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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 estrogen - producing tumor of the female genital tract is characterized by Call - Exner bodies?
Ulnar to radial progression
Granulosa cell tumor of the ovary
Fibrous pericardium
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

2. Why is the cell's resting membrane potential negative?
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
Streptococcus viridans
Thiabendazole
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.

3. Which cestode infection results in alveolar hydatid cyst disease?
Unipolar disorder (major depression)
Inferior phrenic artery
Echinococcus multilocularis
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.

4. Which acid - fast rod is an obligate intracellular parasite?
Methionine (start) and tryptophan are the only two AAs with only one codon.
Paramesonephric ducts
Mycobacterium leprae
Dihydrofolate reductase

5. What is the MCC of the following meningitides? - In adults
CSF
Streptococcus pneumoniae
0.2
Stable

6. Is the Salk polio vaccine inactivated?
Uric acid
Yes
Left atrium
IgE

7. Name the most common cause - Blindness in the United States
Galactose and glucose
Diabetes mellitus
Bronchioloalveolar carcinoma
Capillaries

8. What is the tetrad of tetralogy of Fallot?
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Hydatidiform mole
Chondroitin sulfate and keratan sulfate
Increased leukocyte alkaline phosphatase (LAP)

9. What two drugs block dopa - decarboxylase in the periphery to decrease the conversion of L- dopa to dopamine?
Test - retest reliability
Nitrates
Carbidopa and benserazide
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle

10. What is the term for flattened nose - low - set ears - and recessed chin seen in patients with bilateral renal agenesis?
Potter facies
Fluconazole
Hydrolysis
Nodular melanoma

11. What DNA virus is associated with exanthem subitum (roseola)?
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.
HHV 6
Potter facies
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.

12. What component of the cardiovascular system has the largest blood volume? Second largest blood volume?
Acetyl CoA carboxylase
The systemic veins have the largest blood volume - and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.
Pneumocystis carinii
Huntington's chorea. (Death in 15-20 years - often via suicide.)

13. What major side effect of neuroleptics is characterized by pill rolling - shuffling gait - and tremors that abate during sleep?
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
Selection bias
Temporal lobe
Streptococcus pneumoniae

14. What is the drug of choice for treating a patient with hyperuricemia due to overproduction of uric acid?
Regression
Invasive ductal carcinoma
Allopurinol
Ristocetin

15. Oxidation of Hgb forms what bodies in patients with G-6- PD deficiency?
Nissl substances; there is a great deal of RER in neuron cell bodies - indicating high protein synthesis.
Heinz bodies
Gynecomastia
Pregnancy

16. What is the epithelial lining of the prostatic portion of the urethra?
Hypercortisolism (Cushing syndrome)
Riboflavin (B2) deficiency
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.
Shortens

17. How is velocity related to the total cross - sectional area of a blood vessel?
IL-4 - IL-10 - and IL-13
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
Velocity is inversely related to cross - sectional area.
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts

18. What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels?
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Propranolol
Median (think of it as the halfway point)

19. Russell bodies
Nodular sclerosis
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
Multiple myeloma
Integrase

20. How is sleep affected in a person with alcohol intoxication?
Phase 1
Mercury
Uracil
Decreased REM sleep and REM rebound during withdrawal

21. Name the most common type or cause - Infantile bacterial diarrhea
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
Caisson disease
Paranoid schizophrenia
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)

22. What are the primary neurotransmitters at the following sites? - Autonomic preganglionic neurons
Cryptococcus neoformans
ACh
Calcarine sulcus
Uracil

23. What is the direction of growth for the primitive streak - caudal to rostral or rostral to caudal?
Inhibin - m
The primitive streak grows caudal to rostral.
The energy of activation
Size

24. Name the Plasmodium species based on the following information:Persistent hypnozoite liver stage with relapses; blood smear shows amoeboid trophozoites with oval - jagged infected RBCs; 48- hour fever spike pattern
Left ventricle and auricle of left atrium
C3a - C4a - C5a
Plasmodium ovale
Since they are independent events - their probabilities would be multiplied.

25. What are the three posttranscriptional modifications?

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26. Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?
Ischemia
Chloramphenicol
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.
Squamous cell carcinoma

27. An 80-year - old woman presents to you with right - sided temporal headache - facial pain and blurred vision on the affected side - and an elevated ESR. Your diagnosis?
Temporal arteritis (giant cell arteritis)
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
Pinpoint pupils - decreased respiratory rate - and coma

28. Has very little effect on arteriolar dilation or constriction.
The parasympathetic nervous system
Breast cancer
Mesonephric duct
Schistosoma have separate males and females.

29. Name the most common type or cause - Lung abscess
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Aspiration
1. VSD 2. ASD 3. PDA

30. In high altitudes - What is the main drive for ventilation?
The vermis
Intellectualization
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.

31. Do the following structures pick up stain from hematoxylin or eosin? - RBCs
Cervical neoplasia
Eosin
IgG
3 to 4 days

32. What is the drug of choice for steroid - induced osteoporosis?
Melanocytes
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
CLL (B- cell origin)
Alendronate

33. What eukaryotic translation enzyme is associated with the following: x Initiation
eIF-2 in the P site
Brucella
Zollinger - Ellison syndrome
IL-7 (A 7 upside down is an L; L is for Lymphoid)

34. Name the components of the femoral canal - working laterally to medially.
Reiter syndrome
Increases
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament
Ventral anterior nucleus

35. In what form is excess folate stored in the body?
N-5- methyl THF
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.
Friedreich ataxia
Neisseria meningitides

36. What are the three major functions of secretory IgA?
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
Low molecular weight heparin (LMWH)
Glucocorticoids and amphetamines

37. What is the most common sexual assault?
Vitamin D
Misoprostol
Pedophilia
HPV serotypes 16 - 18 - 31 - and 33

38. What two ligaments of the uterus are remnants of the gubernaculum?
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Round and ovarian ligaments
Left heart failure
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling

39. What prevents the down - regulation of the receptors on the gonadotrophs of the anterior pituitary gland?
Hematogenous
For males - HTN; for females - pregnancy.
The pulsatile release of GnRH
Shine - Dalgarno sequence

40. What inhibitor of microtubule synthesis is the drug of choice for whipworm and pinworm?
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
Mebendazole
Squamous cell carcinoma of the lung
CD8+ T cells (cytotoxic) Remember - 8

41. The blood stored in the systemic veins and the pulmonary circuit are considered part of the...
The AR form is malignant and AD is benign.
The lateral vestibular nucleus
Cardiac output
Copper deficiency

42. What two pituitary hormones are produced by acidophils?
a -1 - 6 transferase
GH and prolactin are produced by acidophils; all others are by basophils.
Fossa ovale
Dimercaprol - penicillamine

43. What part of a neuron receives information?
No - unsaturated fatty acids have double bonds.
Pseudomonas aeruginosa
Dendrites receive information - whereas axons send information.
Leishmania donovani (kala azar is also known as visceral leishmaniasis)

44. What AA is a phenol?
They are in the grey matter of the CNS.
The outer cortex contains most of the germinal centers and therefore also most B cells.
Tyrosine
CN VII and VIII

45. What Hgb - derived endogenous pigment is found in areas of hemorrhage or bruises?
Suprachiasmatic nucleus
H2PO4- (dihydrogen phosphate)
Ch
Hemosiderin

46. Paranoid and catatonic schizophrenia are good...
Translation
prognostic predictors
Naloxone - naltrexone
Simon focus

47. What are the three tissues where triacylglycerols are produced?
Berger disease (IgA nephropathy)
CD19
1. Liver 2. Muscle 3. Adipose tissue
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation

48. What is the only laryngeal muscle innervated by the external laryngeal nerve?
Distal convoluted tubules
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
During stage 3 and 4 (remember - it is called deep sleep.)
Right vagus innervates the SA node and the left vagus innervates the AV node

49. What structure of the knee is described thus? - C- shaped shock absorber; aids in attachment of the tibia to the femur via the medial collateral ligament
First - pass effect
Medial meniscus
Pseudohyphae
CSF

50. Which PG is associated with maintaining a PDA?
CLL (B- cell origin)
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Amantadine
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)