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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 syndrome causes inability to concentrate - easy distractibility - apathy - and regression to an infantile suckling or grasping reflex?
Ordinal scale (e.g. - faster/slower - taller/shorter)
Frontal lobe syndrome (lesion in the prefrontal cortex)
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.)
Granulosa cells

2. With a decrease in arterial diastolic pressure - what happens to x TPR?
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Decreases
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.

3. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Thalamus
Proencephalon
Splenomegaly and anemia (with a high index of suspicion)
Grasp proceeds release
Urophilia

4. What are the three stages that children aged 7 months to 5 years go through when they are separated from a primary caregiver for a long time?
1. Protest 2. Despair 3. Detachment
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
Trapezius and sternocleidomastoid
O2

5. What are the two opsonizing factors?
The Fc region of IgG and C3b
Agglutination test
Negative
Graves disease

6. What are the six substances that promote the secretion of insulin?
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Galactitol

7. What statistical test compares the means of groups generated by two nominal variables by using an interval variable?
Isoniazid
Stage 1
Two - way ANOVA. It allows the test to check several variables at the same time.
Impaired ejaculation

8. What component of the renin - angiotensin - aldosterone axis increases sodium reabsorption in the proximal convoluted tubules and increases thirst drive?
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
Deficiency in surfactant
AT II
A patent processus vaginalis

9. What two pituitary hormones are produced by acidophils?
Phase I
Succinate dehydrogenase
GH and prolactin are produced by acidophils; all others are by basophils.
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)

10. What mineral is associated with impaired glucose tolerance?
Flocculonodular lobe (one of my favorite words in all of medicine!)
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Chromium (Cr)
Neuroblastoma

11. On the venous pressure curve - What do the following waves represent? - V wave?
Atrial filling (venous filling) Atrial - Contraction - Venous
No - therapeutic indices can tell which drug is safer - not more toxic.
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.
Reye syndrome

12. What abdominal muscle runs horizontally - contributes to the posterior rectus sheath - and contributes to form the conjoint tendon?
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Temporal lobe
Transverse abdominis
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade

13. What are the four signs of acute inflammation?
Duchenne muscular dystrophy
Microvillus
Ependymoma
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function

14. What embryonic structure forms the adult female structures? - Ovary - follicles - rete ovarii
Gonads
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
Lysosomal a -1 - 4- glucosidase

15. What lymphoid organ is characterized by germinal centers - plasma cells that secrete IgA - and no encapsulation?

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16. What oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis?
impermeable to water
Hemiballismus
Round and ovarian ligaments
Metformin

17. What is the primary screening test used to detect HIV- infected individuals? Confirmatory test?
1. Sartorius 2. Gracilis 3. Semitendinous
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.
Biotin - ATP - and CO2
Positive

18. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Denial of illness - hemineglect - construction apraxia (can't arrange matchsticks)
Klebsiella pneumoniae
Nondominant parietal lobe
Mitral insufficiency
Marrow failure - cancer - and leukemia

19. What vessels in the systemic circulation have the greatest and slowest velocity?
Vitelline fistula
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
hypophosphatemia
The aorta has the greatest velocity and the capillaries have the slowest velocity.

20. Name the cerebral vessel associated with the following vascular pathologies - Subdural hemorrhage
Bridging veins draining into the sagittal sinus
Primary biliary cirrhosis
Schwannoma
The Fc region of IgG and C3b

21. What primary acid - base disturbance is cause by a decrease in alveolar ventilation (increasing CO2 levels) resulting in the reaction shifting to the right and increasing H+ and HCO3- levels?
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
Tibial nerve
DHEA (androgens) Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Adenosine deaminase (ADA) deficiency

22. What enzyme of pyrimidine synthesis is inhibited by the following? - Hydroxyurea
Ribonucleotide reductase
Liquids - CHO - protein - fat
Kl
Breast

23. What three organs can be affected by Trypanosoma cruzi?
Gametocytes
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)
Virchow triad - associated with the formation of a thrombus.
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.

24. In biostatistics - What are the three criteria required to increase power?
Direct fluorescent Ab test
Afterload
1. Large sample size 2. Large effect size 3. Type I error is greater
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.

25. What CN is associated with the sensory innervation of x Nasopharynx?
Chief cell adenoma (80%)
Maxillary division of CN V and glossopharyngeal nerves
Inspiratory reserve volume (IRV)
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius

26. Which type of hepatitis can cause hepatocellular carcinoma?
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Hepatitis B
Second M PITS for pharyngeal pouch derivatives
Ovulation

27. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Pancreas
Aspiration
Stable
Shifts it to the right
SA node; it is the reason it is the primary pacemaker of the heart.

28. Increases the risk of developing ovarian cancer.
Sporothrix schenckii
Candida
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
Estrogen use

29. If the AV difference is positive - is the substance extracted or produced by the organ?
Area 17
Multiple myeloma
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.
NE - via its vasoconstrictive action on blood vessels

30. What are the three C's of measles?
HBsAg and HBeAg
1. Cough 2. Coryza 3. Conjunctivitis
Proencephalon
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.

31. Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?

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32. Active protein transport requires a...
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
Necrophilia
Concentration gradient
Narcissistic

33. What enzyme is deficient in patients with CGD?
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Ribozymes
Primase
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.

34. What type of skin carcinoma occurring on sun - exposed sites has a low level of metastasis?
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
Squamous cell carcinoma
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Vmax

35. What syndrome is due to anti - GBM Abs directed against the lung and kidneys?
Ependymoma
Goodpasture syndrome
Vitamin A
The kidneys excrete the excess nitrogen from the body as urea in the urine.

36. What embryonic structure forms the following adult structures? - Urinary bladder and urethra
Proencephalon
Antimicrobial agents
Urogenital sinus
Strongyloides stercoralis is treated with thiabendazole.

37. Name the lipoprotein based on the following characteristics - apo A-1 - apo E - apo C- II
HDL
Rationalization
The AR form is malignant and AD is benign.
The entire tubule barring the thick ascending limb

38. What condition is characterized by a 46XY karyotype - testes present - and ambiguous or female external genitalia?
C3 - C4 - and C5 keep the diaphragm alive!
Chlortetracycline
The carotid sinus reflex
Male pseudohermaphrodite (dude looks like a lady!)

39. What form of coarctation of the aorta is associated with Turner syndrome?
Autograft
Preductal (infantile)
Melanocytes
Mast cells

40. What are the three reasons for the effectiveness of the blood - brain barrier?
Alteplase
Left colic - superior rectal - and sigmoidal arteries
Acetaminophen
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries

41. Name the lipoprotein based on the following characteristics - apo E - apo C- II - apoB-48
Ritodrine and terbutaline
P = .05; P < .05 rejects the null hypothesis
Chylomicrons
At least 15%

42. Name the eukaryotic DNA polymerase based on the following information: x Synthesizes the lagging strand during replication
Asbestosis
DNA polymerase - a
O2
Excess lead

43. What bacterium is responsible for woolsorter's disease?
Bacillus anthracis
Placental alkaline phosphatase
Rhabdomyoma
Acetaminophen

44. Name the most common type or cause - Sinusitis and otitis media in children
Pterygopalatine ganglion (I remember this as the only ganglion left.)
Pneumococcus
Kinesins. Dynein generates retrograde transportation of information.
Musculophrenic and superior epigastric arteries

45. What is the name of the SER of striated muscle?
The second pharyngeal pouch and groove
Unconjugated (indirect)
Sarcoplasmic reticulum
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.

46. Name the lipoprotein based on the following characteristics - apo E - apo B-100 - apo C- II
Salmonella
VLDL
Expiratory reserve volume (ERV)
Increased GABA levels decrease the likelihood of learned helplessness.

47. What bedside test is used to differentiate a dorsal column lesion from a lesion in the vermis of the cerebral cortex?

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48. What tract is responsible for voluntary refined movements of distal extremities?
CN III and IV
Down syndrome (trisomy 21)
Corticospinal tract
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.

49. By What age should children be able to draw the following figures? - Rectangle
Meningococcus (Gonococcus does not)
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
ELISA. It detects anti - p24 IgG.
Isocitrate dehydrogenase

50. Which integrin mediates adhesion by binding to lymphocyte function - associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors?
0.21; it is a fancy way of saying 21% of the air is O2.
Isograft
Intercellular adhesion molecule (ICAM) 1
Right atrium