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 Beta2- agonist is used as a prophylactic agent in the treatment of asthma?
Arginine
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum
Salmeterol
Roth spots - and they are seen in bacterial endocarditis.

2. If you order a V/Q scan for suspected pulmonary emboli - is the filling defect seen on the ventilation or perfusion side?
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Introjection (a sports fan is a good example)
Wernicke's encephalopathy
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.

3. What type of symptoms in schizophrenia are associated with x Muscarinic receptors (ACh)?
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
Norm reference (i.e. - 75% of the students in the class will pass)
Stratum granulosum

4. How are flow through the loop of Henle and concentration of urine related?
As flow increases - the urine becomes more dilute because of decreased time for H2O reabsorption.
C wave
Axis I
Intrapleural pressure decreases (becomes more negative).

5. What antitubercular agent causes loss of red - green visual discrimination?
Ethambutol
Complex 4
Hemiazygous vein
Latissimus dorsi

6. Name the hepatitis virus based on the following information - Enveloped DNA hepadnavirus
Hepatitis B
Ipsilateral loss at and below the level of the lesion
Hyperventilation - which decreases CO2 - shifting the reaction to the left and decreasing H+
Humor

7. In What three areas of the body are sympathetics the predominant tone?
Trypanosoma cruzi
>15 mm
High average
1. Sweat glands 2. Arterioles 3. Veins

8. What is the DOC for the following protozoal infections? - Trichomoniasis
Pseudomonas aeruginosa
Psoas major
16S subunit
Metronidazole

9. What foramen must be traversed for entry into the lesser peritoneal sac?
Transcription (C comes before L in the alphabet - and transCription comes before transLation)
Chromosome 3p
Bacillus anthracis
Foramen of Winslow

10. What water - soluble vitamin deficiency results in pellagra?
Middle meningeal artery
Punishment
Niacin (B3)
Anticipation - associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.

11. What cell surface marker is found on activated helper T cells?
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.)
CD40
Phase 0
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.

12. What lower extremity nerve is described by the following motor loss? - Loss of knee extension - weakened hip flexion
Femoral nerve
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Duchenne muscular dystrophy
IF

13. What embryonic structure forms the adult female structures? - Ovarian and round ligaments
Frontal lobe
Gubernaculum
REM latency; normally it is about 90 minutes.
S1 nuclease

14. What is the most common one? - Joint affected in pseudogout
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
Hepatic adenomas
HPV serotypes 6 and 11
Knee

15. What hormone's release is strongly associated with stage 4 sleep?
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
Somatoform disorder
Adenine and guanine

16. What enzyme is deficient in alkaptonuria?
Myasthenia gravis
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
Posterior interventricular artery
Homogentisic oxidase

17. Name the compartment of the mediastinum associated with the following thoracic structures: Ascending aorta
1. Protest 2. Despair 3. Detachment
Middle
Nystagmus and ataxia
Parasites

18. What hormone excess brings about abnormal glucose tolerance testing - impaired cardiac function - decreased body fat - increased body protein - prognathism - coarse facial features - and enlargements of the hands and feet?
External 3' - 5' PDE bonds
Increased secretion of GH postpuberty leading to acromegaly.
Rotavirus
2 ATPs - via the amino acyl tRNA synthase enzyme

19. If you double the infusion rate of a drug - how long will it take to reach steady state?
Libman - Sacks endocarditis
HPV serotypes 1 and 4
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)

20. Males are more likely to develop _______ than females.
Femoral hernias
Amiloride
There would be two Fab and Fc regions.
Adult T- cell leukemia

21. What tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum - helping monitor and modulate muscle movements?
Cholera toxin
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
Coagulative
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)

22. What lymphoid organ has the following characteristics: outer and inner cortical areas - encapsulation - germinal centers - and high endothelial venules?
Lymph nodes
C wave
Marfan syndrome
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.

23. Have catalase.
Positive
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
Streptococci
Arsenic

24. What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb - containing area?
Target cell
4.7 L - 5% of body weight
Pantothenic acid
Plasmodium falciparum

25. What are the pharmacologic effects seen sexually with x Neuroleptics?
Arterioles
None; they are the storage sites for ADH and oxytocin.
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Erectile dysfunction

26. What is the only nonmotile pathogenic Clostridium species?
Chondroitin sulfate and keratan sulfate
Clostridium perfringens
Average
Conn syndrome (primary hyperaldosteronism)

27. Name the T- cell CD marker: x Interacts with MHC class I molecules
Breast cancer
Turcot syndrome
CD8
Bladder cancer

28. Name the laryngeal muscle described by the following: x Adducts the vocal ligaments - closes the air passageway during swallowing - and allows phonation
Squamous cell carcinoma
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
Osteoma
Lateral cricoarytenoid muscles

29. Why is the clearance of creatinine always slightly greater than the clearance of inulin and GFR?
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Apoptosis (Remember - there is a lack of inflammatory response.)
Molindone
Because creatinine is filtered and a small amount is secreted

30. On what chromosome is the adenomatous polyposis coli gene?
Chromosome 5q21
No - it is never acceptable to lie.
The pH of CSF is 7.33 - acidotic.
Urogenital folds

31. What is the term for drug removal per unit of time in a given volume of blood?
Respiratory depression
Clearance
Postinfectious GN
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.

32. What are defined by Ag - binding specificity?
IF and GTP (eIF for eukaryotes)
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
Absolute refractory period is due to voltage inactivation of sodium channels.
Idiotypes

33. What three cephalosporins can produce disulfiram - like reactions?
Red pulp (Remember - Red pulp and RBCs begin with R.)
1. Cefamandole 2. Cefoperazone 3. Moxalactam
CD21; it is a complement receptor for cleaved C3
Hepatitis E

34. Using Laplace's relationship regarding wall tension - why is the wall tension in an aneurysm greater than in the surrounding normal blood vessel's wall?
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
Two - way ANOVA. It allows the test to check several variables at the same time.
IgM

35. Eating fava beans can produce the Mediterranean type of what deficiency?
Primary erectile disorder
Leydig cell tumor
G-6- PD deficiency
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism

36. Why does carbon monoxide diffusion in the lung (DLCO) decrease in emphysema and fibrosis but increase during exercise?
Nystagmus and ataxia
Hypercortisolism (Cushing syndrome)
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
Caseous necrosis

37. What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
After the latent period
Ulcerative colitis
Fitz - Hugh - Curtis syndrome
6 years old

38. What antiviral agent blocks the attachment and penetration of influenza A virus?
Amantadine
Teeth grinding is associated with stage 2 sleep.
Occulta All except occulta cause elevated - fetoprotein levels.
Chromosome 19

39. What blotting technique uses the following for analysis? - DNA
Sj
Southern blot
Teratoma
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.

40. What is the only way to increase maximum velocity (Vmax)?
DNA polymerase - a
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.
Superior rectus (CN III) (LR6 SO4)3
Increase enzyme concentrations

41. Name the lung measurement based on the following descriptions: x Amount of air in the lungs after maximal inspiration
Total lung capacity (TLC)
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
Four
Metronidazole

42. What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
Hemolytic uremic syndrome
Auspitz sign
Proencephalon
IgM

43. What form of the Plasmodium species are injected into humans by mosquitoes?
Sporozoites
Patau syndrome (trisomy 13)
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
CMV retinitis and HSV-2

44. Hereditary angioneurotic edema (AD) produces local edema in organs (e.g. - GI - skin - respiratory tract). What enzyme deficiency causes increased capillary permeability due to a release of vasoactive peptides?
The outer cortex contains most of the germinal centers and therefore also most B cells.
C1 esterase inhibitor (C1INH)
Type II
Bordetella pertussis

45. What disorder is characterized by an alternating pattern of depressed mood with periods of hypomania for more than 2 years?
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
Social learning theory
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
T lymphocyte

46. Name the most common type or cause - Nephritic syndrome in children
Minimal change disease
Homeodomain proteins
Primary hypoaldosteronism (Addison's disease)
Acebutolol and Pindolol

47. Are resistant to the effects of aminoglycosides.
K1 capsule
Streptococcus viridans
Both
Anaerobes

48. What two arteries join to form the superficial and deep palmar arches of the hand?
Ulnar and radial arteries (ulnar is the main supplier)
Left ventricle and auricle of left atrium
Listeria monocytogenes
Nodular sclerosis

49. If the family member of a patient asked you to withhold information - would you?
Scrotal cancer - due to the high exposure to polycyclic aromatic hydrocarbons
An increase in serum glucose levels
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.
Without children (but don't think about this one for too long)

50. What is the name of the major chemotactic agent released from x Neutrophils?
P1 protein
Leukotriene B4 (LTB4)
Pyloric stenosis
Purine nucleoside phosphorylase