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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. Which potassium - sparing drug is an aldosterone receptor antagonist ?
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
Spironolactone
Diphenhydramine
Kinesins. Dynein generates retrograde transportation of information.

2. What enzyme catalyzes the rate - limiting step in pyrimidine synthesis?
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
CN X
Aspartate transcarbamylase
Atracurium

3. What is the name of the monoclonal antibody used in the treatment of Crohn disease and rheumatoid arthritis?
Buffers (remember that buffers are best when they are used in a pH range near its pK)
Infliximab
Cardiac output
IgM

4. How many attacks are needed over how much time before panic disorder is diagnosed?
Bronchial asthma (whorled mucous plugs)
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
Tolcapone and entacapone
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).

5. At high doses aspirin has ________ properties.
Anticipation
Uricosuric
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Huntington disease

6. Serious psychiatric illness is more common _______ than childbirth.
Constipation and miosis
Schistosoma haematobium
after abortion
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells

7. Which two negative sense RNA viruses have neuraminidase enzymes?
Latissimus dorsi
Mitosis
Mumps and influenza virus
Pergolide

8. What type of binding occurs with one Fab or one idiotype of IgG?
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.
Hypocalcemia and hypophosphatemia
Affinity
Riboflavin (B2)

9. What CNs arise from x The pons?
Thyroid hormones
Yellow fever (flavivirus)
CN V - VI - VII - and VIII
CD15 and CD30

10. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Eukaryotic cell; 3 to 10 microns; 80S ribosomes; chitinous cell wall; ergosterol in cell membrane; replicate via cytokinesis with mitosis and meio
Fungi
Standardized rate
Cryptococcus neoformans
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.

11. Name the associated chromosomal translocation - CML
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.
Chromosome 9 - 22 (Philadelphia chromosome)
ACL
Renal cell carcinoma

12. In what layer of the epidermis is melanin transferred from melanocytes to keratinocytes?
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
Integument (skin and its derivatives)
Stratum spinosum
GLUT 4

13. Is associated with CML.
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
Thiazide diuretics
Increased leukocyte alkaline phosphatase (LAP)
Isograft

14. What type of bias is it when the information is distorted because of the way it is gathered?
Left ventricle and auricle of left atrium
Measurement bias
Psoriasis
Arch of the aorta and right subclavian artery

15. What cells of the kidney are extravascular chemoreceptors for decreased Na+ - Cl - - and NaCl?
Increased erection and libido
Epinephrine
Prolactinoma
Macula densa

16. What form of Plasmodium species affects the liver?
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.
Pancreatic delta - cell tumors inhibit CCK secretion
Hypnozoite
Membranoproliferative glomerulonephritis (MGN)

17. What phase of the cell cycle are the following antineoplastic agents specific for? - Nitrosoureas
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
G0 phase
Estriol
GnRH

18. What are the two essential fatty acids?
Adenocarcinoma
Myeloperoxidase
Linoleic acid and linolenic acid
The carotid body - which monitors arterial blood directly

19. When the results of a test are compared to findings for a normative group - what form of reference does the objective test use?
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
Thymus - independent Ags
Norm reference (i.e. - 75% of the students in the class will pass)
The aorta has the greatest velocity and the capillaries have the slowest velocity.

20. What ganglion receives preganglionic sympathetic fibers from T1 to L1-2 and innervates smooth muscle - cardiac muscle - glands - head - thoracic viscera - and blood vessels of the body wall and limbs?
Sympathetic chain ganglion
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
HPV serotypes 16 - 18 - 31 - and 33
Rho (D) immune globulin (RhoGAM) - an anti - RhD IgG antibody - prevents generation of RhD- specific memory B cells in the mother.

21. What is the name of the exotoxin Shigella dysenteriae produces - which interferes with the 60S ribosomal subunit and results in eukaryotic protein synthesis inhibition?
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)
Duodenum
Thymus - independent Ags
Hypervariable region (three per light chain; three per heavy chain)

22. What two classes of drugs can cause schizoid behavior?
Urophilia
Herpes virus I and II
Hexosaminidase A
Glucocorticoids and amphetamines

23. What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
MGB
Mesolimbic system
Histamine
Intraductal papilloma

24. What do the risk factors late menopause - early menarche - obesity - nulliparity - excessive estrogen - genetic factor p53 - and brc - abl characterize?
Breast cancer
Sinus venosus
Vitamin K
Hematoxylin

25. What phase of the cell cycle are the following antineoplastic agents specific for? - Cytarabine
Proencephalon
Coprophilia
Lateral cricoarytenoid muscles
S phase

26. What nerve is compromised in carpal tunnel syndrome?
Median nerve
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning

27. Is a cause of asthma.
Sj
HMP shunt
GERD
H1 histones

28. The fibers of nucleus gracilis and nucleus cuneatus cross at the medullary decussation and ascend contralateral to What thalamic relay nucleus?
Sj
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
Fibroadenoma
Phallic stage (4-6 years)

29. What are the four effects of suckling on the mother?
The vermis
Kinesins. Dynein generates retrograde transportation of information.
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
Risperidone

30. Name the compartment of the lower extremity and the nerve based on its movements - Adduct the thigh and flex the hip
Medial compartment of the thigh - obturator nerve
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
excites the neuron
Somatoform disorder

31. What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia?
90% as HCO3- - 5% as carbamino compounds - and 5% as dissolved CO2
Chloramphenicol
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
Inactivated

32. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Dorsal rami?
Malignancy
Gangrenous necrosis
Paget disease of the breast
Both

33. What substance found in eosinophils is toxic to parasitic worms?
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.
Major basic protein
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
Tetracycline

34. What is secretin's pancreatic action?
Mesonephric duct
Eisenmenger syndrome - which can also occur with any left - to - right shunt
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.
Pseudomonas sp.

35. Patients with sickle cell anemia are at increased risk for infection From what type of organisms?
Streptococcus agalactiae
Staphylococcus aureus
Encapsulated bacteria
Turner syndrome

36. What cancer is particularly likely to affect English chimney sweeps?
Copper deficiency
Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine.
Scrotal cancer - due to the high exposure to polycyclic aromatic hydrocarbons
Constriction of afferent arteriole

37. At the base of the lung - What is the baseline intrapleural pressure - and what force does it exert on the alveoli?
Yohimbine
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
Iodine - resulting in congenital hypothyroidism
Compliance (think of it as distensibility)

38. What embryonic structure forms the following adult structures? - Median umbilical ligament
Neutrophils - eosinophils - and basophils
They are in the grey matter of the CNS.
Urachus
Decrease (5- HT and dopamine levels do the same)

39. What breast pathology involves malignant cells with halos invading the epidermis of the skin?
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Paget disease of the breast
Malassezia furfur (treat with selenium sulfide)

40. What pineal hormone's release is inhibited by daylight and increased dramatically during sleep?
Metformin
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.
Paneth cells

41. What is the term for cytoplasmic remnants of RNA in RBCs - seen in lead poisoning?
Affinity decreases; they are inversely proportional.
Right - sided valves
The AR form is malignant and AD is benign.
Basophilic stippling

42. What is the term for the external urethra opening onto the dorsal surface of the penis?
Epispadia
The gut rotates clockwise around the superior mesenteric artery.
Allotypes
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.

43. What type of jaundice is seen in Dubin - Johnson syndrome?
Acute glomerulonephritis
Superior
Conjugated (direct) hyperbilirubinemia - a transport defect
Hirschsprung disease (aganglionic megacolon)

44. What bacterium is diagnosed using the Dieterle silver stain?
Burr cells (echinocytes)
Plummer - Vinson syndrome
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
Legionella

45. What are the pharmacologic effects seen sexually with x Dopamine agonists?
Marfan syndrome
Increased erection and libido
Postductal coarctation of the aorta (adult)
Disseminated intravascular coagulation (DIC)

46. What phase of the cell cycle are the following antineoplastic agents specific for? - 6- Thioguanine
Trypsin
Transitional cell carcinoma
Carbamazepine
S phase

47. What syndrome is associated with the following brainstem lesions? - Occlusion of the PICA - resulting in ipsilateral limb ataxia - ipsilateral facial pain and temperature loss - contralateral pain and body temperature loss - ipsilateral Horner's synd

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48. In what compartment of the thigh is the profundus femoris artery found?

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49. Where on the codon and anticodon does the wobble hypothesis take place?

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50. What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells?
Valproic acid
Medullary carcinoma of the thyroid
Gaucher disease
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see - can't wee - can't kick with your knee

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USMLE Step 1 Prep

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