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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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. In reference to membrane potential (Em) and equilibrium potential (Ex) - which way do ions diffuse?
Motor nucleus of CN V
Acetyl CoA (pyruvate to acetyl CoA)
Depolarization (i.e. - Na+ influx)
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.

2. What direction does the primitive gut rotate? What is its axis of rotation?
The gut rotates clockwise around the superior mesenteric artery.
Enterobius vermicularis
Bacillus anthracis
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.

3. What are the three Beta - lactamase inhibitors?
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
VSD - RVH - overriding aorta - and pulmonary stenosis
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.
N-5- methyl THF

4. What structure of the knee is described thus? - Prevents anterior displacement and has lateral - to - medial attachment on the tibia
ACL
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
Sadism

5. What type of test asks a patient to draw a scene - attempting to find out the individual's unconscious perceptions in his or her life?
Four high energy bonds - two from ATP in AA activation and two from GTP
Intercellular adhesion molecule (ICAM) 1
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.
Huntington's chorea. (Death in 15-20 years - often via suicide.)

6. Is an anti - HAV IgG Ab associated with immunization or recent infection?
Fibroadenoma
Dantrolene
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
Metronidazole

7. Active protein transport requires a...
Chordae tendineae
Concentration gradient
Akathisia
Initiate and manage gross skeletal muscle movement control

8. What is the size of a positive PPD test for the following? (Reactive) x Healthy suburban male without any medical illnesses
>15 mm
Streptococcus pneumoniae
Cauda equina
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)

9. Reinke crystals
Plummer - Vinson syndrome
Leydig cell tumor
Diphyllobothrium latum
Periaortic lymph nodes

10. What is the drug of choice for treating a patient with hyperuricemia due to overproduction of uric acid?
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Allopurinol
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Upper outer quadrant (left more than right)

11. What factors are needed for elongation in prokaryotes?
Fat necrosis
To provide attachment between contiguous cells and to maintain a semipermeable barrier
EF- Tu or EF- ts and GTP
Four Ms and a U 1. Median 2. Medial antebrachial 3. Medial pectoral 4. Medial brachial cutaneus 5. Ulnar

12. What is the name of the major chemotactic agent released from x The blood serum? (Hint: it is a complement factor.)
C5a
Tibial nerve
Isotonic contraction
ACh

13. What is found in the R group if the AA is acidic? Basic?
The Purkinje cell
Epidural hematoma
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
Pseudomembranous colitis

14. What small - to medium - sized vasculitis is seen in a 35-year - old man who is a heavy smoker presenting with claudication symptoms in the upper and lower extremities?
Buerger disease (thromboangiitis obliterans)
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.
Aedes (the same for yellow fever)
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate

15. What T- cell surface projection recognizes and reacts to foreign Ags (presented by APCs)?
TCR
Hormone - sensitive lipase
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
CD40 ligand

16. What endotoxin receptor is the best marker for macrophages?
CD14
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.
Crossover study
LC4 - LD4 - and LE 4

17. If you order a V/Q scan for suspected pulmonary emboli - is the filling defect seen on the ventilation or perfusion side?
Carbamazepine
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -
Meiosis I; disjunction with centromere splitting occurs during meiosis II.

18. 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?
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
One - and it provides the energy for mechanical contraction.
Hyperventilation - which decreases CO2 - shifting the reaction to the left and decreasing H+
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.

19. What is the most common one? - Primary tumor metastasis to the bone
Cerebellum
Phase 4
PALS
Breast

20. What hormone is required for 1 - 25- dihydroxy- vitamin D (1 - 25- diOH- D) to have bone resorbing effects?
Proencephalon diencephalon derivative
Necrotizing enterocolitis
PTH
G2 phase

21. With a decrease in arterial diastolic pressure - what happens to x TPR?
2 - 4- Dinitrophenol
Decreases
ACh; think about the ANS.
Hyperacute rejection

22. What is the DOC for trigeminal neuralgia?
Thrombus
Linoleic acid and linolenic acid
Carbamazepine
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)

23. What is the term for the number of new events occurring in a population divided by the population at risk?
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn - crosses over - and ascends contralateral in the spinal cord - brainstem - thalamus - and postcentral gyrus.
Incidence rate
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)

24. What two bacteria are associated with drinking unpasteurized milk?
Sciatic nerve
Brucella and Listeria (has tumbling motility)
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
Hepatic adenomas

25. Which carcinoma
Ewing's sarcoma
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Umbilical vein and ductus venosus (80%)
PICA

26. What apoprotein on HDL activates lecithin - cholesterol acyltransferase (LCAT)?
Pregnancy
Hypertension
Thyroid gland
apo A-1

27. What pneumoconiosis is associated with exposure to the following occupations or materials? - Shipyards - brake linings - insulation - and old building construction
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
Porcelain gallbladder
Vitamin B12 deficiency and folate deficiency
Asbestosis

28. What is the term for the negative resting membrane potential becoming more negative?
Hyperpolarization (i.e. - K+ influx)
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Urophilia
The resistance will decrease one - sixteenth of the original resistance.

29. A patient with a history of epilepsy goes to the ER with sedation - gait ataxia - diplopia - and vertical nystagmus. Which anticonvulsant overdose resulted in the patient's symptoms?
During stage 3 and 4 (remember - it is called deep sleep.)
Hepadnavirus
Phenytoin
Parkinson disease

30. Which antimicrobial class may cause tooth enamel dysplasia and decreased bone growth in children?
Case control studies cannot assess incidence or prevalence - but they can determine causal relationships.
Tetracycline
M
Somatomedins

31. What CNS developmental abnormality is associated with 90% of syringomyelia?
Beta- Oxidation of fatty acids
Primary hypercortisolism
Arnold - Chiari malformation type 2
Parvovirus B 19

32. What type of hepatitis has the highest mortality rate among pregnant women?
The AR form is malignant and AD is benign.
Hepatitis E
Subarachnoid hemorrhage
Flutamide

33. What drug of choice for ascaris causes neuromuscular blockade of the worm?
Bactericidal
Pyrantel pamoate
Lower lobe
Burkitt lymphoma

34. What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?
Kayser - Fleischer ring
Concentration gradient
Ulcerative colitis
Acid is needed for the activation of pepsin and therefore needed for protein digestion.

35. With what stage of sleep are night terrors associated?
Dynorphin
Vitamin A is responsible for vision and epithelial health.
Left anterior descending artery
NREM sleep. Night terrors are dreams that we are unable to recall.

36. What syndrome is characterized by sweating - insomnia - nausea - diarrhea - cramps - delirium - and general restlessness secondary to MAOI and SSRI in combination?
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.
First - pass effect
Generalized anxiety disorder
Pseudomonas

37. Should you refer a patient to a form of folk medicine even if you don't believe in it?

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38. What determines the effective osmolarity of the ICF and the ECF compartments?
Simple diffusion; it does not use protein - mediated transport
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.
Anhedonia

39. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Asbestos
Mesothelioma and bronchogenic carcinoma
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.
5- hydroxyindoleacetic acid (5- HIAA)
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

40. What somatomedin serves as a 24- hour marker of GH secretion?
IGF-1 (somatomedin C)
Kidney
Metaproterenol and albuterol
Hyperventilation - which decreases CO2 - shifting the reaction to the left and decreasing H+

41. What are the four Ds of niacin deficiency?
All are lactose fermenters except Yersinia and Proteus.
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)

42. How many carbons do androgens have?
Androgens are 19- carbon steroids.
Flocculonodular lobe (one of my favorite words in all of medicine!)
NE
Medial meniscus

43. What Brodmann area is associated with x Primary auditory cortex?
Bipolar disorder (manic - depressive disorder)
Areas 41 and 42
ELISA. It detects anti - p24 IgG.
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)

44. What two drugs - when mixed - can lead to malignant hyperthermia?
C4 (the upper border of the thyroid cartilage)
Succinylcholine and halothane (Treatment is with dantrolene.)
Eosin
Graves disease

45. What is the first epidermal layer without organelles and nuclei
Stratum lucidum
Parainfluenza virus
The CD4 T cell; the APC is the first cell in the immune response.
X- linked dominant

46. How much of a vessel must be stenosed to cause sudden cardiac death?
More than 75% of the vessel
The resistance will decrease one - sixteenth of the original resistance.
GLUT 4
Galactose and glucose

47. What three carcinomas are associated with EBV?

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48. What is the most common one? - Malignant carcinoma of the ovaries
Osteoma
The basilar artery is formed at the pontomedullary junction.
Cystadenocarcinoma
Posterior cruciate ligament

49. What hormone - produced by the syncytiotrophoblast - stimulates the production of progesterone by the corpus luteum?
Agglutination test
IF-2 of the 30S subunit
hCG
Ch

50. Do the following structures pick up stain from hematoxylin or eosin? - Bacteria
Hematoxylin
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.
ater flows from a low - solute to high - solute concentrations.
Zollinger - Ellison syndrome

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USMLE Step 1 Prep

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