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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 - Urinary tract obstruction
BPH
Gain of hypotonic fluid (water intoxication or hypotonic saline)
Acute rejection
Specific rate (e.g. - men aged 55-60)

2. Is the bound form or free form of a lipid - soluble hormone responsible for the negative feedback activity?
Left heart failure
Free form determines hormone activity and is responsible for the negative feedback loop.
Epinephrine
Serratus anterior

3. 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
Phase 2
Mentally disabled
Tetralogy of Fallot
Fusobacterium

4. Which prophylactic asthmatic agent is an antagonist of LTD4?
Zafirlukast
Caplan syndrome
Constriction of afferent arteriole
Relative refractory period

5. In a skeletal muscle fiber - the interior of the T- tubule is...
CD16 and CD56
Extracellular
after abortion
Laminin

6. What nerve lesion presents with ape or simian hand as its sign?
Median nerve lesion
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
Y - W-135 - and C and A capsular polysaccharides

7. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Dysphoria - irritability - musical and visual abilities decreased
Histamine
Nondominant temporal lobe
Small to medium - sized cerebral vessels
>5 mm

8. What type of Ag do B cells recognize?
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
Free - unprocessed Ag
Glycogen phosphorylase

9. Are the following conditions associated with a negative or positive nitrogen balance? - Growth
Turner syndrome
Positive
Isolation of affect
Ratio scale

10. What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
Syphilitic
Ependymoma
Viruses
42 L - 67% of body weight

11. What is the term for severe and protracted vomiting resulting in linear lacerations at the gastroesophageal junction?
Denial
Mallory- Weiss syndrome
Zonula occludens (tight junctions)
IgA

12. What axis I disorder is characterized by a clinically significant syndrome that affects social - occupational - and/or academic achievement; occurs less than 3 months after a stressor; and abates less than 6 months after the stressor is removed?
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).

13. What two substances stimulate Sertoli cells?
FSH and testosterone
Enterokinase
Phase 2
All

14. Which direction does the uvula deviate in a left vagus nerve lesion?
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
Gubernaculum
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)
It is produced by the preload on the muscle prior to contraction.

15. What is the term to describe a man who has x The ability to have an erection sometimes and other times not?
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)
The courts. These are legal - not medical terms.
MEN I (or Wermer syndrome)
Selective erectile disorder

16. Name the area of the cerebral cortex with the function described: x Motivation - memory - emotions - violent behaviors - sociosexual behaviors - conditioned responses
Limbic system
Metronidazole
Production of oxygen free radicals
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency

17. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x abl
Achalasia
Epispadia
Hepadnavirus
CML and All

18. What is the most common one? - Benign breast tumor in females less than 35 years old
Selenium (Se)
Stable
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
Fibroadenoma

19. Deficiencies In what enzyme result in insoluble glycogen synthesis formation?
Scleroderma
Live vaccines
a -1 - 6 transferase
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae

20. What enzyme catalyzes the rate - limiting step in cholesterol metabolism?
Uracil
NADPH - O2 - and cytochrome b5
HMG- CoA reductase
Carnitine acyl CoA transferase II

21. What enzyme is deficient in selective T cell immunodeficiency?
Primary hyperparathyroidism
Purine nucleoside phosphorylase
Azathioprine
Right brachiocephalic artery

22. What mineral is associated with hypothyroidism?
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
Iodine (I)
Arthroconidia with hyphae
hCG can be detected in the blood by day 8 and in the urine by day 10.

23. What type of erythema do you see in x Stevens - Johnson syndrome?
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
Goodpasture syndrome
Phosphorylation of mannose residues
Erythema multiforme

24. What is the relationship between preload and the passive tension in a muscle?
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Recall bias. These problems arise in retrospective studies.
Urogenital sinus

25. Name the Hgb - O2 binding site based on the following information: x Least affinity for O2; requires the highest PO 2 levels for attachment (approx. 100 mm Hg)
Clear cell
Site 4
Thymine
Combined metabolic and respiratory acidosis

26. What type of correlation is defined as x Two variables that go together in the same direction?
Positive correlation
Right coronary artery
Functional residual capacity (FRC)
Right brachiocephalic artery

27. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Metencephalon
embranoproliferative glomerulonephritis (MPGN)
Mycoplasma
relaxation
Rhombencephalon

28. Name these narcissistic defense mechanisms: x Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.
Resistance increases as resistors are added to the circuit.
Splitting
A high - resistance system is formed when resistors are added in a series.
Thyroid hormones

29. What muscle or muscles are innervated by the following nerves? - Suprascapular nerve
Supraspinatus and infraspinatus
Lung and bronchus cancer
C5a
Gout

30. What is the most common infectious agent in HIV?
Capillaries
Pneumocystis carinii
Lac repressor protein
V wave

31. Name the area of the cerebral cortex with the function described: x Initiation and control of movements
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Complex 4
Mean corpuscular volume (MCV)
Basal ganglia

32. A 20-year - old woman goes to the ER with ptosis - diplopia - weakness in her jaw muscles when chewing - and muscle weakness with repeated use. What is your diagnosis?
Superior rectus (CN III) (LR6 SO4)3
Asbestosis
Toxoplasma gondii
Myasthenia gravis

33. RBC casts in the urine
Burr cells (echinocytes)
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.
LH
Acute glomerulonephritis

34. When referring to a series circuit - what happens to resistance when a resistor is added?
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
Albinism
Resistance increases as resistors are added to the circuit.
Phase 4; NE increases the slope of the prepotential - allowing threshold to be reached sooner - and increases the rate of firing.

35. What lymphoid organ has the following characteristics: outer and inner cortical areas - encapsulation - germinal centers - and high endothelial venules?
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
Leiomyoma
Lymph nodes
Amanita phalloides

36. Are the following major or minor Jones criteria of rheumatic fever? - Elevated acute phase reactants (e.g. - ESR)
Down syndrome (it is slightly more common than fragile X syndrome.)
Minor
Cefamandole - cefoperazone - and moxalactam
Hypochondriasis (they will begin with 'I think I have...')

37. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Chromium and nickel
Bronchogenic carcinoma
PGE 1 - PGI 2 (most potent) - and TXA 2
Ribonucleotide reductase
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -

38. What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
Macula densa
The CD4 T cell; the APC is the first cell in the immune response.
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)

39. What is the only encapsulated fungal pathogen?
Biotin - ATP - and CO2
Friedreich ataxia
Phase 2
Cryptococcus

40. Name the MCC - Epiglottitis in an unvaccinated child
Down syndrome (trisomy 21)
Haemophilus influenzae type B
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
Job syndrome

41. What is the most common one? - Joint affected in pseudogout
Osteosarcoma
Knee
Hepatitis B
NE

42. Name the most common type or cause - Anovulation
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.
Polycystic ovaries
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Avidity. There is a positive correlation between valence numbers and avidity.

43. What is the most common one? - Lymph node affected in non - Hodgkin lymphoma
S phase
Periaortic lymph nodes
Chromophobe adenoma
Misoprostol

44. Name the stages of sleep with these EEG patterns: x Alpha waves
Narcissistic
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
Mode
Being awake

45. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Beta - hCG
Patent urachus
Liver - kidney - and GI epithelium
Inactivated
Choriocarcinomas and trophoblastic tumors

46. What is the lymphatic drainage of the pelvic organs?
Internal iliac nodes
Limbic system
Reinforcement
GERD

47. What GN is highly associated with hepatitis B and C infections?
Concrete operations (6-12 years)
BPH
embranoproliferative glomerulonephritis (MPGN)
To provide attachment between contiguous cells and to maintain a semipermeable barrier

48. What is secretin's pancreatic action?
Uroporphyrinogen - I synthase
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.
Hypoxia
Stapes artery

49. What event signifies the first day of the menstrual cycle?
Mesothelioma and bronchogenic carcinoma
Onset of bleeding
Negative
Hemosiderin

50. Name the form of spina bifida - Defect in the vertebral arch
Isoleucine - leucine - and valine
Succinate dehydrogenase
Occulta All except occulta cause elevated - fetoprotein levels.
IgM; IgD follows shortly thereafter.