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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 disorder is associated with spider angiomas - palmar erythema - gynecomastia - testicular atrophy - encephalopathy - abnormalities in clotting factors - and portal HTN?
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Cirrhosis
a - Blockers (- zosins)
Proencephalon

2. What syndrome is associated with the following brainstem lesions? - Vertebral artery or anterior spinal artery occlusion - resulting in contralateral corticospinal tract and medial lemniscus tract deficits and an ipsilateral CN XII lesion
Homicide. It is also the leading cause of death in black females aged 15 to 24.
Viral meningitis
Anterior nuclear group (Papez circuit of the limbic system)
Medial medullary syndrome

3. What causes the lysis of RBCs by oxidizing agents in a G-6- PD deficiency?
Interferons
Insulinoma
Profound (I.Q. range < 20)
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.

4. What organism is commonly associated with a cellulitis from an animal bite?
Pasteurella multocida
Area 22 and occasionally 39 and 40
prior to birthThe foramen ovale closes just...
80S ribosomes (because they are eukaryotic)

5. What happens to diastolic and systolic intervals with an increase in sympathetic activity?
Alcoholic cirrhosis
Mitral valve prolapse
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
B- cell Ag receptors

6. Which hepatitis B serology markers
hypophosphatemia
Isograft
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)
HBsAb IgG

7. What is the MCC of inherited mental retardation?
Down syndrome
Salmonella typhi
Rabies
Insulin increases intracellular K+ stores while decreasing serum K+ levels.

8. What is the MCC of the following meningitides? - In those 12 months to 6 years of age
Thrombus
Homogentisic oxidase
Laminin
Haemophilus influenzae type B

9. Do you monitor heparin's therapeutic levels by PT or PTT?
There would be two Fab and Fc regions.
Carbamoyl phosphate synthetase I
Motor aspect
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)

10. Kayser - Fleischer rings
Hyperkalemia
Meningioma
Wilson disease
Cerebellum

11. What is the most common chromosomal abnormality associated with CLL?
Formation of an identity through issues of independence and rebellion; they define who they are.
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.
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)
Reticulocyte

12. What artery is formed by the union of the two vertebral arteries?
Rhombencephalon
The basilar artery is formed at the pontomedullary junction.
Hepatitis A (infectious)
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.

13. What chromosome codes for HLA gene products?
The short arm of chromosome 6
Histidine
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.

14. Why is the cell's resting membrane potential negative?
Ampicillin and amoxicillin
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Pyloric stenosis
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.

15. Which region of the variable domain comprises the Ag - binding site of the Ab?
Trichomonas vaginalis (treat with metronidazole)
Sciatic nerve
Vancomycin
Hypervariable region (three per light chain; three per heavy chain)

16. What cytokine do Th1 cells secrete to inhibit Th2 cell function?
Cancer
INF- gamma
From age 5 onward IQ stabilizes.
Hairy cell leukemia

17. What are the two factors that affect alveolar PCO2 levels?
The negative charge inhibits the filtration of protein anions.
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.
It increases REM and total sleep time.
Metabolic rate and alveolar ventilation (main factor)

18. What type of pleura is adherent to the surface of the organ?
Cushing's ulcers
Suppression
Visceral pleura
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).

19. What is the term for black pigmentation of the colon associated with laxative abuse?
Melanosis coli
Minor
Thiamine
They innervate skeletal muscle.

20. What form of nephritic syndrome is associated with celiac sprue and Henoch - Sch
IgA nephropathy
Afterload
a - and Beta- chains are on most T cells.
Gastrin - releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)

21. Are the following major or minor Jones criteria of rheumatic fever? - Sydenham chorea
TAT (Thematic apperception test)
Internal carotid artery
Axillary nerve and posterior humeral artery
Major

22. What are the five branches of the superior mesenteric artery?
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
MstII; changing codon 6 (from A to T) destroys the restriction site.
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Clindamycin

23. Which leukotriene is chemotactic for neutrophils?
LTB4
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
Lead
Ischemic heart disease (MIs)

24. What cells are atypical on a peripheral blood smear in heterophil - positive mononucleosis?
High - frequency sound waves
Chromosome 11p
T cells - not B cells
Dilation of afferent arteriole

25. What term describes how an action potential is propagated along an axon?
The DCML system. (Remember - everything but pain and temperature.)
Stable
Saltatory conduction
The lateral vestibular nucleus

26. A schizophrenic patient who is taking haloperidol is brought to your ER with muscle rigidity - a temperature of 104
Porcelain gallbladder
Neuroleptic malignant syndrome is a potentially life - threatening condition Which is treated with symptomatic support - bromocriptine - and dantrolene.
Asparagine
Histidine - because of the imidazole ring found in the R group - is basic.

27. What is the term for the pH at which the structure carries no charge?
Hypercortisolism (Cushing syndrome)
Mast cells
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
pI (isoelectric point)

28. If a drug is ionized - is it water or lipid soluble? Can it cross a biomembrane?
Cirrhosis
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.
Hepatitis B and hepatitis C
Ischemic

29. What is the most common one? - Helminth parasitic infection in the United States
Foramen of Monro
None; it degenerates.
Enterobius vermicularis
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.

30. What MHC class acts to remove foreign Ags from the body?
MHC class II Ags. This is accomplished via CD4 T cells.
Tibial nerve
Vaginismus; it is the female counterpart of premature ejaculation.
As flow increases - the urine becomes more dilute because of decreased time for H2O reabsorption.

31. What tumor is derived from primitive streak remnants and often contains bone - hair - or other tissue types?
Chi - square.
Ventricular contraction Atrial - Contraction - Venous
Sacrococcygeal teratoma
Biotin - ATP - and CO2

32. What protein carries free fatty acids to the liver?
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Albumin
Metaplasia (usually to a more protective cell type)
Follicular adenoma

33. Name the B- cell CD marker: x Required for class switching signals from T cells
Hemiballismus
CD40
Coarctation of the aorta
First pharyngeal groove; all others degenerate.

34. What mast cell mediator is a chemotactic agent?
Eosinophil chemotactic factor A
Cytochrome b/c1
Intrinsic factor (IF)
Testicular lymphoma

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

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36. Name the antidote - Benzodiazepines
Left posterolateral side of the diaphragm - usually resulting in pulmonary hypoplasia.
Inferior Oblique (CN III) (LR6 SO4)3
Flumazenil
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)

37. What are the three main components of amyloid?
Sorbitol (resulting in cataracts)
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
DNA polymerases
Secondary erectile disorder (Male erectile disorder is the same as impotence.)

38. Name the DNA virus: x Linear dsDNA; naked; replicates in the nucleus
Progestin
Inferior Oblique (CN III) (LR6 SO4)3
Adenovirus
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T

39. What is the best measure of total body vitamin D if you suspect a deficiency?
Berylliosis
S phase
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Serum 25- hydroxy- vitamin D (25- OH- D)

40. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 and int -2
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Velocity is inversely related to cross - sectional area.
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells
Melanoma - cancer of the stomach and bladder

41. Via what cell surface receptor does HDL cholesterol from the periphery enter hepatoceles?
S phase
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.
Scavenger receptor (SR- B1)
Gastric carcinoma

42. What is the only vein in the body with a high O2 content?
Gastric ulcer
Prokaryotes. Polycistronic and prokaryotes both start with P.
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Null hypothesis (what you hope to disprove)

43. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Hematopoietic cells
Labile
Repolarization is from base to apex and from epicardium to endocardium.
Ulcerative colitis
Cytochrome a/a3

44. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol increased - ACTH decreased
Neisseria meningitides
Methanol
Primary hypercortisolism
Breast cancer

45. What type of metal poisoning causes mental retardation - somnolence - convulsions - and encephalopathy?
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Lead
Calcium oxalate
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.

46. In what cycle does glucose go to the muscle - where it is converted to pyruvate and then into alanine before being taken back to the liver?
Arginine
Left ventricle and tip of right ventricle
Alanine cycle
Thiamine

47. What antifungal agent is activated by fungal cytosine deaminase to form 5- FU?
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Inspiratory capacity
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
Flucytosine

48. Both submandibular and sublingual glands are innervated by CN VII (facial) and produce mucous and serous secretions. Which one mainly produces serous secretions?
p -53
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Streptomycin
Edinger - Westphal nucleus (via CN III)

49. On the venous pressure curve - What do the following waves represent? - A wave?
NREM sleep. Remember awake body - sleeping brain
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Atrial contraction Atrial - Contraction - Venous
Undoing

50. Influenza - Vibrio cholera - hepatitis A - rabies - and adenovirus.
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
Listeria monocytogenes
Chi - square (when you are in doubt and have nominal data - use chi - square)
Are inactivated vaccines available in the United States