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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 day of the menstrual cycle does ovulation take place?
Motor
Day 14
Disorganized schizophrenia
First - pass effect

2. What antiviral agent is used to treat RSV - influenza A and B - Lassa fever - and hantavirus and as an adjunct to IFN- in hepatitis C?
Primary follicle (in the white pulp)
Posterior
G-6- PD deficiency
Ribavirin

3. Russell bodies
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
Multiple myeloma
Succinyl CoA
NE - via its vasoconstrictive action on blood vessels

4. What subtype of schizophrenia is characterized by x Stuporous mute echopraxia and automatic obedience - waxy flexibility with rigidity of posture?
Heart disease
Pyridoxine
Catatonic schizophrenia
2 days prior to ovulation

5. What is the term for pus in the pleural space?
Empyema
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
Dynorphin
Gastric cancer

6. What form of bilirubin can cross the blood - brain barrier?
Hepatitis B
Unconjugated free bilirubin
Legionella (think air conditioners)
At least 30% blast in the bone marrow

7. Is derived from the ventral wall of the foregut.
Tetany
The respiratory system
Residual volume (RV)
Dimercaprol

8. What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia - tetany - and T- cell deficiency?
Bacillus cereus
Coarctation of the aorta
DiGeorge syndrome
Pedophilia

9. What enzyme of the purine salvage pathway is deficient in the following? - SCID
Adenosine deaminase
Superior
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
Type 2

10. What vessel is lacerated in an epidural hematoma?
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.
Middle meningeal artery
Type I hypersensitivity (anaphylactic)
Taenia solium

11. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Ipsilateral loss at and below the level of the lesion
Roth spots
Resistance increases as resistors are added to the circuit.
Neonatal respiratory distress syndrome (NRDS)

12. Are the following responses associated with histamines H1 or H2 receptor activation? - SA nodal activity
Liquefaction necrosis
Frontal eye field (Brodmann area 8)
H 2
MEN III (or IIb)

13. What is the term for diffusion of water across a semipermeable or selectively permeable membrane?
Type II pneumocytes
Syringomyelia
Osmosis; water will diffuse from higher to lower water concentrations.
Agglutination test

14. How does L- tryptophan affect sleep?
It increases REM and total sleep time.
Amiloride
d - Tubocurarine
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.

15. In the water deprivation test - does a patient with reduced urine flow have primary polydipsia or diabetes insipidus?
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
Proencephalon diencephalon derivative
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.

16. What three complement fragments are also anaphylatoxins?
SITS
Pulse pressure
Prodrugs
C3a - C4a - and C5a

17. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol decreased - ACTH decreased
Secondary hypocortisolism (pituitary)
Duodenal ulcer
Standardized rate
Fibrinous exudates

18. Name these anxiety defense mechanisms: x Separating oneself from the experience. The facts are accepted but the form is changed for protection.
CN V
antiemetic
Dissociation
Zollinger - Ellison syndrome

19. Streaky ovaries
Vitamin B6
Turner syndrome
17- alpha - Hydroxylase deficiency
Secondary spermatocyte

20. What are the three main components of amyloid?
Galactose and glucose
Where the cell bodies for the DCML and spinothalamic sensory systems are...
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)

21. What are the two broad - spectrum penicillins?
Ampicillin and amoxicillin
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
False - positive rate
Ribavirin

22. Require NaCl in its growth medium.
Propionic acid
Vibrio parahaemolyticus
Galactoside permease
IgA nephropathy (Berger disease)

23. In the systemic circulation - what blood vessels have the largest pressure drop? Smallest pressure drop?
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
Arterioles have the largest drop - whereas the vena cava has the smallest pressure drop in systemic circulation.
Hemostasis
M- cells

24. What operant conditioning therapy or modification is described as x Reinforcing successive attempts that lead to the desired goal (gradual improvement)?
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Shaping (successive approximation)
Male pseudohermaphrodite (dude looks like a lady!)
Theca cell

25. Which anticonvulsant is used in the treatment of bipolar disorder and neuropathic pain?
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.
Spermatogonia (type B)
Gabapentin
Popliteus

26. What female follicular cell is under LH stimulation and produces androgens from cholesterol?
Nicotine (but it sure has a nasty withdrawal!)
Dopamine
Stage 3 and 4
Theca cell

27. What attaches the cusps of the valves to the papillary muscles in the heart?
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Chordae tendineae
1. Cough 2. Coryza 3. Conjunctivitis
Stranger anxiety

28. Name the lung measurement based on the following descriptions: x Additional volume that can be expired after normal expiration
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Expiratory reserve volume (ERV)
Chylomicrons

29. Do genomic or cDNA libraries contain introns - exons - promoters - enhancers - and are they fragmented?
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
H 1
TXA2
Primary hyperparathyroidism

30. When a drug is administered orally and enters into portal circulation - it undergoes hepatic metabolism. What is the name of this effect?
First - pass effect
Chromosome 19
Cancer
Deficiency in surfactant

31. What three substances stimulate glycogenolysis?
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Neuroblastoma
Myasthenia gravis
Amyloidosis

32. Are the following major or minor Jones criteria of rheumatic fever? - Elevated acute phase reactants (e.g. - ESR)
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva
Osteitis fibrosa cystica (von Recklinghausen disease)
Eosin
Minor

33. What embryonic structure forms the adult male structure? - Gubernaculum testes
Gubernaculum
Chromosome 19
Inhibited orgasm
Glucocerebrosidase

34. Fluoroquinolones are...
Pseudomembranous colitis
Bactericidal
Neuroblastoma
Minimal change disease

35. In what disease do you see horseshoe kidneys - rockerbottom feet - low - set ears - micrognathia - and mental retardation?
Niclosamide
Conjugated (direct) hyperbilirubinemia
Edward syndrome (trisomy 18)
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.

36. What happens to the Ab specificity when class switching occurs in mature B cells?
Herpesvirus
Being single
Hemiazygous vein
As the isotype is switched - the Ab specificity does not change because it does not affect the variable chains.

37. What is the name for the following RBC indices? - Average volume of a RBC
PPRF
Nodular sclerosis
Phase III. It is considered the definitive test.
Mean corpuscular volume (MCV)

38. As what compound do the carbons for fatty acid synthesis leave the mitochondria?
IL-4 - IL-10 - and IL-13
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
Citrate - via the citrate shuttle
Ligamentum arteriosum

39. What class of antimicrobial agents should be avoided in patients with a history of GPDH deficiency?
Sulfonamides
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
Zoophilia
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.

40. Hereditary angioneurotic edema (AD) produces local edema in organs (e.g. - GI - skin - respiratory tract). What enzyme deficiency causes increased capillary permeability due to a release of vasoactive peptides?
Ankylosing spondylitis
Bladder cancer
C1 esterase inhibitor (C1INH)
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)

41. What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway?
The mouth
Size
ASA
Anemia of chronic disease

42. Patients with sickle cell anemia are at increased risk for infection From what type of organisms?
Encapsulated bacteria
Chloramphenicol
Lactulose
Salpingitis

43. What three cephalosporins are eliminated via biliary mechanisms?
Oncotic pressure increases because of the removal of water.
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
Sj
Hypoparathyroidism

44. What are five clinical signs of portal HTN?
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Cholera toxin
18 years old (except if emancipated)
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.

45. Name the end product or products: x Fatty acid synthesis
nef and tat genes
Transvestite fetishism
Chromosome 11 - 22
almitate

46. What cells of the adrenal gland are neural crest derivatives?
Chromaffin cells (adrenal medulla)
Plasmodium falciparum
Cryptococcus neoformans
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.

47. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Thalamus
HTN
Vitamin B 6 (pyridoxine)
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
Proencephalon

48. What is the best measure of total body vitamin D if you suspect a deficiency?
Tetralogy of Fallot
Integrase
Serum 25- hydroxy- vitamin D (25- OH- D)
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------

49. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Hematopoietic cells
Osteoclasts
Convergence
Paget disease of the breast
Labile

50. What is the term for the potential difference across a cell membrane?
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Glucagon and epinephrine
Pancreatic cancer
Transmembrane potential (an absolute number)