where in the spinal cord are the presynaptic opioid receptors?
The biofeedback model is based on the parasympathetic nervous system.
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
Membranoproliferative glomerulonephritis (MGN)
In the dorsal horn of the spinal cord on the primary afferent neurons