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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 group of eukaryotic regulatory proteins has a major factor in controlling the gene expression embryonically?
Distal convoluted tubules
Homeodomain proteins
Adenocarcinoma (30% to 35%)
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.

2. What is the physiologic basis for the actions of birth control pills?
They block the midcycle surge of LH.
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.
Mesonephric duct
Alcohol and its related problems cost the country approximately $100 billion a year.

3. What are the two most common chains of the TCR?
Clindamycin
Luteal phase
Nimodipine
a - and Beta- chains are on most T cells.

4. Name three products of HIV's pol gene.
A positive PPD skin test
The pH of CSF is 7.33 - acidotic.
Protease - integrase - and reverse transcriptase
Terbinafine

5. What restriction endonuclease site is destroyed in sickle Beta- globin allele?
MstII; changing codon 6 (from A to T) destroys the restriction site.
The raphe nuclei
12 to 16 weeks (in response to mother's face)
1. Cefamandole 2. Cefoperazone 3. Moxalactam

6. What Brodmann area is associated with x Somatosensory association cortex?
Areas 5 and 7
TAT (Thematic apperception test)
Pyrantel pamoate
Translation

7. A patient with a history of epilepsy goes to the ER with sedation - gait ataxia - diplopia - and vertical nystagmus. Which anticonvulsant overdose resulted in the patient's symptoms?
Berry aneurysm
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.
Phenytoin
Thymus - independent Ags

8. What happens to blood flow and pressure downstream with local arteriolar constriction?
Hemolytic uremic syndrome
Breast
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
With arteriolar constriction both the flow and pressure downstream decrease.

9. What paraphilia is defined as x Deriving sexual pleasure from watching others having sex - grooming - or undressing?
The poly(A) site on the DNA
Vibrio cholera
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.
Voyeurism

10. What lysosomal enzyme is deficient in x Niemann - Pick disease?
Sphingomyelinase
Area 8
Female pseudohermaphrodite
Lumbar splanchnics

11. Name the stages of sleep with these EEG patterns: x Sleep spindles - K- complexes
Cystadenoma
There are no valves and no smooth muscle in the walls of the veins in the face.
Stage 2
Toxoplasmosis

12. What Beta- blocker is also a membrane stabilizer?
Propranolol
Atrial contraction Atrial - Contraction - Venous
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
Coma - convulsions - and cardiotoxicity

13. What is the central chemoreceptor's main drive for ventilation?
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Suppression
Agoraphobia. It also means having a sense of humiliation or hopelessness.

14. What type of hallucination occurs during awakening?
Glucocerebrosidase
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.
Propionic acid
H 1

15. What AA is a precursor of the following substances? - Serotonin
Glucocerebrosidase
Tryptophan
Immature B cells
1. Large sample size 2. Large effect size 3. Type I error is greater

16. What is the DOC for Beta- blocker - induced bronchospasms?
Adrenarche
Ipratropium
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
Acetoacetate - acetone - and Beta- hydroxybutyrate

17. On what chromosome is the adenomatous polyposis coli gene?
von Hippel - Lindau syndrome
The time it takes ACh to diffuse to the postjunctional membrane
Chromosome 5q21
Ethyl alcohol

18. What is the most common infectious agent in HIV?
Pneumocystis carinii
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Phase 4
Right brachiocephalic artery

19. Aschoff bodies
Stable
Rheumatic fever
Copper (Cu+)
Thyroid hormones

20. What is the term for TB with the cervical lymph node involved?
Scrofula
Ordinal scale (e.g. - faster/slower - taller/shorter)
SER
In the JG cells of the kidney

21. What deep cerebellar nuclei receive Purkinje cell projections in x The flocculonodular lobe?
Mean corpuscular hemoglobin concentration (MCHC)
The lateral vestibular nucleus
C3b
cDNA - when it is made from mRNA

22. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CA-19.9 and CEA
Pancreatic cancer
Trypsin
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Non - Hodgkin lymphoma

23. What is the region of an axon where no myelin is found?
Chlortetracycline
Nodes of Ranvier
Osteogenesis imperfecta
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.

24. What family do the following viruses belong to? - RSV
Paramyxovirus
Allograft
Coccidioides immitis
1. Tinea coli 2. Haustra 3. Epiploic appendages

25. What dementia is associated with dilated ventricles with diffuse cortical atrophy - decreased parietal lobe blood flow - and a decrease in choline acetyl transferase activity?

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26. What component of the ANS is responsible for movement of semen from the epididymis to the ejaculatory ducts?
Multiple myeloma
The lateral vestibular nucleus
Sympathetic nervous system
Ligamentum arteriosum

27. In what pathway of the basal ganglia do lesions result in an underactive cortex with hypokinetic - slow - or absent spontaneous movement?

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28. What is the DOC for treating torsade de pointes?
Parietal lobe
Magnesium
Humor
Streptococci

29. What form of antimicrobial therapy is best for an immunocompromised patient?
Postductal coarctation of the aorta (adult)
Metronidazole
Because creatinine is filtered and a small amount is secreted
Bactericidal

30. What embryonic structure forms the adult female structures? - Ovarian and round ligaments
Medullary carcinoma of the thyroid
Vitamin A
Gubernaculum
Lactulose

31. What is the reservoir for the togavirus?
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
Birds
C5a
Coronavirus

32. What nerve or nerves supply general sensation and taste to the posterior third of the tongue?
CN XI and X
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
Streptococcus pneumoniae
Propranolol

33. What neuronal cell bodies are contained in the intermediate zone of the spinal cord? (T1- L2)
Riedel thyroiditis
Median nerve
Epinephrine
Preganglionic sympathetic neurons

34. Are contraindicated in patients with SCID.
Toxoplasma gondii
Live vaccines
transcription
Palms - up before palms - down maneuvers

35. What cells of the parathyroid gland are simulated in response to hypocalcemia?
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons

36. What drug is an M1- specific antispasmodic?
N- Acetylcysteine
Hydralazine
Paget disease of the breast
Pirenzepine

37. From what pharyngeal pouch is the following structure derived? - Superior parathyroid gland and ultimobranchial body of the thyroid
Lysine and tyrosine
Inspiratory reserve volume (IRV)
Fourth M PITS for pharyngeal pouch derivatives
Fluconazole

38. What is the most common one? - Site for colonic diverticula
Sigmoid colon
Volume of distribution is decreased when a large percentage of drug is protein bound.
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+
Patent urachus

39. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebellum
Proencephalon
Rhombencephalon
HPV
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)

40. What remains patent in a hydrocele of the testis - allowing peritoneal fluid to form into a cyst?
A patent processus vaginalis
Thalassemia minor
EF- Tu or EF- ts and GTP
Western blot

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

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42. Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?

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43. Are the following responses associated with histamines H1 or H2 receptor activation? - Edema
Sporozoites
Seasonal affective disorder (treat with bright light therapy)
H 1
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.

44. Arrange the following layers in the correct sequence through which a needle must pass in a lumbar puncture - Skin x Subarachnoid space x Interspinous ligament x Dura mater x Deep fascia x Epidural space x Superficial fascia x Interlaminar space x Su
Mitosis
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
Frameshift

45. What is the most common one? - Renal cell cancer type
Peau d'orange
Clear cell
Hypertrophic scar
Wegener granulomatosis

46. What variant of polyarteritis nodosa is associated with bronchial asthma - granulomas - and eosinophilia?
Churg - Strauss syndrome
Hydroxyproline (breakdown product of collagen)
alpha2- Receptors
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase

47. Can you tell which drug is more toxic based on therapeutic indices alone?
Phase 1
No - therapeutic indices can tell which drug is safer - not more toxic.
Trypanosoma cruzi
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.

48. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ decreased - Pi decreased
Bipolar disorder (manic - depressive disorder)
A decrease in Ca2+ and an increase in PO4
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
Dendrites receive information - whereas axons send information.

49. Four - fifths of those who attempt suicide first...
The small subunit (40S) binds first.
The bifurcation of the abdominal aorta
give a warning
robenecid - a uricosuric agent

50. Name the structure that enters or exits the following foramina: x Foramen magnum
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
CN XI - vertebral arteries
Complex 4
4.7 L - 5% of body weight