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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 type of scheduled reinforcement states that after a desired response - the reinforcement is given x After a set number of responses?
Chief cells
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.
Fixed ratio (rewards set behaviors)
Plasmodium vivax

2. What sphingolipid is formed by the union of serine and palmitoyl CoA?
G0 phase
Poxvirus
Enkephalin
Sphingosine

3. Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
Single - strand DNA binding protein
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
Affinity (one of each)
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent

4. Most sleep time is spent In what stage of sleep?
Stage 2 - which accounts for approximately 45% of total sleep time - with REM occupying 20%.
Positive
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Left eye anopsia (left nasal and temporal hemianopsia)

5. What is the karyotype in Turner syndrome?
Libman - Sacks endocarditis
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
45XO

6. What is the DOC for the following protozoal infections? - Amebiasis
Bile pigments and bile salts
Metronidazole
Foramen of Winslow
Mesencephalic nucleus

7. What are the three benzodiazepines that do not undergo microsomal oxidation?
Oxazepam - temazepam - and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation - not via the cytochrome p450 system.
Four
Dissociation
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.

8. What are the five branches of the superior mesenteric artery?
Preload (the load on the muscle in the relaxed state)
CN V2
Metastatic
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries

9. What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Parallel circuit
Isoniazid
Adrenarche

10. What is the name of the urinary bladder where the ureters enter and the urethra exits?
Case fatality rate
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe
Urinary trigone
Sensory

11. Can be secreted.
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
B- cell Ag receptors
Spectinomycin
Plasma cell

12. What do LMNs innervate?
Missense
They innervate skeletal muscle.
Primary hypoparathyroidism
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.

13. What is the term for increased iron deposition resulting in micronodular cirrhosis - CHF - diabetes - and bronzing of the skin?
Hemochromatosis
Serocystadenocarcinoma
Somatization
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries

14. Name the macrophages by location: x Lungs
Brushfield spots
Alveolar macrophages
Mycosis fungoides (cutaneous T- cell lymphoma)
T3 increases both heart rate and cardiac output by increasing the number of Beta - receptors and their sensitivity to catecholamines.

15. Name the lung measurement based on the following descriptions: x Maximal volume that can be expired after maximal inspiration
Rabies
Vital capacity (VC)
Enterokinase
Depression

16. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Rigors - leukopenia - decrease in blood pressure - and increase in temperature
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament
Ipsilateral flaccid paralysis
Viral meningitis

17. In MHC class II molecules - what chain blocks access to the peptide - binding groove during transportation within the cell - ensuring that the MHC class II- peptide complex is transported to the surface?
1. Short attention span 2. Impulsivity 3. Hyperactivity
Inactivated
Chromosome 11p
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)

18. What enzyme is needed to activate the following reactions? - Chymotrypsinogen to chymotrypsin
IL-4
Trypsin
Adulthood
PGE2 and PGF2a

19. What vein is formed by the union of the right and left brachiocephalic veins?
Third M PITS for pharyngeal pouch derivatives
Ureaplasma urealyticum
Superior vena cava
EF- Tu or EF- ts and GTP

20. What is the respiratory compensation mechanism for metabolic alkalosis?
Frameshift
PRPP aminotransferase
Medial medullary syndrome
Hypoventilation - which increases CO2 - shifting the reaction to the right and increasing H+

21. By What age should children be able to draw the following figures? - Rectangle
Rationalization
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
Class 1 (1A - 1B - and 1C)
Pyelonephritis

22. What axis I disorder is characterized by pronoun reversal - preference for inanimate objects - obliviousness to the external environment - lack of separation anxiety - and abnormalities in language development?
HPV
give a warning
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
Autism. Head - banging - rocking - and self - injurious behaviors are also common in autism.

23. What is the only Ig that crosses the placenta?
naked viruses
IgG
Yolk sac tumor
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.

24. What type of correlation is defined as x Two variables that go together in the same direction?
Melatonin - serotonin - and CCK
Schatzki ring
Positive correlation
Janeway lesions

25. What is the term for the ability of a test to measure something consistently?

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26. What is the term for normal cellular genes associated with growth and differentiation?
Proto - oncogenes
A transport maximum (Tm) system
Rate of absorption
Major

27. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Hematopoietic cells
Labile
4 years old
Pyrantel pamoate
Pneumococcus (Streptococcus pneumoniae)

28. Results in vitamin B12 malabsorption.
Pancreatic insufficiency
QRS complex
Chromosome 14 - 18
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)

29. What area of the limbic system is responsible for attaching emotional significance to a stimulus?
CN VII
Amygdala; it helps imprint an emotional response in memory.
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Internal carotid artery

30. What is the role of the negative charge on the filtering membrane of the glomerular capillaries?
Ego
2.0 or greater
Constipation and miosis
The negative charge inhibits the filtration of protein anions.

31. What form of bilirubin can cross the blood - brain barrier?
Hurler syndrome and Hunter syndrome - respectively
Unconjugated free bilirubin
Minimal change disease
Mesonephric duct

32. What nucleus - found in the intermediate zone of the spinal cord - sends unconscious proprioception to the cerebellum?

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33. What CN nucleus receives auditory information from both ears via the cochlear nuclei?
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
HBsAb IgG
Phase 3
Superior olivary nucleus

34. What immunologic syndrome is due to a pharyngeal pouch 3 and 4 failure?

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35. Name the hepatitis virus based on the following information - Enveloped DNA hepadnavirus
Hepatitis B
Mural infarct
Stratum granulosum
Membranoproliferative glomerulonephritis (MGN)

36. What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100 - 00); decreased LAP levels; and nonspecific symptoms of fatigue - malaise - weight loss - and anorexia?
Beta- Hydroxybutyrate
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
CML
Large segment deletions

37. What is the most common one? - Skin tumor in the United States
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Inferior phrenic artery
Pyridoxine (B6)
Basal cell carcinoma

38. Which hepatitis B Ab indicates low transmissibility?
HBeAb
Paneth cells
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.

39. Pseudorosettes
Ewing sarcoma
The Fc region of IgG and C3b
MEN II and III syndromes
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)

40. Name the structure that enters or exits the following foramina: x Optic canal
Osteoma
Fossa ovale
CN II and ophthalmic artery
Reinforcement

41. What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency - glucocorticoid deficiency - and an excess of adrenal androgens?
Dynorphin
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis

42. What is the term to describe the 5'-3' sequence of one strand being the same as the opposite 5'-3' strand?
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Palindrome
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 -

43. What is the volume of distribution (increased or decreased) of a drug when a large percentage is protein bound?
Depolarization (i.e. - Na+ influx)
Volume of distribution is decreased when a large percentage of drug is protein bound.
Hypoxia
IF-2 of the 30S subunit

44. What is the name for failure of the allantois to close - resulting in a urachal fistula or sinus?
hCS and serum estriol - which are produced by the fetal liver and placenta - respectively - are used as estimates of fetal well - being.
Negative
Hypervariable region (three per light chain; three per heavy chain)
Patent urachus

45. What reflex increases TPR in an attempt to maintain BP during a hemorrhage?
The carotid sinus reflex
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Methyldopa
Infection

46. What disease that involves mental retardation - flat face - muscle hypotonia - and a double - bubble sign on radiograph poses an increased risk of Alzheimer's disease and All?
Hirschsprung's disease (colonic gangliosus)
Risk factors for cervical cancer
Streptococcus viridans
Down syndrome (trisomy 21)

47. Which muscles of the eye are under parasympathetic control?
Negative
Constrictor pupillae and ciliary muscles
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Metastatic carcinomas

48. What is the term for a direct connection between the intestine and the external environment through the umbilicus because the vitelline duct persists?
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.
Vitelline fistula
Undoing
Enteroendocrine (EE) cells; they also secrete secretin.

49. Males are more likely to develop _______ than females.
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.
IgA
Primary erectile disorder
Femoral hernias

50. What is the name of the major chemotactic agent released from x Bacteria?
HTLV-1
Primary intention
1. Big 2. Bilateral 3. Berry aneurysm
F- Met - Peptides