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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 intermediate of cholesterol synthesis anchors proteins in the membranes and forms CoA?
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia
Renin
Farnesyl pyrophosphate (FPP)
Osteosarcoma

2. What is the most common organ involved in amyloidosis?
Orbitomedial frontal lobe
Kidney
Molluscum contagiosum
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.

3. What is the site of action of the following? - Osmotic diuretics
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
Sphingomyelinase
The entire tubule barring the thick ascending limb
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.

4. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 - int -2 - erb -2 - and erb -3
Folic acid deficiency
Breast cancer
Pseudomonas aeruginosa
MGB (think EARS)

5. What encapsulated group of nerve endings seen at the muscle - tendon junction responds to an increase in tension generated in that muscle? (This is dropping a box that is too heavy to carry.)
Chlamydia psittaci
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
Fourth M PITS for pharyngeal pouch derivatives

6. What diseases are associated with HLA- DR4
Arginine
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
Osteoblast (Remember - blasts make - clasts take)

7. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Type II hypersensitivity reaction
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
Mitral insufficiency
From age 5 onward IQ stabilizes.

8. What is the term for flattened nose - low - set ears - and recessed chin seen in patients with bilateral renal agenesis?
Potter facies
Third week
Protease - integrase - and reverse transcriptase
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

9. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Dysphoria - irritability - musical and visual abilities decreased
Metronidazole
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
Nondominant temporal lobe
GP120

10. Name the most common type - Psychiatric disorder in women of all ages
Akathisia
Thrombus
prognostic predictors
Anxiety disorders; for men it is substance abuse.

11. What vitamin deficiency causes a glove - and - stocking neuropathy seen in alcoholics?
Varicella
Pyridoxine (B6) deficiency
Nasopharynx
greater

12. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral hemispheres
H 2
The biofeedback model is based on the parasympathetic nervous system.
Proencephalon
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.

13. What is the DOC for blastomycoses and sporotrichoses?
Acute cystitis
Dominant parietal lobe (Gerstmann's syndrome)
42 L - 67% of body weight
Itraconazole

14. What cycle is responsible for converting to glucose in the liver the lactate produced in the RBCs?
Coronavirus
Ascending limb
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
Cori cycle

15. How many ATPs are generated per acetyl coenzyme A (CoA)?
Good Samaritan Law. (Physicians are not required to stop and help.)
Type II error (beta error). (Remember it as saying something doesn't work when it does.)
Hormone - sensitive lipase
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)

16. What term is described as the prestretch on the ventricular muscle at the end of diastole?
Right brachiocephalic artery
Inferior phrenic artery
Preload (the load on the muscle in the relaxed state)
O2 has a higher driving force but is only one - twenty- fourth as soluble as CO2. CO 2 has a very small partial pressure difference across the alveolar membrane (47-40 = 7 mmHg) - but it is extremely soluble and therefore diffuses readily across the

17. What is the amount in liters and percent body weight for the following compartments? - Vascular fluid
Chromosome 14 - 18
4.7 L - 5% of body weight
Motor
No change in length

18. Name the area of the cerebral cortex with the function described: x Important for REM sleep; origin of NE pathway
Ovulation
Pons
IgG4
Cyanide

19. The clearance of what substance is the gold standard of renal plasma flow?
Para - aminohippurate (PAH)
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
presence of PMNs
Posterior interventricular artery

20. What Brodmann area is associated with x Primary auditory cortex?
CN IX - X - and XI; sigmoid sinus
Areas 41 and 42
Aspartate transcarbamylase
Gout

21. What happens to prevalence as incidence increases?
CN III and IV
Prevalence increases.
Chromaffin cells (adrenal medulla)
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)

22. What is the relationship between chance of error and x Standard deviation?
Anorgasmia. (The overall prevalence is 30%.)
As the standard deviation increases - the greater the chance of error.
Coarctation of the aorta
Class II

23. 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
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)
Posterior
Bacteria
Marfan syndrome

24. What are the pharmacologic effects seen sexually with x Beta- Blockers?
Valence
Impotence
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
total body water

25. What term describes the reflex that increases the curvature of the lens - allowing near vision?
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
Accommodation
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
Th1; they are also responsible for delayed - type hypersensitivity (type IV)

26. What vertebral level is marked by the xiphoid process?
Frontal eye field (Brodmann area 8)
T9
Progestin
Rhombencephalon

27. What are the two ways that nitrogen can enter into the urea cycle?
Aspartate and carbomoyl PO4
Lung cancer
Brain - spleen - and kidney
Menses. (Ovulation occurs 14 days before the beginning of menses.)

28. If free water clearance (CH2O) is positive - What type of urine is formed? And if it is negative?
Risperidone
Pancreas and colon
Invasive ductal carcinoma
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>

29. What female genital tract disorder is characterized by obesity - hirsutism - infertility - amenorrhea - elevated LH and testosterone levels - and low FSH levels?
Deficiency in surfactant
Internal 3' - 5' PDE bonds
Mesonephric duct
Polycystic ovary disease (Stein - Leventhal syndrome)

30. What is the term for the total percentage of correct answers selected on a screening test?
Streptococcus viridans
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Alzheimer disease
Alcohol consumption

31. What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
Trypsin
Fetal alcohol syndrome
Excision endonuclease - which removes thiamine dimers from DNA

32. All spore formers are...
gram positive
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
Minimal change disease
Streptokinase

33. What subunit of hCG is used to detect whether a patient is pregnant?
Previous suicide attempt
The Beta- subunit; remember - the a - subunit is nonspecific.
Primary hypocortisolism (Addison's disease)
Squamous cell carcinoma

34. Which of the following is not a risk factor for cholesterol gallstones: pregnancy - OCP use - female gender - hemolytic anemia - cirrhosis - and obesity? (May be more than one answer.)
P wave
Anterior wall of the first part of the duodenum
Type I pneumocytes
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.

35. What protein prevents ssDNA from reannealing during DNA replication?
Staphylococcus aureus
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12
Sigma factor
Single - strand DNA binding protein

36. What are the top three causes of infant mortality?
ALA dehydrogenase and ferrochelatase
Flumazenil
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
Poststreptococcal GN

37. What is the term to describe a decrease in the cell size and function usually associated with disuse?
almitate
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.
Stratum spinosum
Hepatitis B and hepatitis C

38. What oxygen - dependent killing enzyme requires hydrogen peroxide and halide (Cl -) to produce hypochlorous acid?
Myeloperoxidase
CN I - II - III - VI - and XII Add 1 + 1 = 2 - 1 + 2 = 3 - 1 + 2 + 3 = 6 - 1 + 2 + 3 + 6 = 12
Patent urachus
1. Posterior auricular vein 2. Posterior division of the retromandibular vein

39. If one event precludes another event - their probabilities are combined By what method?
Zoophilia
Duodenum
Addition (They are mutually exclusive.)
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12

40. What level of mental retardation is characterized by x Having the ability to communicate and learn basic habits but training is usually not helpful?
CN IX - X - and XII CN XI arises from the cervical spinal cord.
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
The optic disk is the blind spot.
Severe (range 20-34)

41. What is the only valve in the heart with two cusps?
Hepatitis A
Mitral (bicuspid) valve
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
Bordetella pertussis

42. Arrange the following layers in the correct sequence through which a needle must pass in a lumbar puncture - Skin x Subarachnoid space x Interspinous ligament x Dura mater x Deep fascia x Epidural space x Superficial fascia x Interlaminar space x Su
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Thyroid hormones
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>

43. Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
HHV 6
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
Increase in erythropoietin and increase in 2 - 3- BPG - also called 2 - 3- diphosphoglycerate (2 - 3- P2Gri) (increase in glycolysis)

44. What large - diameter vessel has the smallest cross - sectional area in systemic circulation?
Lente or NPH insulin (neutral protamine Hagedorn insulin)
Candida
IL-10
The aorta

45. What competitive estrogen receptor antagonist is used in the treatment of breast cancer?
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).
Tamoxifen
Alzheimer disease
Ergosterol

46. What two muscles do you test to see whether CN XI is intact?
reflexes
The vestibulo - ocular reflex
Trapezius and sternocleidomastoid
Entamoeba histolytica (treat with metronidazole)

47. Starry sky appearance of macrophages is pathognomonic of what lymphoma?
Haemophilus influenzae type B
Varicocele
Angiosarcoma of the liver
Burkitt lymphoma

48. What is the most common one? - Cancer of the vulva
Squamous cell carcinoma
Phase I
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
Prolactinoma

49. What is the second arrested stage of development in the female reproductive cycle?
Streptococcus agalactiae
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Vancomycin
Coxsackie A

50. What immunologic syndrome is due to a pharyngeal pouch 3 and 4 failure?

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