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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. If the pH is low with increased CO2 levels and decreased HCO3- levels - What is the acid - base disturbance?
Combined metabolic and respiratory acidosis
Class 1 (1A - 1B - and 1C)
Histiocytosis X
1. Large sample size 2. Large effect size 3. Type I error is greater

2. What three substrates control the enzyme PEPCK for the conversion of oxaloacetate (OAA) to pyruvate in the cytoplasm?
Escherichia coli
Histamine
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP
Acetazolamide

3. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Euphoria - delusions - thought disorders - Wernicke's aphasia - auditory hallucinations (Hint: the lesion is in the left hemisph
Enterobius vermicularis; the treatment is albendazole.
Dominant temporal lobe
Aschoff bodies of rheumatic fever
Estrone

4. Name the type of hypersensitivity reaction based on the following properties - IgE- mediated release of chemical mediators from basophils and mast cells; need prior exposure to Ag in the past; eosinophils amplify and continue reaction; can be system
pH of 2 and 9
Type I hypersensitivity (anaphylactic)
Total lung capacity (TLC)
SSRIs

5. What part of a neuron receives information?
Nitrates
Dendrites receive information - whereas axons send information.
Hemiballismus
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.

6. Name the compartment of the mediastinum associated with the following thoracic structures: Ascending aorta
Middle
Left homonymous hemianopsia
Histrionic
Scavenger receptor (SR- B1)

7. With what disease do you see IgA deposits in small vessels of the skin and the kidneys?
Unconjugated free bilirubin
Henoch - Sch
Prevalence rate
Yes. The only civil liberty they lose is the freedom to come and go as they please.

8. How many pairs of spinal nerves exit from the spinal cord?
31 pairs
HBcAb IgG and HBsAb IgG
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Third week; they are derived from the wall of the yolk sac.

9. Name the antimicrobial agent whose major side effect is listed - Auditory toxicity
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.
Glanzmann syndrome
Type III hypersensitivity reaction
Vancomycin

10. What benign cardiac tumor is associated with tuberous sclerosis?
Folic acid deficiency
Fanconi - like syndrome
Rhabdomyoma
Pseudomembranous exudates

11. In regards to solute concentration - how does water flow?
ater flows from a low - solute to high - solute concentrations.
Huntington disease
Cerebellum
Proencephalon diencephalon derivative

12. Which two tetracyclines have the highest plasma binding?
Doxycycline and minocycline
Rods
C5a
G0 phase

13. Which dimorphic fungus is endemic in the Ohio - Mississippi - Missouri - and Eastern Great Lakes - is found in soil with bird and bat feces - and is associated with infections in spelunkers and chicken coop cleaners?
Histoplasma capsulatum
Stable
Phase 1
1. Protest 2. Despair 3. Detachment

14. Which carcinoma
Hyperplasia
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Spinothalamic tract (anterolateral system)
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)

15. In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
Malignant mesothelioma
Misoprostol
Sigmoid colon
Increases

16. What are the five branches of the superior mesenteric artery?
Niemann - Pick and Tay- Sachs diseases
IQ
S phase
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries

17. What enzyme is deficient in alkaptonuria?
Molluscum contagiosum
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
Homogentisic oxidase
Methanol (wood alcohol)

18. Megaloblastic anemia and thrombocytopenia are signs of what vitamin deficiency?
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
Griseofulvin
Folic acid deficiency
Hydroxyapatite

19. What substance is secreted by parietal glands and is required for life?
Doxycycline
The central vein of the liver lobule
Intrinsic factor (IF)
Thymine

20. Are hydrolysis - oxidation - and reduction phase I or II biotransformations?
Phase I
Lower lobe
Pulmonary infections
Mitosis

21. What somatoform disorder is described as x Unrealistic negative opinion of personal appearance - seeing self as ugly?
IL-8 (IL-1 and TNF- gamma also)
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
Body dysmorphic disorder
Gain of hypertonic fluid (mannitol or hypertonic saline)

22. Name the most common cause - Blindness in the United States
Ligamentum venosum
Diabetes mellitus
VLDL
Somatic motor neurons

23. What organism is associated with the following types of diarrhea? Bloody diarrhea associated with hamburger ingestion
Enterohemorhagic Escherichia coli
Ampulla
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.
Renal circulation

24. What sensory system is affected in the late spinal cord manifestation of syphilis?
In the mouth with salivary a - amylase (ptyalin)
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
Ligamentum arteriosum
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.

25. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Vinyl chloride
Coagulative
Stage 2
Pseudomonas sp.
Angiosarcoma of the liver

26. If inserting a needle to perform a pleural tap or insertion of a chest tube - do you use the inferior or the superior border of a rib as your landmark? Why?
Liver (hepatocytes)
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
Folic acid deficiency

27. What AA is substituted for glutamic acid at position 6 on the Beta - chain in patients with sickle cell anemia?
Valine
Zero - order elimination
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Folate deficiency (very common in the elderly)

28. What is the most common one? - Thyroid cancer
Adrenal medulla
Transference. When it is from the physician to the patient it is called countertransference.
Proteus
Papillary carcinoma

29. Name the GLUT transporter based on the following: x Found in liver and pancreatic Beta- cells
GLUT 2
Liver - kidney - and GI epithelium
Proline and lysine
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.

30. Name the ocular lesion; be specific - Right calcarine cortex lesion
AT II
Sublimation
Left homonymous hemianopsia
Anterior hypothalamic zone; lesions here result in hyperthermia.

31. Fact without feeling (la belle indiff
Guanethidine and bretylium
Isolation of affect
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
Adenocarcinoma

32. What is the effect of T3 on heart rate and cardiac output?
Hapten; if it is coupled with a carrier - it may become immunogenic.
T3 increases both heart rate and cardiac output by increasing the number of Beta - receptors and their sensitivity to catecholamines.
HBeAg
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.

33. What AA is a precursor of the following substances? - NAD
Protein A
Leuprolide
Anterior compartment of the leg - deep peroneal nerve
Tryptophan

34. Which cestode infection results in alveolar hydatid cyst disease?
Echinococcus multilocularis
Nodular sclerosis
Hemosiderin
The vagina

35. Name the stages of sleep with these EEG patterns: x Disappearance of alpha waves - appearance of theta waves
Incidence rate
Yolk sac tumor
Average
Stage 1

36. What is the term for the day after the LH surge in the female cycle?
Adulthood
Hepatitis B and hepatitis C
Common and internal carotid arteries
Ovulation

37. What is the term for the appearance of the kidney in malignant hypertension (it has petechiae on its surface)?
Superficial spreading melanoma
Flea - bitten kidney (can also be seen in pyelonephritis)
Prostate and lung cancer - respectively
Sheehan syndrome

38. What is the term for dilated veins within the spermatic cord?
Papillary carcinoma of the thyroid
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
Varicocele

39. What leukemia affects a 4-year - old child with 3 months of fever - fatigue - generalized lymphadenopathy - CNS involvement - hepatosplenomegaly - bleeding - and platelet count below 100 - 000?
Common and internal carotid arteries
Squamous cell carcinoma
Syringomyelia
ll

40. What encapsulated gram - negative - lactose - fermenting rod is associated with pneumonia in patients with alcoholism - diabetes - and chronic lung disease?
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.
produce bile
Roth spots
Klebsiella pneumoniae

41. Where is renin produced?
Reticulocyte
In the JG cells of the kidney
Scrofula
Glycogen phosphorylase

42. What is the most common lysosomal storage disorder?
No. Remember - tests do not diagnose - they confirm or refute your diagnosis. Also - diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI - elevated cardiac enzymes consistent with MI - and ST segment elevati
Being single
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
Gaucher disease

43. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Denial of illness - hemineglect - construction apraxia (can't arrange matchsticks)
Nondominant parietal lobe
Arboviruses (bunyavirus - flavivirus - and togavirus)
Parasites
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.

44. Name the 10 retroperitoneal organs.
Size
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
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

45. Dopamine antagonists are...
<2
antiemetic
Nondominant temporal lobe
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.

46. What parasite found in raw fish can produce vitamin B12 deficiency?
Third week
Anterior tibial artery
Incidence rate
Diphyllobothrium latum

47. What are the three polymorphonuclear leukocytes? Be specific.
Marrow failure - cancer - and leukemia
Neutrophils - eosinophils - and basophils
Prophase of meiosis I (between 12th and 22nd week in utero)
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.

48. Which tetracycline is used in the treatment of SIADH?
Negative
hypophosphatemia
Demeclocycline
Thyroid hormones

49. What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting - fissuring - and oozing?
Hairy cell leukemia
Mean corpuscular volume (MCV)
Sensory
Paget disease of the breast

50. What are the two ways that nitrogen can enter into the urea cycle?
Osteoblast (Remember - blasts make - clasts take)
The tsetse fly
Aspartate and carbomoyl PO4
IgA