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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. Name the most common type or cause - Erysipelas
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
CHF
Familial hypercholesterolemia
Streptococcus pyogenes

2. What AA is a precursor of the following substances? - N2O
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
Gastric carcinoma
Arginine

3. What percent of unwed mothers are teenagers?
Poxvirus
50% - with 50% of them having the child
Osteoporosis
The pulsatile release of GnRH

4. Name the thalamic nucleus based on its input and output - Input from inferior colliculus; output to primary auditory cortex
Total lung capacity (TLC)
MGB (think EARS)
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
Postinfectious GN

5. What Vi - encapsulated gram - negative motile anaerobic rod that produces H2S is associated with enteric fever - gastroenteritis - and septicemia?
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Operant conditioning (reinforcement is after a response)
Giant cell bone tumor (osteoclastoma)
Salmonella typhi

6. What ring is a weblike narrowing of the gastroesophageal junction?
Schatzki ring
Yes - by three to four times. Having multiple sexual partners - being overweight - and pelvic pain and/or inflammatory disorders are also likely to be seen in sexually abused females.
Purine nucleoside phosphorylase
Terminal bronchioles. (No gas exchange occurs here.)

7. Are the following conditions associated with a negative or positive nitrogen balance? - Growth
Mitral stenosis
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
Positive
Urinary trigone

8. What are the five terminal branches of the facial nerve?
2 NADPHs per acetyl CoA
Diacylglycerols and phosphatidic acid
Hirschsprung's disease (colonic gangliosus)
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)

9. What are the primary neurotransmitters at the following sites? - The hypothalamus
Histamine
The resistance increases 16- fold.
Onset of bleeding
The fastigial nucleus

10. Where is the lesion that produces these symptoms when a patient is asked to look to the left? Neither eye can look left with a slow drift to the right
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
Left abducens nucleus or right cerebral cortex
PGE2 and PGF2a
B- cell Ag receptors

11. Name the cluster B personality disorder: x In a constant state of crisis - promiscuous - unable to tolerate anxiety- causing situations - afraid of being alone - and having intense but brief relationships
Borderline
Nominal scale (categorical - e.g. - male or female)
Chromomycosis
MstII; changing codon 6 (from A to T) destroys the restriction site.

12. What is the term for osteophyte formation at the proximal interphalangeal (PIP) joints in osteoarthritis? In the distal interphalangeal (DIP) joints?
Methanol (wood alcohol)
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
Carbamazepine

13. What type of hypersensitivity is a result of high circulating levels of soluble immune complexes made up of IgG or IgM Abs?
Graves disease
Type III hypersensitivity reaction
Papillary carcinoma of the thyroid
Placental alkaline phosphatase

14. Which direct - acting vasodilator is associated with SLE- like syndrome in slow acetylators?
Fixation (arrested development)
a1- Receptors
Hydralazine
Metastatic carcinomas

15. How long after ovulation does fertilization occur?
Dendritic cells - macrophages - and thymic epithelial cells
Operon
8 to 25 hours
Acid is needed for the activation of pepsin and therefore needed for protein digestion.

16. Name the hormone
Both
Epinephrine
Alcoholism
LGB (think EYES)

17. Is CO2 a perfusion - or diffusion - limited O2 gas?
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
IDL
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
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse

18. Under normal conditions - What is the main factor that determines GFR?
Proximal tubule
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
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.
Down syndrome

19. What nerve is compromised in carpal tunnel syndrome?
CD4
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
MEN II and III syndromes
Median nerve

20. Which is the conditioned response - the conditioned stimulus - the unconditioned response - the unconditioned stimulus in this case? A patient has blood withdrawn and faints. The next time she goes to have blood taken - she faints at the sight of the
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting). The needle is part of the blood - drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in th
The kidneys excrete the excess nitrogen from the body as urea in the urine.
HGPRT
Cancer

21. What is the most common one? - Primary malignant tumor of the lungs
Klatskin tumor
Ch
Adenocarcinoma (30% to 35%)
Lipoprotein lipase

22. What type II hypersensitivity disorder is defined as x Autoantibodies directed against ACh receptors?
Primary follicle of the cortex
Myasthenia gravis
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
Histiocytosis X

23. What is it called when levels of sex steroids increase - LH increases - and FSH increases?
Kupffer cells
Stereocilia
GnRH pulsatile infusion
First M PITS for pharyngeal pouch derivatives

24. What glycoprotein in the HIV virus attaches to CD4?
Cholesterolosis
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
Thrombus
GP120

25. What virus causes small pink benign wartlike tumors and is associated with HIV- positive patients?
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
Molluscum contagiosum
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Vitelline fistula

26. What determines the rate of a reaction?
Varicella
Achondroplasia
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.
The energy of activation (Ea)

27. During what stage of B- cell development is IgM first seen on the surface?
Carnitine acyltransferase - I
Immature B cells
Multiple myeloma
Conus arteriosus of the right ventricle and right and left auricles

28. What is the primary risk factor for suicide?
Major
Previous suicide attempt
Al - Anon
Moderate (35-49)

29. Is Dubin - Johnson or Rotor syndrome associated with black pigmentation of the liver?
Edrophonium
Positive
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
1. Iliocostalis 2. Longissimus 3. Spinalis ('I Love Science' muscles)

30. What is the term for the total percentage of correct answers selected on a screening test?
Variola virus (Smallpox)
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Collecting ducts - which make them readily permeable to water reabsorption.
Sensory

31. What disorder is described as having x Conscious symptoms with unconscious motivation?
Isoniazid treatment
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.
Antigenic determinant (epitope)
Factitious disorder

32. Which drug is used to treat respiratory depression associated with an overdose of opioids?
Borderline
Superior and middle
5- hydroxyindoleacetic acid (5- HIAA)
Naloxone or naltrexone

33. Name the product or products of arachidonic acid: x Vasoconstriction and platelet aggregation produced by platelets
G0 phase
TXA2
Neisseria gonorrhoeae and Chlamydia trachomatis
Biotin - ATP - and CO2

34. What artery turns into the dorsalis pedis when it crosses the extensor retinaculum?
Anterior tibial artery
Lewy bodies
Positive
Catechol - O- methyl transferase (COMT)

35. What muscle is the chief flexor of the hip?
Psoas major
Uricosuric
Negative predictive value
Lingual nerve of CN V3

36. Are used in the management of an acute asthmatic attack.
Valproic acid
Dimercaprol - penicillamine
Beta2- Adrenergic agents
Beta- Blockers

37. Name the type of mutation: x Unequal crossover in meiosis with loss of protein function
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
Large segment deletions
Vitreous humor
G0 phase

38. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
Prefrontal cortex; it is in front of the premotor area.
Central. Remember - there is a deficiency in ADH production in the central form.
The T- test (used when comparing two groups)
Hydrostatic pressure of the glomerular capillaries (promotes filtration)

39. What is the most common one? - Benign GI tumor
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.
There would be a Fab' region; thus - it would still be able to participate in precipitation and agglutination.
Pulse pressure
Leiomyoma

40. A patient has to prove his or her...
Odds ratio. (Case control studies deal with prevalence.)
competency
Ethambutol
Confabulation; it is commonly seen in Korsakoff's syndrome.

41. What is the most energy- demanding phase of the cardiac cycle?
Klebsiella pneumoniae
Pulmonary alveolar macrophages
gram positive
Isovolumetric contraction

42. What is the term to describe jumping from one topic to the next without any connection?
IgM
Basal cell carcinoma
Sickle cell disease
Loose association

43. What are the three anatomic characteristics that differentiate the large bowel from the small bowel and the rectum?
1. Tinea coli 2. Haustra 3. Epiploic appendages
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
Coxiella burnetii

44. Name the MCC of death - In patients with cystic fibrosis
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
Pulmonary infections
Relative refractory period

45. What are the three microscopic pathologic changes seen in Alzheimer's disease?
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons
Juxtaglomerular (JG) cell
Onset of bleeding
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.

46. Which type of hepatitis can cause hepatocellular carcinoma?
Hepatitis B
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.

47. What are the two precursors of heme?
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
Glycine and succinyl - CoA
Succinyl CoA synthetase
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.

48. Regarding the viral growth curve - is the external virus present before or after the latent period?
Negative predictive value
After the latent period
Trypsin
Boutonni

49. Lucid interval
Epidural hematoma
gag gene
Hepatitis B and hepatitis C
Calcium oxylate

50. The first area affected during hypoxia.
Ankylosing spondylitis
The central vein of the liver lobule
Fixed interval
Misoprostol