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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 structure that enters or exits the following foramina: x Cribriform plate
Isoleucine - leucine - and valine
CN I
ATP production
Crossover study

2. What family do the following viruses belong to? - Measles
Vibrio parahaemolyticus
Escherichia coli
Paramyxovirus
Lateral medullary (Wallenberg's) syndrome

3. What type II hypersensitivity disorder is defined as x Autoantibodies directed against RBC Ag I?
Cryptococcus
Autoimmune hemolytic anemia
G-6- PD
7 to 14 days

4. What is the term for days 15 to 28 in the female cycle?
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.
Anterior compartment (it's the blood supply to the posterior compartment)
Yolk sac tumor
Luteal phase

5. What drug of choice for ascaris causes neuromuscular blockade of the worm?
Pyrantel pamoate
Antimicrobial agents
>10 mm
Albinism

6. Name the macrophage based on its location: x Epidermal macrophages
Langerhans cells
Median nerve
Dimercaprol - D- penicillamine
Class II

7. What is the most common one? - Form of vasculitis
Bacterial meningitis
Sheehan syndrome
Short - chain fatty acids
Temporal arteritis

8. What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency - glucocorticoid deficiency - and an excess of adrenal androgens?
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
Lung and bronchus cancer
Ribavirin
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.

9. What are the pharmacologic effects seen sexually with x Neuroleptics?
Erectile dysfunction
Conus arteriosus of the right ventricle and right and left auricles
1. Posterior auricular vein 2. Posterior division of the retromandibular vein
Cingulate gyrus herniation (subfalcine)

10. Which type of cerebral herniation is associated with CN III palsy?
Red muscle
Correlation. No - correlation does not imply causation.
Stratum lucidum
Transtentorial (uncal)

11. What component of the ETC is inhibited by the following? - Azide
Sulfonamides
Cytochrome a/a3
Sporothrix schenckii
DNA polymerase I

12. Which CNS ACh receptor or receptors are excitatory? Inhibitory?
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
Testicular tumors
Red pulp (Remember - Red pulp and RBCs begin with R.)
Complex 4

13. What family do the following viruses belong to? - California encephalitis
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Acetazolamide
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
Bunyavirus

14. What is the FiO2 of room air?
Simple diffusion; it does not use protein - mediated transport
Accessory nucleus
0.21; it is a fancy way of saying 21% of the air is O2.
Relative refractory period

15. Craniopharyngiomas are remnants of what?

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16. Name the DNA virus x Linear dsDNA; nuclear envelope; icosahedral; replicates in the nucleus
Serous exudates
The carotid sinus reflex
Herpes virus
Osteosarcoma

17. What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
Cancer
Marrow failure - cancer - and leukemia
No - therapeutic indices can tell which drug is safer - not more toxic.
PGI2

18. What two AAs do not have more than one codon?
Methionine (start) and tryptophan are the only two AAs with only one codon.
Mitochondria
Variable interval
Aminophylline

19. What enzyme catalyzes the rate - limiting step in gluconeogenesis?
MI
HMG- CoA reductase
Fructose -1 - 6- bisphosphatase
presence of PMNs

20. What encephalopathy causes ocular palsies - confusion - and gait abnormalities related to a lesion in the mammillary bodies and/or the dorsomedial nuclei of the thalamus?

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21. What embryonic structure forms the following adult structures? - External genitalia
Phallus - urogenital folds - and labioscrotal swellings
Bladder cancer
Phosphofructokinase -1 and costs 1 ATP
Abs to HBsAg

22. What is the origin of the polyuria if a patient is dehydrated and electrolyte depleted?
There are no valves and no smooth muscle in the walls of the veins in the face.
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
Hirschsprung's disease (colonic gangliosus)

23. Is an anti - HAV IgG Ab associated with immunization or recent infection?
Molluscum contagiosum
Chromium (Cr)
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
Primary intention

24. What cytokine do CD4 T cells secrete to activate B cells when the specific peptide in the groove of the MHC II molecule interacts with the TCR?
antiemetic
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages
Aspiration pneumonia

25. 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
Alteplase
Foscarnet
Internal carotid artery and sympathetic plexus

26. Name the antimicrobial agent whose major side effect is listed - Dental staining in children
X- linked recessive
Tetracycline
Autosomal dominant
The pulsatile release of GnRH

27. At what stage of sleep is GH output elevated?
Stage 4
Lateral cricoarytenoid muscles
Leiomyoma
Klebsiella pneumoniae

28. What component of the inner ear x Contains endolymph and responds to head turning and movement?
Goodpasture disease
Semicircular duct
Sertoli cell
Expressive aphasia

29. Name the antidote - Anticholinergics
Temporal arteritis
Physostigmine
Hematoxylin
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.

30. What IL is important in myeloid cell development?
IL-3 (3 face down is an M)
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Mitral (bicuspid) valve

31. What are the five branches of the posterior cord of the brachial plexus?
The aorta
The vagina
Null hypothesis (what you hope to disprove)
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis

32. What is the epithelial lining of the prostatic portion of the urethra?
Streptococcus agalactiae (Group B Streptococcus - or GBS)
Enterococcus (Streptococcus faecalis)
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.

33. What rare disorder presents as a large - hard - irregular thyroid gland due to fibrous proliferation of connective tissue in the thyroid gland and extends to adjacent structures?
Riedel thyroiditis
Spironolactone
Primary hyperparathyroidism
Fluconazole

34. What organism is associated with the following types of diarrhea? Watery diarrhea from beef - poultry - or gravies
Clostridium perfringens
Pyelonephritis
Haemophilus ducreyi
Bronchioloalveolar carcinoma

35. What molecule that is needed to trigger T cell activation is noncovalently linked to TCR?
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
PPRF
Gastrinoma
Turcot syndrome

36. What are the longest - acting and shortest - acting benzodiazepines?
Water - soluble hormones are considered fast - acting hormones.
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
a1- Receptors
Diazepam is longest acting and midazolam is shortest acting.

37. What are the three Bs of adult polycystic kidneys?
de Quervain thyroiditis
Streptococci
1. Big 2. Bilateral 3. Berry aneurysm
Separation anxiety

38. What thyroid abnormality has the following? - TRH increased - TSH decreased - T4 decreased
Fibrocystic change of the breast
Duchenne muscular dystrophy
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)

39. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Alkylating agents
HBcAb and HBeAb. You see the antibodies c and e.
Succinylcholine
Leukemias and lymphomas
Volvulus

40. What enzyme is deficient in acute intermittent porphyria?
Uroporphyrinogen I synthetase
Langerhans cells
T3
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.

41. What encapsulated lymphoid organ is characterized by presence of Hassall's corpuscles - and absence of germinal centers and B cells?
Thymus gland. (Thymus gland is essential for T cell maturation.)
Standardized rate
Anticentromere Abs
The mouth

42. A clear - hypertonic solution with higher concentrations of K + and HCO3- - than the serum.
It forms a germinal tube at 37
Fructose -1 - 6- bisphosphatase
CSF
Multiple myeloma

43. What is the name of the major chemotactic agent released from x Bacteria?
F- Met - Peptides
Risk factors for cervical cancer
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
Frontal lobe

44. Renal epithelial casts in the urine
Acute toxic or viral nephrosis
Lesch - Nyhan syndrome
Plasma concentration and excretion rate
C1 inhibitor (C1- INH)

45. What disorder is associated with decreased platelet count - prolonged PT and PTT - decreased fibrinogen - and increased fibrin split products (D- dimers)?
Doxacurium
Disseminated intravascular coagulation (DIC)
Hemorrhagic exudates
Calcitriol

46. Both submandibular and sublingual glands are innervated by CN VII (facial) and produce mucous and serous secretions. Which one mainly produces serous secretions?
Silent
Isovolumetric contraction
It is produced by the preload on the muscle prior to contraction.
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.

47. What enzyme is deficient in the following glycogen storage disease? - von Gierke's disease
Mannitol
Glucose -6- phosphatase
hyperventilation
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.

48. Why is there an increase in FF if the GFR is decreased under sympathetic stimulation?
refractory sexual periods
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
Cryptococcus neoformans

49. What type of healing occurs in a clean surgical incision?
Primary intention
Hematoxylin
Clonorchis sinensis
Nocardia asteroides

50. What component of the renin - angiotensin - aldosterone axis increases sodium reabsorption in the proximal convoluted tubules and increases thirst drive?
Dantrolene
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
AT II
Trapezius and sternocleidomastoid

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USMLE Step 1 Prep

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