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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. In what compartment of the thigh is the profundus femoris artery found?

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2. What water - soluble - vitamin deficiency is associated with cheilosis and magenta tongue?
1. Liver 2. Kidney 3. Pituitary gland (via 5'- deiodinase enzyme)
>5 mm
Reverse transcriptase
Riboflavin (B2)

3. What term is an index of the effort needed to expand the lungs (i.e. - overcomes recoil)?
Normal values
Dimercaprol - penicillamine
Compliance; the more compliant a lung is - the easier it is to inflate.
Abs to HBsAg

4. What triggers phase 3 of the action potential in a ventricular pacemaker cell?
The basilar artery is formed at the pontomedullary junction.
Mesolimbic system
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.
Rapid efflux of potassium

5. What is the term for a schizophrenic episode lasting longer than 30 days with full return to former functioning capacity?
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
Thymidylate synthase
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.

6. When the results of a test are compared to findings for a normative group - what form of reference does the objective test use?
Renshaw neuron
Norm reference (i.e. - 75% of the students in the class will pass)
Somatization disorder
0157:H7

7. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x N- myc
Molluscum contagiosum
Neuroblastoma
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
Plasmodium malariae

8. What are the most common causes of osteomyelitis x Overall?
Coarctation of the aorta
Azithromycin
Staphylococcus aureus
IgD; IgM is also correct.

9. What is the DOC for the following protozoal infections? - Amebiasis
Transmembrane potential (an absolute number)
Metronidazole
Glucocerebrosidase
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.

10. Where in the spinal cord are the presynaptic opioid receptors?
In the dorsal horn of the spinal cord on the primary afferent neurons
Down syndrome (trisomy 21)
Prolactinoma
Proto - oncogenes

11. What syndrome is characterized by dynein arm abnormality resulting in chronic sinusitis - recurrent pulmonary infections - and infertility?

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12. Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
Phase 4
The raphe nuclei
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
Rifampin

13. Name these narcissistic defense mechanisms: x Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.
The death of a spouse. The higher the score - the greater the risk of developing an illness in the next 6 months.
Hemolytic uremic syndrome
Splitting
Duchenne muscular dystrophy

14. What is the only neuroleptic that does not cause an increase in weight or appetite?
Ego syntonic
Volvulus
Molindone
S phase

15. What carcinoma produces hematuria - flank pain - and a palpable mass?
Clostridium botulinum
gag gene
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
This is the triad of renal cell carcinoma

16. What part of the ANS is affected in the biofeedback model of operant conditioning?
Flurazepam
The biofeedback model is based on the parasympathetic nervous system.
Ea (activation energy)
ELISA is used as a screening test because it is very sensitive; Western blot is used as a confirmatory test because it detects antibodies (protein) to the HIV virus.

17. What rate is indicated by 1- sensitivity?
Isograft
Verbigeration
False - negative rate
Diphyllobothrium latum

18. What is the term for recurrent and persistent pain before - after - or during sexual intercourse?
Anticipation - associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Bronchioloalveolar carcinoma
Beta- Galactosidase

19. Are the following conditions associated with a negative or positive nitrogen balance? - Recovery from injury
Positive
ACE inhibitors (- pril)
They are in ganglia in the PNS.
Water

20. What two Abs are used to diagnose Hashimoto's thyroiditis?
Guillain - Barr
Antithyroglobulin and antimicrosomal Abs
Propionic acid
Ipratropium

21. What are five clinical signs of portal HTN?
Fetal alcohol syndrome
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Ipratropium
Renal cell carcinoma

22. What two CNs are responsible for the carotid body and sinus reflexes?
CD4+ T cells (helper)
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Metronidazole
CN IX and X

23. Name the type of graft described by these transplants: x From one person to the next (the same species)
Plasmodium malariae
Allograft
Burkitt lymphoma
Onset of bleeding

24. What seronegative spondyloarthropathy is seen in HLA- B27- positive young men - involves the sacroiliac joints - has no subcutaneous nodules - and has a bamboo spine appearance on radiograph?
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
Ankylosing spondylitis
PGE2 and PGF2a
ACE inhibitors (the - pril agents)

25. From what pharyngeal pouch is the following structure derived? - Palatine tonsil
RNA polymerase I
The second pharyngeal pouch and groove
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
Second M PITS for pharyngeal pouch derivatives

26. What gluconeogenic enzyme is absent in muscle - accounting for its inability to use glycogen as a source for blood glucose?
DNA polymerase -?
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Glucose -6- phosphatase
Hemosiderin

27. In the water deprivation test - does a patient with reduced urine flow have primary polydipsia or diabetes insipidus?
Uracil
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
catalase - negative
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.

28. What form of endocarditis do patients with SLE commonly encounter?
Cauda equina
Teeth grinding is associated with stage 2 sleep.
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
Libman - Sacks endocarditis

29. Which direct - acting vasodilator is associated with SLE- like syndrome in slow acetylators?
G-6- PD deficiency; pyruvate kinase deficiency is second.
Cilia
Transketolase and transaldolase. The reactions they catalyze are reversible.
Hydralazine

30. What type of spore is defined as an asexual budding daughter yeast cell?
5' deiodinase
Blastoconidia
Myasthenia gravis
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.

31. What enzyme found in a cholinergic synapse breaks down ACh? What are the byproducts?
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
Bisphosphonates
IL-4
Two major or one major and two minor

32. What is the DOC for the following protozoal infections? - Pneumocystis carinii pneumonia
Haemophilus influenzae type B
The aorta has the greatest velocity and the capillaries have the slowest velocity.
More Ab is produced in less time in a secondary immune response (shorter lag period).
Trimethoprim/sulfamethoxazole (TMP- SMX)

33. What virus is associated with Guarnieri bodies?
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
Transference. When it is from the physician to the patient it is called countertransference.
Variola virus (Smallpox)
1. Posterior auricular vein 2. Posterior division of the retromandibular vein

34. What is the term for RBC remnants of nuclear chromatin in asplenic patients?
Epstein - cardiac anomaly of the tricuspid valve
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
Howell - Jolly bodies
Excess estradiol in the blood

35. What four factors affect diffusion rate?
Prolyl and lysyl hydroxylases
Roth spots
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe
Asbestosis

36. Are contraindicated in patients with SCID.
Live vaccines
Methyldopa
Gradient - time system
Lead

37. What is the first formal IQ test used today for children aged 2 to 18?
Schatzki ring
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Posterior
Ratio scale

38. What are the three anatomic characteristics that differentiate the large bowel from the small bowel and the rectum?
Bactericidal
Rotavirus
1. Tinea coli 2. Haustra 3. Epiploic appendages
Proencephalon

39. What branch off the vertebral artery supplies x The ventrolateral two - thirds of the cervical spinal cord and the ventrolateral part of the medulla?
Anterior spinal artery
Chromosome 18
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
X- linked dominant

40. Name the phase of the ventricular muscle action potential based on the following information: x Slow channels open - allowing calcium influx; voltage - gated potassium channels closed; potassium efflux through ungated channels; plateau stage
The greater the cell diameter - the greater the conduction velocity.
Primary hyperaldosteronism (Conn syndrome)
Prinzmetal variant angina
Phase 2

41. What protozoal parasite forms flasked - shaped lesions in the duodenum - is transmitted via fecal - oral route - and is commonly seen in campers who drank stream water?
Giardia lamblia (treat with metronidazole)
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Vibrio cholera
Tolcapone and entacapone

42. Name the GLUT transporter based on the following: x Found in most tissues - including brain and RBCs
Hemangioma (benign)
GLUT 3 and 4
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
Herpes virus

43. What type of damage to the kidneys is caused by drinking ethylene glycol (antifreeze)?
The sandfly
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Nephrotoxic oxylate stones
Microsporum

44. Results in vitamin B12 malabsorption.
Pancreatic insufficiency
Folic acid
Nystagmus and ataxia
T cells - B cells - and macrophages

45. What are the two ways to leave the prevalence pot?
2 ATPs - via the amino acyl tRNA synthase enzyme
Recovery and death
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
Birds

46. Describe the organism based on the following information: x Beta - Hemolytic Streptococcus; positive cAMP test; hydrolyzes hippurate
Streptococcus agalactiae
Streptococcus viridans
Gabapentin
C- peptide levels

47. What ocular muscle x Depresses and adducts the eyeball?
IGF-1
The splenic vein
1. Sweat glands 2. Arterioles 3. Veins
Inferior rectus (CN III) (LR6 SO4)3

48. Name the thalamic nucleus based on its input and output - Input from the mammillary bodies via the mammillothalamic tract and the cingulated gyrus; output to the cingulated gyrus via the anterior limb of the internal capsule
Uracil
Anterior nuclear group (Papez circuit of the limbic system)
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Zinc (Zn) deficiency

49. What glycoprotein allows platelets to adhere to von Willebrand factor?
One - and it provides the energy for mechanical contraction.
Thrombocytopenia - eczema - and immunodeficiency is the triad of this X- linked recessive disorder.
GP Ib
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.

50. What is the DOC for esophageal candidiasis?
EF- Tu or EF- ts and GTP
Increase enzyme concentrations
Fluconazole
300 mOsm/L