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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 are the four chemotactic agents?
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
Chromosome 22q
The time it takes ACh to diffuse to the postjunctional membrane
Testicular feminization syndrome (Dude looks like a lady!)

2. What three AAs are used to synthesize the purine ring?
In the first 3 months
1. Glycine 2. Aspartate 3. Glutamine
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)

3. Name the product or products of arachidonic acid: x Vasoconstriction and platelet aggregation produced by platelets
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
TXA2
Mesencephalon
Vmax

4. What AD GI neoplasia produces multiple adenomatous polyps - osteomas - fibromas - and epidural inclusion cysts?
Gardner syndrome
Autoimmune hemolytic anemia
Pseudomonas aeruginosa
Scavenger receptor (SR- B1)

5. Do high levels of estrogen and progesterone block milk synthesis?
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
GnRH pulsatile infusion
Non - Hodgkin lymphoma
Free ionized Ca2+

6. At what vertebral level does the trachea bifurcate?
Tetralogy of Fallot
Kartagener's syndrome (also known as immotile cilia syndrome) -------------------------------------------------------------------------------
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
T lymphocyte

7. What form of bias occurs when the experimenter's expectation inadvertently is expressed to the subjects - producing the desired effects? How can it be eliminated?
S phase
Denial
Pygmalion effect (experimenter expectancy). This can be eliminated with double - blind studies.
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.

8. With a decrease in arterial diastolic pressure - what happens to x Stroke volume?
Ixodes (also the vector for Lyme disease)
Histamine
Mycoplasma pneumoniae
Decreases

9. Name the three benzodiazepines that are not metabolized by the cytochrome P450 enzyme system.
Metaraminol (a1 - Beta1 )
Oxazepam - temazepam - and lorazepam ( OTL - Outside The Liver)
Gastric carcinoma
The muscle's ATPase activity

10. What is the term for a unit of DNA that encodes a particular protein or RNA molecule?
Plasmodium malariae
Gastric carcinoma
Somatoform pain disorder
A gene (a rather simple definition but accurate)

11. Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.
Eosin
Poliomyelitis; it is a bilateral LMN lesion.

12. Are always open.
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
Ungated channels
The biofeedback model is based on the parasympathetic nervous system.
Type I hypersensitivity (anaphylactic)

13. Which subtype of AML is most commonly associated with Auer rods?
Western blot
Streptococcus agalactiae (Group B Streptococcus - or GBS)
Hyperpolarization (i.e. - K+ influx)
M3 (promyelocytic leukemia)

14. When a drug is administered orally and enters into portal circulation - it undergoes hepatic metabolism. What is the name of this effect?
Hypertrophic scar
Parvovirus B-19
First - pass effect
Methylphenidate (Ritalin)

15. What AR syndrome is due to a deficiency of glycoprotein Ib - resulting in a defect in platelet adhesion?
Dorsal motor nucleus of CN X
Mycobacterium leprae
EBV
Bernard - Soulier syndrome

16. What nerves carry the sensory and motor components of the blink reflex?
IgA
Volume of distribution is decreased when a large percentage of drug is protein bound.
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.
Cori cycle

17. Why is the cell's resting membrane potential negative?
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Metastatic
Sporozoites
Compliance (think of it as distensibility)

18. What negative sense RNA virus is associated with intracytoplasmic inclusion bodies called Negri bodies?
0157:H7
Clofazimine
Rabies
Direct; in males less than 50 years old indirect hernias are the most common type.

19. What eukaryotic translation enzyme is associated with the following: x Termination
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
Hypotonic - because NaCl is reabsorbed in the salivary ducts
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)

20. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 23/2n
Malignant mesothelioma
From the wall of the yolk sac
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
Secondary spermatocyte

21. What nerve supplies general sensation to the anterior two - thirds of the tongue?
Axillary nerve and posterior humeral artery
The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
Teeth grinding is associated with stage 2 sleep.
Lingual nerve of CN V3

22. What lower extremity nerve is described by the following motor loss? - Loss of adduction of the thigh
Obturator nerve
Fragile X syndrome
HGPRT
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.

23. Which muscle of the eye is under sympathetic control?
100% - with about 20% remaining positive after 1 year
Dilator pupillae muscle
Bacteria
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.

24. What part of the heart forms x Apex?
Herpes virus I and II
H 1
Tip of the left ventricle
MEN IIa (or Sipple syndrome)

25. What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy?
Progestin
Anterior tibial artery
Cystadenocarcinoma
Celecoxib

26. Where is the cupola of the lung in relation to the subclavian artery and vein?
Streptococcus pneumoniae
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.
Decreases
Vimentin

27. What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Popliteus
Astrocytoma

28. Is the hydrophobic or hydrophilic end of the phospholipids of the cell membrane facing the aqueous environment?
Superego
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
Left ventricle and auricle of left atrium
Eisenmenger's syndrome

29. Name the most common type or cause - Hypothyroidism in the United States
Iatrogenesis
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Pearson correlation
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.

30. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - aggression - inability to learn new material - and memory problems
100% - with about 20% remaining positive after 1 year
Limbic system
Tip of the left ventricle
Friedreich ataxia

31. What is the most common primary malignant tumor in bone?
The liver (in the mitochondria)
Osteosarcoma
Are live attenuated vaccines available in the United States
Thymic epithelial cells - dendritic cells - and macrophages

32. What receptors are the best markers for NK cells?
Ampicillin and amoxicillin
Saccule and utricle
Pyridoxine (B6)
CD16 and CD56

33. Name the lipoprotein based on the following characteristics - apo E - apo C- II - apoB-48
Factitious disorder
Chylomicrons
Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone - produced by Leydig cells - is needed for spermatogenesis.
Dilator pupillae muscle

34. What is the most common one? - Renal cell cancer type
Seminoma
Clear cell
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
Myeloperoxidase

35. What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Palindrome
Tylosis
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.

36. What is the name of the bullet - shaped virus?
Extinction
Ventricular fibrillation (V fib)
mRNA
Rhabdovirus

37. What area of the hypothalamus is responsible for recognizing an increase in body temperature and mediates the response to dissipate heat?
Negative
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Tetany
Anterior hypothalamic zone; lesions here result in hyperthermia.

38. What family do the following viruses belong to? - Measles
Paramyxovirus
Proencephalon diencephalon derivative
Down syndrome (it is slightly more common than fragile X syndrome.)
Pyridoxine (B6)

39. What is the most common infectious agent in HIV?
Sporozoites
Estriol
Scrofula
Pneumocystis carinii

40. In the alveoli - what cell type is x responsible for producing surfactant?
Pia mater
Type II pneumocytes
Erythema multiforme
LTB4

41. What enzyme of purine synthesis is inhibited by allopurinol and 6- mercaptopurine?
Hydatidiform mole
Spinothalamic tract (anterolateral system)
Mitral (bicuspid) valve
PRPP aminotransferase

42. How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented?
Tetracycline
Cestodes
Pons
At least 5 lobes

43. What paraphilia is defined as x Having sex with cadavers?
Necrophilia
Shifts it to the right
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
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.

44. Name the macrophages by location: x Lungs
Bacillus anthracis
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
Alveolar macrophages
As the standard deviation increases - the greater the chance of error.

45. Name the cerebral vessel associated with the following vascular pathologies - Subdural hemorrhage
Bridging veins draining into the sagittal sinus
Urophilia
Large intestine. Water is passively removed from the lumen.
Enterokinase

46. What glycogen storage disease is due to the following enzyme deficiencies? - Lysosomal glucosidase (acid maltase)

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47. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH decreased - Ca2+ increased - Pi increased
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.
Secondary hypoparathyroidism (vitamin D toxicity)
Haemophilus influenzae type B
urease positive

48. What is the end product of purine catabolism?
Uric acid
Both
Ampicillin and amoxicillin
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen

49. When a patient closes the eyes while standing with feet together - the visual and cerebellar components of proprioception are removed - so you are testing the dorsal columns. Swaying with eyes closed is a positive Romberg's sign indicating a lesion i
Vitamin A
Vitamin D
PRPP aminotransferase
By asking a patient to close the eyes while standing with feet together

50. What form of coarctation of the aorta is associated with Turner syndrome?
Hepatoma and nonseminomatous testicular germ cell tumors
Biofeedback
Spermatogonia (type B)
Preductal (infantile)