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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. How far below ideal body weight are patients with anorexia nervosa?
Cefuroxime and cefaclor
CML and All
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
At least 15%

2. What two arteries join to form the superficial and deep palmar arches of the hand?
Ulnar and radial arteries (ulnar is the main supplier)
Postductal coarctation of the aorta (adult)
C1 inhibitor (C1- INH)
Kawasaki disease

3. At what stage of cognitive development (according to Piaget) do children x See death as irreversible?
Lithium
Concrete operations (6-12 years)
Ligamentum arteriosum
Rathke's pouch; they can result in compression of the optic chiasm.

4. What cells of the retina sees in color and needs bright light to be activated?
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Salmeterol
Cones (C for color and cones)
Catatonic schizophrenia

5. In prokaryotes - What is the name of the RNA sequence that ribosomes bind to so translation can occur?
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
Shine - Dalgarno sequence
Correlation. No - correlation does not imply causation.
Splitting

6. What purine base is contained in inosine monophosphate?
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
Major
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.

7. Cri - du - chat syndrome results in a terminal deletion of the short arm of what chromosome?
Niemann - Pick and Tay- Sachs diseases
Naloxone - naltrexone
Gout
Chromosome 5

8. What disease is described by the following characteristics: multiple motor and vocal tics - average age of onset 7 - a M:F ratio of 3:1 - and association with increased levels of dopamine?

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9. Name the most common type or cause - Intestinal obstructions in adults
Vancomycin
Staphylococcus aureus
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Adhesions and hernias

10. What is the term for a schizophrenic episode lasting longer than 30 days with full return to former functioning capacity?
Staphylococcus
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
5- hydroxyindoleacetic acid (5- HIAA)
Mesencephalon

11. What neurotransmitter inhibits the optic nerve bipolar cell and shuts off in response to light?
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
Follicular adenoma
Glutamate
Poxvirus

12. What is the pentad of TTP?

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13. Name the nephritic disease based on the immunofluorescent staining - Granular deposits of IgG - IgM - and C3 throughout the glomerulus
Postinfectious GN
S phase
The fastigial nucleus
Carbidopa and benserazide

14. What is the most common one? - Primary malignant tumor of the lungs
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Action potential
Ligamentum arteriosum
Adenocarcinoma (30% to 35%)

15. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 and int -2
Melanoma - cancer of the stomach and bladder
Glycine/arginine
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Conidia

16. What enzyme catalyzes the covalent bonding of the AA's carboxyl group to the 3' end of tRNA?
Factors II - VII - IX - and X and proteins C and S.
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)

17. 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
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.
Pergolide

18. What papillae send their senses via chorda tympani of CN VII?
Factors II - VII - IX - X - and proteins C and S
Fungiform papillae
Right ventricle
Extinction

19. What type of damage to the kidneys is caused by drinking ethylene glycol (antifreeze)?
Selective erectile disorder
Functional residual capacity (FRC)
1. Liver 2. Kidney 3. Pituitary gland (via 5'- deiodinase enzyme)
Nephrotoxic oxylate stones

20. What is the most common one? - Pituitary tumor
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.
Chromophobe adenoma
Efficacy

21. What tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum - helping monitor and modulate muscle movements?
Lung and bronchus cancer
Test - retest reliability
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
ACh receptor

22. Why isn't the incidence of a disease decreased when a new treatment is initiated?
Head of the pancreas
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
Separation anxiety

23. When attempting to make up sleep - what stage of sleep is recovered?
Volvulus
IgM
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.
Prolactinoma

24. A patient has to prove his or her...
Cross - sectional studies determine prevalence - not incidence or cause and effect.
They prevent mast cell degranulation.
S phase
competency

25. Name the end product or products: x Fatty acid synthesis
almitate
Creatinine
Chromosome 1
Methanol

26. What are the two ketogenic AAs?
Obesity - DM - HTN - multiparity - early menarche - and late menopause
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
One day after the LH surge and 2 days after the estrogen peak.
Leucine and lysine

27. Name the DNA virus x Linear dsDNA; nuclear envelope; icosahedral; replicates in the nucleus
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.
Streptomycin
Herpes virus
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime

28. Name the DNA virus: x Partially dsDNA circular; enveloped; virion - associated polymerases; has RNA intermediate; replicates in the nucleus
Hepadnavirus
IgG
For males - HTN; for females - pregnancy.
Peyer's patch

29. Which HPV serotypes are associated with condyloma acuminatum?
Insulinoma
Case control studies cannot assess incidence or prevalence - but they can determine causal relationships.
NADPH - O2 - and cytochrome b5
HPV serotypes 6 and 11

30. What two factors determine the clearance of a substance?
Complex I
Chromosome 22q
Plasma concentration and excretion rate
Pseudogout

31. What is the most common one? - Testicular tumor in infants and children
Transcription factor IID
Yolk sac tumor
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
Chloramphenicol

32. What pyrimidine base is found x Only in RNA?
H2PO4- (dihydrogen phosphate)
Uracil
Severe combined immunodeficiency disease
1. Propranolol 2. Timolol 3. Carteolol

33. What is the label given to an individual whose IQ is x 90 to 109
Huntington disease
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Papillary carcinoma of the thyroid
Average

34. There are no central ___ receptors.
Absolute refractory period is due to voltage inactivation of sodium channels.
EBV
O2
Suppression

35. What enzyme of heme synthesis is deficient in the autosomal dominant disorder acute intermittent porphyria?
Positive
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.
Uroporphyrinogen - I synthase
Chlamydia psittaci

36. A migrating myoelectric complex is a propulsive movement of undigested material of undigested material from the stomach to the small intestine to the colon. During a fast - What is the time interval of its repeats?
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
HBsAg and HBeAg
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.

37. What non - spore - forming gram - positive aerobic rod produces bull neck - sore throat with pseudomembranes - myocarditis - and sometimes respiratory obstructions?
As flow increases - the urine becomes more dilute because of decreased time for H2O reabsorption.
Gonococcus
Nephrotoxicity
Corynebacterium diphtheriae

38. Name the most common type or cause - UTIs
Inferior rectus (CN III) (LR6 SO4)3
Round and ovarian ligaments
Escherichia coli
MHC class I antigens; they are also found on the surface of platelets.

39. Where in the GI tract does the reabsorption of bile salts take place?
Tyramine
Vimentin
Cystadenocarcinoma
Bile salts are actively reabsorbed in the distal ileum.

40. What is the tetrad of tetralogy of Fallot?
VSD - RVH - overriding aorta - and pulmonary stenosis
CCK stimulates the pancreas to release amylase - lipase - and proteases for digestion.
Vesicle (e.g. - poison ivy)
Type III hypersensitivity reaction

41. What facultative intracellular fungus is associated with hepatosplenomegaly?
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)
Leydig cell tumor
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Deficiency in surfactant

42. What modified smooth muscle cells of the kidney monitor BP in the afferent arteriole?
Neonatal respiratory distress syndrome (NRDS)
The JG cells
Medial meniscus
Adenovirus

43. What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?
Pseudogout
Antigenic determinant (epitope)
Puberty
Sorbitol (resulting in cataracts)

44. Irreversible ototoxicity is associated with which loop diuretic?
Ethacrynic acid
Right - sided valves
Chromosome 11p
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases

45. What type of skin carcinoma occurring on sun - exposed sites has a low level of metastasis?
Schizotypal
Vitamin A
Squamous cell carcinoma
IDL

46. What CNS tumor arises from Rathke's pouch?
Phenylalanine hydroxylase
Factors II - VII - IX - X - and proteins C and S
Craniopharyngioma
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)

47. What is the most common one? - Germ cell tumor in men
Insulin
Id (pleasure principle)
Seminoma
Herpes virus

48. What disorder is associated with loss of polarity - anaplasia - pleomorphism - discohesiveness - increase in the nuclear:cytoplasmic ratio - hyperchromasia - and increase in the rate of mitosis?
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).
Malignancy
T9
Parkinson's disease

49. What substance found in eosinophils is toxic to parasitic worms?
Major basic protein
Turner syndrome
Shortens
Intellectualization

50. Name the structure that enters or exits the following foramina: x Foramen ovale
CN V3 and the lesser petrosal nerve
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae
The vagina
well - fed and fasting