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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 is the only Ig that crosses the placenta?
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet
Chromosome 14 - 18
IgG
Pulse pressure

2. Which form of emphysema is associated with an alpha1- antitrypsin deficiency?
Calicivirus
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
Dissociative fugue. (Patients are unaware of memory loss.)
Panacinar

3. What disease is seen in children younger than 5 years of age and is characterized by X- linked recessive cardiac myopathies - calf pseudohypertrophy - lordosis - protuberant belly - an increase then a decrease in CPK - and death commonly in the secon
Sporozoites
Rhombencephalon
Duchenne muscular dystrophy
Dominant parietal lobe (Gerstmann's syndrome)

4. Name the associated chromosome - Cystic fibrosis
CN XI and X
HMG CoA reductase
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
Chromosome 7

5. Is there more circulating T3 or T4 in plasma?
Melanin
Repaglinide
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
Calcium oxylate

6. What is the term to describe how easily a vessel stretches?
hCG
Compliance (think of it as distensibility)
Ulcerative colitis
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion

7. How far below ideal body weight are patients with anorexia nervosa?
At least 15%
NADPH - O2 - and cytochrome b5
Glucose -6- phosphatase
Pyridoxine (B6)

8. Do the following structures pick up stain from hematoxylin or eosin? - Nucleoli
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Hematoxylin
Entamoeba histolytica
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.

9. What is it called when levels of sex steroids increase - LH increases - and FSH increases?
Ticlopidine or clopidogrel
Outside the cell
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
GnRH pulsatile infusion

10. Name the aphasia based on these characteristics: x Both Broca's and Wernicke's areas damaged by lesion in the presylvian speech area; trouble repeating statements; poor comprehension with telegraphic speech
Global aphasia
Thyroid hormones are necessary for conversion of carotene to vitamin A.
PTH
Amiloride

11. Being college educated increases a man's risk of having...
Hydroxyapatite
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
Absolutely not! Answer any question you are asked.
premature ejaculation

12. Which muscles of the eye are under parasympathetic control?
Medial nuclear group (limbic system)
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Constrictor pupillae and ciliary muscles
The basilar artery is formed at the pontomedullary junction.

13. What are the two side effects of opioids to which the user will not develop tolerance?
Pneumothorax
Sarcoidosis
Constipation and miosis
Afferent arteriole

14. Which three factors cause the release of epinephrine from the adrenal medulla?
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
AT II
after abortion
Crohn disease

15. What area of the brain is responsible for emotion - feeding - mating - attention - and memory?
The limbic system
Functional residual capacity (FRC)
Diazepam is longest acting and midazolam is shortest acting.
Acute pyelonephritis

16. What form of arthritis is associated with calcium pyrophosphate crystals?
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
Pseudogout
Prostatic carcinoma
Anterior wall of the first part of the duodenum

17. What is the most common organ involved in amyloidosis?
Staphylococcus aureus
Effective dose for 50% of drug takers (median effective dose)
Kidney
eEF-1

18. Patients with ___________ have no Barr bodies.
Turner syndrome
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
C1 - C2 - or C4 deficiency
Surface tension; in the alveoli - it is a force that acts to collapse the lung.

19. Where are the enzymes for the ETC and oxidative phosphorylation found?
Amiloride
Sigmoid colon
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
The inner membrane of the mitochondria (cristae)

20. In a negatively skewed curve is the mean greater than the mode?
Areas 5 and 7
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Pulmonary embolism due to a DVT; this is not absolute but a classic description.

21. Is not found in smooth muscle - liver - and the kidneys.
Spironolactone
Catechol - O- methyl transferase (COMT)
Pedophilia
Areas 41 and 42

22. What is the most common one? - Benign tumor of the ovary
Serocystadenoma
Minocycline
Anterior wall of the first part of the duodenum
Positive

23. What vascular injury may result from a supracondylar fracture of the femur?
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
Molluscum contagiosum
Bactericidal

24. What type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea?
Achondroplasia
Hgb F
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
Allograft

25. What small gram - negative aerobic rod requires Regan - Lowe or Bordet - Gengou medium for growth?
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12
Spironolactone
Circumvallate papillae
Bordetella pertussis

26. What specifies how accurately the sample values and the true values of the population lie within a given range?
Tibial nerve
Confidence interval. It is a way of admitting estimation for the population.
Filovirus
Gardnerella vaginalis

27. What three complement fragments are also anaphylatoxins?
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.
Posterior
ELISA test
C3a - C4a - and C5a

28. If a peripheral blood smear shows schistocytes - reticulocytes - and thrombocytopenia - is it more commonly seen in patients with ITP or TTP?
Ordinal scale (e.g. - faster/slower - taller/shorter)
Cerebellum
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
Vitelline fistula

29. Anatomical and alveolar dead spaces together constitute what space?
Atropine with pralidoxime
Physiologic dead space is the total dead space of the respiratory system.
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Type IV collagen

30. What complement factor or factors are associated with x Membrane attack complex (MAC)?
C5- C9
Sexual aversion disorder
Dihydrofolate reductase
Alternative hypothesis (What is left after the null has been defined)

31. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Withdrawn - fearful - explosive moods - violent outbursts - and loss of inhibitions
Bitemporal heteronymous hemianopsia
Orbitomedial frontal lobe
Choriocarcinoma
Vesicular stomatitis virus

32. What segments of the lumbosacral plexus form the following nerves? - Obturator nerve
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Muscles of the internal eye
Swan - neck deformities
LTB4

33. What hormones - secreted in proportion to the size of the placenta - are an index of fetal well - being?
IgG
hCS and serum estriol - which are produced by the fetal liver and placenta - respectively - are used as estimates of fetal well - being.
The conversion of CHO to pregnenolone via the enzyme desmolase
Vitamin A is responsible for vision and epithelial health.

34. What enzyme is deficient in chronic granulomatous disease of childhood?
Inferior phrenic artery
NADPH oxidase
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
Gametocytes

35. What is the term for days 15 to 28 in the female cycle?
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
Luteal phase
Lateral compartment of the leg - superficial peroneal nerve
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)

36. What classical conditioning therapy or modification is described as x Triage of a hierarchy of fears (from least to most) - then teaching muscle relaxation techniques in the presence of those fears until the subject is not afraid anymore?
Systematic desensitization
Protamine sulfate
CN IX - X - and XII CN XI arises from the cervical spinal cord.
Libman - Sacks endocarditis

37. Which acid - fast rod is an obligate intracellular parasite?
Chief cells
Mycobacterium leprae
Leydig cell tumor
Basal ganglia

38. Bloody tap on lumbar puncture
Subarachnoid hemorrhage
Intellectualization
RBCs
Emphysema

39. Are white rami preganglionic or postganglionic fibers?
CD15 and CD30
More Ab is produced in less time in a secondary immune response (shorter lag period).
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.

40. Place in order from fastest to slowest the rate of gastric emptying for CHO - fat - liquids - and proteins.
Inferior phrenic artery
Log - kill hypothesis (follows first order kinetics)
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.
Liquids - CHO - protein - fat

41. A single mRNA strand translated by a ribosome is termed what?

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42. Name the most common one - Chromosomal disorder involving sex chromosomes
Bile pigments and bile salts
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
1 day prior to ovulation
Klinefelter syndrome

43. Name the reaction that appears in babies who are temporarily deprived of their usual caretaker. (This reaction usually begins around 6 months of age - peaks around 8 months - and decreases at 12 months.)
Separation anxiety
Right vagus innervates the SA node and the left vagus innervates the AV node
Inferior rectus (CN III) (LR6 SO4)3
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.

44. What is the name for inability to stop a movement at the intended target?
Dysmetria; this is seen in a finger - to - nose test.
HPV serotypes 1 and 4
Ulnar nerve
Schizoid

45. What lymphoma is characterized by CD19 - CD20 - CD5; CD23- negative; and chromosome 11;14 translocations?
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
Mantle cell lymphoma
PCR
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)

46. What syndrome is associated with the following brainstem lesions? - Vertebral artery or anterior spinal artery occlusion - resulting in contralateral corticospinal tract and medial lemniscus tract deficits and an ipsilateral CN XII lesion
IgA nephropathy
Methylation of bacterial DNA
Medial medullary syndrome
Clearance

47. What is the name of the postganglionic parasympathetic ganglion that innervates x The lacrimal gland and oral and nasal mucosa?
antiemetic
Pterygopalatine ganglion (I remember this as the only ganglion left.)
The fast component is directed toward the affected side of a cerebellar lesion.
Epidural hematoma

48. What disorder is due to a 5-- reductase deficiency - resulting in testicular tissue and stunted male external genitalia?
Phase 1
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
Hydroxyproline (breakdown product of collagen)
Hydrolysis

49. What three bases are pyrimidines?
1. Cytosine 2. Uracil (only in RNA) 3. Thymidine
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
CD15 and CD30
Acetoacetate - acetone - and Beta- hydroxybutyrate

50. What enzyme catalyzes the rate - limiting step of the urea cycle?
Folic acid
Carbamoyl phosphate synthetase I
Krukenberg tumor
Posterior cricoarytenoid muscles