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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 type of resistance system (i.e. - high or low) is formed when resistors are added in parallel?
A low - resistance system is formed by resistors added in parallel.
Specificity (it deals with the healthy)
Postinfectious GN
Third M PITS for pharyngeal pouch derivatives

2. During What embryonic week do somites begin to form?
Third week
Fragile X syndrome
Clonidine
RU 486

3. What type of spore is defined as an asexual budding daughter yeast cell?
Blastoconidia
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Tetracycline
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord

4. Name the most common type or cause - Panhypopituitarism
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Pedophilia
Chromosome 5q21
Sheehan syndrome

5. What are the five branches of the posterior cord of the brachial plexus?
Fragile X syndrome
Salmonella
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis

6. What is the term for headaches - inability to concentrate - sleep disturbances; avoidance of associated stimuli; reliving events as dreams or flashbacks following a psychologically stressful event beyond the normal range of expectation?
Cocaine
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
T cells - not B cells
Neomycin

7. What ganglion supplies the postganglionic parasympathetic fibers to the ciliary muscles of the eye?
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Ciliary ganglion
Glioblastoma multiforme
Menstruation

8. Name the antidote - Atropine
Physostigmine
IgG4
The fast component is directed toward the affected side of a cerebellar lesion.
Fitz - Hugh - Curtis syndrome

9. In what stage of psychosexual development - according to Freud - do children resolve the Oedipus complex?
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.
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
Latency stage (6-12 years)

10. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Lateral ventricles
Middle
Proencephalon
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
Utricle and saccule

11. What is the most common one? - Renal pathology in patients with SLE
Down syndrome (trisomy 21)
Diffuse proliferative GN
Bile salts are actively reabsorbed in the distal ileum.
Hepatic glycogen phosphorylase

12. What enzyme is needed to activate the following reactions? - Procarboxypeptidase to carboxypeptidase
Being awake
Trypsin
For the USMLE Step 1 the answer is no - but if the information would do more harm than good - withhold. This is very rare but it does occur.
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)

13. What potentially fatal disease occurs in children who are given aspirin during a viral illness?
Carcinoid tumor
Rabies
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
Reye syndrome

14. Which major cell type is found in the red pulp of the spleen?
RBCs. That is why it is called red pulp.
ATP production
CHF
Site 2

15. The ___________ of the urinary bladder and the urethra are embryologic hindgut derivatives.
Dependent
epithelial lining
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.

16. What is the term for granuloma at the lung apex in TB?
NREM sleep. Night terrors are dreams that we are unable to recall.
Simon focus
Factitious disorder
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.

17. Which three aminoglycosides have vestibular toxicity?
1. Streptomycin 2. Gentamicin 3. Tobramycin
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
alpha2- Receptors
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age

18. What percent of sexual abuse cases are committed by family members?
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
HHV-8
Dimercaprol - penicillamine
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.

19. Where is ADH synthesized?
Mycoplasma pneumoniae
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.

20. How many carbons do estrogens have?
Serratia
Latissimus dorsi
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
Average

21. What substrate builds up in Tay- Sachs disease?
Accidents
Case control studies cannot assess incidence or prevalence - but they can determine causal relationships.
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Purulent exudates

22. Name the compartment of the mediastinum associated with the following thoracic structures: Esophagus
Tay- Sachs disease
Metastatic
IgM
Superior and posterior

23. What is the only neuroleptic agent that does not cause hyperprolactinemia?
excites the neuron
Clozapine
QRS complex
Conidia

24. What form of continuous DNA - used in cloning - has no introns or regulatory elements?
Severe combined immunodeficiency disease
cDNA - when it is made from mRNA
Occulta All except occulta cause elevated - fetoprotein levels.
NH4+(ammonium)

25. What is the term for a raised fluid - filled cavity greater than 0.5 cm that lies between the layers of the skin?
Epinephrine
Bulla
Streptococcus pyogenes
Altruism

26. What fat - soluble vitamin is connected to selenium metabolism?
C1 through C4
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Vitamin E
Finasteride

27. What vessel can be found atop the scalene anterior?
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.
PGE2 and PGF2a
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.
Subclavian vein

28. Name the DNA virus: x Partially dsDNA circular; enveloped; virion - associated polymerases; has RNA intermediate; replicates in the nucleus
Obturator nerve
The DCML system. (Remember - everything but pain and temperature.)
Hepadnavirus
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors

29. How many covalent bonds per purine - pyrimidine base pairing are broken during denaturation of dsDNA?
Total lung capacity (TLC)
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Osteosarcoma
2 NADPHs per acetyl CoA

30. Name the ocular lesion; be specific - Left Meyer's loop lesion of the optic radiations.
Epinephrine
Hemangioma (benign)
Cori cycle
Left homonymous hemianopsia

31. What structure is derived from the prochordal plate?
Estradiol
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
Sideroblastic anemia
The mouth

32. What type of scale is graded into equal increments - showing not only any difference but how much?
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
As the isotype is switched - the Ab specificity does not change because it does not affect the variable chains.
IgM; IgD follows shortly thereafter.
Interval scale (a ruler - for example)

33. Is seen in TB.
Coarctation of the aorta
Monocytosis
Streptococcus viridans
Subarachnoid hematoma

34. When is the surface tension the greatest in the respiratory cycle?
Aspiration pneumonia
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Malignancy
Obsessive - compulsive

35. What two Beta- blockers decrease serum lipids?
Acebutolol and Pindolol
Physiologic dead space is the total dead space of the respiratory system.
Turner syndrome
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.

36. Is nystagmus defined by the fast or slow component?
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Vitamin E
Proencephalon
Isoniazid

37. If a peripheral blood smear shows schistocytes - reticulocytes - and thrombocytopenia - is it more commonly seen in patients with ITP or TTP?
hyperventilation
ACh - histamine - and gastrin
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
Mycoplasma pneumoniae

38. How are pulse pressure and compliance related?
Silicosis - Coal worker's pneumoconiosis is synonymous with black lung disease - an upper lobe occupational disorder
Enkephalin
Direct pathway; a good example is Parkinson's disease.
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.

39. What bacterium is diagnosed using the Dieterle silver stain?
Atracurium
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
Somatization
Legionella

40. What is the first branch of the abdominal artery?
Disseminated intravascular coagulation (DIC)
Familial polyposis coli
Inferior phrenic artery
Squamous cell carcinoma

41. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Polycyclic aromatic hydrocarbons
Bipolar disorder (manic - depressive disorder)
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Femoral hernias
Bronchogenic carcinoma

42. Name the most common type or cause - Nephrotic syndrome in children
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Biotin - ATP - and CO2
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
Lipoid nephrosis

43. In what pathway of the basal ganglia do lesions result in hyperactive cortex with hyperkinetic - chorea - athetosis - tics - and dystonia?
Labile
Succinate dehydrogenase
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
Indirect pathway (Tourette syndrome for example)

44. What is the polarity (i.e. - 5'-3' or 3'-5') of a positive sense RNA?

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45. What phobia is described as the fear of open spaces?
Mesonephric duct (ureteric bud)
Gastric ulcer
Female pseudohermaphrodite
Agoraphobia. It also means having a sense of humiliation or hopelessness.

46. What attaches to protons and allows them to enter into the mitochondria without going through the ATP- generating system?
Liquids - CHO - protein - fat
Poxvirus
2 - 4- Dinitrophenol
Mesocortical area

47. What is the only antifungal agent to penetrate CSF?
Streptococcus viridans
Fluconazole
Chemotaxis
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)

48. What form of dementia is characterized by onset at age 40 to 50 - rapid progression - infection by a prion - and death within 2 years?

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49. What two bacteria are associated with drinking unpasteurized milk?
Papillary carcinoma of the thyroid
Xenograft
Brucella and Listeria (has tumbling motility)
Removal of the ileum

50. What is the rate - limiting step of the following? - Ketogenolysis
Positive predictive value
Serotonin
HTN
HMG CoA synthase