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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 testicular tumor of infancy is characterized by elevated - fetoprotein levels and Schiller - Duval bodies?
Ribonucleotide reductase
Yolk sac tumor
Third week
Chondroitin sulfate and keratan sulfate

2. Which protozoal parasitic vaginal infection produces a positive whiff test with KOH staining?
Trichomonas vaginalis (treat with metronidazole)
Early distal tubule
Four
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.

3. What obligate extracellular fungus is silver stain - positive and is associated with pneumonia in patients with AIDS?
Bronchioloalveolar carcinoma
Antimicrobial agents
Pneumocystis carinii
Mycoplasma pneumoniae

4. Name the hypochromic microcytic anemia based on the following laboratory values - Decreased iron - percent saturation - and ferritin; increased TIBC
1. Glycine 2. Aspartate 3. Glutamine
Iron deficiency anemia
ASD
Toxic dose for 50% of drug takers (median toxic dose)

5. Which dimorphic fungus is found as Arthroconidia in desert sand of the southwestern United States (e.g. - San Joaquin Valley)?
Molluscum contagiosum
RSV
Coccidioides immitis
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.

6. What area of the GI tract has the highest activity of brush border enzymes?
Normal values
Integument (skin and its derivatives)
Jejunum (upper)
Both Neisseria and Moraxella are gram - negative cocci.

7. Should you refer a patient to a form of folk medicine even if you don't believe in it?

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8. Name the associated chromosomal translocation - M3 AML
Chromosome 15 - 17
Extrahepatic biliary atresia
From the wall of the yolk sac
MGB

9. How many bronchopulmonary segments are on the right lung? Left lung?
There are 10 bronchopulmonary segments on the right and 8 on the left.
Respiratory depression
Posterior cricoarytenoid muscles
The primitive streak grows caudal to rostral.

10. Results in vitamin B12 deficiencies.
Removal of the ileum
REM latency; normally it is about 90 minutes.
Preoperational (2-6 years)
Common and internal carotid arteries

11. From What embryonic structure are the following structures derived? - The sinus venarum - coronary sinus - and the oblique vein of the left atrium
Waldeyer's ring
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.
Sinus venosus
Pancreatic delta - cell tumors inhibit CCK secretion

12. With what stage of sleep are night terrors associated?
Vitamin B6
NREM sleep. Night terrors are dreams that we are unable to recall.
Down syndrome (trisomy 21)
Renal cell carcinoma

13. What mast cell mediator is a chemotactic agent?
Chemotaxis
Preoperational (2-6 years)
Eosinophil chemotactic factor A
Magnesium ammonium phosphate (struvite)

14. What abdominal muscle runs horizontally - contributes to the posterior rectus sheath - and contributes to form the conjoint tendon?
Caplan syndrome
Trimethoprim
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Transverse abdominis

15. What is the term to describe inability to recall the past and possible assumption of a completely new identity?
Dissociative fugue. (Patients are unaware of memory loss.)
Monosodium urate crystals
TXA2
Utricle and saccule

16. Name the compartment of the mediastinum associated with the following thoracic structures: Splanchnic nerves
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
Knee
Methicillin
Posterior

17. What parasite is associated with squamous cell carcinoma of the urinary bladder?
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
Sickle cell disease
Rhombencephalon
Schistosoma haematobium

18. What is the most common one? - Site for carcinoid tumors
Posterior
Appendix (second is terminal ileum)
Frontal lobe syndrome (lesion in the prefrontal cortex)
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.

19. What syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands?
Asbestosis
Tyrosine
300 mOsm/L
Waterhouse - Friderichsen syndrome

20. If inserting a needle to perform a pleural tap or insertion of a chest tube - do you use the inferior or the superior border of a rib as your landmark? Why?
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
Streptococcus agalactiae and Escherichia coli
Acetoacetate - acetone - and Beta- hydroxybutyrate

21. Is GH considered a gluconeogenic hormone?
Yes - it decreases fat and muscle uptake of glucose - thereby increasing blood glucose levels.
Cholesterol biosynthesis
Orotic acid (purine metabolism)
The T- test (used when comparing two groups)

22. What enzyme is inhibited by disulfiram?
Hematoxylin
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.
IgE

23. What area of the hypothalamus is the feeding center?
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
B- cell Ag receptors
Coxsackie B
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)

24. What two PGs are used to induce labor?
Propionibacterium acnes
Somatomedins (IGF-1)
PGE2 and PGF2a
CD40

25. What is the term for severe and protracted vomiting resulting in linear lacerations at the gastroesophageal junction?
Liquids - CHO - protein - fat
Mallory- Weiss syndrome
Nigrostriatal pathways (basal ganglia)
Euchromatin - the dark stuff in the nucleus on an electron microscope image.

26. Which leukotriene is chemotactic for neutrophils?
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.
Infection
LTB4
Celecoxib

27. Increases your risk of suicide.
Thyroid hormones
Poxvirus
Semicircular duct
Being single

28. What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
Selegiline
Biotin - ATP - and CO2
Primary sclerosing cholangitis
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine

29. What is the term for inflamed - thickened skin on the breast with dimpling associated with cancer?

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30. What two forms of insulin - if mixed together - precipitate zinc?
Xanthine oxidase
Arcuate line
Toxic or viral hepatitis
Lente insulin and either NPH or protamine zinc insulin (PZI)

31. What vessels have the largest total cross - sectional area in systemic circulation?
Chromosome 11p
Capillaries
Eosin
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.

32. What is the most common serotype of enterohemorrhagic Escherichia coli?
Stratum granulosum
Helicobacter pylori - Which is also associated with an increased risk of gastric carcinoma
0157:H7
Chordae tendineae

33. What type of collagen is abnormal in patients with osteogenesis imperfecta?
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase
Tip of the loop of Henle (1200 mOsm/L)
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)

34. What is the neurotransmitter at the
Succinyl CoA synthetase
Beta- Endorphin
Puborectalis
Schizoid

35. A Japanese man has weight loss - anorexia - early satiety - epigastric abdominal pain - and a palpable left supraclavicular lymph node. On endoscopy you find a large - irregular ulcer with elevated margins on the lesser curvature of the stomach. What
Pneumocystis carinii
Streptococcus viridans
impermeable to water
Gastric carcinoma

36. What agent is used IM to treat acute dystonias?
Middle meningeal artery
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Diphenhydramine
Arboviruses (bunyavirus - flavivirus - and togavirus)

37. What hematologic agent is used in the treatment of intermittent claudication because it decreases blood viscosity and increases RBC membrane flexibility and stability?
Zona fasciculata and zona reticularis
Chromosome 20q (deficiency in adenosine deaminase)
Common peroneal nerve
Pentoxifylline

38. What segment of the small intestine is associated with Brunner's glands?
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Amnesia. (The person is aware of the memory loss.)
Duodenum
6 years old

39. What is the most common one? - Type of ASD
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
The fast component is directed toward the affected side of a cerebellar lesion.
Ostium secundum defects
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.

40. How is sleep affected in a person with alcohol intoxication?
Combined metabolic and respiratory acidosis
B cells; macrophages and dendritic cells are nonspecific.
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.
Decreased REM sleep and REM rebound during withdrawal

41. What gram - positive rod is distinguished by its tumbling motility?
Maxillary division of CN V and glossopharyngeal nerves
Isoniazid treatment
Listeria
Macrophages

42. What are the three exceptions to the rule of codominant gene expression?
1. Short attention span 2. Impulsivity 3. Hyperactivity
Transcortical aphasia
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)

43. What primary acid - base disturbance is caused by a gain in fixed acid forcing the reaction to shift to the left - decreasing HCO3- and slightly increasing CO2?
Pancreatic delta - cell tumors inhibit CCK secretion
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
Osteitis fibrosa cystica (von Recklinghausen disease)
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.

44. Name the correct artery - The left recurrent laryngeal nerve passes around it.
Multiple myeloma
Arch of the aorta
Chlamydia trachomatis
Leptospira

45. What liver tumor is associated with oral contraceptive pill use?
Frontal lobe
Cerebellum
Carbidopa and benserazide
Hepatic adenomas

46. What is the most common one? - Helminth parasitic infection in the United States
Glucocerebrosidase
Enterobius vermicularis
Rapid efflux of potassium
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.

47. What enzyme is deficient in patients with CGD?
CD3
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
Klinefelter syndrome
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.

48. What X- linked recessive disorder is characterized by hyperuricemia - spastic cerebral palsy - mental retardation - and self - mutilation?
Calcarine sulcus
Lesch - Nyhan syndrome
Sideroblastic anemia
Eosin

49. What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
Aldosterone
Klinefelter syndrome
Myeloschisis All except occulta cause elevated - fetoprotein levels.
Ergotamines

50. What paraphilia is defined as x Deriving sexual pleasure from watching others having sex - grooming - or undressing?
The resistance will decrease one - sixteenth of the original resistance.
greater
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.
Voyeurism