Test your basic knowledge |

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 two forms of insulin - if mixed together - precipitate zinc?
Chylomicrons
Coccidioides immitis
Al - Anon
Lente insulin and either NPH or protamine zinc insulin (PZI)

2. What pattern of genetic transmission affects only M and has no M- to - M transmission - and mother is usually an unaffected carrier?
Zinc (Zn) deficiency
Carnitine acyl CoA transferase II
X- linked recessive
Phenylalanine hydroxylase

3. What disorder - experienced more than half of the time for a 6- month period - is described as being fearful - worrisome - or impatient and having sleep disturbances - poor concentration - hyperactivity - and an overall sense of autonomic hyperactivi
False - negative rate
Generalized anxiety disorder
IgG4
PKU

4. What enzyme of the TCA cycle catalyzes the substrate level phosphorylation?
Acebutolol and Pindolol
Succinyl CoA synthetase
Temporal arteritis
By causing rebound insomnia and decrease in REM sleep

5. Name the correct artery - The right recurrent laryngeal nerve passes around it.
Common and internal carotid arteries
Right brachiocephalic artery
Myasthenia gravis
The entire tubule barring the thick ascending limb

6. What is the term for a schizophrenic episode lasting longer than 30 days with full return to former functioning capacity?
Stage 4
Aged adult
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
Empyema

7. Require NaCl in its growth medium.
HHV 6
None; it degenerates.
Vibrio parahaemolyticus
GLUT 4

8. What determines the Vmax of skeletal muscle?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

9. Prolactin levels can serve as a rough indicator of...
S phase
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
overall dopamine activity
Axis I

10. What non - spore - forming gram - positive aerobic rod produces bull neck - sore throat with pseudomembranes - myocarditis - and sometimes respiratory obstructions?
Osteoblasts (Remember - they modulate the function of osteoclasts.)
Corynebacterium diphtheriae
Areas 1 - 2 - and 3
No. Remember - tests do not diagnose - they confirm or refute your diagnosis. Also - diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI - elevated cardiac enzymes consistent with MI - and ST segment elevati

11. What five things are checked in the APGAR test?
F- Met - Peptides
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
Translation

12. What virus is associated with both nasopharyngeal carcinoma and Burkitt lymphoma?
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
EBV
Dendritic cells - macrophages - and thymic epithelial cells
The inner membrane of the mitochondria (cristae)

13. Name the most common type or cause - Noniatrogenic hypothyroidism in the United States
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
Hashimoto thyroiditis
P = .05; P < .05 rejects the null hypothesis
IQ

14. What component of the corneal reflex is lost in a CN VII deficit?
Brucella
Leuprolide
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
Motor aspect

15. What is the MCC of the following meningitides? - In those 12 months to 6 years of age
Haemophilus influenzae type B
env structural protein
Parainfluenza virus
Type II

16. What statistical method do you use when analyzing x Cohort studies?
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
External abdominal oblique
Dorsal motor nucleus of CN X

17. What is the precursor of all sphingolipids?
Ceramide
EF- Tu or EF- ts and GTP
Neomycin
Alkaline phosphatase

18. Where does the parotid (Stensen's) duct enter the oral cavity?
Hemostasis
At least 5 lobes
Opposite the second upper molar tooth
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)

19. What are the three stages that children aged 7 months to 5 years go through when they are separated from a primary caregiver for a long time?
1. Protest 2. Despair 3. Detachment
Major
Second M PITS for pharyngeal pouch derivatives
Allelic exclusion. It is to ensure that one B cell produces only one Ab.

20. What stage of male development is characterized by the following LH and testosterone levels? - Decreased testosterone production is accompanied by an increase in LH production.
Pygmalion effect (experimenter expectancy). This can be eliminated with double - blind studies.
Phase 1
Aged adult
Vibrio parahaemolyticus

21. Name the associated chromosomal translocation - CML
Chromosome 9 - 22 (Philadelphia chromosome)
Nephrotoxicity
Entamoeba histolytica (treat with metronidazole)
Aminoglycosides

22. What is the name of the hypothesis you are trying to prove?
Alternative hypothesis (What is left after the null has been defined)
Nondominant temporal lobe
Plasma concentration and excretion rate
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)

23. What happens to the following during skeletal muscle contraction? - Actin and myosin lengths
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)
No change in length
Medial meniscus
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.

24. What Ab is an indication of recurrent disease for hepatitis?
Lung cancer
Water - soluble hormones are considered fast - acting hormones.
HBc Ab
Cortisol levels increase. Lymphocyte levels decrease in sleep - deprived individuals.

25. What nematode is known as pinworms? What is the treatment?
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.
Median (think of it as the halfway point)
Enterobius vermicularis; the treatment is albendazole.
Stimulus control

26. What enzyme of the purine salvage pathway is deficient in the following? - Lesch - Nyhan syndrome
HGPRT
unprocessed Ags
Palms - up before palms - down maneuvers
Mannitol

27. What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?
Syringomyelia
Affinity (one of each)
Splitting
Free ionized Ca2+

28. What hereditary bone disorder is due to decreased osteoclast function - resulting in thick - sclerotic bones that fracture easily?
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
Osteopetrosis (Albers - Sch
Confounding bias
2 NADPHs per acetyl CoA

29. Name the antimicrobial agent whose major side effect is listed - CN VIII damage (vestibulotoxic)
Mural infarct
Eosinophil chemotactic factor A
Aminoglycosides
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion

30. What cells of the adrenal gland are neural crest derivatives?
Umbilical vein and ductus venosus (80%)
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
M
Chromaffin cells (adrenal medulla)

31. Name the macrophage based on its location: x Bone macrophages
Obesity - DM - HTN - multiparity - early menarche - and late menopause
Osteoclasts
Type IV hypersensitivity (cell - mediated)
Variola virus (Smallpox)

32. In what condition do you see dimpling on the kidney's surface?
Pyelonephritis
Positive correlation
Ganciclovir
Limbic system

33. Name the phase of the eukaryotic cell cycle: x Period of cellular growth (translation and transcription) before DNA synthesis
Corticosteroid
Coxiella burnetii
G1 phase (gap 1)
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.

34. Which parasitic organism - when it crosses the placenta - results in intracerebral calcifications - chorioretinitis - microcephaly - hydrocephaly - and convulsions?
In the mouth with salivary a - amylase (ptyalin)
Toxoplasma gondii
Large segment deletions
Testosterone

35. What projective test asks the patient to tell a story about What is going on in the pictures - evaluating the conflicts - drives - and emotions of the individual?
Endometrial cancer
catalase - negative
Myeloperoxidase
TAT (Thematic apperception test)

36. Why should opioid analgesics be avoided for patients with head trauma?
Priapism
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Tetracycline
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent

37. What form of penicillin is stable in acid environments?
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
Penicillin V
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Relative refractory period

38. What are the three stimuli that result in the reninangiotensin - aldosterone secretion?
Pulse pressure
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.
Grasp proceeds release
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells

39. If a drug is ionized - is it water or lipid soluble? Can it cross a biomembrane?
Class II
IL-4 - IL-10 - and IL-13
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.
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w

40. Which of the following Enterobacteriaceae family members
Superior vena cava
All are lactose fermenters except Yersinia and Proteus.
Rickets
Phase 4; NE increases the slope of the prepotential - allowing threshold to be reached sooner - and increases the rate of firing.

41. What leukemia affects a 4-year - old child with 3 months of fever - fatigue - generalized lymphadenopathy - CNS involvement - hepatosplenomegaly - bleeding - and platelet count below 100 - 000?
ll
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
Outside the cell
Ceramide

42. What lower extremity nerve is described by the following motor loss? - Loss of eversion; inversion - dorsiflexion - and plantarflexion of the foot
Atropine and 2- PAM (pralidoxime)
Common peroneal nerve
Odds ratio. (Case control studies deal with prevalence.)
Group A Beta- hemolytic streptococci

43. Is spousal abuse a mandatory reportable offense?
Suprachiasmatic nucleus
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
Multiple myeloma

44. Name the ventricular muscle membrane channel: x Closed at rest; depolarization causes channels to open slowly
Absolute refractory period is due to voltage inactivation of sodium channels.
Voltage - gated calcium channel
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
Histiocytosis X

45. What syndrome is associated with the following brainstem lesions? - Contralateral corticospinal and medial lemniscus tract deficits and an ipsilatera medial strabismus secondary to a lesion in CN VI
prior to birthThe foramen ovale closes just...
Mesolimbic system
Medial pontine syndrome
Serocystadenocarcinoma

46. What pneumoconiosis is associated with exposure to the following occupations or materials? - Aerospace industry - nuclear reactors
Osteoclasts
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
alpha - Motor neurons innervate extrafusal muscle fibers (a motor unit) - whereas gamma - motor neurons innervate intrafusal muscle fibers.
Berylliosis

47. Which nicotinic receptor antagonist is inactivated to laudanosine?
Atracurium
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
>10 mm
Visceral pleura

48. What structure of the knee is described thus? - Prevents anterior displacement and has lateral - to - medial attachment on the tibia
Measles (rubeola)
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.
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
ACL

49. What is the most common one? - Form of muscular dystrophy
Goodpasture disease
Prader - Willi syndrome and Angelman syndrome - respectively
Duchenne muscular dystrophy
Beta- Endorphin

50. What is the DOC for hyperprolactinemia?
Cardiac muscle
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern - my senior resident asked me this question more times than I would like to remember.)
Pergolide