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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 second leading cause of cancer deaths in males? In females?

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2. What is the effect of insulin on protein storage?
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
Bacterial meningitis
Anaerobes
Mitosis

3. What water - soluble - vitamin deficiency is associated with neural tube defects in the fetus?
None; they are not formed until a girl reaches puberty.
Nodes of Ranvier
Bronchogenic carcinoma
Folic acid

4. Which class of antihyperlipidemics would you avoid for a patient with elevated triglyceride levels?
The parasympathetic nervous system
Ovulation
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.
Decreasing potassium conductance - which results in increased excitability

5. What enzyme of pyrimidine synthesis is inhibited by the following? - 5- FU
Thymidylate synthase
Alcohol abuse
Berylliosis
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.

6. What CN is associated with the x First pharyngeal arch?
Lesser curvature of the antrum of the stomach
Operant conditioning (reinforcement is after a response)
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
CN V

7. What AA undergoes N- glycosylation?
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Asparagine
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)

8. What is the most common one? - Organ involved in amyloidosis
Kidney
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
Increase enzyme concentrations
Infection

9. What is the most common one? - Helminth parasitic infection in the United States
Endometrial cancer
Enterobius vermicularis
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Medial midbrain (Weber's) syndrome

10. What is the most common one? - Route for infectious arthritis
Constrictor pupillae and ciliary muscles
Hematogenous
Urogenital sinus
Vitamin B12 deficiency and folate deficiency

11. What is the term for the collapse of the vertebral body due to TB?
Third week
Pott disease
Operant conditioning (reinforcement is after a response)
HPV serotypes 1 and 4

12. A marfanoid patient presents with tearing retrosternal chest pain radiating to her back. What is your first diagnosis?
The larger the volume of distribution - the lower the plasma concentration of a drug.
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.
ELISA is used as a screening test because it is very sensitive; Western blot is used as a confirmatory test because it detects antibodies (protein) to the HIV virus.

13. What is the only glycosaminoglycan (GAG) that binds to the linker portion of the proteoglycan?
Mitral insufficiency
Hyaluronic acid (all sulfates bind to the core protein)
Distal convoluted tubules
There would be a Fab' region; thus - it would still be able to participate in precipitation and agglutination.

14. Name the laryngeal muscle described by the following: x Only muscle to abduct the vocal cords
LTB4
Meckel diverticulum
Posterior cricoarytenoid muscles
Fading

15. What AA is a precursor of the following substances? - Creatine
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages
Glycine/arginine

16. What is the most common infectious agent in HIV?
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
Amiloride
Pneumocystis carinii
Nissl substances; there is a great deal of RER in neuron cell bodies - indicating high protein synthesis.

17. What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN - hypokalemia - and low rennin levels?
Reaction formation
Decreases
Corticosteroid
Conn syndrome (primary hyperaldosteronism)

18. What embryonic structure forms the following adult structures? - Urinary bladder and urethra
Eosinophils
Urogenital sinus
Marfan syndrome
Reserpine

19. Where are the lowest resting PO2 levels in a resting individual?
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
unprocessed Ags
Coronary circulation
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)

20. Name the hormone
Epinephrine
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Metronidazole
Omphalocele and gastroschisis

21. What cells of the epidermis - derived from the neural crest - act as mechanoreceptors?

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22. What is given to pregnant women within 24 hours after birth to eliminate Rh+ fetal blood cells from their circulation?
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Apoptosis (Remember - there is a lack of inflammatory response.)
Rho (D) immune globulin (RhoGAM) - an anti - RhD IgG antibody - prevents generation of RhD- specific memory B cells in the mother.
Rheumatoid arthritis

23. What pyrimidine base is found x Only in RNA?
Uracil
Ependymoma
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
Double - blind study. It is the most scientifically rigorous study known.

24. Why is spermatogenesis decreased with anabolic steroid therapy?
Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone - produced by Leydig cells - is needed for spermatogenesis.
Nodular sclerosis
Libman - Sacks endocarditis
Intellectualization

25. What somatoform disorder is described as x La belle indiff
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.
embranoproliferative glomerulonephritis (MPGN)
Conversion disorder
Gubernaculum

26. What organism is associated with the following types of diarrhea? Day care - associated diarrhea in infants
Rotavirus
Phase 0
Lead poisoning
3 ATPs by oxidative phosphorylation

27. Name the type of exudate - given the following examples - Parasitic infection
Selegiline
Eosinophilic exudates
Upper outer quadrant (left more than right)
Glucagon and epinephrine

28. What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
Myasthenia gravis
Fragile X syndrome
Decreases
Streptococcus agalactiae

29. What vitamin deficiency produces angular stomatitis - glossitis - and cheilosis?
Adenosine deaminase (ADA) deficiency
Riboflavin (B2) deficiency
Atracurium
Prolactin

30. What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
Malingering
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.

31. What enzyme of the TCA cycle also acts as complex II of the ETC?
The aorta
Anterior compartment of the thigh - femoral nerve
Succinate dehydrogenase
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.

32. How are flow through the loop of Henle and concentration of urine related?
From age 5 onward IQ stabilizes.
As flow increases - the urine becomes more dilute because of decreased time for H2O reabsorption.
Hapten (not immunogenic)
Chloramphenicol

33. How are pulse pressure and compliance related?
Transudative; exudative has the opposite values and has an elevated cellular content.
Progestin
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
Shigella

34. What deep cerebellar nuclei receive Purkinje cell projections in x The intermediate hemispheres?
Red muscle
Chromosome 14 - 18
The dentate nucleus
Fragile X syndrome

35. What nerve is compromised in carpal tunnel syndrome?
Bordetella pertussis
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Standardized rate
Median nerve

36. What two enzymes of heme synthesis are inhibited by lead?
Motor
Blastomyces dermatitidis
Secondary spermatocyte
ALA dehydrogenase and ferrochelatase

37. Name the area of the cerebral cortex with the function described: x Important for REM sleep; origin of NE pathway
Brain abscess
Plasmodium vivax
PICA
Pons

38. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Withdrawn - fearful - explosive moods - violent outbursts - and loss of inhibitions
Crohn disease
IgG
LVEDV and LVEDP (left ventricular end - diastolic volume and end - diastolic pressure - respectively)
Orbitomedial frontal lobe

39. What term is described as the prestretch on the ventricular muscle at the end of diastole?
Preload (the load on the muscle in the relaxed state)
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
Medullary carcinoma of the thyroid
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.

40. Name the most common type or cause - Childhood heart disease in the United States
Congenital heart disease
Transketolase and transaldolase. The reactions they catalyze are reversible.
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
The larger the volume of distribution - the lower the plasma concentration of a drug.

41. What is the MCC of the following meningitides? - In neonates to 3 months of age
Primary intention
Streptococcus agalactiae and Escherichia coli
1. Propranolol 2. Timolol 3. Carteolol
Fanconi - like syndrome

42. What nephrotic syndrome has effacement of the epithelial foot processes without immune complex deposition?
Minimal change disease
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
Mycobacterium marinum
Abs to HBsAg

43. What is the first formal IQ test used today for children aged 2 to 18?
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
A low - resistance system is formed by resistors added in parallel.
ydroxyproline
Homeodomain proteins

44. Which bacteria are associated with the following pigment production? - Red pigmentation
3 years old
Ethambutol
Intercellular adhesion molecule (ICAM) 1
Serratia

45. What is the major hormone produced in the following areas of the adrenal cortex? - Zona reticularis
Risperidone
F- Met - Peptides
DHEA (androgens) Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
HHV-8

46. What thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 increased
HPV infection
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
Mycobacterium leprae
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.

47. What type of correlation compares two interval variables?
Lateral part of the hemispheres
alpha2- Receptors
Biotin (only if eaten in large quantities)
Pearson correlation

48. Is the AD or AR form of osteopetrosis malignant?
Flucytosine
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
The AR form is malignant and AD is benign.
Unconjugated free bilirubin

49. Name the cluster C personality disorder: x Gets others to assume responsibility - is subordinate - and is fearful of being alone and caring for self
Dependent
Calcium influx secondary to slow channel opening
There would be two Fab and Fc regions.
As the standard deviation increases - the greater the chance of error.

50. What class of pharmaceuticals are inactive until they are metabolized to their active products?
Western blot
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)
Prodrugs