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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 which region of the lung are 75% of the pulmonary infarcts seen?
Superior and posterior
Muscle glycogen phosphorylase
All
Lower lobe

2. What malignant tumor of the trophoblast causes high levels of hCG and may occur after a hydatidiform mole - abortion - or normal pregnancy?
Estradiol
CO
Anopheles mosquito
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)

3. Name the MCC - Aspiration pneumonia in an alcoholic
The T- test (used when comparing two groups)
Klebsiella pneumoniae
<2
HBsAg as its envelope

4. Is it acceptable to lie - even if it protects a colleague from malpractice?
urease positive
Snails
Cones (C for color and cones)
No - it is never acceptable to lie.

5. Which potassium - sparing drug is an aldosterone receptor antagonist ?
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.
Rhombencephalon
Spironolactone
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa

6. ______________ that slow bacterial growth are bactericidal.
Cardiac muscle
Antimicrobial agents
Gain of hypotonic fluid (water intoxication or hypotonic saline)
Left ventricle and auricle of left atrium

7. What HIV enzyme produces a dsDNA provirus?
Reverse transcriptase
ACh
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Severe (range 20-34)

8. What three cephalosporins have good penetration against Bacteroides fragilis?
Primary hypercortisolism
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
VSD
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime

9. Do the following structures pick up stain from hematoxylin or eosin? - Bacteria
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.
T3
Hematoxylin
HPV

10. What DNA virus is associated with exanthem subitum (roseola)?
HHV 6
1. Protest 2. Despair 3. Detachment
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Flumazenil

11. If a mother delivers a Rho - positive baby - she should receive...
Rho-immunoglobin
Parkinson disease
Ventricular fibrillation (V fib)
Multiple myeloma

12. Name the three methods of vasodilation via the sympathetic nervous system.
Plasmodium malariae
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
1. Decrease alpha -1 activity 2. Increase Beta -2 activity 3. Increase ACh levels
Id

13. Can a physician commit a patient?
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
IgM
Ethyl alcohol
Helicobacter pylori

14. What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
There are 10 bronchopulmonary segments on the right and 8 on the left.
Kimmelstiel - Wilson disease
Anemia of chronic disease
ACE inhibitors (the - pril agents)

15. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH ?
Clearance
Denial
Posterior
Primary hypogonadism (postmenopausal women)

16. In what pathway of the basal ganglia do lesions result in hyperactive cortex with hyperkinetic - chorea - athetosis - tics - and dystonia?
Fluconazole
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.
Indirect pathway (Tourette syndrome for example)
Sensory

17. Neurons in the dorsal horn participate in...
reflexes
Snails
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
Digoxin is renally eliminated; digitoxin is hepatically eliminated.

18. Name the most common cause - Infectious pancreatitis
Mumps
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
Atelectasis
Taenia saginata

19. What ocular muscle x Elevates and abducts the eyeball?
Sideroblastic anemia
Puberty
Inferior Oblique (CN III) (LR6 SO4)3
Hypoactive sexual desire disorder

20. What cell in bone is a part of the mononuclear phagocytic system?
Sciatic nerve
Osteoclasts
Linoleic acid and linolenic acid
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)

21. What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
Brucella
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
T9
Fitz - Hugh - Curtis syndrome

22. Are the following conditions associated with a negative or positive nitrogen balance? - Infection
Janeway lesions
Second M PITS for pharyngeal pouch derivatives
Roth spots
Negative

23. What component of the ANS is responsible for movement of semen from the epididymis to the ejaculatory ducts?
Depression
Opposite the second upper molar tooth
Sympathetic nervous system
Osteitis fibrosa cystica (von Recklinghausen disease)

24. Name the product or products of arachidonic acid: x Chemotactic for neutrophils
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
LTB4
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.
The Purkinje cell

25. The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?
Adenosine (it is an excellent agent to use in emergencies because its half - life is 30 seconds)
Insulin
Sporothrix schenckii
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.

26. How many kilocalories per gram are produced from the degradation of fat? CHO? Protein?
No - unsaturated fatty acids have double bonds.
Metaraminol (a1 - Beta1 )
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
Granulosa/thecal cell tumor of the ovary

27. Patients with _______________ have B cells in the peripheral blood.
Penicillin V
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
common variable hypogammaglobinemia
Hepatitis E

28. What is the only drug that does not have an intoxication?
Enterokinase
Thymus gland. (Thymus gland is essential for T cell maturation.)
Antisocial personality
Nicotine (but it sure has a nasty withdrawal!)

29. What thyroid abnormality has the following? - TRH increased - TSH increased - T4 decreased
Mode
Isovolumetric contraction
Primary hypothyroidism (Low T4 has a decreased negative feedback loop - resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release - respectively.)
Ventral posterolateral nucleus

30. What component of the ETC is inhibited by the following? - Cyanide
Cytochrome a/a3
Uroporphyrinogen I synthetase
Rotavirus
Desipramine

31. What nematode is known as hookworms? What is the treatment?
Necator americanus is treated with mebendazole and iron therapy.
Peyer's patch
Log - kill hypothesis (follows first order kinetics)
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts

32. Name the type of graft described by these transplants: Between genetically identical individuals
Paneth cells
Isograft
Primary hypoaldosteronism (Addison's disease)
CN V2

33. What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100 - 00); decreased LAP levels; and nonspecific symptoms of fatigue - malaise - weight loss - and anorexia?
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)
IgA nephropathy
CML
No change in length

34. What nerve is associated with the following functions? - Innervation of the flexor carpi ulnaris - flexor digiti profundus (pinky and ring fingers) - and the intrinsic muscles of the hand
Ulnar nerve
Antithyroglobulin and antimicrosomal Abs
Histidine - because of the imidazole ring found in the R group - is basic.
Glutamate dehydrogenase

35. What do the risk factors late menopause - early menarche - obesity - nulliparity - excessive estrogen - genetic factor p53 - and brc - abl characterize?
Free form determines hormone activity and is responsible for the negative feedback loop.
Breast cancer
Turner syndrome
Hepatoma and nonseminomatous testicular germ cell tumors

36. A known IV drug abuser goes to the ER with respiratory depression and pinpoint pupils and in a semicomatose state. What overdose do you suspect - and What agent will you give to reverse its effects?
The triad of respiratory depression - pinpoint pupils - and coma in an IV drug abuser suggests opioid overdose (e.g. - heroin) - and you should give naloxone.
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.
Id
Hormone - sensitive lipase

37. What mineral is an important component of the enzyme xanthine oxidase?
Galactoside permease
>15 mm
Molybdenum (Mb)
3 months of symptoms in 2 consecutive years

38. What three AAs must patients with maple syrup urine disease not eat?
Isoleucine - leucine - and valine
Extrahepatic biliary atresia
The mouth
One day after the LH surge and 2 days after the estrogen peak.

39. What purine base is contained in inosine monophosphate?
Alcohol. Nearly 10% of adults have a problem with alcohol.
Plasmin
Proteus
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)

40. The opening of what valve indicates the termination of isovolumetric relaxation phase of the cardiac cycle?
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
Venous pressure above the heart is subatmospheric - so a puncture there has the potential to introduce air into the system.
The resistance will decrease one - sixteenth of the original resistance.
This is the triad of renal cell carcinoma

41. What parasympathetic nucleus is found on the floor of the fourth ventricle and supplies preganglionic fibers innervating the terminal ganglias of the thorax - foregut - and midgut?
Dorsal motor nucleus of CN X
Squamous cell carcinoma
3 months of symptoms in 2 consecutive years
Staphylococcus aureus (but they are more prone to salmonella infections)

42. Where are the tonsillar tissues?

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43. From What aortic arch are the following structures derived?
HDL
Histiocytosis X
HPV serotypes 1 and 4
Degenerates

44. RBCs in the urine
Bladder carcinoma
Temporal arteritis (giant cell arteritis)
Tamoxifen
Erythema marginatum

45. What are the four most common causes of femoral head necrosis?
ACh - histamine - and gastrin
Raloxifene
Paramyxovirus
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia

46. Name the antidote - Nitrates
Lipoxygenase pathway - from arachidonic acid
Conjugated (direct) hyperbilirubinemia - a transport defect
HPVs 16 and 18
Methylene blue

47. Name the macrophage based on its location: x Epidermal macrophages
Langerhans cells
Verbigeration
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.
Pinpoint pupils - decreased respiratory rate - and coma

48. What are the four functions of saliva?
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Squamous cell carcinoma
3'-5' direction - synthesizing RNA in the 5'-3' direction
Positive sense RNA means it can serve as mRNA and therefore has 5'-3' polarity

49. What serves as a marker of endogenous insulin secretion?
Renin secretion
CD40
C- peptide levels
Enkephalin

50. Which of the following is not a risk factor for cholesterol gallstones: pregnancy - OCP use - female gender - hemolytic anemia - cirrhosis - and obesity? (May be more than one answer.)
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Gap junctions
Aromatase
apo B-48