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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. By which process do Abs make microorganisms more easily ingested via phagocytosis?
Opsonization
Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle.
Granulosa cell
PICA

2. Are contraindicated in patients who present to the hospital with CHF.
Streptococcus pneumoniae
Beta- Blockers
Bell pad
Disulfiram

3. Name the macrophage based on its location: x Brain macrophages
Priapism
Microglia
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.
PPRF

4. What enzyme found in a cholinergic synapse breaks down ACh? What are the byproducts?
Rhinovirus and hepatitis A virus
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
Phase 2
Systemic lupus erythematosus

5. What virus is associated with the Norwalk agent?
9.3 L - 15% of body weight
H 2
Calicivirus
Alanine cycle

6. What is the term for a large - immature RBC that is spherical - blue - and without a nucleus?
No CHO - AA - ketones - or peptides are left in the tubular lumen.
Hematoxylin
Reticulocyte
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.

7. What acid - base disturbance is produced from vomiting?
hCG can be detected in the blood by day 8 and in the urine by day 10.
Alcoholism
LTC4 - LTD4 - and LTE4
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.

8. What enzyme is deficient in chronic granulomatous disease of childhood?
Sideroblastic anemia
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
NADPH oxidase
MGB (think EARS)

9. Is encapsulated.
Insulinoma
Dyslexia
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Gonococcus

10. Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Lateral rectus (CN VI) (LR6 SO4)3
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve
Major

11. What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Myasthenia gravis
Carbamoyl phosphate synthetase I
The subclavian artery

12. What is the end product of purine catabolism?
Spleen
12 days after ovulation
Breast and lung cancer - respectively.
Uric acid

13. What hereditary bone disorder is due to decreased osteoclast function - resulting in thick - sclerotic bones that fracture easily?
There would be two Fab and Fc regions.
Aedes mosquito
Enterohemorhagic Escherichia coli
Osteopetrosis (Albers - Sch

14. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol increased - ACTH decreased
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
Primary hypercortisolism
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.
IF and GTP (eIF for eukaryotes)

15. What is the renal compensation mechanism for alkalosis?
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
MGB
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+

16. What is the most common one? - Renal pathology in patients with SLE
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
nef and tat genes
Diffuse proliferative GN
Parvovirus

17. What glycolytic enzyme has a high Vmax - high Km - and low affinity for glucose?
Mural infarct
Puborectalis
Glucokinase
Renal cell carcinoma

18. What Brodmann area is associated with x Primary motor cortex?
Area 4
Mixed (both cholesterol and calcium)
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Hepatitis - with or without necrosis

19. What adult structures are derived from preotic somites?
Helicobacter pylori
Muscles of the internal eye
Double - blind study. It is the most scientifically rigorous study known.
Metronidazole

20. What is the name of the exotoxin Shigella dysenteriae produces - which interferes with the 60S ribosomal subunit and results in eukaryotic protein synthesis inhibition?
Hepatitis B
Herpes virus I and II
Diphyllobothrium latum
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)

21. From the fourth month of fetal life to term - what secretes the progesterone and estrogen to maintains the uterus?
Achondroplasia
Conn syndrome (primary hyperaldosteronism)
Area 22 and occasionally 39 and 40
The placenta

22. Name the nephritic disease based on the immunofluorescent staining - Smooth and linear pattern of IgG and C3 in the GBM
Griseofulvin
The outer cortex contains most of the germinal centers and therefore also most B cells.
Amnesia. (The person is aware of the memory loss.)
Goodpasture disease

23. What type of error is made if you reject the null hypothesis when it is true?

24. What vein is formed by the union of the right and left brachiocephalic veins?
Supraspinatus and infraspinatus
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
SA node; it is the reason it is the primary pacemaker of the heart.
Superior vena cava

25. What is the most common one? - Site of ulcerative colitis
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
Rectum

26. What hormone is characterized by the following renal effects? - Calcium reabsorption - phosphate excretion
Saltatory conduction
B cells; macrophages and dendritic cells are nonspecific.
Crohn disease
PTH

27. What enzyme is deficient in the following glycogen storage disease? - McArdle's disease
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Ventral anterior nucleus
Muscle glycogen phosphorylase
Four

28. What vitamin deficiency can result in high - output cardiac failure?
Isotonic contraction
Pregnancy
Thiamine
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.

29. Which leukotrienes are associated with the late - phase inflammatory response?
Area 4
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
LTC4 and LTD4
The T- test (used when comparing two groups)

30. What phase of the cell cycle are the following antineoplastic agents specific for? - Cytarabine
Breast
Vitreous humor
Fading
S phase

31. What acid form of H+ in the urine cannot be titrated?
Sphingomyelin (lecithin also - but it is not a sphingolipid)
Middle
Embolism
NH4+(ammonium)

32. Does light or darkness regulate the pineal gland?
Anopheles mosquito
Linoleic acid and linolenic acid
Kidney
Light regulates the activity of the pineal gland via the retinal - suprachiasmatic - pineal pathway.

33. According to Freud - what facet of the psyche represents the internalized ideals and values of one's parents?
Stable
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
Superego
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.

34. What are the three epidermal derivatives?
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
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.
Alveolar macrophages
Mebendazole

35. What is the most common one? - Type of PUD
Lateral compartment of the leg - superficial peroneal nerve
Duodenal ulcers (4 times as common as gastric)
Selection bias
Affinity

36. What happens to NE levels in x Major depression?
Area 22 and occasionally 39 and 40
First - pass effect
Decrease (5- HT and dopamine levels do the same)
Hairy cell leukemia

37. What enzyme of the TCA cycle catalyzes the substrate level phosphorylation?
t the end of the PCT 25% of Na+ - Cl - - K+ is left
Succinyl CoA synthetase
Metabolic rate and alveolar ventilation (main factor)
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

38. Which type of hepatitis is a calicivirus?
Nitroprusside
Good Samaritan Law. (Physicians are not required to stop and help.)
Hepatitis E (enteric)
Arthroconidia with hyphae

39. What CNS demyelinating disease is characterized by diplopia - ataxia - paresthesias - monocular blindness and weakness - or spastic paresis?
Breast cancer
Multiple sclerosis
Alteplase
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.

40. Name the antidote - Ethylene glycol
Ethyl alcohol
CN V3 and the lesser petrosal nerve
Neisseria meningitides
Corticosteroid

41. What is the DOC for the following protozoal infections? - Trichomoniasis
Adult T- cell leukemia
IgE
Increase enzyme concentrations
Metronidazole

42. What two forms of insulin - if mixed together - precipitate zinc?
Thymus gland. (Thymus gland is essential for T cell maturation.)
2 NADPHs per acetyl CoA
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
Lente insulin and either NPH or protamine zinc insulin (PZI)

43. What two drugs inhibit the release of neurotransmitters from storage granules?
a -1 - 6 transferase
Guanethidine and bretylium
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
17- alpha - Hydroxylase deficiency

44. What are the first signs of overdose from phenobarbitals?
Nystagmus and ataxia
T lymphocyte
RBCs. That is why it is called red pulp.
alpha - Cells; glucagon has stimulatory effects on - cells and inhibitory effects on - cells.

45. How many ATPs per glucose are produced by pyruvate dehydrogenase?
Turner syndrome
<2
Plasmodium malariae
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)

46. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Clinical disorders (e.g. - schizophrenia)?
Axis I
One - way ANOVA
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
Gout

47. What transient deficiency may result in a hypercoagulable state if warfarin is given alone?
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Terbinafine
Factors II - VII - IX - and X and proteins C and S.

48. What paraphilia is defined as x Combining sex with defecation?
Renal failure
Being awake
Coprophilia
Calcium oxylate

49. What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?
Major
Onion skinning
Tidal volume (VT)
Risk factors for cervical cancer

50. A patient goes to the ER with signs and symptoms of biliary colic. Which opioid analgesic do you choose?
RSV
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.
Hypotonia (rag doll appearance)
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons