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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. Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
One - and it provides the energy for mechanical contraction.
Sporozoites
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Coombs test

2. What linkage of complex CHOs does pancreatic amylase hydrolyze? What three complexes are formed?
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.
Renal cell carcinoma
Hepatitis C
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.

3. What cell in bone is a part of the mononuclear phagocytic system?
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
Osteoclasts
Actually - yes. You should encourage your patient to try other forms of medicine as long as they are not contraindicated with the patient's preexisting illness. You must be able to accept the health beliefs of your patients - even if you don't agree.
Inhibin - m

4. What are the strongest determinants of gender identity?
Chief cells
Somatic motor neurons
S phase
Parental assignment and culture (not biology)

5. Which penicillin can cause interstitial nephritis?
Methicillin
Hepatitis B
Yes
Purine nucleoside phosphorylase

6. Name the most common type or cause - Noniatrogenic hypothyroidism in the United States
Negative selection. This helps to prevent autoimmune diseases.
Hashimoto thyroiditis
Both
Sideroblastic anemia

7. What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated?
Aspiration pneumonia
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.
2 and 5HT3 receptors

8. Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
Embolic
Demeclocycline
Membrane conductance (think conductance = channels open)
Thiogalactoside transacetylase

9. With what stage of sleep are bruxisms associated?
Posterior
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Teeth grinding is associated with stage 2 sleep.
Increased secretion of GH postpuberty leading to acromegaly.

10. Name the end product or products: x Fatty acid oxidation
Metastatic
DNA ligase
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Passive - aggressive

11. What is the most common one? - Form of arthritis
McArdle's syndrome
Osteoarthritis
C3b
Citrate - via the citrate shuttle

12. What glycogen storage disease is due to the following enzyme deficiencies? - Lysosomal glucosidase (acid maltase)

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13. What hormone's release is strongly associated with stage 4 sleep?
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
Follicular phase
Carnitine acyl CoA transferase II
relaxation

14. What disorder - experienced more than half of the time for a 6- month period - is described as being fearful - worrisome - or impatient and having sleep disturbances - poor concentration - hyperactivity - and an overall sense of autonomic hyperactivi
HBsAg and HBeAg
Generalized anxiety disorder
Infection
Chromosome 5q21

15. What chromosome 4 - AD disorder is a degeneration of GABA neurons in the striatum of the indirect pathway of the basal ganglia?

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16. How are flow through the loop of Henle and concentration of urine related?
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -
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.)
Primary hypocortisolism (Addison's disease)
As flow increases - the urine becomes more dilute because of decreased time for H2O reabsorption.

17. Name the MCC of death - In patients with cystic fibrosis
Enkephalins
Pulmonary infections
HMG CoA synthase
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.

18. What form of the Plasmodium species are injected into humans by mosquitoes?
Sporozoites
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
GABA - quantitatively
alpha2- Receptors

19. What is the only muscle of the soft palate that is innervated by CN V3?
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
Liver
Calcitriol

20. What is the term for the force the ventricular muscle must generate to expel the blood into the aorta?
Doxycycline and minocycline
Afterload
Ratio scale
The limbic system

21. What are the two broad - spectrum penicillins?
Serocystadenoma
Postinfectious GN
Superior gluteal nerve
Ampicillin and amoxicillin

22. What is the name of a thin brown ring around the outer edge of the cornea - seen in Wilson's disease?
Hydroxyproline (breakdown product of collagen)
Cancer
Kayser - Fleischer ring
Subarachnoid hematoma

23. The closure of what valve indicates the beginning of isovolumetric contraction?
Somatization disorder
Basal cell carcinoma
Malpighian layer (made up of the stratum basale and stratum spinosum)
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.

24. Increased levels of what neurotransmitter - in the hippocampus - decrease the likelihood of learned helplessness?
Nocardia asteroides
Cleft palate
Increased GABA levels decrease the likelihood of learned helplessness.
Fibrous pericardium

25. What two Beta2- agonists are used to produce bronchodilation?
Heinz bodies
Meningocele All except occulta cause elevated - fetoprotein levels.
Direct pathway; a good example is Parkinson's disease.
Metaproterenol and albuterol

26. What viral infection is associated with black vomit?
Pneumococcus
Yellow fever (flavivirus)
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
Proximal tubule

27. What is the term for hyphae with constrictions at each septum that are commonly seen in Candida albicans?
Pernicious anemia
Pseudohyphae
False - positive rate
On the superior body of the posterior wall of the uterus

28. Name the structure that enters or exits the following foramina: x Hypoglossal canal
CN XII
Duodenum
DHEA (androgens) Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Measurement bias

29. What are the four DNA oncogenic viruses?
Carbamazepine
Temporal arteritis
gag gene
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma

30. What enzyme is inhibited by disulfiram?
Anopheles mosquito
Zero - order elimination
Acetaldehyde dehydrogenase
Ultraviolet B (UVB) sunlight

31. What is the main factor determining FF?
Hirschsprung's disease (colonic gangliosus)
Adenovirus
TB meningitis
Renal plasma flow (decrease flow - increase FF)

32. Name the associated chromosome - Edward syndrome
SITS
Chromosome 18
Frontal eye field (Brodmann area 8)
Hydrolysis

33. What is the only tongue muscle innervated by CN X?
Both
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
Since they are independent events - their probabilities would be multiplied.
Cori cycle

34. What artificial sweetener must patients with PKU avoid?
Alcoholic cirrhosis
Adulthood
Prostatic carcinoma
Aspartame

35. What fungus is seen as colored cauliflower lesions?
Chromomycosis
Diethylcarbamazine
Borrelia recurrentis
Hemosiderin

36. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Hypothalamus
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Proencephalon diencephalon derivative
Duchenne muscular dystrophy
Paramyxovirus

37. What complement factor deficiency leads to x Hereditary angioedema?
C1 inhibitor (C1- INH)
Frotteurism
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Acute toxic or viral nephrosis

38. What regulates the rate of ketone body formation?
The rate of Beta- oxidation
From age 5 onward IQ stabilizes.
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
Legionella (think air conditioners)

39. Name the 10 retroperitoneal organs.
Positive
IgA - IgD - IgE - IgG - and IgM
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum
Dorsal prefrontal cortex

40. Name the valve abnormality based on the following criteria: x Back - filling into the left atrium during systole; increased v - wave - preload - left atrial volume - and left ventricular filling
Mitral insufficiency
Accommodation
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling
Amyloidosis

41. Which laxative is used in the treatment of hepatic encephalopathy ?
Lactulose
Residual volume
Membrane conductance (think conductance = channels open)
Displacement

42. What are the three tissues where triacylglycerols are produced?
8 weeks (response to a face)
IgG4
It causes a buildup of dATP - which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate - a precursor of DNA - resulting in overall bone marrow suppression.
1. Liver 2. Muscle 3. Adipose tissue

43. Is excretion greater than or less than filtration for net secretion to occur?
Toxic or viral hepatitis
Excretion is greater than filtration for net secretion to occur.
Osteoarthritis
Yohimbine

44. What CN is associated with the x First pharyngeal arch?
CN V
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
Missense

45. What syndrome results when there is a deletion to paternal chromosome 15? Maternal?
Inhibin - m
Granulosa cell
Prader - Willi syndrome and Angelman syndrome - respectively
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)

46. What enzyme is blocked by hydroxyurea?
Appendix (second is terminal ileum)
Coma - convulsions - and cardiotoxicity
In the JG cells of the kidney
Ribonucleotide reductase

47. What 11- amino acid peptide is the neurotransmitter of sensory neurons that conveys pain from the periphery to the spinal cord?
Primary sclerosing cholangitis
Niacin (B3)
Substance P. (Opioids relieve pain in part by blocking substance P.)
Plasma cell (mature B lymphocyte)

48. From What embryonic structure are the following structures derived? - The aortic vestibule and the conus arteriosus
Bulbus cordis
Occipital lobe
Glossopharyngeal nerve
Hepatic adenomas

49. What is the most common one? - Bone tumor
Leydig cell tumor
Nystagmus and ataxia
Histoplasma capsulatum
Metastatic

50. What is the most common one? - Form of vasculitis
IgA
90% as HCO3- - 5% as carbamino compounds - and 5% as dissolved CO2
Temporal arteritis
Isovolumetric contraction