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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. Reed - Sternberg cells
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
Anterior compartment (it's the blood supply to the posterior compartment)
Inferior rectus (CN III) (LR6 SO4)3
Hodgkin lymphoma

2. Which class of antiarrhythmics are potassium channel blockers?
Class III
Citrate - via the citrate shuttle
First - order elimination
Filiform papillae

3. What bonds are broken by endonucleases?

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4. What is the most common one? - Organism that causes pyelonephritis
Decreases
Yes - it decreases fat and muscle uptake of glucose - thereby increasing blood glucose levels.
Escherichia coli
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.

5. Which muscle of the eye is under sympathetic control?
Onset of bleeding
Pulse pressure
Cysticerci
Dilator pupillae muscle

6. Name the RNA subtype based on the following: x Only type of RNA that is translated
mRNA
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
Pancreas and colon
Celiac sprue (gluten - sensitive enteropathy)

7. What is the only pharyngeal muscle not innervated by CN X?
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
Iron deficiency anemia
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.
Blastomyces dermatitidis

8. Name the DNA virus: x ssDNA; naked; icosahedral; replicates in the nucleus
Herpes I
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive - compulsive disorder and learning disabilities.
Parvovirus
5' deiodinase

9. What is the term for chemicals that keep the pH constant despite the formation of acids and bases during metabolism?
Substantia nigra
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Buffers (remember that buffers are best when they are used in a pH range near its pK)
IgG

10. Is an embryologic foregut derivative.
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
Squamous cell carcinoma
Aldehyde dehydrogenase
The thyroid gland

11. Name the thalamic nucleus based on its input and output - Input from globus pallidus and substantia nigra; output to primary motor cortex
Ventral anterior nucleus
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Fibrous pericardium
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)

12. In what stage of sleep is it hardest to arouse a sleeping individual?
Moderate (35-49)
During stage 3 and 4 (remember - it is called deep sleep.)
Neuroblastoma
Topoisomerase I (Relaxase)

13. What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
Sacrococcygeal teratoma
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Cytochrome c
Operant conditioning (reinforcement is after a response)

14. Which macrolide is used in the treatment of gastroparesis?
The first trimester
Erythromycin
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
Third week

15. How many carbons do estrogens have?
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.

16. What Freudian psyche component is described as x The conscience - morals - beliefs (middle of the road)?
HHV 6
Glyceraldehyde dehydrogenase
Superego
HHV 8

17. Why is the base of the lung hyperventilated when a person is standing upright?
Oxygen
Dimercaprol - penicillamine
Emphysema
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.

18. What CNs are affected if there is a lesion in x Pontomedullary junction?
CN VI - VII - and VIII
Crohn disease
Unipolar disorder (major depression)
Streptococcus agalactiae and Escherichia coli

19. Name the cluster C personality disorder: x Gets others to assume responsibility - is subordinate - and is fearful of being alone and caring for self
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Internal abdominal oblique
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Dependent

20. RBCs in the urine
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Snails
The right gonadal vein drains into the inferior vena cava directly - and the left gonadal vein drains into the left renal vein.
Bladder carcinoma

21. What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency - glucocorticoid deficiency - and an excess of adrenal androgens?
A high - resistance system is formed when resistors are added in a series.
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
GH deficiency
Gout

22. What two forces affect movement of ions across a membrane?
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT - which means warfarin - extrinsic - PT; heparin - intrinsic - PTT)
Concentration force and electrical force
Prefrontal cortex; it is in front of the premotor area.
In the dorsal horn of the spinal cord on the primary afferent neurons

23. What is the most common one? - Benign tumor of the breast
unprocessed Ags
Buerger disease (thromboangiitis obliterans)
Fibroadenoma
mRNA

24. What syndrome is due to anti - GBM Abs directed against the lung and kidneys?
Homocysteine methyl transferase
Wegener granulomatosis
Goodpasture syndrome
Childhood

25. What is the size of a positive PPD test for the following? (Reactive) x Recent immigrant from India
Axis IV
It forms a germinal tube at 37
>10 mm
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.

26. What is the DOC for the treatment of the late phase response in an asthmatic attack?
Quinolones
Immature B cells
Corticosteroid
Demeclocycline

27. What neuroleptic agent is also considered to be an antihistamine?
Clostridium botulinum
reflexes
GP120
Risperidone

28. The ophthalmic artery is a branch of what vessel?
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
Internal carotid artery
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Aortic stenosis

29. What three complement fragments are also anaphylatoxins?
Chromosome 20q (deficiency in adenosine deaminase)
Coxiella burnetii
Increased erection and libido
C3a - C4a - and C5a

30. What is the term for the external urethra opening onto the ventral surface of the penis?
prior to birthThe foramen ovale closes just...
HMG- CoA reductase
Hypospadia
Pancreas and colon

31. What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?
Parainfluenza virus
Melasma
Thiamine
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).

32. Is jugular venous distention a presentation of isolated left or right heart failure?
Right - sided
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Escherichia coli
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.

33. Kaiser - Fleischer rings - abnormal copper metabolism - and ceruloplasmin deficiency characterize what disease - which may include symptoms of dementia when severe?

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34. By What age should children be able to draw the following figures? - Square
1. The child poses an imminent danger to self or others. 2. The child is unable to self - care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety e
Opposite the second upper molar tooth
5 years old
ELISA test

35. How many kilocalories per gram are produced from the degradation of fat? CHO? Protein?
Positive
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
Glycogen synthase
0157:H7

36. What is the most common one? - Lymph node affected in non - Hodgkin lymphoma
90% as HCO3- - 5% as carbamino compounds - and 5% as dissolved CO2
Aldehyde dehydrogenase
Periaortic lymph nodes
REM sleep. Remember - awake brain in a sleeping body.

37. Name the most common cause - Blindness in the United States
Diabetes mellitus
Where the cell bodies for the DCML and spinothalamic sensory systems are...
Fluconazole
Hemiballismus

38. With what disease do you see IgA deposits in small vessels of the skin and the kidneys?
Affinity decreases; they are inversely proportional.
In the first 3 months
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
Henoch - Sch

39. What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?
PKU
Pneumococcus
Stable
Acetazolamide

40. Name the most common cause - Dementia in persons aged 60 to 90 years
Filtration is greater than excretion for net reabsorption to occur.
Alzheimer disease
Rhabdovirus
Plasma concentration and excretion rate

41. What P value defines whether the hull hypothesis should or should not be rejected?
P = .05; P < .05 rejects the null hypothesis
Staphylococcus aureus
CN X
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.

42. What part of the inner ear contains the gravity receptors for changes in the position of the head?
Reject it
Bipolar disorder (manic - depressive disorder)
Saccule and utricle
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)

43. Name the compartment of the mediastinum associated with the following thoracic structures: Thymus
Birds
Depolarization is from apex to base and from endocardium to epicardium.
Superior and anterior
Squamous cell carcinoma

44. Where is renin produced?
Hydralazine
Cytochrome b/c1
In the JG cells of the kidney
Oxytocin

45. What stage of sleep is associated with somnambulism?
Cocaine
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Yes
Internal carotid artery and sympathetic plexus

46. A schizophrenic patient who is taking haloperidol is brought to your ER with muscle rigidity - a temperature of 104
Androgen - binding protein
Anterior spinal artery
Neuroleptic malignant syndrome is a potentially life - threatening condition Which is treated with symptomatic support - bromocriptine - and dantrolene.
Mitochondria - linked disorders are always inherited from the mother.

47. What class of antimicrobial agents should be avoided in patients with a history of GPDH deficiency?
IDL
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
Ego dystonic
Sulfonamides

48. Name the associated chromosome - Familial hypercholesterolemia
Pyelonephritis
Chromosome 6
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone - whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
Chromosome 19

49. What two factors result in the base of the lung being hyperperfused?
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
Splenomegaly and anemia (with a high index of suspicion)
Gastric carcinoma
Voltage - gated potassium channels

50. What region of the Ig does not change with class switching?
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
Suppression
42 L - 67% of body weight
Hypervariable region