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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 syndrome is rheumatoid arthritis with pneumoconiosis?
7 to 14 days
Caplan syndrome
Mercury
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)

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

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3. What is the most common one? - Complication of nasogastric tube feeding
Aspiration pneumonia
Pneumocystis carinii
Amphotericin B
Entamoeba histolytica

4. Name the valve abnormality based on the following criteria: x Systolic murmur - increased preload and afterload - decreased aortic pulse pressure and coronary blood flow
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
Aortic stenosis
Water soluble
Valence

5. If the occurrence of one event had nothing to do with the occurrence of another event - How do you combine their probabilities?
Chloramphenicol
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.
Since they are independent events - their probabilities would be multiplied.
Mitochondria - linked disorders are always inherited from the mother.

6. Name the antidote - Opioids
Menses
Plummer - Vinson syndrome
Carnitine acyltransferase I
Naloxone - naltrexone

7. What are the three exceptions to the rule of codominant gene expression?
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Stage 4
Quaternary structure

8. What is the term for the type of pupil seen in neurosyphilis - and what ocular reflexes are lost?
No change in length
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Bile salts are actively reabsorbed in the distal ileum.

9. Name the associated chromosome - Tay- Sachs disease
Vancomycin
Chromosome 15q
SSRIs
Spermatogonia (type A)

10. What is the most common one? - Thyroid adenoma
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
IgG4
Follicular adenoma
Lung cancer

11. What is the term to describe how easily a vessel stretches?
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Osteosarcoma
Compliance (think of it as distensibility)
Erectile dysfunction

12. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Mucosal epithelium
Minocycline
Duchenne muscular dystrophy
Positive reinforcement
Labile

13. What vasculitis is characterized by systemic vasculitis in small to medium - size vessels (except the lung); affecting young males; 30% HBsAg - positive; P- ANCA and autoantibodies against myeloperoxidase?
Cytochrome a/a3
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
Polyarteritis nodosa
Missense

14. What Ig prevents bacterial adherence to mucosal surfaces?
Wegener granulomatosis
IgA
a - and Beta- chains are on most T cells.
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.

15. What is the tetrad of Jarisch - Herxheimer reaction?
Rigors - leukopenia - decrease in blood pressure - and increase in temperature
Coxiella burnetii
Herpesvirus
Musculophrenic and superior epigastric arteries

16. What type of hallucination occurs during awakening?
Chronic end - stage renal disease
Odds ratio. (Case control studies deal with prevalence.)
Erythromycin
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.

17. What vessels carry deoxygenated blood into the lungs from the right ventricle?
Conjugated (direct) hyperbilirubinemia
Aminophylline
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood
well - fed and fasting

18. On the venous pressure curve - What do the following waves represent? - A wave?
Phase 2
Glutamine and aspartate
Atrial contraction Atrial - Contraction - Venous
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.

19. Name the most common type or cause - Cushing syndrome
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
Turner syndrome
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
Pituitary adenoma

20. What is the term for the number of trinucleotide repeats increasing with successive generations and correlating with increased severity of disease?

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21. What embryonic structure forms the adult female structures? - Ovarian and round ligaments
Glutamate dehydrogenase
Gubernaculum
Phase 2
Uroporphyrinogen I synthetase

22. What is the major Ab of the primary immune response?
IgM
Polycystic ovary disease (Stein - Leventhal syndrome)
Bitemporal heteronymous hemianopsia
Left atrium and tip of the right atrium

23. What is the rate - limiting step in a conduction of a NMJ?
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 -
Free ionized Ca2+
The time it takes ACh to diffuse to the postjunctional membrane
Valence

24. Name the ocular lesion; be specific - Left optic nerve lesion
Cancer
Wilson disease
Left eye anopsia (left nasal and temporal hemianopsia)
Thymine

25. What vitamin deficiency can result in high - output cardiac failure?
Thiamine
Aspartic acid and glutamic acid
Chromosome 14 - 18
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.

26. What are the primary neurotransmitters at the following sites? - All motor neurons - postganglionic parasympathetic neurons
ACh
Bronchial asthma (whorled mucous plugs)
MEN II and III syndromes
Sheehan syndrome

27. What portion of the intervertebral disk is a remnant of the notochord?
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
Alendronate
Physiologic dead space is the total dead space of the respiratory system.
Nucleus pulposus

28. What is the most common one? - Primary CNS tumor in adults
HIV and poxvirus
IF and GTP (eIF for eukaryotes)
Reserpine
Glioblastoma multiforme

29. Which agent used in the treatment of asthma is a selective inhibitor of the lipoxygenase pathway?
Toxic or viral hepatitis
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
Zileuton
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).

30. What is the ratio of pulmonary to systemic blood flow?
Glyceraldehyde dehydrogenase
Moving objects - along with large bright objects with curves and complex designs.
epithelial lining
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.

31. At the base of the lung - What is the baseline intrapleural pressure - and what force does it exert on the alveoli?
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Cholera toxin irreversibly activates the cAMP- dependent chloride pumps of the small and large intestine - producing a large volume of chloride - rich diarrhea.
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
t the end of the PCT 25% of Na+ - Cl - - K+ is left

32. What are the two side effects of opioids to which the user will not develop tolerance?
HPV serotypes 1 and 4
Buffers (remember that buffers are best when they are used in a pH range near its pK)
T3
Constipation and miosis

33. What form of poisoning is associated with bitter almond - scented breath?
TCR
Cyanide
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).
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.

34. Which hepatitis B Ab indicates low transmissibility?
Antisocial personality
Waldenstr
HBeAb
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.

35. What B- cell neoplasm is seen in males with massive splenomegaly - produces dry tap on bone marrow aspirations - and stains positive for tartrate - resistant acid phosphatase (TRAP)?
Hairy cell leukemia
REM sleep. Nightmares are frightening dreams that we recall.
MI
Niemann - Pick and Tay- Sachs diseases

36. What form of bilirubin is carried on albumin?
Unconjugated (indirect)
Air flows into the respiratory system.
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
Jejunum (upper)

37. What thalamic relay nucleus do the mammillary bodies project to?
The anterior nucleus of the thalamus
The aorta
Double - blind study. It is the most scientifically rigorous study known.
Volkmann's contracture

38. What rare disorder presents as a large - hard - irregular thyroid gland due to fibrous proliferation of connective tissue in the thyroid gland and extends to adjacent structures?
Basal cell carcinoma
An increase in serum glucose levels
Riedel thyroiditis
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.

39. What type of questions should you begin with when a patient seeks your medical opinion?
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns
Dendritic cells - macrophages - and thymic epithelial cells
Combined metabolic and respiratory acidosis
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.

40. Are the following conditions associated with a negative or positive nitrogen balance? - Uncontrolled DM
Clindamycin
Negative
LTC4 - LTD4 - and LTE4
IGF-1 (somatomedin C)

41. Where is the cupola of the lung in relation to the subclavian artery and vein?
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
The lung will expand; also the opposite is true.
Secondary hypocortisolism (pituitary)

42. What CNs arise from x The pons?
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
Upper outer quadrant (left more than right)
CN V - VI - VII - and VIII

43. What three complement fragments are also anaphylatoxins?
C3a - C4a - and C5a
Neutrophils - eosinophils - and basophils
Adenocarcinoma (30% to 35%)
Pterygopalatine ganglion (I remember this as the only ganglion left.)

44. What are the two hepatitis viruses that can be chronic and can lead eventually to hepatocellular carcinoma?
Phase 1
Sexual aversion disorder
X- linked recessive
Hepatitis B and hepatitis C

45. Which nicotinic receptor antagonist is inactivated to laudanosine?
The cat
Gluteus maximus
Hemochromatosis
Atracurium

46. What is the most common one? - Bladder tumor
Musculophrenic and superior epigastric arteries
Cholesterol biosynthesis
Transitional cell carcinoma
rRNA

47. What are the rules of 10 regarding pheochromocytoma?
Ischemic heart disease (MIs)
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
Tolcapone and entacapone
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland

48. Name the most common type or cause - Acute metal poisoning in the United States
DNA polymerase I
H 2
Vibrio vulnificus
Arsenic

49. The probability that a person with a negative test result is truly disease free refers to what value?
Gain of hypertonic fluid (mannitol or hypertonic saline)
Negative predictive value
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
Trazodone

50. What test is used to detect anti - RBC Abs seen in hemolytic anemia?
Arch of the aorta and right subclavian artery
Folic acid deficiency
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
Coombs test