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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 mortality rate is defined as the number of deaths x From a specific cause per all deaths?
Cause - specific mortality rate
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages
Proportionate mortality rate
Tryptophan

2. How does L- tryptophan affect sleep?
Carbidopa and benserazide
Hepatitis E
Flocculonodular lobe (one of my favorite words in all of medicine!)
It increases REM and total sleep time.

3. Which subset of MEN syndrome is associated with the following? - Parathyroid - pancreatic - and pituitary gland tumors and Zollinger - Ellison syndrome
MEN I (or Wermer syndrome)
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
Nodular melanoma
Hapten; if it is coupled with a carrier - it may become immunogenic.

4. Name the two purine bases found in both DNA and RNA.
No CHO - AA - ketones - or peptides are left in the tubular lumen.
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.
Adenine and guanine
Skin - liver - and kidneys

5. Does the heart rate determine the diastolic or systolic interval?
Molindone
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
Nephroblastoma
Bactericidal

6. In skeletal muscle ________ is an active event.
IgA
relaxation
Proud flesh
It decreases insulin secretion.

7. What nematode is known as pinworms? What is the treatment?
Complex I
Enterobius vermicularis; the treatment is albendazole.
The number of Ags that the Ab can bind
Salmeterol

8. What are the three tissues where triacylglycerols are produced?
1. Liver 2. Muscle 3. Adipose tissue
Lente insulin and either NPH or protamine zinc insulin (PZI)
RES(Reticular endothelial system)
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.

9. What type II hypersensitivity disorder is defined as x Autoantibodies directed against platelet integrin?
Autoimmune thrombocytopenia purpura
Sensory
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons
Isocitrate dehydrogenase

10. Name the structure that enters or exits the following foramina: x Foramen rotundum
Encapsulated bacteria
Alzheimer disease
CN V2
Propionic acid

11. Does alcoholism increase the rate of suicide?
ASA (salicylate)
Sucralfate
Down syndrome
Yes. It increases the rate of suicide to nearly 50 times that of the general population.

12. What thyroid abnormality has the following? - TRH increased - TSH increased - T4 decreased
Norm reference (i.e. - 75% of the students in the class will pass)
Pedophilia
In the mouth with salivary a - amylase (ptyalin)
Primary hypothyroidism (Low T4 has a decreased negative feedback loop - resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release - respectively.)

13. What is the primary risk factor for suicide?
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
Large intestine. Water is passively removed from the lumen.
Ascending limb
Previous suicide attempt

14. What negative sense RNA virus is associated with cough - coryza - and conjunctivitis with photophobia?
2 and 5HT3 receptors
Pterygopalatine ganglion (I remember this as the only ganglion left.)
Opsonization
Measles (rubeola)

15. What a1- agonist - not inactivated by catechol - O- methyl transferase (COMT) - is used as a decongestant and for treatment of paroxysmal atrial tachycardia?
Onset of bleeding
Internal iliac nodes
Phenylephrine
Substance P. (Opioids relieve pain in part by blocking substance P.)

16. From which two substances are phospholipids made?
Voltage - gated sodium channel
Rickets
Diacylglycerols and phosphatidic acid
Xenograft

17. Which organism causes trench fever?
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
Rochalimaea quintana (now called Bartonella quintana)
Polycystic kidney disease of childhood
Affinity

18. Development of what T cell line follows low affinity for self - MHC class II Ags in the thymus?
C3b
Osteoporosis
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
CD4+T cells

19. If the radius of a vessel doubles - what happens to resistance?
Four
Phase II
Cefuroxime and cefaclor
The resistance will decrease one - sixteenth of the original resistance.

20. Name the type of hypersensitivity reaction based on the following properties - IgG or IgM Abs against a specific target cell or tissue; complement - dependent or ADCC.
Type II hypersensitivity (cytotoxic)
Median (think of it as the halfway point)
The vagina
Dihydrofolate reductase

21. Prolactin levels can serve as a rough indicator of...
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
Afterload
Bisphosphonates
overall dopamine activity

22. What neuroendocrine tumor produces excess serotonin; is associated with diarrhea - flushing - bronchospasms - wheezing; and is diagnosed by findings of elevated urinary 5- HIAA levels?
Carcinoid tumor
The negative charge inhibits the filtration of protein anions.
Jejunum (upper)
Ethyl alcohol

23. Which anticonvulsant is also used in the treatment of bipolar disorder and for migraine headaches?
Stage 1
Third week
Ewing sarcoma
Valproic acid

24. What organ functions to keep blood glucose levels normal through both well - fed and fasting states and produces ketones in response to increased fatty acid oxidation?
Liver
Anhedonia
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva
Microsporum

25. What are the CAGE questions?
NADPH oxidase
Bacterial meningitis
CLL (B- cell origin)
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)

26. What type of erythema do you see in x Stevens - Johnson syndrome?
Streptococcus viridans
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.
Menstruation
Erythema multiforme

27. What is the precursor of all sphingolipids?
Ceramide
Tylosis
Clostridium perfringens
Good Samaritan Law. (Physicians are not required to stop and help.)

28. Which potassium - sparing drug is an aldosterone receptor antagonist ?
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Histamine
Fixed ratio (rewards set behaviors)
Spironolactone

29. Which HPV serotypes are associated with condyloma acuminatum?
Thymus gland. (Thymus gland is essential for T cell maturation.)
HPV serotypes 6 and 11
Pergolide
Passive - aggressive

30. Via what pathway is glycolysis increased after phagocytosis?
Glycine/arginine
2 ATPs - via the amino acyl tRNA synthase enzyme
Salpingitis
HMP shunt

31. What is the most common organ involved in amyloidosis?
Acute pyelonephritis
Decrease (5- HT and dopamine levels do the same)
Kidney
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)

32. The first area to be oxygenated in the liver.
Lateral fissure (fissure of Sylvius)
1. ADP 2. PG 3. TXA2
Anopheles mosquito
The portal tract of the liver lobule

33. What are the two most common chains of the TCR?
The energy of activation
Staphylococcus aureus (but they are more prone to salmonella infections)
A transport maximum (Tm) system
a - and Beta- chains are on most T cells.

34. Name the three enzymes that protect the cell from oxygen - derived free radicals.
Squamous cell carcinoma
Superoxide dismutase - glutathione peroxidase - catalase
Non - Hodgkin lymphoma
IgA

35. What parasite found in raw fish can produce vitamin B12 deficiency?
Diphyllobothrium latum
Graves disease
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
RES(Reticular endothelial system)

36. What is the antidote for organophosphate ingestion?
Negative correlation
Atropine and 2- PAM (pralidoxime)
Leptospira
Paramesonephric ducts

37. What form of AA is found only in collagen?
Hydroxyproline
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.
Reverse transcriptase
Nucleolus. Ribosomal assembly also takes place in the nucleolus.

38. Which IL increases IgA synthesis?
Preganglionic sympathetic neurons
IL-5. It also stimulates eosinophil proliferation.
Addition (They are mutually exclusive.)
HPV serotypes 6 and 11

39. What enzyme catalyzes the covalent bonding of the AA's carboxyl group to the 3' end of tRNA?
Posterior chamber
Lipoprotein lipase
Purulent exudates
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.

40. The elimination of the unfertilized egg. In females - meiosis II is incomplete unless fertilization takes place.
Anticentromere Abs
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Posterior
Menses

41. Which sedative - hypnotic is contraindicated for patients taking warfarin?
Chloral hydrate
G1 phase; G2 and S phase are diploid (2N).
Gaucher disease
Nocardia asteroides

42. What is the term for RBC remnants of nuclear chromatin in asplenic patients?
Mycosis fungoides (cutaneous T- cell lymphoma)
Marfan syndrome
Epidural hematoma
Howell - Jolly bodies

43. Why does carbon monoxide diffusion in the lung (DLCO) decrease in emphysema and fibrosis but increase during exercise?
Transferrin
MGB (think EARS)
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
ACE inhibitors (- pril)

44. What is the most common one? - Testicular tumor in men over 50 years old
Xanthine oxidase
Testicular lymphoma
Acute rejection
Paranoid schizophrenia

45. Name the three benzodiazepines that are not metabolized by the cytochrome P450 enzyme system.
Repolarization is from base to apex and from epicardium to endocardium.
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
Cricothyroid muscles
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)

46. What is the term for the summation of mechanical stimuli due to the skeletal muscle contractile unit becoming saturated with calcium?
Stable
Carbidopa and benserazide
Tetany
Gaucher disease

47. What two veins form the portal vein?
Minor
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
Progestins
The anterior nucleus of the thalamus

48. What type of hypersensitivity is an Ab - mediated response against our own cells - receptors - or membranes via IgG or IgM?
Serratia
Smooth muscle
Type II hypersensitivity reaction
Erythema nodosum

49. What is the most common cancer diagnosed in men? In women?
Asparagine
In men it is prostate cancer - and in women it is breast cancer.
IgM
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice

50. What component of the ANS - when stimulated - results in bronchoconstriction?
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.
The zygote divides mitotically; only germ cells divide meiotically.
2.0 or greater
Guanethidine and bretylium