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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 is the key issue surrounding teenagers' maturation?
Sigma factor
Superior olivary nucleus
Formation of an identity through issues of independence and rebellion; they define who they are.
Viruses

2. What disease is X- linked recessive - is associated with eczema thrombocytopenia and an increased chance of developing recurrent infections - involves a decrease in serum IgM and in the T cell - dependent paracortical areas of the lymph nodes - and m
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
TXA2
Wiskott - Aldrich syndrome
IgG3

3. At What age does IQ stabilize?
Oligodendroglioma
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
From age 5 onward IQ stabilizes.
Inspiratory reserve volume (IRV)

4. If the pH is low with increased CO2 levels and decreased HCO3- levels - What is the acid - base disturbance?
Cholera toxin
Right - sided valves
The AR form is malignant and AD is benign.
Combined metabolic and respiratory acidosis

5. What subtype of schizophrenia is characterized by x Delusions of persecution and/or grandeur - auditory hallucinations - late onset - and the best prognosis?
The rectouterine pouch (of Douglas)
Paranoid schizophrenia
All are lactose fermenters except Yersinia and Proteus.
Metronidazole

6. What two AAs do not have more than one codon?
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
Cardiac muscle
Methionine (start) and tryptophan are the only two AAs with only one codon.
1. Large sample size 2. Large effect size 3. Type I error is greater

7. Is nystagmus defined by the fast or slow component?
Fovea
Gap junctions
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
2 - 4- Dinitrophenol

8. RBCs in the urine
Nicotine (but it sure has a nasty withdrawal!)
Stratum spinosum
First - pass metabolism and acid lability
Bladder carcinoma

9. What vasculitis affects a 30-year - old Asian female having visual field deficits - dizziness - decreased blood pressure - and weakened pulses in the upper extremities?
Takayasu arteritis (medium - size to large vessels)
Histamine
Flocculonodular lobe (one of my favorite words in all of medicine!)
Pulse pressure

10. What disorder is characterized by autoantibodies to IF?
Cytochrome a/a3
Pernicious anemia
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
Shortens

11. What is the only dsRNA virus?
White muscle; short term too
Reovirus
P24
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.

12. What is the most common one? - Benign ovarian tumor
Gardnerella vaginalis
Cystadenoma
Avidity. There is a positive correlation between valence numbers and avidity.
The time it takes ACh to diffuse to the postjunctional membrane

13. Name the lung measurement based on the following descriptions: x Additional volume that can be expired after normal expiration
Class III
Physiologic antagonism
Expiratory reserve volume (ERV)
Seminoma

14. Where are the lowest resting PO2 levels in a resting individual?
Imipenem and meropenem
Coronary circulation
Primary follicle of the cortex
H 2

15. Why is there a decrease in the production in epinephrine when the anterior pituitary gland is removed?
High - frequency sound waves
Tamoxifen
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Adenovirus

16. With What three enzymes is thiamin pyrophosphate (TPP) associated?
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 -
C1 esterase inhibitor (C1INH)
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
Superior olivary nucleus

17. When is the surface tension the greatest in the respiratory cycle?
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
3'-5' direction - synthesizing RNA in the 5'-3' direction
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Squamous cell carcinoma

18. Name the cerebral vessel associated with the following vascular pathologies - Epidural hemorrhage
Upper outer quadrant (left more than right)
Middle meningeal artery
IgE
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.

19. What adrenergic receptors use inositol triphosphate (IP3) and diacylglycerol (DAG) for their second messenger system?
Chromosome 11 - 22
Temporal arteritis
a1- Receptors
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.

20. What is the fluid of the posterior compartment of the eye?
Vitreous humor
Serocystadenocarcinoma
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
Imipenem and meropenem

21. What is the term for diffusion of water across a semipermeable or selectively permeable membrane?
When it crosses the teres major
Osmosis; water will diffuse from higher to lower water concentrations.
Compliance (think of it as distensibility)
Huntington disease

22. Which penicillin can cause interstitial nephritis?
They are preganglionic sympathetic axons. They are white because they are myelinated.
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Testosterone
Methicillin

23. What are the pharmacologic effects seen sexually with x Neuroleptics?
Erectile dysfunction
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
ACTH
The vaccine contains 23 capsular polysaccharides.

24. What happens to the intrapleural pressure when the diaphragm relaxes?
Rectum
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Primary biliary cirrhosis

25. A 20-year - old woman who was recently diagnosed with a sexually transmitted disease goes to the ER with a tender - painful - swollen - and erythematous knee (monoarticular). What organism is the likely culprit?
Areas 18 and 19
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
IgM

26. What are the proteoglycans of cartilage and bone?
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
Chondroitin sulfate and keratan sulfate
Osteoarthritis
Subacute bacterial endocarditis

27. What is the relationship between chance of error and x Sample size?
As sample size increases - the lower the chance of error.
The venae recta maintain the gradient via countercurrent flow.
2 NADPHs per acetyl CoA
Rheumatoid arthritis

28. What enzyme of heme synthesis is deficient in the autosomal dominant disorder acute intermittent porphyria?
Deltoid
Uroporphyrinogen - I synthase
300 mOsm/L
Uracil

29. Based on operant conditioning - What type of reinforcement is described when x Adding a stimulus reinforces a behavior?
Positive reinforcement
Cardiac muscle
Decrease (5- HT and dopamine levels do the same)
Immature B cells

30. What area of the limbic system is responsible for attaching emotional significance to a stimulus?
Amygdala; it helps imprint an emotional response in memory.
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Alzheimer disease
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.

31. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH ?
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
Primary hypogonadism (postmenopausal women)
Cervical neoplasia
Chronic end - stage renal disease

32. What enzyme of the TCA cycle catalyzes the production of the following: x NADH (hint: 3 enzymes)
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase
Pulse pressure
Hairy cell leukemia

33. Name the antidote - Opioids
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Naloxone - naltrexone
Avoidant

34. What is the most common one? - Proliferative abnormality of an internal organ
Duchenne muscular dystrophy (Remember - Becker's is slower in progress - less severe - later in onset - and lacks cardiac involvement.)
BPH
Small cell carcinoma (oat cell)
Axis III

35. What causes a skeletal muscle contraction to terminate?
Melasma
Schistosoma have separate males and females.
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Tropomyosin

36. What is the primary method of nonverbal communication of emotional states?
Facial expression (the second is vocal intonation)
HBsAb IgG
Streptococcus agalactiae (Group B Streptococcus - or GBS)
ACh; think about the ANS.

37. What component of the inner ear x Contains endolymph and gravity receptors monitoring linear acceleration and deceleration of the head - noting changes in head position?
ASD
Guillain - Barr
Utricle and saccule
Area 4

38. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x sis
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Astrocytoma
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
Nitrates

39. What two factors cause PTH to be secreted?
Mesolimbic system
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Marrow failure - cancer - and leukemia
A decrease in Ca2+ and an increase in PO4

40. What Ig is the major protective factor in colostrum?
The conversion of CHO to pregnenolone via the enzyme desmolase
Thoracic splanchnic fibers
IgA
RSV

41. What is the label given to an individual whose IQ is x Below 69
Foramen of Monro
Mentally disabled
3 ATPs by oxidative phosphorylation
2 and 5HT3 receptors

42. What muscle or muscles are innervated by the following nerves? - Upper subscapularis nerve
Subscapularis
Null hypothesis (what you hope to disprove)
The number of Ags that the Ab can bind
PGE2 and PGF2a

43. Does ELISA or Western blot confirm whether a patient is HIV- positive?
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.
Lesch - Nyhan syndrome
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)
ELISA screens and Western blot confirms the diagnosis.

44. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Small prokaryotic cells; no histones; 70S ribosomes; no sterols in cell membrane; peptidoglycans in cell wall; replicate by binary fission
Bacteria
Streptococcus pneumoniae
de Quervain thyroiditis
Lentigo maligna melanoma

45. What are the five F's associated with gallstones?
Shortens
Proencephalon
The rate of infusion
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile

46. Under resting conditions - What is the main determinant of cerebral blood flow?
The central vein of the liver lobule
Arterial PCO2 levels are proportional to cerebral blood flow.
CD19
Hepatic adenomas

47. What CN is associated with the sensory innervation of x Laryngopharynx?
Vagus nerve
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Musculophrenic and superior epigastric arteries
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.

48. Which dopamine receptor excites the direct pathway of the basal ganglia?
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
Astrocytoma
Avoidant
Proencephalon diencephalon derivative

49. What AR CNS disorder presents early in childhood with gait ataxia - loss of deep tendon reflexes - impaired vibratory sensation - hand clumsiness - and loss of position sense?
Uricosuric
Suppression
Procainamide
Friedreich ataxia

50. Which hepatitis B serology markers
Gain of hypotonic fluid (water intoxication or hypotonic saline)
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
HBcAb IgM
Niemann - Pick and Tay- Sachs diseases