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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 antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
Arterial PCO2 levels are proportional to cerebral blood flow.
Dantrolene
Medial nuclear group (limbic system)
Corticospinal tract

2. What type of random controlled test is least subjective to bias?
CD16 and CD56
Decreases
Double - blind study. It is the most scientifically rigorous study known.
MEN III (or IIb)

3. How does myelination affect conduction velocity of an action potential?
Stages 3 and 4 (NREM)
The greater the myelination - the greater the conduction velocity.
Cestodes
Area 22 and occasionally 39 and 40

4. What Brodmann area is associated with x Wernicke's area?
Pseudogout
Listeria monocytogenes
Crohn disease
Area 22 and occasionally 39 and 40

5. From What do catalase - superoxide dismutase - and glutathione peroxidase defend the cell?
Production of oxygen free radicals
Parvovirus B-19
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
Left atrium

6. What component of the ETC is inhibited by the following? - Oligomycin
Adenosine deaminase
Multiple myeloma
Hydatidiform mole
Fo/F1 complex

7. What AR disorder is seen by age 1 to 2 with recurrent sinopulmonary infections - uncoordinated muscle movements - and dilation of the blood vessels?
Ataxia - telangiectasia
G0 phase
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Eosin

8. What component of the ANS - when stimulated - results in bronchoconstriction?
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.
Streptococcus agalactiae
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
Concrete operations (6-12 years)

9. What bile pigment is formed by the metabolism of bilirubin by intestinal bacteria - giving stool its brown color?
Stercobilin
The aorta
Phenylephrine
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.

10. What antiviral agent blocks the attachment and penetration of influenza A virus?
Amantadine
Massive influx of calcium
Preductal (infantile)
Lead

11. What is the only encapsulated fungal pathogen?
Saccule and utricle
Cryptococcus
IgA
Gain of isotonic fluid (isotonic saline)

12. What enzyme catalyzes the covalent bonding of the AA's carboxyl group to the 3' end of tRNA?
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.
CML and All
The folding of an AA chain
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12

13. What happens to cortisol levels in sleep - deprived individuals?
Alcohol and its related problems cost the country approximately $100 billion a year.
Cortisol levels increase. Lymphocyte levels decrease in sleep - deprived individuals.
Internal iliac nodes
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase

14. What liver enzyme - for triglyceride synthesis - converts glycerol to glycerol -3- phosphate?
Pseudogout
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.
Glycerol kinase
Major

15. What agent used in the treatment of BPH and baldness is a 5- a - reductase inhibitor?
Finasteride
Gilbert's syndrome
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva
Single - strand DNA binding protein

16. What ring is a weblike narrowing of the gastroesophageal junction?
Schatzki ring
Median nerve
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.)
Water soluble

17. Describe What type of fluid is either gained or lost with the following changes in body hydration for the ECF volume - ICF volume - and body osmolarity - respectively: x ECF - increase; ICF - increase; body - decrease
Hyperpolarization (i.e. - K+ influx)
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Extracellular
Gain of hypotonic fluid (water intoxication or hypotonic saline)

18. What type of personality test is the Rorschach inkblot test - objective or projective?
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Primary hypocortisolism (Addison's disease)
Projective test. Most tests with a wide range of possibilities for the answers are projective.
Chromosome 20q (deficiency in adenosine deaminase)

19. Panic attacks can be induced by __________ or carbon dioxide.
robenecid - a uricosuric agent
hyperventilation
Superficial spreading melanoma
Estriol

20. What urease - positive non - lactose - fermenting gram - negative rod with swarming - type motility is associated with staghorn renal calculi?
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
VSD
Proteus
Prostatic carcinoma

21. Name the most common cause - Blindness in the United States
Diabetes mellitus
Methicillin
Musculophrenic and superior epigastric arteries
Lente insulin and either NPH or protamine zinc insulin (PZI)

22. What antihistamine is used in the treatment of serotonergic crisis?
Thiamine
Carbamazepine
Cyproheptadine
Histiocytosis X

23. Where is the action potential generated on a neuron?
1. Large sample size 2. Large effect size 3. Type I error is greater
Lateral part of the hemispheres
Axon hillock
C3a - C4a - and C5a

24. What are the five Ig isotypes?
Hyperacute rejection
IgA - IgD - IgE - IgG - and IgM
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
Very superior (<2.5% of the population)

25. Is spousal abuse a mandatory reportable offense?
Cytosine
ACTH
Choriocarcinomas and trophoblastic tumors
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.

26. Which type of hepatitis is a picornavirus?
Four
Frontal lobe syndrome (lesion in the prefrontal cortex)
Hepatitis A (infectious)
Peyer's patch

27. What is the tumor at the bifurcation of the right and left hepatic ducts?
Klatskin tumor
Squamous cell carcinoma
Median nerve
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.

28. What is the name for failed recanalization of the duodenum resulting in polyhydramnios - bile - containing vomitus - and a distended stomach?
Astrocytoma
The urea cycle
Rifampin
Duodenal atresia

29. In What area of the GI tract are water - soluble vitamins absorbed?
The zygote divides mitotically; only germ cells divide meiotically.
Duodenum
LTC4 and LTD4
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)

30. What abdominal muscle runs in a posteroinferior direction - splits to contribute to the rectus sheath - contributes to the formation of the conjoint tendon - and in men gives rise to the middle spermatic fascia and the cremasteric muscle of the sperm
Internal abdominal oblique
Hypercortisolism (Cushing syndrome)
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.
Aortic stenosis

31. What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting - fissuring - and oozing?
Membranous glomerulonephritis
Vitamin C
Paget disease of the breast
Crohn disease

32. What embryonic structure forms the adult female structures? - Ovarian and round ligaments
Areas 18 and 19
Fungi
Gubernaculum
Acebutolol and Pindolol

33. Name the MCC - Pneumonia in a neutropenic burn patient
Streptomycin
Selenium (Se)
Pseudomonas sp.
Staphylococcus

34. What enzyme is deficient in the following glycogen storage disease? - Pompe's disease
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
RNA polymerase I
Lysosomal a -1 - 4- glucosidase
Aortic insufficiency

35. What pneumoconiosis is associated with exposure to the following occupations or materials? - Miners - metal grinders - and sandblasters

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36. What phase of the cell cycle are the following antineoplastic agents specific for? - Alkylating agents
ACE inhibitors (the - pril agents)
G0 phase
Scleroderma
Biofeedback

37. What cells of the kidney are extravascular chemoreceptors for decreased Na+ - Cl - - and NaCl?
Osteosarcoma
Macula densa
MEN III (or IIb)
Vimentin

38. What happens to the resistance of the system when a resistor is added in a series?
Giardia lamblia (treat with metronidazole)
Third week; they are derived from the wall of the yolk sac.
Left anterior descending artery
Resistance of the system increases. (Remember - when resistors are connected in a series - the total of the resistance is the sum of the individual resistances.)

39. In the water deprivation test - does a patient with reduced urine flow have primary polydipsia or diabetes insipidus?
TCR
Chromosome 15
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Corynebacterium diphtheriae

40. What cells of the thyroid gland are stimulated in response to hypercalcemia?
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
Hepatitis E
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Zinc (Zn) deficiency

41. If one event precludes another event - their probabilities are combined By what method?
Melasma
Dendritic cells - macrophages - and thymic epithelial cells
M
Addition (They are mutually exclusive.)

42. What small - facultative gram - negative intracellular rod's transmission is associated with unpasteurized dairy products and undulant fever?
Alteplase
VLDL
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
Brucella

43. Is a cause of asthma.
Internal 3' - 5' PDE bonds
GERD
Plasma concentration and excretion rate
The greater the myelination - the greater the conduction velocity.

44. Is increased in 21-Beta- hydroxylase deficiency.
Penicillin V
Renin secretion
Goodpasture disease
The small subunit (40S) binds first.

45. Name the MCC of death - In patients with cystic fibrosis
Pulmonary infections
Cerebellum
hnRNA
Hydrolysis

46. Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid?
Astrocytoma
Cleft lip
Diethylcarbamazine
Doxycycline

47. What is the MCC of cancer mortality in males and females?
Right coronary artery
Duodenum
Rate of absorption
Lung cancer

48. What vessels carry deoxygenated blood into the lungs from the right ventricle?
Increase the concentration of enzymes
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood
NE
Right vagus innervates the SA node and the left vagus innervates the AV node

49. What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord?
Ventricular fibrillation (V fib)
The fasciculus cuneatus
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
Salmeterol

50. What are known as jumping genes?
Medial midbrain (Weber's) syndrome
Transposons
Pantothenic acid
Subacute bacterial endocarditis