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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. How many ATPs per glucose are generated from glycolysis in RBCs?
Constipation and miosis
Mycoplasma pneumoniae
Epstein - cardiac anomaly of the tricuspid valve
2 ATPs - because RBCs use only anaerobic metabolism.

2. What is the name of the spinal cord passing within the subarachnoid space and forming the spinal nerves that exit the lumbar and sacral foramina?
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
Complex I
Cauda equina
Ticlopidine or clopidogrel

3. Which IgG cannot activate complement?
IgG4
Water - soluble hormones are considered fast - acting hormones.
Proencephalon
Lispro insulin

4. Based on operant conditioning - What type of reinforcement is described when x Removing a stimulus stops a behavior?
Verbigeration
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12
Ultraviolet B (UVB) sunlight
Extinction

5. What two Beta2- agonists are used to produce bronchodilation?
Metaproterenol and albuterol
It decreases insulin secretion.
Chromosome 19
Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine.

6. Is not found in smooth muscle - liver - and the kidneys.
Truncus arteriosus
Catechol - O- methyl transferase (COMT)
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Ritodrine and terbutaline

7. What chromosome 4 - AD disorder is a degeneration of GABA neurons in the striatum of the indirect pathway of the basal ganglia?

8. Which gram - negative diplococcus grows on chocolate agar? Thayer - Martin medium?
Lateral pontine syndrome
Metronidazole
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.

9. What are the five Ig isotypes?
1. Sweat glands 2. Arterioles 3. Veins
IgA - IgD - IgE - IgG - and IgM
Hot pink with PAS and grey to black with silver stain
Mannitol

10. Name the area of the cerebral cortex with the function described: x Recall of objects - distances - and scenes; visual input processed here
Necrotizing enterocolitis
Thoracic and sacral
Red muscle
Occipital lobe

11. What antimuscarinic is used as an inhalant for asthma?
Both Neisseria and Moraxella are gram - negative cocci.
Permanent
Ipratropium
Left atrium and tip of the right atrium

12. What is the name for the following RBC indices? - Average Hgb concentration/given volume of packed RBCs
0157:H7
Astrocytoma
Mean corpuscular hemoglobin concentration (MCHC)
NADPH oxidase

13. Which subset of MEN syndrome is associated with the following? - Medullary carcinoma of the thyroid - pheochromocytoma - and mucocutaneous neuromas
Propionic acid
Streptococci
RBCs. That is why it is called red pulp.
MEN III (or IIb)

14. What are the three C's of a TCAD overdose?
Rhabdomyoma
Coma - convulsions - and cardiotoxicity
Meningomyelocele All except occulta cause elevated - fetoprotein levels.
Pinpoint pupils - decreased respiratory rate - and coma

15. What B- cell neoplasm is seen in males with massive splenomegaly - produces dry tap on bone marrow aspirations - and stains positive for tartrate - resistant acid phosphatase (TRAP)?
Your duty is to tell the patient - not the family. The patient decides who gets to know and who doesn't - not you.
Hairy cell leukemia
Paranoid schizophrenia
EF-1 and GTP

16. What segments of the lumbosacral plexus form the following nerves? - Obturator nerve
Folate - vitamin B12 - and vitamin B6
Axis III
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.

17. Name the Plasmodium species based on the following information: Persistent hypnozoite liver stage with relapses; blood smear shows amoeboid trophozoites; 48- hour fever spike pattern; the most prevalent form worldwide
Hematogenous
Left eye anopsia (left nasal and temporal hemianopsia)
Plasmodium vivax
Public speaking (Remember: stage fright)

18. What lower extremity nerve is described by the following motor loss? - Loss of flexion of the knees and toes - plantarflexion - and weakened inversion
Uroporphyrinogen I synthetase
Tibial nerve
Roth spots
Complex 4

19. Name the most common type or cause - Acute bacterial endocarditis
Alcoholics Anonymous
Staphylococcus aureus
In men it is prostate cancer - and in women it is breast cancer.
Stage 4

20. Name the compartment of the mediastinum associated with the following thoracic structures: Azygos vein
Superior and posterior
Down syndrome
Because the large drop in TPR is accompanied by a large increase in cardiac output - resulting in a minimal change in BP.
Para - aminohippurate (PAH)

21. What abdominal muscle runs in a posteroinferior direction - splits to contribute to the rectus sheath - contributes to the formation of the conjoint tendon - and in men gives rise to the middle spermatic fascia and the cremasteric muscle of the sperm
First - order elimination
Constriction of efferent arteriole
Internal abdominal oblique
Pyruvate - acetyl CoA - and propionyl CoA carboxylase

22. What IL - produced by macrophages - is chemotactic for neutrophils?
Ileum
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
Stratum corneum (keratinized)
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.

23. What thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 decreased
Anopheles mosquito
Menses
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning

24. Name the Plasmodium species based on the following information:No persistent liver stage or relapse; blood smear shows rosette schizonts; 72- hour fever spike pattern
Osteoporosis
Ependymal cells
Plasmodium malariae
Listeria monocytogenes

25. What is the site of action of the following? - K+- sparing diuretics
Kimmelstiel - Wilson disease
Early collecting duct
Extracellular
Odds ratio. (Case control studies deal with prevalence.)

26. What is the most common one? - Renal calculus type
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
REM latency; normally it is about 90 minutes.
Carnitine acyl CoA transferase II
Calcium oxylate

27. Is excretion greater than or less than filtration for net secretion to occur?
Vitamin K
Excretion is greater than filtration for net secretion to occur.
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+
The liver (in the mitochondria)

28. Name the most common type or cause - GN in the world
GH deficiency
Ganglioside
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
IgA nephropathy

29. What is the term to describe how easily a vessel stretches?
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
Luteal phase
Molybdenum (Mb)
Compliance (think of it as distensibility)

30. What is the most common one? - Primary malignant tumor of the ovary
Ceramide
Galactose and glucose
Serocystadenocarcinoma
TXA2

31. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Months to years after transplantation; gradual onset of HTN - oliguria - and azotemia; seen as intimal fibrosis of the blood vessels and in
Group A Beta- hemolytic streptococci
Chronic rejection
Urophilia
Aspiration

32. What triggers phase 0 of the action potential in a ventricular pacemaker cell?
Giardia lamblia (treat with metronidazole)
Calcium influx secondary to slow channel opening
Null hypothesis (what you hope to disprove)
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.

33. What muscles in the hand adduct the fingers?
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
Renal cell carcinoma
Trimethoprim/sulfamethoxazole (TMP- SMX)
Blastomyces dermatitidis

34. What Brodmann area is associated with x Primary visual cortex?
gamma and delta chains
Lateral pontine syndrome
Epinephrine
Area 17

35. What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia?
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
Chloramphenicol
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Atropine and 2- PAM (pralidoxime)

36. What form of Plasmodium species affects the liver?
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
Osteoarthritis
Histidine - because of the imidazole ring found in the R group - is basic.
Hypnozoite

37. What determines the overall force generated by the ventricular muscle during systole?
prior to birthThe foramen ovale closes just...
Neisseria gonorrhoeae
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.

38. What syndrome is associated with gastrin - producing islet cell tumor resulting in multiple intractable peptic ulcers?
Zollinger - Ellison syndrome
Filovirus
Biotin (only if eaten in large quantities)
The CD4 T cell; the APC is the first cell in the immune response.

39. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol decreased - ACTH decreased
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.
Secondary hypocortisolism (pituitary)
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.

40. What is the central issue regarding the Roe vs. Wade decision (legalization of abortion)?
Kayser - Fleischer rings
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
Invasive ductal carcinoma
Papillary carcinoma of the thyroid

41. How many major and/or minor Jones criteria are required for the diagnosis of rheumatic fever?
Posterior
Scleroderma
Two major or one major and two minor
Pseudogout

42. Being college educated increases a man's risk of having...
Thymine (B1)
Pyridoxine
Selegiline
premature ejaculation

43. What is the most common one? - Stromal tumor of the ovary
The primitive streak grows caudal to rostral.
Punishment
Ovarian fibroma
Edinger - Westphal nucleus (via CN III)

44. What antitubercular agent causes a red - orange tinge to tears and urine?
2 and 5HT3 receptors
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Nephroblastoma
Rifampin

45. What is the only DNA virus that does not replicate its DNA in the nucleus of the host cell?
Folic acid
Rifampin
Poxvirus replicates its DNA in the cytoplasm.
When the intra - alveolar pressure equals zero - there is no airflow.

46. What is the most common one? - Renal cell cancer type
Metastatic calcification
Clear cell
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Prolyl and lysyl hydroxylases

47. What structure of the knee is described thus? - C- shaped shock absorber; aids in attachment of the tibia to the femur via the medial collateral ligament
Medial meniscus
Leukotriene B4 (LTB4)
Fibrocystic change of the breast
Hapten; if it is coupled with a carrier - it may become immunogenic.

48. What is the term for tissue - based basophils?
Pompe's disease
Mast cells
Klatskin tumor
Non - Hodgkin lymphoma

49. What CNs are affected if there is a lesion in x The midbrain?
Variola virus (Smallpox)
CN III and IV
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Hypertrophic scar

50. Are contraindicated in patients with SCID.
Duodenum
Live vaccines
CN I - II - III - VI - and XII Add 1 + 1 = 2 - 1 + 2 = 3 - 1 + 2 + 3 = 6 - 1 + 2 + 3 + 6 = 12
Trimethoprim