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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 vein is formed by the union of the right and left brachiocephalic veins?
Remember the mnemonic PAM SMIDT P - (hyper) Parathyroid/ Paget disease A - Addison's disease M - Milk - alkali syndrome/metastatic cancer S - Sarcoidosis M - Multiple myeloma I - Immobilization/idiopathic D - Vitamin D intoxication T - Tumors
Superior vena cava
Thymus - independent Ags
Polycystic kidney disease of childhood

2. Name the antidote - Heparin
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
Protamine sulfate
Erythema marginatum
IgA

3. What is the only dsRNA virus?
Reovirus
From the wall of the yolk sac
Rhombencephalon
Gastrin - releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)

4. What AR disorder is seen by age 1 to 2 with recurrent sinopulmonary infections - uncoordinated muscle movements - and dilation of the blood vessels?
Ataxia - telangiectasia
PCR
Kawasaki disease
Initiate and manage gross skeletal muscle movement control

5. From What embryonic structure are the following structures derived? - The ascending aorta and the pulmonary trunk
Caseous necrosis
Atropine - 2- PAM (pralidoxime)
Pernicious anemia
Truncus arteriosus

6. Can a patient refuse life - saving treatment for religious reasons?

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7. What is the name of the urinary bladder where the ureters enter and the urethra exits?
Urinary trigone
Risperidone
The greater the cell diameter - the greater the conduction velocity.
Nodular sclerosis

8. What disorder leads to IgG autoantibodies to the TSH receptor?
Graves disease
LTB4
GH- producing adenoma
GP Ib

9. What type of error is made if you reject the null hypothesis when it is true?

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10. Unconsciously forgetting(forgetting that you forgot something!)
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.
Transketolase and transaldolase. The reactions they catalyze are reversible.
No CHO - AA - ketones - or peptides are left in the tubular lumen.
Repression

11. Name the most common type or cause - Anovulation
Polycystic ovaries
Secondary lysosome (think of the primary as inactive and secondary as active)
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
MHC class I antigens; they are also found on the surface of platelets.

12. What abdominal muscle runs horizontally - contributes to the posterior rectus sheath - and contributes to form the conjoint tendon?
Achondroplasia
Transverse abdominis
1. Decrease alpha -1 activity 2. Increase Beta -2 activity 3. Increase ACh levels
Pergolide

13. What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?
Type I pneumocytes
Syringomyelia
Vitelline fistula
G-6- PD deficiency

14. What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
GABA and glutamic acid
Ostium secundum defects
Heroin
Mesolimbic system

15. What encapsulated group of nerve endings seen at the muscle - tendon junction responds to an increase in tension generated in that muscle? (This is dropping a box that is too heavy to carry.)
Rhinovirus and hepatitis A virus
Arthroconidia with hyphae
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
ACh

16. What component of the ETC is inhibited by the following? - Antimycin A
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
Pregnancy
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)
Cytochrome b/c1

17. What type of correlation is defined as x Two variables that go together in the same direction?
common variable hypogammaglobinemia
Isocitrate dehydrogenase
Positive correlation
Nominal scale (categorical - e.g. - male or female)

18. What sided muscle weakness is seen in an UMN corticospinal tract injury above the pyramidal decussation?
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.
8 to 25 hours
Severe (range 20-34)

19. What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?
Narcissistic
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Volvulus
Dimercaprol - penicillamine

20. What are the three major functions of secretory IgA?
Metastatic calcification
Duodenal ulcer
Neuroblastoma
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases

21. What part of the heart forms x Superior border?
Gardnerella vaginalis
Conus arteriosus of the right ventricle and right and left auricles
Reaction formation
Ceramide

22. What embryonic structure forms the adult male structure? - Urinary bladder - urethra - prostate gland - bulbourethral gland
Urogenital sinus
The myotatic reflex is responsible for the tension present in all resting muscle.
Granulosa cell
Fibroadenoma

23. What ribosomal subunit binds first to the mRNA strand?
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
Microvillus
Adenosine deaminase (ADA) deficiency
The small subunit (40S) binds first.

24. Name the most common type or cause - Hypothyroidism in the United States
Iatrogenesis
Primary hyperparathyroidism
Sheehan syndrome
rRNA

25. What happens to the following during skeletal muscle contraction? - Actin and myosin lengths
Four high energy bonds - two from ATP in AA activation and two from GTP
No change in length
ACTH
In the first 3 months

26. Both submandibular and sublingual glands are innervated by CN VII (facial) and produce mucous and serous secretions. Which one mainly produces serous secretions?
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Hirschsprung disease (aganglionic megacolon)
Metronidazole
Antigenic determinant (epitope)

27. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x c - myc
Asbestosis
The limbic system
Burkitt lymphoma
B cells; macrophages and dendritic cells are nonspecific.

28. What is the most common one? - Tumor in individuals exposed to asbestos
Bronchogenic carcinoma
Fibrous pericardium
Hypoactive sexual desire disorder
Chromosome 5p

29. What is the second cell involved in the immune response?
Stapedius muscle
The CD4 T cell; the APC is the first cell in the immune response.
The T- test (used when comparing two groups)
Interferons

30. What is the term for pus in the pleural space?
Follicular lymphoma
Third week
Empyema
Occipital lobe

31. Name the compartment of the lower extremity and the nerve based on its movements - Extend the hip and flex the knee
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
Vaginismus; it is the female counterpart of premature ejaculation.
Clozapine
Posterior compartment of the thigh - tibial nerve

32. Is the carotid sinus sensitive to pressure or oxygen?

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33. What enzyme produces an RNA primer in the 5'-3' direction and is essential to DNA replication because DNA polymerases are unable to synthesize DNA without an RNA primer?
Stable
One - and it provides the energy for mechanical contraction.
Cirrhosis
Primase

34. What is the term for a single isolated antigenic determinant?
Hapten (not immunogenic)
Superior and anterior
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)

35. What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
Very superior (<2.5% of the population)
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Intraductal papilloma
Hepatitis A

36. What is the rate - limiting step of the following? - Beta- Oxidation
Ribavirin
Superior and middle
Ticlopidine or clopidogrel
Carnitine acyltransferase I

37. What are the five pieces of information considered necessary for fully informed consent?

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38. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF ? - capillary pressure ?
Ulnar nerve
Dilation of efferent arteriole
Dendrites receive information - whereas axons send information.
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.

39. What hormone is characterized by the following renal effects? - Calcium excretion - phosphate excretion
The resistance will decrease one - sixteenth of the original resistance.
Calcitriol
Raloxifene
Glycine/arginine

40. What is the most common one? - Form of vasculitis
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
Temporal arteritis
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
Fixed ratio (rewards set behaviors)

41. Name the associated chromosome - Huntington disease
GABA and glutamic acid
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle - and you would risk injury if you went below the rib.
Chromosome 4p
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.

42. Is increased in 21-Beta- hydroxylase deficiency.
Renin secretion
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
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.

43. From What embryonic structure are the following structures derived? - The aortic vestibule and the conus arteriosus
Bulbus cordis
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Penicillin G (benzylpenicillin)
Osteoarthritis

44. Name the insulin preparation based on the peak effect and duration of action - Peak - 8 to 12 hours; duration - 18 to 24 hours
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major
Lente or NPH insulin (neutral protamine Hagedorn insulin)
Fat necrosis
Deltoid

45. Name four major risk factors for atherosclerosis.
Single - strand DNA binding protein
Enterokinase
Alzheimer disease
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.

46. Name the type of necrosis - The most common form of necrosis; denatured and coagulated proteins in the cytoplasm
Coagulative necrosis
Salpingitis
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)

47. Name the antidote - Copper
Giant cell bone tumor (osteoclastoma)
Spectinomycin
Chief cell adenoma (80%)
D- Penicillamine

48. Name the associated chromosomal translocation - Follicular lymphoma
Mycoplasma pneumoniae
Chromosome 14 - 18
First - pass effect
Reinforcement

49. What do the following values indicate? - TD50
Toxic dose for 50% of drug takers (median toxic dose)
Folic acid
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Cones (C for color and cones)

50. What is the most common one? - Sites for abdominal aorta aneurysm
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia
Between the renal arteries and at the bifurcation of the abdominal aorta
Pelvic splanchnics (They all begin with P.)