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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 is the term for the syndrome consisting of hepatomegaly - ascites - and abdominal pain due to hepatic vein thrombosis?
Adenovirus
Corynebacterium diphtheriae
Posterior chamber
Budd - Chiari syndrome

2. What is the triad of Horner's syndrome?
Cerebral aqueduct
8 to 25 hours
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.
Third week

3. At What age does IQ stabilize?
From age 5 onward IQ stabilizes.
Preganglionic sympathetic neurons
transcription
Nephrotoxic oxylate stones

4. Four - fifths of those who attempt suicide first...
give a warning
Silent
Edrophonium
As the name indicates - there is no change in volume but there is an increase in pressure.

5. What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency - glucocorticoid deficiency - and an excess of adrenal androgens?
Cholera toxin
Lewy bodies
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

6. What structure of a protein describes the interaction among subunits?
Quaternary structure
CN IX - X - and XI; sigmoid sinus
The Fc region of IgG and C3b
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels

7. What region of the nephron has the highest osmolarity?
Tip of the loop of Henle (1200 mOsm/L)
A positive PPD skin test
Galactoside permease
tRNA

8. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF normal - capillary pressure ?
IL-7 (A 7 upside down is an L; L is for Lymphoid)
Constriction of afferent arteriole
Reticulocyte
Secondary hypercortisolism (pituitary)

9. What form of oxidation takes place with the addition of a water molecule and breakage of bonds?
Impotence
Hydrolysis
DiGeorge syndrome
Parasympathetic

10. At the base of the lung - What is the baseline intrapleural pressure - and what force does it exert on the alveoli?
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
Multiple myeloma
CD8+ T cells
Chromosome 15

11. What percent of unwed mothers are teenagers?
Erythromycin
ASD
50% - with 50% of them having the child
Xenograft

12. How many pairs of spinal nerves exit from the spinal cord?
Cushing's ulcers
Eosinophil chemotactic factor A
31 pairs
Metronidazole

13. What is the most common one? - Primary malignant tumor of the female genital tract in the United States
Adenocarcinoma of the cervix
Motor
Sigmoid colon
Mitral stenosis

14. On the venous pressure curve - What do the following waves represent? - V wave?
Atrial filling (venous filling) Atrial - Contraction - Venous
Streptococcus viridans
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
CD8

15. Does light or darkness regulate the pineal gland?
Site 4
Crossover study
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.
Marijuana

16. What happens to free hormone levels when the liver decreases production and release of binding proteins?
Major
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Thoracic and sacral
Serotonin

17. What segment of the gastrointestinal tract lacks villi - has crypts - and actively transports sodium out of its lumen?
Systematic desensitization
Nephrotoxicity
Large intestine. Water is passively removed from the lumen.
Adenine and guanine

18. When a drug is administered orally and enters into portal circulation - it undergoes hepatic metabolism. What is the name of this effect?
First - pass effect
Chronic alcoholic
Thoracic and sacral
Th2 cells

19. Name the type of hypersensitivity reaction based on the following properties - IgG or IgM Abs against a specific target cell or tissue; complement - dependent or ADCC.
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
Measurement bias
Type II hypersensitivity (cytotoxic)
RSV

20. What is the term to describe how easily a vessel stretches?
BPH
Compliance (think of it as distensibility)
C1 inhibitor (C1- INH)
Macula densa

21. Describe the organism based on the following information: x Beta - hemolytic Streptococcus sensitive to bacitracin
PALS (Parietolateral lymphocytic sheath)
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
Masochism
Streptococcus pyogenes

22. What is the name of the postganglionic parasympathetic ganglion that innervates x The papillary sphincter and ciliary muscle of the eye?
ASA (salicylate)
Nissl substances; there is a great deal of RER in neuron cell bodies - indicating high protein synthesis.
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
Clostridium perfrigens

23. Name the DNA virus: x Linear dsDNA; naked; replicates in the nucleus
Adenovirus
Indirect pathway (Tourette syndrome for example)
Ethambutol
Bile salts are actively reabsorbed in the distal ileum.

24. In a topographical arrangement of the cerebellar homunculus map - What area or lobe x Controls balance and eye movements?
CN VII and VIII
HBcAb and HBeAb. You see the antibodies c and e.
Macula densa
Flocculonodular lobe (one of my favorite words in all of medicine!)

25. Which phenotype of osteogenesis imperfecta is incompatible with life?
Type II
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
PTH
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.

26. To what host cell receptor does the rabies virus attach?
Ephedrine
ACh receptor
Reticulocyte
Operon

27. What is the only sphingolipid that contains choline and PO4?
Flocculonodular lobe (one of my favorite words in all of medicine!)
Sphingomyelin (lecithin also - but it is not a sphingolipid)
Prolactinoma
Courvoisier's law

28. Name the most common one - Chromosomal disorder involving sex chromosomes
The energy of activation
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c
Klinefelter syndrome
Y - W-135 - and C and A capsular polysaccharides

29. What rate is indicated by 1- specificity?
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
Fibrocystic change of the breast
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva
False - positive rate

30. What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?
common variable hypogammaglobinemia
Enterococcus (Streptococcus faecalis)
The Purkinje cell
Onion skinning

31. What foramen must be traversed for entry into the lesser peritoneal sac?
Foramen of Winslow
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Raloxifene
First M PITS for pharyngeal pouch derivatives

32. How are drugs that are excreted via the biliary system resorbed by the GI tract?
Enterohepatic cycling
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.
ACh; think about the ANS.
total body water

33. Why should opioid analgesics be avoided for patients with head trauma?
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Waldeyer's ring
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see - can't wee - can't kick with your knee
Ovulation

34. What syndrome is characterized by sweating - insomnia - nausea - diarrhea - cramps - delirium - and general restlessness secondary to MAOI and SSRI in combination?
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Filtration is greater than excretion for net reabsorption to occur.
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.
Bulla

35. What AA is classified as basic even though its pK is 6.5 to 7?
Multiple myeloma
Histidine - because of the imidazole ring found in the R group - is basic.
Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance - taking longer to reach threshold and slowing the rate of firing.
CD3

36. What is the most common one? - Tumor on sun - exposed sites
Basal cell carcinoma
Leucine and lysine
Parasites
Intrapleural pressure decreases (becomes more negative).

37. What two glycolytic enzymes catalyze the substrate - level phosphorylations?
HMG CoA synthase
Hepatitis B and hepatitis C
CN IX - X - and XII CN XI arises from the cervical spinal cord.
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)

38. What is the only CN nucleus found in the cervical spinal cord?
Accessory nucleus
NE
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase
Axis I

39. What phobia is described as the fear of open spaces?
Pulmonary infections
RNA polymerase III
Agoraphobia. It also means having a sense of humiliation or hopelessness.
Humerus (between the medial epicondyle and the trochlea)

40. What is the anatomic positioning of the right and left gastric nerve plexus of the esophagus as they pass through the diaphragm?
Trypanosoma cruzi
Rhombencephalon
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
Lower lobe

41. When a person goes from supine to standing - what happens to the following? - Cardiac output
Flumazenil
Osler nodes
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
Epidural hematoma

42. What are the five Ig isotypes?
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.
Takayasu arteritis (medium - size to large vessels)
IgA - IgD - IgE - IgG - and IgM
Superior and posterior

43. What is the term for the dementia characterized by decremental or patchy deterioration in cognitive function due to a cerebrovascular accident?
Fusobacterium
It decreases insulin secretion.
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
Reverse transcription

44. Which drug is used to treat opioid withdrawal - ADHD - and sometimes Tourette's syndrome?
Selegiline
Superior and posterior
False - negative rate
Clonidine

45. What cells of the thyroid gland are stimulated in response to hypercalcemia?
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Chromosome 19
Multiple myeloma
Neutrophils - eosinophils - and basophils

46. Name the type of exudate - given the following examples - Rickettsial infection
Mean corpuscular hemoglobin (MCH)
PTH
T lymphocyte
Hemorrhagic exudates

47. What is the DOC for blastomycoses and sporotrichoses?
Prefrontal cortex; it is in front of the premotor area.
EBV
Common peroneal nerve
Itraconazole

48. Is T3 or T4 responsible for the negative feedback loop on to the hypothalamus and anterior pituitary gland?
Fentanyl
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
The Purkinje cell
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.

49. What is the most common lethal AR disorder affecting white Americans?
Papillary carcinoma
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
Cystic fibrosis
Clarke's nucleus

50. What is the term for the total percentage of correct answers selected on a screening test?
Paramesonephric ducts
Superior
Accuracy (think of it as all the trues - because they are the ones correctly identified)
The Fc region of IgG and C3b