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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. Are used in combination with estrogens to decrease the risk of endometrial cancer.
Progestins
Western blot
Squamous cell carcinoma
Atropine - 2- PAM (pralidoxime)

2. What syndrome is characterized by the triad of renal tubular acidosis - nephrosis - and amino aciduria?
One - and it provides the energy for mechanical contraction.
Fanconi - like syndrome
Missense
Goodpasture disease

3. What are the four ways to down - regulate the immune system?
Microsporum
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti - Ab
Friedreich ataxia
CN XI and X

4. What test is used to detect anti - RBC Abs seen in hemolytic anemia?
Middle meningeal artery
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
Biotin - ATP - and CO2
Coombs test

5. What is the second leading cause of death in the United States?
Cancer
Superoxide dismutase - glutathione peroxidase - catalase
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
Skin - liver - and kidneys

6. What is the triad of NPH?
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)
V wave
Somatomedins (IGF-1)
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.

7. Who decides competency and sanity?
The courts. These are legal - not medical terms.
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result) - these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease - when obstructive symptoms begin to occur.
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Bcl -2

8. What is the primary screening test used to detect HIV- infected individuals? Confirmatory test?
Clarke's nucleus
Folate - vitamin B12 - and vitamin B6
LGB (think EYES)
ELISA is used as a screening test because it is very sensitive; Western blot is used as a confirmatory test because it detects antibodies (protein) to the HIV virus.

9. Are sexually abused females more likely to have learning disabilities than the general population?
Proton pump inhibitors
Yes - by three to four times. Having multiple sexual partners - being overweight - and pelvic pain and/or inflammatory disorders are also likely to be seen in sexually abused females.
Bronchogenic carcinoma
Zanamivir and oseltamivir

10. What three bacteria are positive to quellung reactive test?
Phase 0
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae
Cytochrome c
Adult T- cell leukemia

11. Cowdry type A bodies
Herpesvirus
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.
hCG can be detected in the blood by day 8 and in the urine by day 10.

12. What peripheral chemoreceptor receives the most blood per gram of weight in the body?
C- peptide levels
Pituitary hypogonadism
The carotid body - which monitors arterial blood directly
Digoxin is renally eliminated; digitoxin is hepatically eliminated.

13. What is the only neuroleptic agent that does not cause hyperprolactinemia?
Clozapine
Glutamate
Beta- Blockers
Ependymal cells

14. What is the DOC for Beta- blocker - induced bronchospasms?
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
Ipratropium
Null hypothesis (what you hope to disprove)
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell

15. Is a marker for increased bone formation.
White muscle; short term too
PGE 1 - PGI 2 (most potent) - and TXA 2
An elevated serum osteocalcin level
Escherichia coli and Pseudomonas sp.

16. What is the most abundant neuron in the cerebellum?
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
Plummer - Vinson syndrome
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
Pulmonary embolism due to a DVT; this is not absolute but a classic description.

17. Name the lipoprotein based on the following characteristics - apo A-1 - apo E - apo C- II
HDL
Erythema marginatum
To provide attachment between contiguous cells and to maintain a semipermeable barrier
Staphylococcus aureus (but they are more prone to salmonella infections)

18. What is the name of the force that develops in the wall of the lungs as they expand?
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
Quinolones
Lead poisoning
Mode

19. What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
Ungated channels
Afferent arteriole
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
Astrocytoma

20. What substance is used to test platelets' response in patients with von Willebrand disease?
Ristocetin
Neuroleptic malignant syndrome is a potentially life - threatening condition Which is treated with symptomatic support - bromocriptine - and dantrolene.
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
refractory sexual periods

21. What muscle laterally rotates the femur to unlock the knee?
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
Radial Immuno Diffusion (RID) for Ig levels.
Popliteus
CD8

22. What is the epithelial lining of the prostatic portion of the urethra?
From age 5 onward IQ stabilizes.
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.
IgG4
M- cells

23. A urethral swab of a patient shows gram - negative diplococci in PMNs; what organism do you diagnose?
Live vaccines
Temporal arteritis
Neisseria gonorrhoeae
Alteplase

24. What foramen must be traversed for entry into the lesser peritoneal sac?
Protamine sulfate
CMV retinitis and HSV-2
For the USMLE Step 1 the answer is no - but if the information would do more harm than good - withhold. This is very rare but it does occur.
Foramen of Winslow

25. Is filtration greater than or less than excretion for net reabsorption to occur?
Libman - Sacks endocarditis
Valence
Choriocarcinomas and trophoblastic tumors
Filtration is greater than excretion for net reabsorption to occur.

26. Is a side effect of cimetidine.
Gynecomastia
Chief cells
Succinyl CoA
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.

27. Acts as the vertebral body of C1 allowing lateral rotation of the head. The first cervical vertebra has no vertebral body.
Chronic end - stage renal disease
The odontoid process of C2
1. Iliocostalis 2. Longissimus 3. Spinalis ('I Love Science' muscles)
Primary biliary cirrhosis

28. What is the term for dilated veins within the spermatic cord?
ELISA screens and Western blot confirms the diagnosis.
Neomycin
Isotonic contraction
Varicocele

29. What direction would the tongue protrude in a left CN XII lesion?
Filtration; if hydrostatic pressure is less than oncotic pressure - reabsorption is promoted.
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).
It increases REM and total sleep time.
RNA polymerase III

30. Name the macrophage based on its location: x Connective tissue macrophages
1. Tinea coli 2. Haustra 3. Epiploic appendages
In the first and second bronchi
Left anterior descending artery
Histiocytes

31. What is the relationship between ventilation and PCO2 levels?
LTC4 and LTD4
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
Duodenal ulcers (4 times as common as gastric)
Ligamentum arteriosum

32. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 and int -2
As sample size increases - the lower the chance of error.
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
G-6- PD
Melanoma - cancer of the stomach and bladder

33. Name the antidote - Heparin
Protamine sulfate
Onion skinning
The aorta has the greatest velocity and the capillaries have the slowest velocity.
All are lactose fermenters except Yersinia and Proteus.

34. Are the following responses associated with histamines H1 or H2 receptor activation? - Bronchial smooth muscle activity
Para - aminohippurate (PAH)
Polycystic ovaries
Plasma concentration and excretion rate
H 1

35. It degenerates 4 to 5 days post fertilization - and implantation occurs __ days post fertilization!
Glioblastoma multiforme
Streptococcus viridans
7
Suprachiasmatic nucleus

36. Is marital satisfaction higher for couples with or without children?

37. At what stage of cognitive development (according to Piaget) do children x See death as irreversible?
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Metastatic
Concrete operations (6-12 years)
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)

38. What is the term to describe a man who has x Used to be able to achieve an erection but now cannot?
Autoimmune hemolytic anemia
Hapten (not immunogenic)
Left eye anopsia (left nasal and temporal hemianopsia)
Secondary erectile disorder (Male erectile disorder is the same as impotence.)

39. To what viral family does the polio virus belong?
At birth (reflex)
Picornaviridae
Chromosome 11p
It increases REM and total sleep time.

40. Which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida?
Native Americans
Carbamazepine
Phallus - urogenital folds - and labioscrotal swellings
Cerebral aqueduct

41. Is bone deposition or resorption due to increased interstitial Ca2+concentrations?
Bronchogenic carcinoma
Primary sclerosing cholangitis
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone - whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
Bone deposition increases with increased Ca2+ or PO 4- concentrations - whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.

42. What two vitamins are inactivated when they come in contact with acetaldehyde?
Psoriasis - ankylosing spondylitis - inflammatory bowel disease - and Reiter's syndrome
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
C5b - C9
Thiamine and folate

43. Name the area of the cerebral cortex with the function described: x Recall of objects - distances - and scenes; visual input processed here
DiGeorge's syndrome
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
Occipital lobe

44. What component of the trigeminal nuclei x Receives sensory input (all but pain and temperature) from the face - scalp - dura - and the oral and nasal cavities?
Spinal trigeminal nucleus
Hot pink with PAS and grey to black with silver stain
CN III
Metronidazole

45. What is the MCC of the following meningitides? - In renal transplant patients
Left ventricle and auricle of left atrium
Melatonin - serotonin - and CCK
Listeria monocytogenes
hypophosphatemia

46. What area of the hypothalamus is the feeding center?
Because the large drop in TPR is accompanied by a large increase in cardiac output - resulting in a minimal change in BP.
G1 phase; G2 and S phase are diploid (2N).
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
Impotence

47. Which antihistamine is one of the DOCs for treatment of vertigo?
Meclizine
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
Standardized rate
Vibrio cholera

48. What is the most important stimulus for the secretion of insulin?
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
TXA2
Puborectalis
An increase in serum glucose levels

49. What assay is used to identify MHC class I molecules?
Type II hypersensitivity (cytotoxic)
Niemann - Pick disease
Non - Hodgkin lymphoma
Microcytotoxic assay

50. Are the following responses associated with histamines H1 or H2 receptor activation? - Inotropic action and automaticity
Melatonin - serotonin - and CCK
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards - so remember it.
H 2
Galactitol