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Test your basic knowledge |
USMLE Step 1 Prep
Start Test
Study First
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. Name the antidote - Atropine
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
Stable
Adhesions and hernias
Physostigmine
2. What happens to total and alveolar ventilation with x Increased depth of breathing?
Sporothrix schenckii
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
Escherichia coli
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.
3. How many months in How many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
HBeAg
3 months of symptoms in 2 consecutive years
total body water
Renal plasma flow (decrease flow - increase FF)
4. What substrate gets built up in Gaucher's disease?
Glucosyl cerebroside
Huntington disease
Chromosome 5q21
Quaternary structure
5. What is the pyrimidine intermediate that joins PRPP (5- Phosphoribosyl -1- Pyrophosphate)?
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.
Orotic acid (purine metabolism)
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
6. What is the essential reservoir host for Toxoplasma gondii?
Isocitrate dehydrogenase
The cat
Hemangioma (benign)
The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated.
7. What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
Dominant parietal lobe (Gerstmann's syndrome)
Transketolase and transaldolase. The reactions they catalyze are reversible.
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Klinefelter syndrome
8. The surge of what hormone induces ovulation?
IgA
Left eye anopsia (left nasal and temporal hemianopsia)
PTH
LH
9. Is DM a contraindication to use of a Beta- blocker in a patient who is having an MI?
Doxycycline and minocycline
Fluconazole
Major
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
10. What vitamin is a cofactor of aromatic amino acid decarboxylase and decreases the efficacy of L- dopa if used concomitantly?
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Vitamin B 6 (pyridoxine)
Magnesium
Eisenmenger's syndrome
11. In the elderly - what happens to total sleep time - percentage of REM sleep - and percentage of NREM sleep?
Left heart failure
The limbic system
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Increased secretion of GH postpuberty leading to acromegaly.
12. Name the ventricular muscle membrane channel: x Closed at rest; depolarization causes channels to open quickly; will not respond to a second stimulus until cell is repolarized.
Venlafaxine. (It also has a mild dopaminergic effect.)
Voltage - gated sodium channel
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
2 ATPs by oxidative phosphorylation
13. What is the most common one? - Viral cause of myocarditis
Coxsackie B
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.
Short - chain fatty acids
An internal elastic lamina
14. In which region of the lung are 75% of the pulmonary infarcts seen?
Howell - Jolly bodies
Lower lobe
Between the renal arteries and at the bifurcation of the abdominal aorta
Cefuroxime and cefaclor
15. The lack of dopamine production in the substantia nigra leads to the ______________ - characteristically seen in patients with Parkinson's disease.
epithelial lining
extrapyramidal dysfunction
The optic disk is the blind spot.
absorption
16. What are the four functions of saliva?
Macula densa
Staphylococcus saprophyticus
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Copper (Cu+)
17. What paraphilia is defined as x Deriving sexual pleasure from other peoples' pain?
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.
Sadism
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.
Dendrites receive information - whereas axons send information.
18. What is the most common one? - Germ cell tumor of the ovary
Dysgerminoma
Placental alkaline phosphatase
RBCs
Alveolar dead space
19. What is the drug of choice for treating ADHD?
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.
Bronchogenic carcinoma
Being single
Methylphenidate (Ritalin)
20. 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?
Ependymal cells
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
GERD
Riedel thyroiditis
21. What CNS tumor arises from Rathke's pouch?
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Doxycycline and minocycline
Estrogen use
Craniopharyngioma
22. What enzyme of the purine salvage pathway is deficient in the following? - Lesch - Nyhan syndrome
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
HGPRT
Sickle cell disease
Chromosome 18
23. What happens to the resistance of the system when a resistor is added in a series?
Adenocarcinoma of the cervix
Resistance of the system increases. (Remember - when resistors are connected in a series - the total of the resistance is the sum of the individual resistances.)
Vitamin D
Interval scale (a ruler - for example)
24. What is the term for taking an mRNA molecule and arranging the AA sequence forming a protein?
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)
Enterohepatic cycling
Translation
Type II pneumocytes
25. In which quadrant is breast cancer most commonly found?
Upper outer quadrant (left more than right)
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
Negative
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
26. Name the most common type or cause - Nephrotic syndrome
Wegener granulomatosis
Psammoma bodies
Membranoproliferative glomerulonephritis (MGN)
Parkinson's disease
27. How do elevated blood glucose levels decrease GH secretion? (Hint: what inhibitory hypothalamic hormone is stimulated by IGF-1?)
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
1. Tinea coli 2. Haustra 3. Epiploic appendages
BPH
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.
28. Blue sclera
Allograft
Osteogenesis imperfecta
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
Hypersegmented neutrophils
29. What is found in the R group if the AA is acidic? Basic?
Langerhans cells (found in the stratum spinosum)
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
DNA ligase
HPV serotypes 1 and 4
30. Name the antimicrobial agent whose major side effect is listed - Grey baby syndrome
Creatinine
Lateral collateral ligament
Chloramphenicol
Parkinson disease
31. What cancer is particularly likely to affect English chimney sweeps?
Sadism
Scrotal cancer - due to the high exposure to polycyclic aromatic hydrocarbons
Primary hypoparathyroidism
In early- morning sleep - usually between the sixth and eighth hours
32. Damage to what nerve will give you winged scapula?
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
CN II and ophthalmic artery
Odds ratio. (Case control studies deal with prevalence.)
33. In What area of the brain can an excess of dopamine lead to psychotic symptoms?
relaxation
Ethyl alcohol
Mesocortical area
Lateral pontine syndrome
34. What is the most energy- demanding phase of the cardiac cycle?
Cytochrome a/a3
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.
Are live attenuated vaccines available in the United States
Isovolumetric contraction
35. What is the most common one? - Valve abnormality associated with rheumatic fever
Mitral valve stenosis
Clonidine
Sj
Berry aneurysm in the circle of Willis
36. Which leukotriene is chemotactic for neutrophils?
Syphilitic
RNA polymerase II
To provide attachment between contiguous cells and to maintain a semipermeable barrier
LTB4
37. Name these immature defense mechanisms: x Psychic feelings converted to physical symptoms
Somatization
Waldenstr
Tryptophan
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
38. What is the end product of purine catabolism?
Water
Uric acid
Alzheimer disease
Wilson disease
39. What is the term for the total percentage of correct answers selected on a screening test?
Borrelia burgdorferi
Bell pad
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Corynebacterium diphtheriae
40. What is the tetrad of tetralogy of Fallot?
Urachus
Prader - Willi syndrome and Angelman syndrome - respectively
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
41. What aphasia is seen as an inability to comprehend spoken language and speaking in a word salad?
Motor nucleus of CN V
Lesser curvature of the antrum of the stomach
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.
Left colic - superior rectal - and sigmoidal arteries
42. What two lysosomal storage diseases have cherry- red spots on the retina?
Peyer's patch
Niemann - Pick and Tay- Sachs diseases
Vitamin A
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)
43. What is the term for failure of the testes to descend into the scrotum?
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.
Chromosome 21
Poststreptococcal GN
44. What is the term for a substance secreted by a leukocyte in response to a stimulus?
Vimentin
Klebsiella pneumoniae
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
Absolute refractory period is due to voltage inactivation of sodium channels.
45. Used in the treatment of barbiturate overdose.
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
Transient ischemic attack
Flumazenil
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
46. In regard to motor development during infancy - choose the motor response that happens first - Release or grasp
Type II pneumocytes
Job syndrome
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Grasp proceeds release
47. What are the five AAs that are both ketogenic and glucogenic?
Aspartic acid and glutamic acid
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
The Beta- subunit; remember - the a - subunit is nonspecific.
48. Are always open.
Ungated channels
Arch of the aorta and right subclavian artery
CD28
C2 deficiency
49. What form of arthritis is associated with calcium pyrophosphate crystals?
Leiomyoma
Pseudogout
The zygote divides mitotically; only germ cells divide meiotically.
More Ab is produced in less time in a secondary immune response (shorter lag period).
50. Where are the preganglionic neuron cell bodies - the CNS or the PNS?
They are in the grey matter of the CNS.
Projection
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.
6 years old