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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 a2- antagonist is used to treat impotence and postural hypotension?
Yohimbine
Dimercaprol - D- penicillamine
Plasmodium ovale
Superior and middle

2. What is the most common one? - Bone disorder in the United States
Flumazenil
Osteoporosis
Progestins
Negative

3. What area of the female reproductive tract is lined by stratified squamous epithelium rich in |glycogen?
Job syndrome
Folic acid deficiency
Bulbus cordis
The vagina

4. What is the site of action for carbonic anhydrase inhibitors?
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
Proximal tubule
Spectinomycin
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.

5. Name the area of the cerebral cortex with the function described: x Skill - based memory - verbal recall - balance - refined voluntary movements
Resistance decreases as resistors are added in parallel.
Factitious disorder
Cerebellum
TB meningitis

6. Which cerebral herniation results in compression of the anterior cerebral artery?
Cingulate gyrus herniation (subfalcine)
Lac repressor protein
Melanin
Fever - night sweats - and hemoptysis

7. How many ATPs per glucose are generated in glycolysis?
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
Isolation of affect
Acral - lentiginous melanoma
Burkitt lymphoma

8. What is the most common one? - Form of muscular dystrophy
Cross - sectional studies determine prevalence - not incidence or cause and effect.
Hyaluronic acid (all sulfates bind to the core protein)
Duchenne muscular dystrophy
Flocculonodular lobe (one of my favorite words in all of medicine!)

9. Name the most common type - Phobia
Paroxysmal nocturnal hemoglobinuria
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
Goodpasture syndrome
Stage fright (discrete performance anxiety)

10. What are the two most common viral infections in HIV?
CMV retinitis and HSV-2
Mantle cell lymphoma
Chromomycosis
None; they are the storage sites for ADH and oxytocin.

11. What is the enzyme for the oxidative reaction in glycolysis?
Glyceraldehyde dehydrogenase
Emphysematous bleb
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.
Duchenne muscular dystrophy

12. In which form of emphysema - panacinar or centriacinar - is the effect worse in the apical segments of the upper lobes?
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
HMG CoA synthase
Allograft
Anemia

13. What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
Raloxifene
Phosphorylation of mannose residues
Area 17
Cryptococcus

14. What vitamin is necessary for epithelial health?
Malpighian layer (made up of the stratum basale and stratum spinosum)
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
NE - via its vasoconstrictive action on blood vessels
Vitamin A is responsible for vision and epithelial health.

15. Where is the action potential generated on a neuron?
Axon hillock
Alzheimer disease
Clostridium botulinum
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.

16. What form of arthritis is associated with calcium pyrophosphate crystals?
Diphyllobothrium latum
Agoraphobia. It also means having a sense of humiliation or hopelessness.
Gout
Pseudogout

17. What type of Plasmodium affects x RBCs of all ages?
Cause - specific mortality rate
Hypocalcemia and hypophosphatemia
Plasmodium falciparum
ACh receptor

18. In which quadrant is breast cancer most commonly found?
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
Eaton - Lambert syndrome
Dihydropteroate synthetase
Upper outer quadrant (left more than right)

19. What are the primary neurotransmitters at the following sites? - Postganglionic sympathetic neurons
Between the renal arteries and at the bifurcation of the abdominal aorta
IQ
NE
Middle cerebral artery

20. What is the biochemical trigger for REM sleep?
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Varicella
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
Papillary carcinoma of the thyroid

21. What vitamin deficiency causes a glove - and - stocking neuropathy seen in alcoholics?
Pyridoxine (B6) deficiency
Proencephalon diencephalon derivative
hnRNA
Superior and posterior

22. What two areas of the skin do not contain sebaceous glands?
Rhinoviruses for summer and fall; coronaviruses for winter and spring
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Action potential
IgE

23. What genetic defect is characterized by coarse facial features - gingival hyperplasia - macroglossia - psychomotor and growth retardation - club foot - claw hand - cardiorespiratory failure - and death in the first decade of life?
Monocytosis
Negative reinforcement
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
Increase enzyme concentrations

24. What type of erythema do you see in x Rheumatic fever?
Shortens
Calcium influx secondary to slow channel opening
Bronchogenic carcinoma
Erythema marginatum

25. What hormone controls relaxation of the lower esophageal sphincter during swallowing?
eIF-2 in the P site
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.
Osteogenesis imperfecta

26. What is the most common one? - Site of ischemia in the GI tract
Splenic flexure
Extracellular
Aspartame
Homocysteine methyl transferase

27. What is the most common one? - Malignancy in children
Humerus (between the medial epicondyle and the trochlea)
All
The venae recta maintain the gradient via countercurrent flow.
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.

28. What law was adopted to shield physicians from liability when helping at the scene of an accident?
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
Good Samaritan Law. (Physicians are not required to stop and help.)
Reiter syndrome
C- peptide levels

29. What neurotransmitter is associated with sedation and weight gain?
Histamine
EBV
The aorta
Because it is the largest vessel and has the highest velocity in systemic circulation

30. What are the three stages that children aged 7 months to 5 years go through when they are separated from a primary caregiver for a long time?
Efficacy
1. Protest 2. Despair 3. Detachment
Cushing's ulcers
Hydralazine

31. What is the term for formation of a stable fibrin - platelet plug to stop bleeding?
Hemostasis
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
Trichophyton
Superior and posterior

32. What type of bilirubin is found in neonatal jaundice?
Indirect or unconjugated
Streptococcus agalactiae
Area 17
Palindrome

33. What Hgb - derived endogenous pigment is found in areas of hemorrhage or bruises?
Arch of the aorta and right subclavian artery
Salpingitis
Acute glomerulonephritis
Hemosiderin

34. What protein is required by prokaryotic RNA polymerases to initiate transcription at the promoter region of DNA?
Sigma factor
Phallus
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.
Renshaw neuron

35. What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Hypothyroidism. (TSH levels must be monitored.)
Areas 1 - 2 - and 3
Thoracic splanchnic fibers
Visceral pleura

36. What percentage of CO2 is carried in the plasma as HCO3- ?
90% as HCO3- - 5% as carbamino compounds - and 5% as dissolved CO2
The conversion of CHO to pregnenolone via the enzyme desmolase
Herpes II
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino

37. What bones make up the acetabulum?
Pubis - ilium - and ischium
Eosinophil chemotactic factor A
Clostridium botulinum
Estrogen use

38. What type of drug elimination is characterized by the following? - Elimination directly proportional to plasma level; constant fraction eliminated per unit time; fixed half - life
Creatinine
1. Covalent bonding between the hapten and carrier 2. B- cell exposure to hapten twice 3. T- cell exposure to carrier twice
IL-5. It also stimulates eosinophil proliferation.
First - order elimination

39. What Ig is the major protective factor in colostrum?
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Catatonic schizophrenia
IgA

40. Name the T- cell CD marker: Is a costimulatory molecule in T cell activation
The DCML system. (Remember - everything but pain and temperature.)
CD28
GnRH
All are lactose fermenters except Yersinia and Proteus.

41. Which B- cell neoplasm has the following cell surface markers: CD19 - CD20 - CD5 (T- cell marker) - CD23; and are CD10- negative?
Shaping (successive approximation)
Parietal cells (Remember - they secrete HCl - too.)
CLL (B- cell origin)
Misoprostol

42. What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
Tylosis
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
Arterial PCO2 levels are proportional to cerebral blood flow.
Gabapentin

43. A 20-year - old college student has fever - grey- white membranes over the tonsils - posterior auricular lymphadenitis - and hepatosplenomegaly. What is your diagnosis? What test do you order to confirm your diagnosis?
Down syndrome (trisomy 21)
Aedes mosquito
Embolism
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember - it may be negative in the first week of the illness - so retest if you have a high index of suspicion.)

44. What component of the ETC is inhibited by the following? - Barbiturates
Complex I
Gluteus maximus
Primary hypercortisolism
Subacute bacterial endocarditis

45. Is there more circulating T3 or T4 in plasma?
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
Conidia
CD19
Seminoma

46. What is the term for pelvic inflammatory disease of the fallopian tubes?
Trichuris trichiura is treated with albendazole.
Salpingitis
Liquids - CHO - protein - fat
Gastric carcinoma

47. Name the most common type or cause - Infantile bacterial diarrhea
It increases REM and total sleep time.
Metastatic carcinomas
Ethyl alcohol
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)

48. What virus causes hoof - and - mouth disease?
Glioblastoma multiforme
Vesicular stomatitis virus
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result) - these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease - when obstructive symptoms begin to occur.
Viruses

49. Does being a female physician increase or decrease the risk of suicide?
Chromosome 5p
Correlation. No - correlation does not imply causation.
Being a female physician increases the risk of suicide nearly four times the general population.
Malpighian layer (made up of the stratum basale and stratum spinosum)

50. Name the most common type or cause - Hematologic cause of papillary necrosis
Sickle cell disease
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
Dihydrofolate reductase
Somatic motor neurons