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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. Name the antimicrobial agent whose major side effect is listed - CN VIII damage (vestibulotoxic)
Stimulus control
The gut rotates clockwise around the superior mesenteric artery.
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available - but the renal collecting ducts are impermeable to its actions.
Aminoglycosides

2. What is the major hormone produced in the following areas of the adrenal cortex? - Zona fasciculata
Preductal (infantile)
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Duchenne muscular dystrophy
Poxvirus replicates its DNA in the cytoplasm.

3. What virus is associated with Guarnieri bodies?
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
Membranous glomerulonephritis
Labioscrotal swelling
Variola virus (Smallpox)

4. What malignant tumor of the trophoblast causes high levels of hCG and may occur after a hydatidiform mole - abortion - or normal pregnancy?
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
Compliance (think of it as distensibility)
Resorb CSF into the blood
The dentate nucleus

5. How many days prior to ovulation does estradiol peak in the menstrual cycle?
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
Glucagon
2 days prior to ovulation
Negative

6. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral hemispheres
Areas 44 and 45
Proencephalon
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland
Elongation factor - G and GTP

7. Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism?
Physiologic antagonism
Pneumothorax
Reserpine
The fastigial nucleus

8. What region of the pharynx does the eustachian tube enter?
Nasopharynx
Profound (I.Q. range < 20)
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis

9. All streptococci are...
refractory sexual periods
Dendritic cells - macrophages - and thymic epithelial cells
Leydig cell tumor
catalase - negative

10. What Brodmann area is associated with x Broca's area?
Areas 44 and 45
IL-7 (A 7 upside down is an L; L is for Lymphoid)
In early- morning sleep - usually between the sixth and eighth hours
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.

11. Name the Plasmodium species based on the following information:No persistent liver stage or relapse; blood smear shows rosette schizonts; 72- hour fever spike pattern
Chromosome 3p
Primary hypercortisolism
LH
Plasmodium malariae

12. What is the most common one? - Viral cause of myocarditis
Coxsackie B
Mitochondria
Parallel circuit
IgA nephropathy

13. What is the term for the day after the LH surge in the female cycle?
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells
Glossopharyngeal nerve
Anopheles mosquito
Ovulation

14. Thyroid _____ is a measure of its function.
Enterokinase
Upper outer quadrant (left more than right)
Schwannoma
Size

15. What enzyme is deficient in the following glycogen storage disease? - von Gierke's disease
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Glucose -6- phosphatase
Chromosome 11p
Graves disease

16. A urethral swab of a patient shows gram - negative diplococci in PMNs; what organism do you diagnose?
Neisseria gonorrhoeae
Inferior phrenic artery
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
Hirschsprung disease

17. What form of bias is due to false estimates of survival rates?

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18. What cell of the duodenum contains high concentrations of lysozymes and has phagocytic activity?
Pituitary hypogonadism
Th2 cells
Gonads
Paneth cells

19. HIV's capsid - core nucleocapsid - and matrix proteins are products of what structural gene?
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
Reovirus
gag gene
Coxsackie A

20. Name the DNA virus x Linear dsDNA; enveloped; virion - associated polymerases; replicates in the cytoplasm :
Meningioma
Confabulation; it is commonly seen in Korsakoff's syndrome.
Poxvirus
Systemic lupus erythematosus

21. When a person goes from supine to standing - what happens to the following? - BP
1. ADP 2. PG 3. TXA2
Somatization disorder
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------

22. If inserting a needle to perform a pleural tap or insertion of a chest tube - do you use the inferior or the superior border of a rib as your landmark? Why?
Waldenstr
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
M
Humerus with ulna (major) and radius (minor)

23. 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
DiGeorge syndrome
Volume of distribution is decreased when a large percentage of drug is protein bound.
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)

24. What is the DOC for severe infections with Sporothrix - Mucor - Histoplasma - Cryptococcus - Candida - and Aspergillus?
Amphotericin B
Primary hyperparathyroidism
Subarachnoid hemorrhage
Osler nodes

25. Progesterone has __________ activities.
Parasympathetic
Thermogenic
The increased H+ moves intracellularly and is buffered by K+ leaving the cells - resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis - even though the serum
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.

26. Name the end product or products: x Fatty acid oxidation
Ipsilateral flaccid paralysis
Flurazepam
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Increases

27. What is the term for the potential difference across a cell membrane?
Prostate and lung cancer - respectively
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
CD40 ligand
Transmembrane potential (an absolute number)

28. Name at least three causes of metastatic calcification.

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29. Dopamine antagonists are...
Arterioles
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
antiemetic
Average

30. What is the term to describe the 5'-3' sequence of one strand being the same as the opposite 5'-3' strand?
Posterior chamber
MI
Glucagon and epinephrine
Palindrome

31. Is a side effect of cimetidine.
eIF-2 in the P site
Dapsone
Adenovirus
Gynecomastia

32. What enzyme is deficient in patients with CGD?
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
This is the triad of renal cell carcinoma
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Short - chain fatty acids

33. What enzyme of the TCA cycle catalyzes the production of the following: x NADH (hint: 3 enzymes)
Live vaccines
Phenytoin
Chronic rejection
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase

34. What are the three rules of clonal selection?
Gonads
Alcoholics Anonymous
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
There are no valves and no smooth muscle in the walls of the veins in the face.

35. Increased urinary excretion of what substance is used to detect excess bone demineralization?
The venae recta maintain the gradient via countercurrent flow.
Obturator nerve
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
ydroxyproline

36. What somatoform disorder is described as x Severe - prolonged pain that persists with no cause being found - disrupts activities of daily living?
Itraconazole
Nitrates
Somatoform pain disorder
Anterior tibial artery

37. What are the first intermediate hosts for trematodes?
VLDL
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.
Snails
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.

38. What cells contribute to the blood - brain barrier and proliferate in response to CNS injury?
Obese patients
Antimicrobial agents
Blastoconidia
Astrocytes

39. What mixed a - antagonists are used for patients with pheochromocytoma?
Phentolamine and phenoxybenzamine
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
Entamoeba histolytica
Deferoxamine - penicillamine

40. What agent is used IM to treat acute dystonias?
Diphenhydramine
Osler nodes
Middle cerebral artery
Obesity - DM - HTN - multiparity - early menarche - and late menopause

41. Are the following conditions associated with a negative or positive nitrogen balance? - Pregnancy
PGE (along with low oxygen tension)
Positive
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Aspartate and carbomoyl PO4

42. Name the T- cell CD marker: x Essential for Ab isotype switching (for B cell binding)
CD40 ligand
Cystadenoma
LH
DNA polymerase - a

43. Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?

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44. What is the only vein in the body with a high O2 content?
18 years old (except if emancipated)
Superior
Ferritin
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.

45. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Ventral rami?
DiGeorge syndrome
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
Both
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes

46. Name the associated chromosomal translocation - Follicular lymphoma
Chromosome 14 - 18
It increases REM and total sleep time.
Schwannoma
Palms - up before palms - down maneuvers

47. What are five clinical signs of portal HTN?
Superior
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.

48. What complement factor or factors are associated with x Anaphylaxis?
HMG- CoA reductase
C3a - C4a - C5a
Abs to HBsAg
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.

49. Name the most common type or cause - Acute bacterial endocarditis
Staphylococcus aureus
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
Papovavirus

50. What glycogen storage disease is due to the following enzyme deficiencies? - Glucose -6- phosphatase

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