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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 test is done to diagnose CGD?
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
Leydig cell tumor
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
Boutonni

2. What is the site of action of the following? - Thiazide diuretics
HTLV-1
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
Chromosome 5q21
Early distal tubule

3. What type of GN - associated with celiac disease and dermatitis herpetiformis - has mesangial deposits of IgA - C3 - properdin - IgG - and IgM?
Berger disease (IgA nephropathy)
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
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)
CD3

4. What are the five terminal branches of the facial nerve?
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Pneumocystis carinii
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)
Pyrantel pamoate

5. What is defined as a general estimate of the functional capacities of a human?
Area 8
Gubernaculum
All are lactose fermenters except Yersinia and Proteus.
IQ

6. Name the compartment of the mediastinum associated with the following thoracic structures: Trachea
Superior
Obsessive - compulsive
Diphenhydramine
Transmembrane potential (an absolute number)

7. Name the most common cause - Dementia in persons aged 60 to 90 years
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
Alzheimer disease
Zoophilia
Temporal arteritis

8. What hormone is characterized by the following renal effects? - Calcium reabsorption - phosphate reabsorption
Bitemporal heteronymous hemianopsia
Vitamin D3
Sertoli cell
gram positive

9. If a drug is ionized - is it water or lipid soluble? Can it cross a biomembrane?
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia
Plasmodium falciparum

10. Name these cluster A personality disorders: x Baseline mistrust; carries grudges; afraid to open up; uses projection as defense mechanism; lacks hallucinations or delusions
Paranoid
1. Liver 2. Kidney 3. Pituitary gland (via 5'- deiodinase enzyme)
S phase
Moving objects - along with large bright objects with curves and complex designs.

11. At what stage of B- cell development can IgM or IgD be expressed on the cell surface?
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
Lymphoblastic lymphoma
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.

12. Unconsciously forgetting(forgetting that you forgot something!)
Fanconi - like syndrome
8 to 25 hours
Repression
Libman - Sacks endocarditis

13. What malignant neoplasm of the bone has a soap bubble appearance on radiograph?
Epinephrine
Giant cell bone tumor (osteoclastoma)
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Chlamydia psittaci

14. What lecithin: sphingomyelin ratio indicates lung maturity?
2.0 or greater
GABA and glutamic acid
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Areas 1 - 2 - and 3

15. What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
Congenital heart disease
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Functions of hepatocytes

16. What two pathologic conditions occur when the gut does not return to the embryo?
Rhabdomyoma
Streptokinase
Omphalocele and gastroschisis
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.

17. What is the term to describe homosexuals who x Are uncomfortable with their own person and disagree with their sense of self?
Constrictor pupillae and ciliary muscles
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
The carotid sinus reflex
Ego dystonic

18. What paraphilia is defined as x Having a recurrent desire to expose the genitals to strangers?
Superficial spreading melanoma
Pearson correlation
Exhibitionism
Leiomyoma (fibroids)

19. Inhibition of peripheral aromatic amino acid decarboxylase and increased CNS availability of L- dopa are results of what drug used in the treatment of Parkinson's disease?
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Carbidopa and benserazide
Eaton - Lambert syndrome
Arboviruses (bunyavirus - flavivirus - and togavirus)

20. Name the components of the femoral canal - working laterally to medially.
Hepatic glycogen phosphorylase
pH of 2 and 9
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament

21. Name the period described by the following statement: no matter how strong a stimulus is - no further action potentials can be stimulated.
Mode
Superior
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Absolute refractory period is due to voltage inactivation of sodium channels.

22. What small coagulase - positive - gram - negative rod with bipolar staining is a facultative intracellular parasite resulting in buboes?
gram positive
The negative charge inhibits the filtration of protein anions.
Yersinia pestis
Hypercortisolism (Cushing syndrome)

23. If you report a suspected case of child abuse and are wrong - are you protected from legal liability?
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
Phase 2
Breast cancer
Microglia (Microglia and mesoderm both begin with M)

24. Name the pattern of genetic transmission characterized thus: both M and F affected; no M- to - M transmission; affected M passes trait to all daughters - every generation; affected F passes trait to both sons and daughters; a single mutant allele can
Mesocortical area
Frameshift
X- linked dominant
Trypanosoma cruzi

25. Which genus of dermatophytes is associated with the following sites of infection? - Skin - hair - and nails
Atropine with pralidoxime
Trichophyton
Increase (5- HT and dopamine levels do the same)
Papillary carcinoma of the thyroid

26. Can you tell which drug is more toxic based on therapeutic indices alone?
Ventricular fibrillation (V fib)
No - therapeutic indices can tell which drug is safer - not more toxic.
Estradiol
The left is a branch of the aortic arch - while the right is a branch of the brachiocephalic trunk.

27. If the pH is low with increased CO2 levels and decreased HCO3- levels - What is the acid - base disturbance?
Combined metabolic and respiratory acidosis
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
Fibrocystic change of the breast

28. What syndrome is described by a lesion in the angular gyrus (area 39) resulting in alexia - agraphia - acalculia - finger agnosia - and right - left disorientation?

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29. What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
Phase 1
Enterohemorhagic Escherichia coli
Parvovirus (it is the only ssDNA virus)

30. Name the type of mutation: x New codon specifies for the same AA
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
GERD
Silent
The urine becomes hypertonic because of water reabsorption in the collecting duct.

31. What is the degree to which two measures are related? Does it imply causation?
Posterior chamber
Staphylococcus aureus
Correlation. No - correlation does not imply causation.
Priapism

32. What form of depression is due to abnormal metabolism of melatonin?
Seasonal affective disorder (treat with bright light therapy)
Hydroxyproline (breakdown product of collagen)
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
Ligamentum arteriosum

33. Can parents withhold treatment from their children?
IL-4 - IL-10 - and IL-13
LDL
Hypoactive sexual desire disorder
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.

34. What are the two ketogenic AAs?
Negative
Leucine and lysine
Transverse abdominis
Non - Hodgkin lymphoma

35. What general pattern of sleep is described by slowing of EEG rhythms (high voltage and slower synchronization) - muscle contractions - and lack of eye movement or mental activity?
NREM sleep. Remember awake body - sleeping brain
Bisphosphonates
Increased erection and libido
An internal elastic lamina

36. Name the aphasia based on these characteristics: x Lesion in the prefrontal cortex; inability to speak spontaneously; unimpaired ability to repeat
Transcortical aphasia
REM
Dissociation
Parvovirus B 19

37. Which region of the variable domain comprises the Ag - binding site of the Ab?
Projective test. Most tests with a wide range of possibilities for the answers are projective.
Hypervariable region (three per light chain; three per heavy chain)
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
X- linked dominant

38. What are the three functions of surfactant?
Denial
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Streptomycin
CN XI and X

39. What is the function of the basal ganglia?
Vitelline fistula
Initiate and manage gross skeletal muscle movement control
Public speaking (Remember: stage fright)
Potter facies

40. What muscle acts in all ranges of motion of the arm?
Lipoprotein lipase
Stranger anxiety
Deltoid
Ethyl alcohol

41. Cowdry type A bodies
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
The inner membrane of the mitochondria (cristae)
Herpesvirus

42. What enzyme is deficient in alkaptonuria?
Endometrial cancer
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g. - long bone fracture)
Homogentisic oxidase
Excess estradiol in the blood

43. Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia?
Cholera toxin
Pneumocystis carinii
Burkitt lymphoma
d - Tubocurarine

44. What enzyme catalyzes the rate - limiting step in heme synthesis?
Anterior compartment of the leg - deep peroneal nerve
Autosomal recessive
d - ALA synthase
Coarctation of the aorta

45. What form of hormone is described as having membrane - bound receptors that are stored in vesicles - using second messengers - and having its activity determined by free hormone levels.
Oxytocin
Streptococcus viridans
Red muscle
Water - soluble hormones are considered fast - acting hormones.

46. Name the B- cell CD marker: x Used clinically to count B cells in blood
Hepatitis - with or without necrosis
CD19
Ganciclovir
FSH

47. What mast cell mediator is a chemotactic agent?
Iatrogenesis
Eosinophil chemotactic factor A
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
Renin secretion

48. What is the term of the viral growth period when no viruses can be found intracellularly?
Chromosome 15q
prognostic predictors
Eclipse period
PGI2

49. What syndrome has loss of deep tendon reflexes - muscle weakness - and ascending paralysis preceded by a viral illness?
Functional residual capacity (FRC)
Glioblastoma multiforme
HBsAg as its envelope
Guillain - Barr

50. What are the longest - acting and shortest - acting benzodiazepines?
Mixed (both cholesterol and calcium)
Diazepam is longest acting and midazolam is shortest acting.
During stage 3 and 4 (remember - it is called deep sleep.)
Staphylococcus aureus