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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. The probability that a person with a negative test result is truly disease free refers to what value?
Negative predictive value
Orotic acid (purine metabolism)
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.
Thioridazine

2. What is the most common one? - Renal pathology in patients with SLE
DNA polymerase -?
HGPRT
Acarbose
Diffuse proliferative GN

3. What cell transports IgA - is secreted by plasma cells - and is in Peyer's patches to the gastrointestinal lumen?
M- cells
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
RNA polymerase III
Menstruation

4. Name the type of necrosis - Seen as dead tissue with coagulative necrosis
Fungiform papillae
Gangrenous necrosis
Cancer
Glucagon and epinephrine

5. What syndrome arises from mutation in the fibrillin gene (FBN1) on chromosome 15q21?
It forms a germinal tube at 37
Broca's aphasia
Areas 1 - 2 - and 3
Marfan syndrome

6. What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin?
Meiosis I; disjunction with centromere splitting occurs during meiosis II.
Griseofulvin
Berger disease (IgA nephropathy)
HBeAg

7. What disease is produced by a deficiency in the enzyme tyrosinase?
Medial nuclear group (limbic system)
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
Leiomyoma
Hypotonic - because NaCl is reabsorbed in the salivary ducts

8. Can an acute MI be diagnosed only by looking at an ECG?
Clearance
The JG cells
Physostigmine
No. Remember - tests do not diagnose - they confirm or refute your diagnosis. Also - diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI - elevated cardiac enzymes consistent with MI - and ST segment elevati

9. What is the term for the unidirectional attraction of cells toward a chemical mediator released during inflammation?
Ketoconazole
Chemotaxis
Rotavirus
Pheochromocytoma

10. Name the associated chromosome - Albinism
Chromosome 11p
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
Rhinoviruses for summer and fall; coronaviruses for winter and spring
Alveolar dead space

11. What class of drugs are the DOCs for peptic ulcer disease - Zollinger - Ellison syndrome - and gastroesophageal reflux disease?
Proton pump inhibitors
Cytochrome b/c1
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
Anticipation - associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.

12. What disorder of bone remodeling results in thick - weak bones and is associated with high - output cardiac failure?
G2 phase
Bladder carcinoma
Paget disease (osteitis deformans)
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)

13. Are associated with poststreptococcal GN.
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
Hematoxylin
Elevated ASO titers and serum complement levels
HMG CoA synthase

14. What is the most common one? - Intramedullary spinal cord tumor in adults
Alternative hypothesis (What is left after the null has been defined)
Tamoxifen
Ependymoma
Marfan syndrome

15. Name these immature defense mechanisms: x Taking others' beliefs - thoughts - and external stimuli and making them part of the self. (Hint: if it's done consciously - it is called imitation.)
1 day prior to ovulation
Introjection (a sports fan is a good example)
Zileuton
Lysosomal a -1 - 4- glucosidase

16. Why is there an increase in FF if the GFR is decreased under sympathetic stimulation?
Ewing's sarcoma
Hypotonic - because NaCl is reabsorbed in the salivary ducts
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Increase the concentration of enzymes

17. What eukaryotic translation enzyme is associated with the following: x Initiation
Melanin
CN XII
eIF-2 in the P site
>10 mm

18. What protein allows Mycoplasma to attach to the respiratory epithelium?
P1 protein
Pancreatic insufficiency
Stable angina
Proencephalon diencephalon derivative

19. What projective test asks the patient to tell a story about What is going on in the pictures - evaluating the conflicts - drives - and emotions of the individual?
Utricle and saccule
CD28
TAT (Thematic apperception test)
LVEDV and LVEDP (left ventricular end - diastolic volume and end - diastolic pressure - respectively)

20. What are the three characteristics of ADHD?
Previous suicide attempt
Metanephros
1. Short attention span 2. Impulsivity 3. Hyperactivity
1. Sartorius 2. Gracilis 3. Semitendinous

21. What somatoform disorder is described as x La belle indiff
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Priapism
Ungated channels
Conversion disorder

22. In the alveoli - what cell type is x responsible for producing surfactant?
Type II pneumocytes
Dilation of afferent arteriole
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)
Hirschsprung disease (aganglionic megacolon)

23. What abdominal muscle runs horizontally - contributes to the posterior rectus sheath - and contributes to form the conjoint tendon?
Ulnar to radial progression
Transverse abdominis
Factitious disorder
Lac repressor protein

24. What is the most common complement deficiency?
Dihydrofolate reductase
Aminophylline
C2 deficiency
Transketolase and transaldolase. The reactions they catalyze are reversible.

25. Name the cluster C personality disorder: x Gets others to assume responsibility - is subordinate - and is fearful of being alone and caring for self
Dependent
Primary hyperparathyroidism
Fourth M PITS for pharyngeal pouch derivatives
Frameshift

26. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ decreased - Pi decreased
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
Adhesions and hernias
Between the renal arteries and at the bifurcation of the abdominal aorta
Negative predictive value

27. What is the amount in liters and percent body weight for the following compartments? - ICF
Intermediate part of the hemispheres
Semicircular duct
28 L - 40% of body weight
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.

28. What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Thoracic splanchnic fibers
Zileuton
Middle
Cleft lip

29. What term describes the reflex that increases the curvature of the lens - allowing near vision?
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.
Pseudogout
Cytochrome a/a3
Accommodation

30. What are the three main components of amyloid?
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
Chromosome 8 - 14
Rhabdovirus
Rickets

31. What two bacteria are associated with drinking unpasteurized milk?
Glycerol kinase
Aminophylline
Pseudomonas
Brucella and Listeria (has tumbling motility)

32. What bone houses the ulnar groove?
Humerus (between the medial epicondyle and the trochlea)
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
RNA polymerase II
Jejunum (upper)

33. The opening of what valve indicates the termination of isovolumetric relaxation phase of the cardiac cycle?
Ciliary ganglion producing a tonic pupil
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
C3a - C4a - C5a
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.

34. What is the only antifungal agent to penetrate CSF?
Fluconazole
Huntington disease
CD28
Aedes (the same for yellow fever)

35. Which class of antiarrhythmics are calcium channel blockers?
Class IV
Hydatidiform mole
Pneumococcus (Streptococcus pneumoniae)
Muscle spindles

36. What three lung measurements must be calculated because they cannot be measured by simple spirometry?
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
HIV and poxvirus
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.

37. Has no underlying pathology.

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38. What is the most important determinant of drug potency?
Edward syndrome (trisomy 18)
Nitrates
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
The affinity of the drug for its receptor

39. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Nitrosamines
Gastric cancer
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.

40. Name the lung measurement based on the following descriptions: x Amount of air in the lungs after maximal expiration
Residual volume (RV)
Menstruation
Scleroderma
Anaerobes

41. What is the most common form of elderly abuse?
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
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%.
Physostigmine
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.

42. What cell surface marker do all T cells have?
Skeletal muscle
Squamous cell carcinoma
>5 mm
CD3

43. What type of scheduled reinforcement states that after a desired response - the reinforcement is given x Varying in time?
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
Campylobacter jejuni
Eosinophil
Variable interval

44. What do the risk factors late menopause - early menarche - obesity - nulliparity - excessive estrogen - genetic factor p53 - and brc - abl characterize?
Macula densa
Gastric cancer
Breast cancer
Hepatitis B

45. Name the ocular lesion; be specific - Left optic nerve lesion
Without children (but don't think about this one for too long)
Left eye anopsia (left nasal and temporal hemianopsia)
Prolyl and lysyl hydroxylases
Agglutination test

46. What happens to the following during skeletal muscle contraction? - H zone
Arch of the aorta and right subclavian artery
CN VII and VIII
Bronchogenic carcinoma
Shortens

47. What condition results in the following CSF results? - Opening pressure 70 to 180 mm H2O; 0-10 WBCs (monocytes); glucose 45 to 85 - protein 15 to 45
Urogenital sinus
Normal values
QRS complex
Pygmalion effect (experimenter expectancy). This can be eliminated with double - blind studies.

48. What AR disorder of copper metabolism can be characterized by Kayser - Fleischer rings - decreased ceruloplasmin levels - and increased urinary copper excretion and tissue copper levels?
Type IV collagen
Autosomal recessive
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
No. Prions are infectious proteins - so antibiotics are useless.

49. What autoimmune liver disease is characterized by affecting a middle - aged woman with jaundice - pruritus - fatigue - xanthomas - increased direct bilirubin levels - and antimitochondrial Abs?
IDL
Strongyloides stercoralis is treated with thiabendazole.
Primary biliary cirrhosis
Parietal cells (Remember - they secrete HCl - too.)

50. How many bronchopulmonary segments are on the right lung? Left lung?
Type II hypersensitivity (cytotoxic)
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
There are 10 bronchopulmonary segments on the right and 8 on the left.
Parvovirus