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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 backward masking - and is there a positive correlation with schizophrenic patients?
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.
Stage fright (discrete performance anxiety)
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Motor

2. What paraphilia is defined as x Deriving sexual pleasure from other peoples' pain?
Acetazolamide
X- linked recessive
Sadism
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+

3. What seronegative spondyloarthropathy is seen in HLA- B27- positive young females and presents with the triad of conjunctivitis - urethritis - and arthritis affecting the knees and ankles?
Superficial spreading melanoma
C4 (the upper border of the thyroid cartilage)
Tay- Sachs disease
Reiter syndrome

4. Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
Class 1 (1A - 1B - and 1C)
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
Range
Truncus arteriosus

5. What are the most common causes of osteomyelitis x Overall?
alpha - Motor neurons innervate extrafusal muscle fibers (a motor unit) - whereas gamma - motor neurons innervate intrafusal muscle fibers.
Plasma concentration and excretion rate
Staphylococcus aureus
Progestins

6. What syndrome is characterized by dynein arm abnormality resulting in chronic sinusitis - recurrent pulmonary infections - and infertility?

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7. What vitamin deficiency produces homocystinuria and methylmalonic aciduria?
Chordae tendineae
Ventromedial nucleus; lesions here result in obesity.
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
Increased androgen secretion at puberty drives the increased GH secretion.

8. What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia?
Left atrium
Misoprostol
Chloramphenicol
Coxiella burnetii

9. What is the essential reservoir host for Toxoplasma gondii?
The cat
The negative charge inhibits the filtration of protein anions.
HBeAg
Fungi

10. What urinary metabolite is elevated in pheochromocytoma?
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)
almitate
Vanillylmandelic acid (VMA)
Metaproterenol and albuterol

11. What is used as an index of the number of functioning carriers for a substance in active reabsorption in the kidney?
Preganglionic sympathetic neurons
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
naked viruses

12. Where is the most frequent site of ectopic pregnancy?
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
TAT (Thematic apperception test)
Riboflavin (B2) deficiency
Ampulla of the fallopian tube

13. Which form of melanoma carries the best prognosis?
ASD
Lentigo maligna melanoma
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Sphingosine

14. In reference to membrane potential (Em) and equilibrium potential (Ex) - which way do ions diffuse?
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Crohn disease
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)

15. What disorder - experienced more than half of the time for a 6- month period - is described as being fearful - worrisome - or impatient and having sleep disturbances - poor concentration - hyperactivity - and an overall sense of autonomic hyperactivi
Breast
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)
Odds ratio. (Case control studies deal with prevalence.)
Generalized anxiety disorder

16. From What aortic arch are the following structures derived?
Granulosa cell
Right and left pulmonary arteries and the ductus arteriosus
Flumazenil
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)

17. What is the term for the point on a scale that divides the population into two equal parts?
Peyer's patch
Median (think of it as the halfway point)
Toxic dose for 50% of drug takers (median toxic dose)
Resistance decreases as resistors are added in parallel.

18. What water - soluble - vitamin deficiency is associated with neural tube defects in the fetus?
Atropine with pralidoxime
Gerstmann's syndrome; spoken language is usually understood.
Folic acid
CN V3 and the lesser petrosal nerve

19. How many ATPs per glucose are produced by pyruvate dehydrogenase?
Pasteurella multocida
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)
NE
Parietal cells (Remember - they secrete HCl - too.)

20. The left subclavian artery is a branch of What artery?
T3
The left is a branch of the aortic arch - while the right is a branch of the brachiocephalic trunk.
Phosphorylation of mannose residues
Hypoglycemia for secretion and hyperglycemia for inhibition

21. Of what serotonin receptor is sumatriptan an agonist?
5HT1D
Bacillus anthracis
Uroporphyrinogen III cosynthase
Phase 3

22. What is the DOC for esophageal candidiasis?
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
Serotonin
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly
Fluconazole

23. What is the name of the superficial subcutaneous fascia of the abdomen containing fat?

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24. In regard to motor development during infancy - choose the motor response that happens first - Release or grasp
Job syndrome
Grasp proceeds release
Adenocarcinoma
Orbitomedial frontal lobe

25. Which class of diuretics is used to treat metabolic acidosis - acute mountain sicknesses - and glaucoma and to aid in the elimination of acidic drug overdoses?
Voltage - gated calcium channel
Bordetella pertussis
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Ulcerative colitis

26. What cell type is found in the peripheral white pulp of the spleen?
Ganciclovir
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.
Myasthenia gravis
embranoproliferative glomerulonephritis (MPGN)

27. Is GH considered a gluconeogenic hormone?
Posterior
CD4
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
Yes - it decreases fat and muscle uptake of glucose - thereby increasing blood glucose levels.

28. Which cerebral herniation results in compression of the anterior cerebral artery?
Cingulate gyrus herniation (subfalcine)
RNA polymerase II
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
GnRH constant infusion

29. Name the most common type or cause - Acute metal poisoning in the United States
Fibrocystic change of the breast
Arsenic
Negative
GERD

30. Fracture of the fibular neck - resulting in foot drop - is an injury of what nerve?
Common peroneal nerve
Reinforcement
Syringomyelia
Fibrocystic change of the breast

31. How do the corticobulbar fibres of CN VII differ from the rest of the CNs?
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
Alcoholics Anonymous
Removal of the ileum
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.

32. What cell type of the epidermis functions as antigen - presenting cells?
Langerhans cells (found in the stratum spinosum)
One - way ANOVA
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
TXA2

33. What is the name of the protein coat that surrounds the nuclear envelope?
Filtration is greater than excretion for net reabsorption to occur.
Vimentin
Merkel cells (Merkel's tactile cells)
AML- M3

34. What type of circuit is described when the total resistance is always greater than the sums of the individual resistors?
From age 5 onward IQ stabilizes.
Haemophilus influenzae type B
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
Series circuit

35. Name the area of the cerebral cortex with the function described: x Recall of objects - distances - and scenes; visual input processed here
Occipital lobe
CN III
Confidence interval. It is a way of admitting estimation for the population.
Posterior compartment of the leg - tibial nerve

36. What CN is associated with the x Fifth pharyngeal arch?
Malpighian layer (made up of the stratum basale and stratum spinosum)
None; it degenerates.
RNA polymerase III
Streptococcus pyogenes

37. A 20-year - old woman goes to the ER with ptosis - diplopia - weakness in her jaw muscles when chewing - and muscle weakness with repeated use. What is your diagnosis?
Thiazide diuretics
Myasthenia gravis
Histiocytes
1. Sweat glands 2. Arterioles 3. Veins

38. What type of GN - associated with celiac disease and dermatitis herpetiformis - has mesangial deposits of IgA - C3 - properdin - IgG - and IgM?
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Stages 3 and 4 (NREM)
Berger disease (IgA nephropathy)
Fetal alcohol syndrome

39. What vitamin deficiency can result in high - output cardiac failure?
Thiamine
Spermatid
Chronic end - stage renal disease
Alanine cycle

40. What bactericidal agents are resistant to Beta- lactamases and are used to treat in - hospital life - threatening infections?
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Folic acid deficiency
Phenylephrine
Imipenem and meropenem

41. What area of the female reproductive tract is lined by stratified squamous epithelium rich in |glycogen?
Lymphoblastic lymphoma
Shortens
urease positive
The vagina

42. Name the antidote - Heparin
M12 strains
Protamine sulfate
a - Methyldopa (Guanabenz or clonidine is also used.)
Nominal scale (categorical - e.g. - male or female)

43. How many high - energy bonds are used to activate an AA?
2 ATPs - via the amino acyl tRNA synthase enzyme
Relative refractory period
Vibrio parahaemolyticus
Kidney

44. What are the four characteristics of all protein - mediated transportation?
Interferons
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero - order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than i

45. What is the signal to open the voltage - gated transmembrane sodium channels?
Direct pathway; a good example is Parkinson's disease.
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
GnRH
Yolk sac tumor

46. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Pancreas
Stable
Squamous cell carcinoma
Axis V
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)

47. What do LMNs innervate?
Axis IV
Gonads
Lipoprotein lipase
They innervate skeletal muscle.

48. What judgment states that the decision - by rights of autonomy and privacy - belongs to the patient - but if the patient is incompetent to decide - the medical decision is based on subjective wishes?
Substituted judgment. It is made by the person who best knows the patient - not the closest relative.
Internal carotid artery and sympathetic plexus
Multiple sclerosis
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.

49. What component of the pelvic diaphragm forms the rectal sling (muscle of continence)?
Yohimbine
CN II and ophthalmic artery
Puborectalis
M

50. What vessels carry deoxygenated blood into the lungs from the right ventricle?
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood
IgM
Glutamine and aspartate