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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. Which laxative is used in the treatment of hepatic encephalopathy ?
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae
Lactulose
Type II error (beta error). (Remember it as saying something doesn't work when it does.)
Internal 3' - 5' PDE bonds

2. Is heparin contraindicated in pregnancy?
Transcortical aphasia
Ampicillin and amoxicillin
Estradiol
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.

3. What are the four ways to increase TPR?
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels
IgA nephropathy
IgD; IgM is also correct.
Homeodomain proteins

4. What is the MCC of the following meningitides? - In neonates to 3 months of age
Type I pneumocytes
Eosin
Streptococcus agalactiae and Escherichia coli
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle

5. Is an excitatory neurotransmitter in the CNS.
Beta- Endorphin
Dopamine
The gut rotates clockwise around the superior mesenteric artery.
Ovulation

6. What phase of the cell cycle are the following antineoplastic agents specific for? - 6- Thioguanine
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
The aorta
S phase
Pseudohyphae

7. If you order a V/Q scan for suspected pulmonary emboli - is the filling defect seen on the ventilation or perfusion side?
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
CD15 and CD30
Dorsal motor nucleus of CN X
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.

8. What condition is manifested by bilateral sarcoidosis of the parotid glands - submaxillary gland - and submandibular gland with posterior uveal tract involvement?
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.
Mikulicz syndrome
Serocystadenocarcinoma
Tetany

9. What AA is a precursor of the following substances? - Creatine
IgE
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius
Staphylococcus aureus
Glycine/arginine

10. What is the most common one? - Malignant tumor in women
Breast
One - and it provides the energy for mechanical contraction.
Ipsilateral loss at and below the level of the lesion
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)

11. What is the only dsRNA virus?
Reovirus
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.
Chemotaxis
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.

12. What syndrome is rheumatoid arthritis with pneumoconiosis?
Allograft
Caplan syndrome
Coarctation of the aorta
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).

13. What type of muscle is characterized by no myoglobin - anaerobic glycolysis - high ATPase activity - and large muscle mass?
IgE
Propranolol
Occulta All except occulta cause elevated - fetoprotein levels.
White muscle; short term too

14. What three organs can be affected by Trypanosoma cruzi?
Saccule and utricle
Urogenital sinus
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
IgM

15. What part of the ANS (i.e. - PNS or CNS) controls the constriction of the pupil in response to light?
Voyeurism
unprocessed Ags
Parasympathetic
The basilar artery is formed at the pontomedullary junction.

16. What are the longest - acting and shortest - acting benzodiazepines?
Toxoplasmosis
Blastomyces dermatitidis
Diazepam is longest acting and midazolam is shortest acting.
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa

17. In a parallel circuit - what happens to resistance when a resistor is added in parallel
Infiltrating ductal carcinoma
Pyrantel pamoate
Resistance decreases as resistors are added in parallel.
HPV

18. What enzyme is inhibited by sulfonamides?
Waterhouse - Friderichsen syndrome
Dihydropteroate synthetase
Mitosis
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)

19. What substrate is built up in Niemann - Pick disease?
Mast cells
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
Stable angina
Sphingomyelin

20. What is the most common one? - Primary malignant tumor in the liver
Bulbus cordis
Hepatocellular carcinoma
Cones (C for color and cones)
GLUT 2

21. What ocular muscle x Elevates and abducts the eyeball?
First - pass metabolism and acid lability
Proencephalon diencephalon derivative
Inferior Oblique (CN III) (LR6 SO4)3
Decreases

22. Increased self - esteem - flight of ideas - decreased sleep - increased libido - weight loss - and erratic behavior are all symptoms of what disorder?
EF- Tu and EF- Ts of the 30S ribosomal subunit
Trypanosoma cruzi
Pyelonephritis
Bipolar disorder (manic - depressive disorder)

23. What pneumoconiosis is associated with exposure to the following occupations or materials? - Aerospace industry - nuclear reactors
Hemosiderin
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
Berylliosis
Labile

24. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Kidney
Venlafaxine. (It also has a mild dopaminergic effect.)
Tay- Sachs disease
Stable
UMP

25. What AD syndrome involves 1000 or more edematous polyps - most commonly affects the colorectal area - and is associated with chromosome 5q21?
Familial polyposis coli
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Splitting

26. What form of penicillin is stable in acid environments?
Hemophilia A
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
Penicillin V
Labile

27. What muscle or muscles are innervated by the following nerves? - Long thoracic nerve
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
Serratus anterior
NREM sleep. Remember awake body - sleeping brain
Arginine

28. What protein catalyzes the formation of the last PDE bond between the Okazaki fragments to produce a continuous strand?
DNA ligase
Semicircular canal
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.
Blood clots

29. What factors are needed for translation in prokaryotes?
Burkitt lymphoma
Elongation factor - G and GTP
Nocardia asteroides
Superior

30. What is the amount in liters and percent body weight for the following compartments? - ECF
Prolyl and lysyl hydroxylases
14 L - 33% of body weight
Glossopharyngeal nerve
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.

31. To differentiate central from nephrogenic diabetes insipidus - after an injection of ADH - which will show a decreased urine flow?
Arterial PCO2 levels are proportional to cerebral blood flow.
Free ionized Ca2+
Central. Remember - there is a deficiency in ADH production in the central form.
Staphylococcus aureus

32. What infection is associated with ring - enhancing lesions seen on computed tomography (CT) of the brain in an HIV- positive individual?
Streptococcus agalactiae (Group B Streptococcus - or GBS)
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
1. Sartorius 2. Gracilis 3. Semitendinous
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)

33. A patient can ______ a feeding tube.
Hypervariable region (three per light chain; three per heavy chain)
Enterobius vermicularis; the treatment is albendazole.
refuse
Healing by secondary intention

34. What is used as an index of cortisol secretion?
Nephrotoxicity
Urinary 17- OH steroids
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
Trimethoprim

35. What three cephalosporins inhibit vitamin K- dependent factors?
Cefamandole - cefoperazone - and moxalactam
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
HPV infection
Acetyl CoA (pyruvate to acetyl CoA)

36. Name the most common type or cause - Hematuria
INF- gamma
5 years old
Infection
Epinephrine

37. What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
Low average
Serotonin
PR interval
Fitz - Hugh - Curtis syndrome

38. What disease is diagnosed by findings of ANAs and anti - SCL-70 antibodies?
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP
Intraductal papilloma
Scleroderma
Lipoprotein lipase

39. What CNs are affected if there is a lesion in x Pontomedullary junction?
CN VI - VII - and VIII
Pontocerebellar angle syndrome
SSRIs
Amnesia. (The person is aware of the memory loss.)

40. What AR disorder is seen by age 1 to 2 with recurrent sinopulmonary infections - uncoordinated muscle movements - and dilation of the blood vessels?
Secondary hypoparathyroidism (vitamin D toxicity)
Ataxia - telangiectasia
Negative
Non - Hodgkin lymphoma

41. What is the term for the proportion of a drug that reaches systemic circulation?
Toxic dose for 50% of drug takers (median toxic dose)
Pseudomonas aeruginosa
Bioavailability
Operon

42. What is the term for the appearance of the kidney in malignant hypertension (it has petechiae on its surface)?
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
Flea - bitten kidney (can also be seen in pyelonephritis)
Proencephalon diencephalon derivative
Rapidly progressive glomerulonephritis (RPGN)

43. What is the drug of choice for treating Tourette syndrome?
Diphenhydramine
Mercury
Pimozide
Free form determines hormone activity and is responsible for the negative feedback loop.

44. What type of correlation is defined as x Two variables with no linear relation to one another?
Since they are independent events - their probabilities would be multiplied.
Systematic desensitization
Zero correlation
Unconjugated free bilirubin

45. What is the primary screening test used to detect HIV- infected individuals? Confirmatory test?
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.
Asparagine
prior to birthThe foramen ovale closes just...
Ethyl alcohol

46. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x abl
Acetoacetate - acetone - and Beta- hydroxybutyrate
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
CML and All
FSH

47. What is the most common one? - Testicular tumor in infants and children
Area 4
Yolk sac tumor
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Hematogenous

48. What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
Conduction aphasia
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.
HHV-8
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.

49. Name the associated chromosome - Cri - du - chat
Folic acid
The greater the myelination - the greater the conduction velocity.
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Chromosome 5p

50. What is the pancreatic action of CCK?
Aminoglycosides
PDA
CCK stimulates the pancreas to release amylase - lipase - and proteases for digestion.
Giant cell tumor of the bone