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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. When does the primitive gut herniate out of the embryo? When does it go back into the embryo?
6 weeks 10 weeks
Streptococcus agalactiae and Escherichia coli
Papovavirus
Zanamivir and oseltamivir

2. A 60-year - old man has back pain (compression spinal fracture) - hypercalcemia - increased serum protein - Bence - Jones proteinuria - and monoclonal M- spike on serum electrophoresis. What is your diagnosis?
Multiple myeloma
Chromosome 18
Ulcerative colitis
Takayasu arteritis (medium - size to large vessels)

3. What is the most common one? - Neurotransmitter in the brain
Cause - specific mortality rate
Pneumococcus (Streptococcus pneumoniae)
GABA - quantitatively
Hyperacute rejection

4. What are the two ways to leave the prevalence pot?
Molluscum contagiosum
RSV
Minor
Recovery and death

5. Name these mature defense mechanisms: x Preparing for an upcoming event
Pyrantel pamoate
One - way ANOVA
Anticipation
Maxillary division of CN V and glossopharyngeal nerves

6. What nucleus supplies the preganglionic parasympathetic fibers to the ciliary ganglion?
Hepatic adenomas
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.
The systemic veins have the largest blood volume - and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.
Edinger - Westphal nucleus (via CN III)

7. Name the phase of the ventricular muscle action potential based on the following information: x Fast channels open - then quickly close - and sodium influx results in depolarization
Leydig cell tumor
Phase 0
Reverse transcriptase
Zoophilia

8. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Skeletal muscle
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
2 days prior to ovulation
Permanent
Benign lentigo

9. What enzyme is deficient in alkaptonuria?
Familial hypercholesterolemia
Syringomyelia
Yohimbine
Homogentisic oxidase

10. If one event precludes another event - their probabilities are combined By what method?
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
Addition (They are mutually exclusive.)
LTC4 and LTD4
Insulin

11. What antifungal agent is used in the treatment of androgen receptor - positive cancers?
Ketoconazole
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
Laminin
Adenocarcinoma (30% to 35%)

12. What pulmonary disease - most commonly associated with smoking - results in enlarged - overinflated lungs owing to the destruction of the alveolar walls with diminished elastic recoil?
Plasmodium malariae
Giardia lamblia (treat with metronidazole)
Hypoactive sexual desire disorder
Emphysema

13. What area of the retina consists of only cones and has the greatest visual acuity?
Guanethidine and bretylium
Primary follicle of the cortex
External abdominal oblique
Fovea

14. What is the triad of Wiskott - Aldrich syndrome?
Permanent
HGPRT
Arterioles
Thrombocytopenia - eczema - and immunodeficiency is the triad of this X- linked recessive disorder.

15. If a patient asks you a question and you do not know the answer - do you tell a white lie or simply not respond?
Absolutely not! Answer any question you are asked.
presence of PMNs
Melanin
The short arm of chromosome 6

16. Homer - Wright rosettes
Neuroblastoma
Vitamin E
Pneumotaxic center (short - fast breaths)
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.

17. What factors are needed for translation in prokaryotes?
Spironolactone (binds to aldosterone receptors)
Escherichia coli
Elongation factor - G and GTP
CN XI and X

18. What is the most common one? - Cancer of the esophagus in the world
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
Somatomedins
Squamous cell carcinoma

19. Which genus of dermatophytes is associated with the following sites of infection? - Hair and skin only
Microsporum
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
Accessory nucleus
Frontal eye field (Brodmann area 8)

20. Are white rami preganglionic or postganglionic fibers?
Diazepam is longest acting and midazolam is shortest acting.
Validity (remember - reliability is necessary but not the only thing needed for validity)
Copper
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.

21. Based on operant conditioning - What type of reinforcement is described when x Adding a stimulus stops a behavior?
Spironolactone (binds to aldosterone receptors)
Snails
Punishment
Tidal volume (VT)

22. A mother takes her 2- week - old infant to the ER because the baby regurgitates and vomits after eating and has peristaltic waves visible on the abdomen and a palpable mass in the right upper quadrant. What is your diagnosis?
The liver (in the mitochondria)
Down syndrome (it is slightly more common than fragile X syndrome.)
Glucose -6- phosphatase
Pyloric stenosis

23. Is allopurinol used in the acute treatment of gout?
Motor aspect
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.
Major
Supraoptic nuclei; lesions here result in diabetes insipidus.

24. What virus lies dormant in the x Trigeminal ganglia?
Right brachiocephalic artery
Small to medium - sized cerebral vessels
1 day prior to ovulation
Herpes I

25. What bone disorder is characterized by brown tumors - bone pain - deformities - and fractures due to excessive PTH?
Phase III. It is considered the definitive test.
Negative
Osteitis fibrosa cystica (von Recklinghausen disease)
5 years old

26. What is the primary predisposing factor for vascular dementia?
Hypertension
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
Folic acid deficiency
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.

27. What CN is associated with the x Second pharyngeal arch?
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age
Metastatic carcinoma
CN VII

28. What protein causes fibrinolysis?
Yes - because they both activate the BZ1- receptors - which can be reversed by flumazenil.
Plasmin
Ascending limb
Basal cell carcinoma

29. What is the biochemical trigger for REM sleep?
PGE2 and PGF2a
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Argyll Robertson pupils
Hypoxia

30. How many pairs of spinal nerves are associated with x Cervical vertebrae?
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
Bunyavirus

31. How many days before the first day of menstrual bleeding is ovulation?
Stratum granulosum
14 days in most women (Remember - the luteal phase is always constant.)
Mentally disabled
Teratoma

32. What Staphylococcus aureus protein inhibits phagocytosis?
Granulosa cells
REM sleep. Remember - awake brain in a sleeping body.
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
Protein A

33. What form of diabetes insipidus is due to an insufficient amount of ADH for the renal collecting ducts?
CN V2
Beta- Blockers
CD40 ligand
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available - but the renal collecting ducts are impermeable to its actions.

34. 1- a - Hydroxylase activity is increased in response to What two physiologic states? (hint: think of vitamin D activity)
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
Mitosis
Mikulicz syndrome
Hypocalcemia and hypophosphatemia

35. What is the term for the pH at which the structure carries no charge?
Trypsin
pI (isoelectric point)
Nystagmus and ataxia
Proto - oncogenes

36. What AD syndrome produces hamartomatous polyps in the small intestine and pigmentation of the lips and oral mucosa?
IgA
Peutz - Jeghers syndrome
Chronic rejection
Fungi

37. What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
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.
The resistance increases 16- fold.
Nodes of Ranvier
Syphilitic

38. What does a loss of afferent activity from the carotid sinus onto the medulla signal?
One - and it provides the energy for mechanical contraction.
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
Aromatase
IF and GTP (eIF for eukaryotes)

39. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Placental alkaline phosphatase
Seminoma
IL-10
Hemophilia A
presence of PMNs

40. Name the nephritic disease based on the immunofluorescent staining - Mesangial deposits of IgA and C3
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
IgA nephropathy (Berger disease)
Type III hypersensitivity (immune complex)
Profound (I.Q. range < 20)

41. What is the most common one? - Route of spread in pyogenic osteomyelitis
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
Hematogenous

42. What is the most common opportunistic infection of the CNS in HIV?
Tetracycline
Toxoplasmosis
Free form determines hormone activity and is responsible for the negative feedback loop.
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function

43. What would be the result if an Ab were cleaved with papain?
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
Rate of absorption
Acarbose
There would be two Fab and Fc regions.

44. What Freudian psyche component is described as x The conscience - morals - beliefs (middle of the road)?
Antidigoxin Fab fragments
Superego
Thick skin
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.

45. What AD dementia has a defect in chromosome 4 - onset between the ages of 30 and 40 - choreoathetosis - and progressive deterioration to an infantile state?
HIV
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
PRPP aminotransferase
Huntington's chorea. (Death in 15-20 years - often via suicide.)

46. What disease is associated with the HLA- A3 allele
excites the neuron
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
Concrete operations (6-12 years)
Primary Hemochromatosis

47. What nonmotile gram - negative - non - lactose - fermenting facultative anaerobic rod uses the human colon as its only reservoir and is transmitted by fecal - oral spread?
C3 deficiency
Shigella
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
Constipation and miosis

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

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49. What is the name of depression and mania alternating within a 48- to 72- hour period?
Rapid cycling bipolar disorder
Galactoside permease
Pulmonary shunt (i.e. - pulmonary embolism)
Positive reinforcement

50. What determines the Vmax of skeletal muscle?

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