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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. On what chromosome is the adenomatous polyposis coli gene?
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Calcium oxalate
Chromosome 5q21

2. What catecholamine - hypersecreting tumor - a secondary cause of HTN - results in headache - diaphoresis - anxiety - tachycardia - and palpitations?
Ewing's sarcoma
Pheochromocytoma
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
Gardnerella vaginalis

3. What two areas of the skin do not contain sebaceous glands?
The placenta
High - frequency sound waves
Cocaine - induced coronary ischemia
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.

4. How many ATPs are generated per acetyl coenzyme A (CoA)?
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
produce bile
Alzheimer disease

5. What neuroleptic agent causes agranulocytosis but does not induce tardive dyskinesia?
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Suprachiasmatic nucleus
Phallus
Clozapine

6. What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.
Rhabdomyoma
Chi - square (when you are in doubt and have nominal data - use chi - square)
Vancomycin

7. What region of the Ig does not change with class switching?
There would be a Fab' region; thus - it would still be able to participate in precipitation and agglutination.
Fovea
Hypervariable region
Mitochondria

8. What mineral is associated with impaired glucose tolerance?
Validity (remember - reliability is necessary but not the only thing needed for validity)
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
Chromium (Cr)
HBsAb IgG

9. What enzyme catalyzes the rate - limiting step in the TCA cycle?
DNA polymerase -?
Isocitrate dehydrogenase
Cricothyroid muscles
Mesonephric duct

10. What is the venous and arterial stretch receptors' function regarding the secretion of ADH?
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.
Teratoma
Reiter syndrome
Argyll Robertson pupils

11. Name the most common cause - Dementia in persons aged 60 to 90 years
Benign lentigo
Initiate and manage gross skeletal muscle movement control
Alzheimer disease
Left atrium

12. In reference to membrane potential (Em) and equilibrium potential (Ex) - which way do ions diffuse?
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Thrombus
Escherichia coli

13. What type of hormone is described as having intracellular receptors - being synthesized as needed - mostly bound to proteins - and having its activity determined by free hormone levels?
Lipid - soluble hormones are considered slow - acting hormones.
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Paranoid schizophrenia
Renal plasma flow (decrease flow - increase FF)

14. What are the two ways to leave the prevalence pot?
Tensor tympani
The placenta
NH4+(ammonium)
Recovery and death

15. What are the three anatomic characteristics that differentiate the large bowel from the small bowel and the rectum?
1. Tinea coli 2. Haustra 3. Epiploic appendages
Tetracycline
Bile salts are actively reabsorbed in the distal ileum.
Site 1

16. What substrate gets built up in Gaucher's disease?
Free form determines hormone activity and is responsible for the negative feedback loop.
Cyanocobalamin (B12)
Glucosyl cerebroside
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.

17. What happens to prevalence as the number of long - term survivors increases?
Infliximab
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Iodine - resulting in congenital hypothyroidism
Cancer

18. What AA is a precursor of the following substances? - Creatine
12 days after ovulation
Glycine/arginine
CD8
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation

19. During a prolonged fast - why is the brain unable to use fatty acids?
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
The biofeedback model is based on the parasympathetic nervous system.
The energy of activation

20. What virus is associated with both nasopharyngeal carcinoma and Burkitt lymphoma?
Somatomedins (IGF-1)
Multiple myeloma
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
EBV

21. What malignant tumor of the skin is associated with Birbeck granules?
Right - sided
Ventral lateral nucleus
The subclavian artery
Histiocytosis X

22. Is the coding or the template strand of DNA identical to mRNA (excluding the T/U difference)?
Extinction
The small subunit (40S) binds first.
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane

23. Name the T- cell CD marker: x Interacts with MHC class II molecules
Bisphosphonates
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
CD4
Permanent

24. What happens to total and alveolar ventilation with x Increased depth of breathing?
Metronidazole
Subscapularis
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).
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.

25. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Placental alkaline phosphatase
Oxytocin
Seminoma
ACh - histamine - and gastrin
DNA polymerase I

26. What is flat - circumscribed nonpalpable pigmented change up to 1 cm?
Macule (e.g. - a freckle)
Farnesyl pyrophosphate (FPP)
Estrogen use
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections

27. By What age should children be able to draw the following figures? - Cross
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
IgG
4 years old
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.

28. What virus causes small pink benign wartlike tumors and is associated with HIV- positive patients?
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
Facial expression (the second is vocal intonation)
Arginine
Molluscum contagiosum

29. How many ATPs per glucose are produced by pyruvate dehydrogenase?
Vaginismus; it is the female counterpart of premature ejaculation.
Galactoside permease
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)
Risperidone

30. What is the rule of one - third regarding muscle type of the esophagus?
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Seasonal affective disorder (treat with bright light therapy)

31. Regarding the viral growth curve - is the external virus present before or after the latent period?
Phosphofructokinase -1 and costs 1 ATP
After the latent period
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
Poxvirus

32. What nerves provide sensory innervation above the vocal cords? Below the vocal cords?
Rheumatoid arthritis
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
Hirschsprung disease
Expressive aphasia

33. What enzyme catalyzes the rate - limiting step in glycogenolysis?
Oligodendroglioma
Range
Week four - and they remain dormant there until puberty.
Glycogen phosphorylase

34. Why is the cell's resting membrane potential negative?
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Alanine cycle
Profound (I.Q. range < 20)
Thrombus

35. What is the most common one? - Form of arthritis
It forms a germinal tube at 37
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
Osteoarthritis
Medullary carcinoma of the thyroid

36. What is the term for the pH range where the dissociation of H+ occurs?
Hypersegmented neutrophils
pK (think of it as where half is base and half is acid)
Teratoma
Lead

37. What is the name of the T cell - rich area of the lymph node?
Somatization
Paracortex
G0 phase
Flumazenil

38. What cells of the epidermis - derived from the neural crest - act as mechanoreceptors?

39. What diagnosis ensues from finding well - demarcated erythematous plaques with silvery scales on the knees - elbows - and scalp along with nail bed pitting and discoloration?
Apoptosis (Remember - there is a lack of inflammatory response.)
7
Psoriasis
Al - Anon

40. What is the physiologic storage form of iron?
Pubis - ilium - and ischium
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
Ferritin
MI

41. What substance is secreted by parietal glands and is required for life?
Melanin
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
GnRH
Intrinsic factor (IF)

42. What type of correlation compares two interval variables?
Interval scale (a ruler - for example)
Proencephalon diencephalon derivative
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.
Pearson correlation

43. With which CN are preganglionic parasympathetic axons arising from the Edinger - Westphal nucleus associated?
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
Herpes virus I and II
CN III

44. Describe the organism based on the following information: x Beta - hemolytic Streptococcus sensitive to bacitracin
Succinylcholine and halothane (Treatment is with dantrolene.)
Bainbridge reflex
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
Streptococcus pyogenes

45. What is the longest and most convoluted segment of the nephron?
Creutzfeldt - Jakob disease
PCT
QRS complex
Heart rate determines the diastolic interval - and contractility determines the systolic interval.

46. What is the term for a raised fluid - filled cavity greater than 0.5 cm that lies between the layers of the skin?
Bulla
Foramen of Winslow
Rapid cycling bipolar disorder
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.

47. What component of the inner ear x Contains perilymph and responds to angular acceleration and deceleration of the head?
Respiratory depression
Semicircular canal
ll
Conduction aphasia

48. How many months in How many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern - my senior resident asked me this question more times than I would like to remember.)
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
3 months of symptoms in 2 consecutive years
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)

49. What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade?
CD19
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.
They prevent mast cell degranulation.
CD3

50. Are the following major or minor Jones criteria of rheumatic fever? - Erythema marginatum
Major
100% - with about 20% remaining positive after 1 year
ICF volume decreases when there is an increase in osmolarity and vice versa.
Chromosome 11p