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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 two factors result in the apex of the lung being hypoperfused?
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.
ACE inhibitors (the - pril agents)
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.

2. What nematode is known as threadworms? What is the treatment?
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
Shaping (successive approximation)
Strongyloides stercoralis is treated with thiabendazole.
Granulosa cells

3. What is the neurotransmitter at the d - receptor?
Left heart failure
Ethyl alcohol
Enkephalin
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.

4. What type of healing occurs in a clean surgical incision?
Primary intention
Somatomedins
Metastatic
Histrionic

5. Name the type of mutation: x New codon specifies for the same AA
Dapsone
Sphingomyelinase
Silent
Are live attenuated vaccines available in the United States

6. What are the two most common AAs found in histones?
Proencephalon
The pH of CSF is 7.33 - acidotic.
Lysine and arginine
Mast cells

7. Name the hormone
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death
Glucagon
Hyperplasia
Yellow fever (flavivirus)

8. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol decreased - ACTH decreased
Ritodrine and terbutaline
Secondary hypocortisolism (pituitary)
Opsonization
Avoidant

9. Which shuttle is used to bring fatty acyl CoA from the cytoplasm for ketogenesis?
Carnitine acyl CoA transferase II
Bile salts are actively reabsorbed in the distal ileum.
Four high energy bonds - two from ATP in AA activation and two from GTP
Ependymoma

10. What is the MCC of inherited mental retardation?
Down syndrome
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
REM
Temporal arteritis

11. What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
ACE inhibitors (- pril)
Somatoform pain disorder
Pyrantel pamoate
Terbinafine

12. What is the most common one? Site of congenital diaphragmatic hernias
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.
Turcot syndrome
Yolk sac tumor
Four

13. What mosquito is the vector for dengue fever?
Rotavirus
Ribavirin
Catalase - negative bacteria secrete H2O2 as a byproduct (remember - catalase breaks down H2O2) - allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase - positive bacterial infect
Aedes (the same for yellow fever)

14. What disorder is due to a deficiency in tyrosinase?
Merkel cells (Merkel's tactile cells)
Waldeyer's ring
Albinism
Tetracyclines

15. From which two substances are phospholipids made?
Glutamine and aspartate
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase
Subscapularis
Diacylglycerols and phosphatidic acid

16. What phase of the menstrual cycle is dominated by estrogen? Progesterone?
MGB (think EARS)
Third week
Hemorrhagic exudates
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.

17. Name the area of the cerebral cortex with the function described: x Skill - based memory - verbal recall - balance - refined voluntary movements
Red muscle
Libman - Sacks endocarditis
Cerebellum
Blood clots

18. How far below ideal body weight are patients with anorexia nervosa?
PALS
Femoral nerve
Borderline
At least 15%

19. What bones make up the acetabulum?
Pubis - ilium - and ischium
Mixed (both cholesterol and calcium)
Squamous cell carcinoma
Cortisol

20. How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented?
Hypoxia
Penicillin V
At least 5 lobes
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero - order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than i

21. What artificial sweetener must patients with PKU avoid?
Henoch - Sch
No. It is abnormal only if it interferes with normal sexual or occupational function.
Duodenum
Aspartame

22. What disease results in a failure of neural crest cells to migrate to the myenteric plexus of the sigmoid colon and rectum?

23. What happens to the lung if the intrapleural pressure exceeds lung recoil?
The lung will expand; also the opposite is true.
F- Met - Peptides
Membrane conductance (think conductance = channels open)
Latissimus dorsi

24. What area of the lymph node contains germinal centers?
The outer cortex contains most of the germinal centers and therefore also most B cells.
The systemic veins have the largest blood volume - and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.
Bladder cancer
Uricosuric

25. Orphan Annie cells
Succinylcholine
d - ALA synthase
Papillary carcinoma of the ovary
Serous exudates

26. What syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands?
REM latency; normally it is about 90 minutes.
Plummer - Vinson syndrome
Waterhouse - Friderichsen syndrome
Pantothenic acid

27. What structure is derived from the prochordal plate?
The mouth
Third week; they are derived from the wall of the yolk sac.
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
Social learning theory

28. What is the drug of choice for threadworm - trichinosis - and larva migrans?
Chi - square.
Thiabendazole
An elevated serum osteocalcin level
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.

29. Name the form of spina bifida - Defect in the vertebral arch
apo A-1
Streptococcus agalactiae (Group B Streptococcus - or GBS)
Erythema multiforme
Occulta All except occulta cause elevated - fetoprotein levels.

30. What testicular tumor of infancy is characterized by elevated - fetoprotein levels and Schiller - Duval bodies?
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
Yolk sac tumor
Hirschsprung's disease (colonic gangliosus)
Metronidazole

31. What paraphilia is defined as x Combining sex with defecation?
Combined metabolic and respiratory acidosis
Coprophilia
Hydatidiform mole
Mixed (both cholesterol and calcium)

32. Pseudorosettes
Ewing sarcoma
Eaton - Lambert syndrome
Alcohol. Nearly 10% of adults have a problem with alcohol.
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.

33. Describe the organism based on the following information: x Beta - Hemolytic Streptococcus; positive cAMP test; hydrolyzes hippurate
PR interval
Streptococcus agalactiae
Simple diffusion; it does not use protein - mediated transport
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.

34. What is the most important stimulus for the secretion of insulin?
Neonatal respiratory distress syndrome (NRDS)
An increase in serum glucose levels
Middle
Vitamin D3

35. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
Breast cancer
rRNA
Ventral anterior nucleus
AT II

36. Clue cells are associated with which organism that causes vaginal discharge?
Temporal arteritis
CCK stimulates the pancreas to release amylase - lipase - and proteases for digestion.
Gardnerella vaginalis
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see - can't wee - can't kick with your knee

37. Deficiencies In what enzyme result in insoluble glycogen synthesis formation?
a -1 - 6 transferase
Trimethoprim/sulfamethoxazole (TMP- SMX)
IgD; IgM is also correct.
Metabolic rate and alveolar ventilation (main factor)

38. What is the major stimulus for cell division in chondroblasts?
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
IGF-1
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
Doxycycline and minocycline

39. Which sodium channel blocker is used to treat lithium - induced diabetes insipidus?
Chromosome 5p
B cells; macrophages and dendritic cells are nonspecific.
Amiloride
Increase in erythropoietin and increase in 2 - 3- BPG - also called 2 - 3- diphosphoglycerate (2 - 3- P2Gri) (increase in glycolysis)

40. What lower extremity nerve is described by the following motor loss? - Loss of eversion; inversion - dorsiflexion - and plantarflexion of the foot
Latency stage (6-12 years)
Kinesins. Dynein generates retrograde transportation of information.
Common peroneal nerve
Parasympathetics (parasympathetics point - sympathetics shoot)

41. Which bacteriostatic drug whose major side effect is the lepra reaction inhibits folic acid synthesis?
DNA polymerases
Antisocial
P = .05; P < .05 rejects the null hypothesis
Dapsone

42. Inhibition of peripheral aromatic amino acid decarboxylase and increased CNS availability of L- dopa are results of what drug used in the treatment of Parkinson's disease?
Trichuris trichiura is treated with albendazole.
Carbidopa and benserazide
Glutamate
Prevalence increases. (Incidence does not change.)

43. What negative sense RNA virus is associated with intracytoplasmic inclusion bodies called Negri bodies?
Rabies
Hematoxylin
Lateral pontine syndrome
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland

44. What CNS tumor commonly produces tinnitus and hearing loss?
Trimethoprim
Monosodium urate crystals
Schwannoma
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)

45. What condition is defined by both testicular and ovarian tissues in one individual?
Type IV hypersensitivity (cell - mediated)
Isograft
True hermaphrodism
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)

46. What is the DOC for the following protozoal infections? - Amebiasis
Beryllium
Metronidazole
Plasmodium ovale
Malignant mesothelioma

47. What type of chromatin is transcriptionally inactive?
Squamous cell carcinoma
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
RU 486

48. Name the 10 retroperitoneal organs.
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
Clonidine
Intraductal papilloma
Monocytosis

49. What enzyme of the purine salvage pathway is deficient in the following? - Selective T- cell immunodeficiency
It is rare with normal grief; however - it is relatively common in depression
HPV infection
Purine nucleoside phosphorylase
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.

50. What antiviral agent blocks the attachment and penetration of influenza A virus?
Amantadine
Day 14
Ulnar to radial progression
Coagulative necrosis