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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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. Birbeck granules
Pernicious anemia
Positive
Histiocytosis X
45XO

2. Setting up to be let down (it is unconscious; if conscious - you're just rude)
RBCs
Paget disease of the breast
Passive - aggressive
IGF-1

3. What vascular injury may result from a supracondylar fracture of the femur?
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
Obturator nerve
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Functions of hepatocytes

4. What AA has a pKa of 13?
Arginine
Stable
Antithyroglobulin and antimicrosomal Abs
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.

5. Regarding skeletal muscle mechanics - What is the relationship between velocity and afterload?
Cyproheptadine
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
Inferior rectus (CN III) (LR6 SO4)3
Rods

6. Abs to what hepatitis B Ag provide immunity?
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)
Alendronate
Abs to HBsAg
G1 phase; G2 and S phase are diploid (2N).

7. Where are the postganglionic neuron cell bodies - the CNS or the PNS?
Sphingomyelinase
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
Prostate cancer
They are in ganglia in the PNS.

8. Which a - blocking agent is used to treat refractory hypertension and baldness?
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Peau d'orange
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+
Minoxidil (orally and topically - respectively!)

9. What neurotransmitter is essential for maintaining a normal BP when an individual is standing?
NE - via its vasoconstrictive action on blood vessels
Estriol
Nodular sclerosis
Staphylococcus aureus

10. What is used as an index of the number of functioning carriers for a substance in active reabsorption in the kidney?
Treacher Collins syndrome
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
Alveoli; they are part of the respiratory portion.
Plasmodium malariae

11. What is the polarity (i.e. - 5'-3' or 3'-5') of a positive sense RNA?

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12. Name the cluster C personality disorder: x Sensitive to criticism - shy - anxious; socially isolated but yearns to be in the crowd
Lateral part of the hemispheres
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Sarcoidosis
Avoidant

13. What water - soluble - vitamin deficiency is associated with cheilosis and magenta tongue?
Candida
2.0 or greater
Henoch - Sch
Riboflavin (B2)

14. What subset of CD4 helper T- cell function is helping the development of CD8 T cells?
Adenosine deaminase (ADA) deficiency
Brucella and Listeria (has tumbling motility)
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
Autoimmune hemolytic anemia

15. Which cestode infection results in alveolar hydatid cyst disease?
Histamine
Echinococcus multilocularis
Chromosome 9 - 22 (Philadelphia chromosome)
Scavenger receptor (SR- B1)

16. In which syndrome does a person present with intentionally produced physical ailments with the intent to assume the sick role?
Venlafaxine. (It also has a mild dopaminergic effect.)
Anterior tibial artery
M
Ergotamines

17. Name the DNA virus: x Partially dsDNA circular; enveloped; virion - associated polymerases; has RNA intermediate; replicates in the nucleus
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
Paroxysmal nocturnal hemoglobinuria
Hepadnavirus
Remember the mnemonic PAM SMIDT P - (hyper) Parathyroid/ Paget disease A - Addison's disease M - Milk - alkali syndrome/metastatic cancer S - Sarcoidosis M - Multiple myeloma I - Immobilization/idiopathic D - Vitamin D intoxication T - Tumors

18. What is the most common one? - Malignancy of the female genital tract
Streptococci
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Endometrial cancer
Picornaviridae

19. What is the term for the load a muscle is trying to move during stimulation?
Histoplasma capsulatum
Afterload
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Intercellular adhesion molecule (ICAM) 1

20. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Eukaryotic cell; 3 to 10 microns; 80S ribosomes; chitinous cell wall; ergosterol in cell membrane; replicate via cytokinesis with mitosis and meio
Hepatitis - with or without necrosis
Albinism
Fungi
Uricosuric

21. Which integrin mediates adhesion by binding to lymphocyte function - associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors?
Urogenital folds
CSF
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.
Intercellular adhesion molecule (ICAM) 1

22. What stromal tumor in males is characterized histologically with crystalloids of Reinke?
Leydig cell tumor
Action potential
Pneumocystis carinii
Median (think of it as the halfway point)

23. What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
Fentanyl
Parasympathetics (parasympathetics point - sympathetics shoot)
Epstein - cardiac anomaly of the tricuspid valve
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.

24. What component of the ANS - when stimulated - results in bronchoconstriction?
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.
Fibrocystic change of the breast
By causing rebound insomnia and decrease in REM sleep

25. Which subtype of AML is most commonly associated with Auer rods?
Osteoclasts
M3 (promyelocytic leukemia)
They innervate skeletal muscle.
Fibroadenoma

26. What syndrome is associated with the following brainstem lesions? - Contralateral corticospinal and medial lemniscus tract deficits and an ipsilatera medial strabismus secondary to a lesion in CN VI
Marfan syndrome
0.21; it is a fancy way of saying 21% of the air is O2.
Poxvirus
Medial pontine syndrome

27. What is the most energy- demanding phase of the cardiac cycle?
No change in length
Isovolumetric contraction
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
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

28. What is the most common one? - Brain tumor
Metastatic
Parainfluenza virus
Range
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.

29. What excitatory fibers arise from the inferior olivary nuclei on the contralateral side of the body?
Campylobacter jejuni
C3a - C4a - C5a
Female pseudohermaphrodite
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.

30. Are the following parameters associated with an obstructive or restrictive lung disorder: decreased FEV1 - FVC - peak flow - and FEV1/FVC; increased TLC - FRC - and RV?
Rate of absorption
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
Hematoxylin
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c

31. A 25-year - old black woman presents with nonproductive cough - shortness of breath - fatigue - and malaise; she has bilateral hilar lymphadenopathy on chest radiography and elevated ACE levels. What do you diagnose?
Rhombencephalon
Mitral stenosis
Early distal tubule
Sarcoidosis

32. Anatomical and alveolar dead spaces together constitute what space?
2 days prior to ovulation
Dystrophic calcification
Physiologic dead space is the total dead space of the respiratory system.
Hepadnavirus

33. What enzyme requires molybdenum as a cofactor?
produce bile
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
Xanthine oxidase
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.

34. What is the MCC of the following endocarditis scenarios? - Post dental work
Streptococcus viridans
Prostatic carcinoma
Pyruvate carboxylase
Transcription (C comes before L in the alphabet - and transCription comes before transLation)

35. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Acellular; some are enveloped; replicate within the host cell; no cell walls
Viruses
Staphylococcus aureus
Nicotinic acid - because its side effects include hyperuricemia and exacerbation of ulcers.
Hirschsprung's disease (colonic gangliosus)

36. What small gram - negative facultative intracellular rod is transmitted to human host by Dermacentor tick bite?
Hepadnavirus
Copper
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Francisella tularensis

37. What three chemical agents are associated with angiosarcomas of the liver?
Mesonephric duct
Shigella
Arsenic - thorotrast - and vinyl chloride
Prokaryotes. Polycistronic and prokaryotes both start with P.

38. What statistical test compares the means of many groups (>2) of a single nominal variable by using an interval variable?
One - way ANOVA
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
Prefrontal cortex; it is in front of the premotor area.

39. What three drugs are associated with SLE- like syndrome in slow acetylators?
Hydralazine - isoniazid - and procainamide (HIP)
Factitious disorder
Middle
pH of 2 and 9

40. What cell type involves humoral immunity?
B lymphocyte
Brushfield spots
Antidigoxin Fab fragments
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.

41. Name the stages of sleep with these EEG patterns: x Alpha waves
Thalassemia minor
Mesencephalic nucleus
Being awake
Occipital lobe

42. What is the term for RNA- dependent DNA polymerase?
Reverse transcriptase
Chromosome 11 - 22
Ratio scale
Sphingosine

43. What three complement fragments are also anaphylatoxins?
C3a - C4a - and C5a
hCG can be detected in the blood by day 8 and in the urine by day 10.
Papillary carcinoma
Fibrocystic change of the breast

44. What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
Size
Being a white male
ASD
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.

45. What oral hypoglycemic agent stimulates pancreatic Beta- cell release of insulin and is given just prior to meals because of its short half - life?
Breast and lung cancer - respectively.
Parasympathetic
Henoch - Sch
Repaglinide

46. With a decrease in arterial diastolic pressure - what happens to x Heart rate?
Ceramide
Erythema multiforme
For males - HTN; for females - pregnancy.
Decreases

47. What genetic defect is characterized by coarse facial features - gingival hyperplasia - macroglossia - psychomotor and growth retardation - club foot - claw hand - cardiorespiratory failure - and death in the first decade of life?
Pulse pressure
Parvovirus
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>

48. How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle?
3 ATPs by oxidative phosphorylation
Functional residual capacity (FRC)
Middle meningeal artery
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.

49. Which of the following
Osteosarcoma
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Coxiella burnetii
Berylliosis

50. How many mature sperm are produced by one type B spermatogonium?
For the USMLE Step 1 the answer is no - but if the information would do more harm than good - withhold. This is very rare but it does occur.
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.
Pseudomonas aeruginosa
Four

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USMLE Step 1 Prep

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