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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 death in the United States?
Papillary carcinoma
Cancer
Eisenmenger's syndrome
Ligamentum arteriosum

2. At the base of the lung - What is the baseline intrapleural pressure - and what force does it exert on the alveoli?
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
ELISA. It detects anti - p24 IgG.
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Nodular sclerosis

3. How early can a pregnancy be detected by hCG assays in the blood? In urine?
Yolk sac tumor
hCG can be detected in the blood by day 8 and in the urine by day 10.
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Operon

4. Name these immature defense mechanisms: x Psychic feelings converted to physical symptoms
Francisella tularensis
Mycoplasma pneumoniae
Osteocyte
Somatization

5. What hypothalamic nucleus is responsible for the production of ADH?
HBeAg
gamma and delta chains
Supraoptic nuclei; lesions here result in diabetes insipidus.
N- formyl - methionine LTB4 C5a IL-8

6. In what pathway of the basal ganglia do lesions result in hyperactive cortex with hyperkinetic - chorea - athetosis - tics - and dystonia?
epithelial lining
Primary hypogonadism (postmenopausal women)
Mild (50-70)
Indirect pathway (Tourette syndrome for example)

7. What Ig is associated with ADCC for parasites?
Sigmoid colon
Glycogen synthase
IgE
Vitreous humor

8. What is the site of action of the following? - Loop diuretics
Ascending limb
Multiple myeloma
Primary biliary cirrhosis
Duchenne muscular dystrophy

9. What CN is associated with the sensory innervation of x Nasopharynx?
FSH and testosterone
The limbic system
Maxillary division of CN V and glossopharyngeal nerves
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)

10. What is the relationship between ventilation and PCO2 levels?
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
Plasma concentration and excretion rate
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.
H1 histones

11. What breast pathology involves malignant cells with halos invading the epidermis of the skin?
Paget disease of the breast
All are lactose fermenters except Yersinia and Proteus.
Bactericidal
Hematoxylin

12. What is the term for any stimulus that increases the probability of a response happening?
The number of Ags that the Ab can bind
Sympathetic chain ganglion
Reinforcement
Infliximab

13. What is the site of action of the following? - Aldosterone antagonists
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.
Distal convoluted tubules
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
Antigenic determinant (epitope)

14. What two classes of drugs can cause schizoid behavior?
Indirect or unconjugated
Glucocorticoids and amphetamines
HBeAg
Transferrin

15. Name the muscle type based on the histological features: x Actin and myosin in sarcomeres; striated; multinuclear; lacks gap junctions; troponin:calcium binding; T tubules and SR forming triadic contacts; highest ATPase activity; no calcium channels
Dendritic cells - macrophages - and thymic epithelial cells
Rathke's pouch; they can result in compression of the optic chiasm.
Skeletal muscle
Superior rectus (CN III) (LR6 SO4)3

16. What enzyme is deficient in the following glycogen storage disease? - Pompe's disease
Lysosomal a -1 - 4- glucosidase
Uricosuric
CD8+ T cells
von Hippel - Lindau syndrome

17. What enzyme catalyzes the rate - limiting step in cholesterol metabolism?
Low molecular weight heparin (LMWH)
Parkinson's disease
Prolactinoma
HMG- CoA reductase

18. What are the three major functions of secretory IgA?
T cells - not B cells
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases
Uracil
Interval scale (a ruler - for example)

19. What enzyme is associated with osteoblastic activity?
Paramesonephric ducts
Permanent
Phase I
Alkaline phosphatase

20. What is absorbed in the gallbladder to concentrate bile?
Prolactin
Microglia. All others are neuroectodermal derivatives.
Water
Parallel circuit

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

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22. What Brodmann area is associated with x Broca's area?
Teratoma (dermoid cyst)
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
Areas 44 and 45
Meningocele All except occulta cause elevated - fetoprotein levels.

23. What fat - soluble vitamin is connected to selenium metabolism?
Acute glomerulonephritis
Congenital heart disease
Lactulose
Vitamin E

24. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Hypothalamus
Fibrocystic change of the breast
Proencephalon diencephalon derivative
VSD
The negative charge inhibits the filtration of protein anions.

25. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF ? - capillary pressure ?
Constriction of efferent arteriole
Valine
Target cell
Nearly 25% of patients taking lithium develop polyuria and polydipsia.

26. What condition results in a strawberry gallbladder?
Neuroleptic malignant syndrome is a potentially life - threatening condition Which is treated with symptomatic support - bromocriptine - and dantrolene.
Papillary carcinoma of the ovary
Stable
Cholesterolosis

27. What lysosomal enzyme is deficient in x Tay- Sachs disease?
Both
Reaction formation
Thymus - independent Ags
Hexosaminidase A

28. What is the term for new made - up words?

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29. What type of anemia is the result of a deficiency in intrinsic factor?
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
Anterior spinal artery
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
Chromosome 19

30. What component of the ETC is inhibited by the following? - Cyanide
CHF - cirrhosis - and nephrosis
Cytochrome a/a3
Production of oxygen free radicals
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)

31. What type of circuit is described when the total resistance is always greater than the sums of the individual resistors?
LGB (think EYES)
Series circuit
FSH and testosterone
Carbamazepine

32. Name the compartment of the mediastinum associated with the following thoracic structures: Descending aorta
Intercellular adhesion molecule (ICAM) 1
Posterior
1. Short attention span 2. Impulsivity 3. Hyperactivity
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)

33. What is the rate - limiting step of the following? - Beta- Oxidation
EF- Tu or EF- ts and GTP
Carnitine acyltransferase I
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
Somatoform pain disorder

34. What three cephalosporins can produce disulfiram - like reactions?
Dihydrotestosterone
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Prolactinoma
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.

35. Testing of a drug in a small group of volunteers without the disease is a component of which phase of clinical drug testing?
The optic disk is the blind spot.
ACTH
Phase 1
Ultraviolet B (UVB) sunlight

36. Which gram - negative diplococcus ferments maltose?
Meningococcus (Gonococcus does not)
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Omega -3 fatty acids
Orbitomedial frontal lobe

37. What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?
Aminoglycosides
Hepatitis D
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.

38. What AD renal disorder is associated with mutations of the PKD 1 gene on chromosome 16 and berry aneurysms in the circle of Willis and presents in the fifth decade with abdominal masses - flank pain - hematuria - HTN - and renal insufficiency?
Benign nevus (mole)
Succinate dehydrogenase
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Adult polycystic kidney disease

39. Which virus is the MCC of a cold in the summer and fall? Winter and spring?
Rhinoviruses for summer and fall; coronaviruses for winter and spring
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Glucose and galactose
Narcissistic

40. Name the aphasia based on these characteristics: x Lesion in the prefrontal cortex; inability to speak spontaneously; unimpaired ability to repeat
Transcortical aphasia
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Hematogenous
CN V3 and the lesser petrosal nerve

41. What is the main inhibitor of pyruvate dehydrogenase?
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Acetyl CoA (pyruvate to acetyl CoA)
G-6- PD
Pseudomonas aeruginosa

42. 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?
1. Protest 2. Despair 3. Detachment
Standardized rate
Limbic system
Small to medium - sized cerebral vessels

43. What are the five penicillinase - resistant penicillins?
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
VSD - RVH - overriding aorta - and pulmonary stenosis
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)

44. What rate is indicated by 1- specificity?
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
False - positive rate
Voltage - gated sodium channel
GH and prolactin are produced by acidophils; all others are by basophils.

45. What IL down - regulates cell mediated immunity?
Giardia lamblia (treat with metronidazole)
Arginine
IL-10
Chloral hydrate

46. What vitamin deficiency is evidenced by poor wound healing - loose teeth - bleeding gums - petechiae - and ecchymosis?
Malassezia furfur (treat with selenium sulfide)
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
Axis IV
Stage 4

47. What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN - hypokalemia - and low rennin levels?
Catatonic schizophrenia
Ventricular contraction Atrial - Contraction - Venous
Conn syndrome (primary hyperaldosteronism)
Clindamycin

48. What cells of the retina see in black and white and are used for night vision?
Rods
C4 (the upper border of the thyroid cartilage)
Chromosome 11 - 22
It increases Ca2+ excretion from the kidney and increases bone mineralization.

49. What hormones - secreted in proportion to the size of the placenta - are an index of fetal well - being?
Tolcapone and entacapone
hCS and serum estriol - which are produced by the fetal liver and placenta - respectively - are used as estimates of fetal well - being.
Plasmodium malariae
IL-5. It also stimulates eosinophil proliferation.

50. What type of crystals are associated with gout?
Gap junctions
Monosodium urate crystals
Gerstmann's syndrome; spoken language is usually understood.
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.