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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. Name the insulin preparation based on the peak effect and duration of action - Peak - 8 to 12 hours; duration - 18 to 24 hours
ACh receptor
Lente or NPH insulin (neutral protamine Hagedorn insulin)
Superior and posterior
Toxoplasma gondii

2. What naturally occurring substances mimic the effects of opioids?
Trichuris trichiura is treated with albendazole.
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.
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.
Enkephalins

3. What type of collagen is associated with the basement membrane?
Rate of absorption
Type IV collagen
Isotypes
Leiomyoma

4. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF ? - capillary pressure ?
Constriction of efferent arteriole
False - positive rate
Necator americanus is treated with mebendazole and iron therapy.
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.

5. Can committed mentally ill patients refuse medical treatment?
Hydroxyproline
CN XI - vertebral arteries
Salmeterol
Yes. The only civil liberty they lose is the freedom to come and go as they please.

6. A marfanoid patient presents with tearing retrosternal chest pain radiating to her back. What is your first diagnosis?
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
Proto - oncogenes
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid

7. What aspects of sleep are affected during benzodiazepine use?
Undoing
REM and stage 4 sleep; they decrease.
Double - blind study. It is the most scientifically rigorous study known.
Constriction of efferent arteriole

8. Do the following structures pick up stain from hematoxylin or eosin? - Calcium
Gastrinoma
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)
Hematoxylin

9. Where is tropocollagen aggregated to form a collagen fibril?
Rapidly progressive glomerulonephritis (RPGN)
Mesocortical area
Outside the cell
Azathioprine

10. What five pathways use SAM (S- adenosylmethionine) as the methyl donor?
Smooth muscle
Bisphosphonates
Insulinoma
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA

11. Are resistant to the effects of aminoglycosides.
Herpes virus I and II
Anaerobes
Monocytosis
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.

12. Name the antidote - Carbon monoxide (CO)
Proencephalon
Oxygen
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Polycythemia vera (Remember - polycythemia vera is a risk factor for acute leukemias.)

13. Name the most common type or cause - Urinary tract obstruction
Craniopharyngioma
Th2 cells
BPH
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.

14. What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells?
Medullary carcinoma of the thyroid
Size
Panacinar
ELISA. It detects anti - p24 IgG.

15. What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
Ulnar to radial progression
Fentanyl
Pneumocystis carinii
Simon focus

16. What competitive estrogen receptor antagonist is used in the treatment of breast cancer?
Glucose -6- phosphatase
Tamoxifen
Chromosome 8 - 14
Ethyl alcohol

17. Which protozoal parasitic vaginal infection produces a positive whiff test with KOH staining?
Trichomonas vaginalis (treat with metronidazole)
Carbamazepine
Fluconazole
Stratum granulosum

18. To What does failure to resolve separation anxiety lead?
They innervate LMNs.
School phobia
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells
Chemotaxis

19. From What aortic arch are the following structures derived?
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.
Zileuton
Log - kill hypothesis (follows first order kinetics)
Right and left pulmonary arteries and the ductus arteriosus

20. What is the most common one? - Germ cell tumor in boys
Folic acid
Plasma cell
Rheumatoid arthritis
Yolk sac tumor

21. What antiviral agent for ganciclovir - resistant infections has limited utility because of its nephrotoxic side effect?
Capillaries
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Lead
Foscarnet

22. What enzyme of pyrimidine synthesis is inhibited by the following? - 5- FU
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
AT II
SITS
Thymidylate synthase

23. What are the two side effects of opioids to which the user will not develop tolerance?
A decrease in Ca2+ and an increase in PO4
Breast cancer
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
Constipation and miosis

24. What three cephalosporins have good penetration against Bacteroides fragilis?
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Antigenic determinant (epitope)
Constriction of afferent arteriole
Enterokinase

25. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 and int -2
Cytochrome a/a3
Disseminated intravascular coagulation (DIC)
Cytochrome a/a3
Melanoma - cancer of the stomach and bladder

26. What two Ags must be positive for a patient to have chronic active hepatitis?
HBsAg and HBeAg
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get
Femoral hernias
Beryllium

27. What eukaryotic translation enzyme is associated with the following: x Initiation
Nitrates
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons
eIF-2 in the P site
Mean

28. Is a cause of asthma.
14 days in most women (Remember - the luteal phase is always constant.)
P24
GERD
Increase (5- HT and dopamine levels do the same)

29. What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?
LC4 - LD4 - and LE 4
Anopheles mosquito
Filiform papillae
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels

30. Name the compartment of the lower extremity and the nerve based on its movements - Flex the hip and extend the knee
Internal abdominal oblique
Anterior compartment of the thigh - femoral nerve
Ulcerative colitis
All (nearly 15-20 times the normal risk)

31. What AA is a precursor of the following substances? - NAD
Radial nerve
Ischemia
Pancreatic delta - cell tumors inhibit CCK secretion
Tryptophan

32. Which trematode is associated with bladder carcinoma in Egypt and Africa?
Cocaine
Schistosoma haematobium
Four
Osmosis; water will diffuse from higher to lower water concentrations.

33. What bacterium is characterized by large boxcar - shaped gram - positive rods and is spore - forming - aerobic - and associated with cutaneous infections and woolsorter's disease?
Glucose -6- phosphatase
Utricle and saccule
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies
Bacillus anthracis

34. What T cell deficiency syndrome is associated with facial anomalies - hypoparathyroidism - thymic hypoplasia - and recurrent viral and fungal infections?
Dynorphin
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
Stable
Female pseudohermaphrodite

35. Which of the following Enterobacteriaceae family members
Coccidioides immitis
Systematic desensitization
All are lactose fermenters except Yersinia and Proteus.
Ergotamines

36. What virus lies dormant in the x Dorsal root ganglia?
CML
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.
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
Varicella

37. What urease - positive non - lactose - fermenting gram - negative rod with swarming - type motility is associated with staghorn renal calculi?
It both begins and ends at T4 (sternal angle [of Louis]).
G0 phase
Direct; in males less than 50 years old indirect hernias are the most common type.
Proteus

38. What is the site of action of the following? - K+- sparing diuretics
Early collecting duct
1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity
Raynaud's phenomenon
1. Liver 2. Muscle 3. Adipose tissue

39. Where does CHO digestion begin?
In the mouth with salivary a - amylase (ptyalin)
hCG
Papillary carcinoma of the thyroid
Capillaries

40. Which is the conditioned response - the conditioned stimulus - the unconditioned response - the unconditioned stimulus in this case? A patient has blood withdrawn and faints. The next time she goes to have blood taken - she faints at the sight of the
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
Mumps
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting). The needle is part of the blood - drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in th
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.

41. What thalamic relay nucleus do the mammillary bodies project to?
Pancreatic cancer
The anterior nucleus of the thalamus
Thymus - independent Ags
H2PO4- (dihydrogen phosphate)

42. Causes of avascular necrosis of bone.
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Avidity (more than one binding site)
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.

43. What organism is associated with megaloblastic anemia?
Cocaine
Diphyllobothrium latum
IDL
Depression

44. What is the term for the amount of blood in the ventricle after maximal contraction?
Palms - up before palms - down maneuvers
Four
Residual volume
Trimethoprim/sulfamethoxazole (TMP- SMX)

45. Name the product or products of arachidonic acid: x Chemotactic for neutrophils
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
The fastigial nucleus
LTB4

46. What do low levels of Ca2+ and PO4- along with neuromuscular irritability indicate?
Hypoparathyroidism
Dysplasia
Klebsiella pneumoniae
Spectinomycin

47. What condition results in the following CSF results? - Opening pressure 100 mm H2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17
Site 4
Selection bias
Phase II
Viral meningitis

48. What capsular serotype is associated with Escherichia coli - induced meningitis?
K1 capsule
MEN I (or Wermer syndrome)
Vitamin E
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion

49. What type of correlation is defined as x One variable that diminishes in the presence of the other?
Thrombus
Negative correlation
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.

50. What generate anterograde transport of information in a neuron?
Kinesins. Dynein generates retrograde transportation of information.
Niclosamide
Parvovirus B 19
Peutz - Jeghers syndrome