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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 most common one? - Malignant tumor in women
Filtration is greater than excretion for net reabsorption to occur.
Breast
>10 mm
Mean corpuscular hemoglobin concentration (MCHC)

2. What type of spore is defined as an asexual budding daughter yeast cell?
Blastoconidia
Pituitary adenoma
Streptomycin
Lateral rectus (CN VI) (LR6 SO4)3

3. What encephalitis is associated with the JC virus?
Leydig cell tumor
When it crosses the teres major
Exposure
Progressive multifocal leukoencephalopathy

4. What complement factor or factors are associated with x Opsonization?
PGE2 and PGF2a
C3b
Prinzmetal variant angina
Marrow failure - cancer - and leukemia

5. When attempting to make up sleep - what stage of sleep is recovered?
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.
Hypersegmented neutrophils
Methylphenidate (Ritalin)
Large segment deletions

6. What structure or structures cross the diaphragm at x T10 level?
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
5 years old
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12

7. Name the bony articulations of the following sites. Be specific. Wrist
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)
Papule
Tetracyclines
RSV

8. Clarke's nucleus is the second ascending sensory neuron of which spinocerebellar tract?
Ependymal cells
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
The splenic vein

9. What organ of the body has the smallest AV oxygen difference?
Hodgkin lymphoma
C5a
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.
Right brachiocephalic artery

10. What is the most common opportunistic infection of the CNS in HIV?
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Proencephalon
Toxoplasmosis
Bernard - Soulier syndrome

11. Name the compartment of the mediastinum associated with the following thoracic structures: Pulmonary artery and veins
Guillain - Barr
Middle
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)

12. Four - fifths of those who attempt suicide first...
give a warning
Rifampin
Vagus nerve
Epstein - cardiac anomaly of the tricuspid valve

13. How much of a vessel must be stenosed to cause sudden cardiac death?
Propofol
More than 75% of the vessel
Coombs test
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.

14. Name these immature defense mechanisms: x Inability to remember a known fact (aware of forgetting)
Cryptococcus neoformans
Blocking
NE
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.

15. Name the most common type or cause - Infection in a patient on a ventilator
Seminoma
Pseudomonas aeruginosa
Phallus
Fibroadenoma

16. What antiviral agent is used in the treatment of drug - induced Parkinson's disease?
Separation anxiety
Flocculonodular lobe (one of my favorite words in all of medicine!)
Hirschsprung's disease (colonic gangliosus)
Amantadine

17. Name the laryngeal muscle described by the following: x Pulls the arytenoids cartilages closer to the thyroid - relaxing the vocal ligaments and thereby decreasing the pitch
Periaortic lymph nodes
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Obturator nerve
Thyroarytenoid muscles

18. What fissure of the cerebral cortex runs perpendicular to the lateral fissure and separates the frontal and the parietal lobes?
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
Preductal (infantile)
Central sulcus (sulcus of Rolando)
Two major or one major and two minor

19. Are the following conditions associated with a negative or positive nitrogen balance? - Growth
Conjugated (direct) hyperbilirubinemia - a transport defect
Osteoblast (Remember - blasts make - clasts take)
Regular insulin
Positive

20. What is the vector for yellow fever?
Aedes mosquito
G0 phase
Indirect or unconjugated
Seminoma

21. What is the term when the brachial artery is compressed - resulting in ischemic contracture of the hand?

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22. What aspects of sleep are affected during benzodiazepine use?
60%
REM and stage 4 sleep; they decrease.
Rifampin
Thymidylate synthetase

23. What protein prevents ssDNA from reannealing during DNA replication?
Ampulla
Single - strand DNA binding protein
Poxvirus
Constipation and miosis

24. What paraphilia is defined as x Having a recurrent desire to expose the genitals to strangers?
Filiform papillae
Exhibitionism
Rho-immunoglobin
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.

25. What stage of male development is characterized by the following LH and testosterone levels? - Both LH and testosterone levels drop and remain low.
Mannitol
Neisseria meningitidis
Alcohol consumption
Childhood

26. In which quadrant is breast cancer most commonly found?
The portal tract of the liver lobule
Upper outer quadrant (left more than right)
F- Met - Peptides
Membrane conductance (think conductance = channels open)

27. What is the term for repetitive actions blocking recurring bad thoughts?
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
Metastatic carcinomas
IgE
Parkinson disease

28. What two HIV regulatory genes down - regulate MHC class I expression in the host?
nef and tat genes
CD40
Atracurium
Amyloidosis

29. What is the ratio of T4:T3 secretion from the thyroid gland?
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Carnitine acyl CoA transferase II
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
Saltatory conduction

30. What vitamin deficiency produces homocystinuria and methylmalonic aciduria?
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
A low - resistance system is formed by resistors added in parallel.
Protamine sulfate
Corynebacterium diphtheriae

31. An 80-year - old woman presents to you with right - sided temporal headache - facial pain and blurred vision on the affected side - and an elevated ESR. Your diagnosis?
Palindrome
Pneumocystis carinii
Clostridium botulinum
Temporal arteritis (giant cell arteritis)

32. What is the main mechanism for exchange of nutrients and gases across a capillary membrane?
excites the neuron
The small subunit (40S) binds first.
Simple diffusion; it does not use protein - mediated transport
The rate of infusion

33. What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
Duodenal ulcer
Coxiella burnetii
Acetyl CoA carboxylase
Bcl -2

34. Name these mature defense mechanisms: x Easing anxiety with laughter
Mesonephric duct (ureteric bud)
C3b
Parietal lobe
Humor

35. Which way will the O2 dissociation curve shift with the addition of 2 - 3- bisphosphoglycerate (2 - 3- BPG) to adult hemoglobin (Hgb)?
Wilms tumor
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts
Hepatitis C
Shifts it to the right

36. Waxy casts
Gastric ulcer
Chronic end - stage renal disease
Conduction aphasia
IQ

37. What is the largest nucleus in the midbrain?
They are in the grey matter of the CNS.
Sciatic nerve
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.

38. Which hepatitis B Ab indicates low transmissibility?
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Physiologic antagonism
TCA cycle.
HBeAb

39. Movement disorders are associated with what dopamine pathway (What part of the brain)?
Schizoid
Second M PITS for pharyngeal pouch derivatives
Nigrostriatal pathways (basal ganglia)
Displacement

40. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - poor grooming - poor ability to think abstractly - decreased drive - poor attention span (Hint: if the lesion is in the
Priapism
NE
Dorsal prefrontal cortex
Increased GABA levels decrease the likelihood of learned helplessness.

41. Name these narcissistic defense mechanisms: x Not allowing reality to penetrate because afraid of becoming aware of painful aspect of reality.
Denial
Glossopharyngeal nerve
DNA polymerase I
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.

42. What type of correlation is defined as x One variable that diminishes in the presence of the other?
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
Negative correlation
Herpes II
Pseudomonas aeruginosa

43. What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
Raloxifene
Pirenzepine
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)
Skeletal muscles

44. Which cestode infection results in alveolar hydatid cyst disease?
Echinococcus multilocularis
Yohimbine
Norm reference (i.e. - 75% of the students in the class will pass)
Anorgasmia. (The overall prevalence is 30%.)

45. What are the four components of the basement membrane?
Chromosome 1
Leukemias
Site 4
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen

46. What aminoglycoside causes disruption of CN I?
IgA
Streptomycin
Pyridoxine (B6) deficiency
Tyrosine

47. Which IgG cannot activate complement?
IgG4
Vibrio parahaemolyticus
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
Distal convoluted tubules

48. Is used to detect Abs in a patient?
Hematoxylin
HMG CoA synthase
They innervate skeletal muscle.
Direct fluorescent Ab test

49. Fact without feeling (la belle indiff
Streptococci
Papillary carcinoma of the thyroid
Isolation of affect
Cyanide

50. What type of binding occurs with one Fab or one idiotype of IgG?
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
Affinity
1. Sartorius 2. Gracilis 3. Semitendinous
Lispro insulin