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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. Which two negative sense RNA viruses have neuraminidase enzymes?
Penicillin V
Mumps and influenza virus
Early collecting duct
Alcoholic cirrhosis

2. By What age should children be able to draw the following figures? - Diamond
Hematogenous
7 years old
Phosphofructokinase -1 and costs 1 ATP
Type II hypersensitivity (cytotoxic)

3. What agent - in combination with a MAOI inhibitor - can cause hypertensive crisis?
Chronic end - stage renal disease
No CHO - AA - ketones - or peptides are left in the tubular lumen.
Hashimoto thyroiditis
Tyramine

4. Which sodium channel blocker is used to treat lithium - induced diabetes insipidus?
Decreases
Propranolol
Integument (skin and its derivatives)
Amiloride

5. Regarding neuroleptics - What is the relationship between potency and anticholinergic side effects?
Polyarteritis nodosa
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
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.
Adrenal medulla

6. What virus lies dormant in the x Dorsal root ganglia?
Varicella
Goodpasture syndrome
Metaphase of meiosis II (in the oocyte of the graafian follicle)
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.

7. What do the following values indicate? - ED50
Effective dose for 50% of drug takers (median effective dose)
Ethyl alcohol
Hormone - sensitive lipase
Chloral hydrate

8. What is the direction of growth for the primitive streak - caudal to rostral or rostral to caudal?
The primitive streak grows caudal to rostral.
Myasthenia gravis
Cortisol - a 21- carbon steroid - has a - OH group at position 17.
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.

9. Name the antidote - AChE inhibitors
MGB (think EARS)
Labetalol
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
Atropine with pralidoxime

10. Is the bound form or free form of a lipid - soluble hormone responsible for the negative feedback activity?
Staphylococcus aureus
Cilia
Free form determines hormone activity and is responsible for the negative feedback loop.
Hydatidiform mole

11. What enzyme system is the most common form of phase II biotransformation?
Bulbus cordis
Erythema multiforme
Glucuronidation
Right ventricle

12. What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?
Crude mortality rate
Translation
Excision endonuclease - which removes thiamine dimers from DNA
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.

13. What is the order of attachment of O2 to Hgb - binding sites in the lung? Order of release from the binding sites in the tissue?
FSH and testosterone
Aortic insufficiency
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
White muscle; short term too

14. What is the leading cause of school dropout?
Pregnancy
>15 mm
Yes. The only civil liberty they lose is the freedom to come and go as they please.
Ependymoma

15. What is the term for the negative resting membrane potential becoming more negative?
Hyperpolarization (i.e. - K+ influx)
Dependent
RSV
Tyrosine

16. What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
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.
RSV
Primary erectile disorder

17. What is the only enzyme in the body that uses N-5- methyl folate?
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
C5b - C9
Compliance; the more compliant a lung is - the easier it is to inflate.
Homocysteine methyl transferase

18. What two Ags must be positive for a patient to have chronic active hepatitis?
Edward syndrome (trisomy 18)
HBsAg and HBeAg
Glucuronidation
Positive correlation

19. What is the only 17- hydroxysteroid with hormonal activity?
Confidence interval. It is a way of admitting estimation for the population.
Cortisol - a 21- carbon steroid - has a - OH group at position 17.
Intraductal papilloma
IgA

20. What cell type of the epidermis originates from the neural crest?
Melanocytes
PTH
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.
Yes. It increases the rate of suicide to nearly 50 times that of the general population.

21. What is the size of a positive PPD test for the following? (Reactive) x Patient with AIDS
Superego
Internal carotid artery
Schistosoma haematobium
>5 mm

22. From what pharyngeal pouch is the following structure derived? - Palatine tonsil
Variable ratio If it is based on time - it is an interval - and if it is based on the number of responses - it is a ratio.
Second M PITS for pharyngeal pouch derivatives
Crigler - Najjar syndrome
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.

23. Name the three hormones produced by pinealocytes.
reflexes
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
Melatonin - serotonin - and CCK

24. What CNS developmental abnormality is associated with 90% of syringomyelia?
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
Arnold - Chiari malformation type 2
hCG can be detected in the blood by day 8 and in the urine by day 10.
HHV 6

25. What is the first Ab a baby makes?
HBsAg (incubation period)
P = .05; P < .05 rejects the null hypothesis
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
IgM

26. What CN is associated with the x First pharyngeal arch?
Appendix (second is terminal ileum)
Hyperkalemia
CN V
GABA - quantitatively

27. Neurons in the dorsal horn participate in...
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed - thereby increasing the secretion of prolactin.
1. Cefamandole 2. Cefoperazone 3. Moxalactam
Hyperkalemia
reflexes

28. Name these immature defense mechanisms: x Psychic feelings converted to physical symptoms
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Somatization
C3 deficiency
Gynecomastia

29. The vertebral artery is a branch of What artery?
produce bile
The subclavian artery
Enterobius vermicularis; the treatment is albendazole.
HHV 6

30. What is the only laryngeal muscle innervated by the external laryngeal nerve?
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Sheehan syndrome
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)

31. Increased urinary excretion of what substance is used to detect excess bone demineralization?
ydroxyproline
First - order elimination
Nephrotoxicity
Internal 3' - 5' PDE bonds

32. Which extravascular chemoreceptor detects low NaCl concentrations?
Macula densa
60%
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.
Affinity decreases; they are inversely proportional.

33. What are the five K
cDNA - when it is made from mRNA
Microvillus
Cystic fibrosis
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.

34. Which tetracycline is used in the treatment of SIADH?
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Graves disease
Demeclocycline
Between the renal arteries and at the bifurcation of the abdominal aorta

35. Name the MCC - Pneumonia in adults
BPH
Streptococcus pneumoniae
Kimmelstiel - Wilson disease
Endometriosis

36. What is the term for squamous to columnar metaplasia of the distal esophagus secondary to chronic inflammation?
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
DiGeorge syndrome
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
Clostridium botulinum

37. What type of potential is characterized as graded - decremental - and exhibiting summation?
Subthreshold potential
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
C1 esterase inhibitor (C1INH)
3 years old

38. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x PSA and prostatic acid phosphatase
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
Prostate cancer
Negative
Turcot syndrome

39. What type of symptoms in schizophrenia are associated with x Dopamine receptors?
Four high energy bonds - two from ATP in AA activation and two from GTP
Oblique fissure
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Palms - up before palms - down maneuvers

40. What enzyme of purine synthesis is inhibited by allopurinol and 6- mercaptopurine?
Common peroneal nerve
PRPP aminotransferase
Adenosine deaminase (ADA) deficiency
No change in length

41. How much of a vessel must be stenosed to cause sudden cardiac death?
Homocysteine methyl transferase
transcription
More than 75% of the vessel
Depression

42. Name the following descriptions associated with bacterial endocarditis: x Painful subcutaneous nodules on fingers and toes
Phase 4
Dystrophic calcification
Osler nodes
Alanine cycle

43. Influx of what ion is associated with irreversible cell injury?
Aspartic acid and glutamic acid
Eosin
Massive influx of calcium
Fragile X syndrome

44. Name three products of HIV's pol gene.
Pseudomonas aeruginosa
Constrictor pupillae and ciliary muscles
Protease - integrase - and reverse transcriptase
Total ventilation (minute ventilation or minute volume)

45. What facultative gram - negative anaerobic rod is motile - ferments lactose - and is the MCC of UTIs?
Gastrinoma
Escherichia coli
No. It is abnormal only if it interferes with normal sexual or occupational function.
Pterygopalatine ganglion (I remember this as the only ganglion left.)

46. What triggers phase 0 of the action potential in a ventricular pacemaker cell?
Fat necrosis
An elevated serum osteocalcin level
Hepatitis A (infectious)
Calcium influx secondary to slow channel opening

47. Name the phase of the eukaryotic cell cycle: x Cells cease replicating (i.e. - nerve cell)
Since they are independent events - their probabilities would be multiplied.
absorption
G0 phase
Osler nodes

48. Will a unilateral lesion in the spinothalamic tract result in a contralateral or ipsilateral loss of pain and temperature?
Turcot syndrome
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.
Superior
Dapsone

49. What is the most common one? - Primary malignant tumor of the female genital tract in the United States
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
HHV-8
Serratus anterior
Adenocarcinoma of the cervix

50. Which direct - acting vasodilator is associated with SLE- like syndrome in slow acetylators?
Area 17
Fibrous pericardium
Staphylococcus aureus (but they are more prone to salmonella infections)
Hydralazine

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