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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 saliva is produced under parasympathetic stimulation?
Agglutination test
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
90% of benign myxomas arise within the left atrium near the fossa ovalis.
Reinforcement

2. Where does the synthesis of ACh occur?
Edrophonium
Libman - Sacks endocarditis
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.

3. What Freudian psyche component is described as x The urges - sex aggression - and 'primitive' processes?
Id (pleasure principle)
Alanine cycle
The stapedius muscle
Mikulicz syndrome

4. What is the term for ventilation of unperfused alveoli?
Occipital lobe
a - and Beta- chains are on most T cells.
Alveolar dead space
1. Clavulanic acid 2. Sulbactam 3. Tazobactam

5. What enzyme deficiency results in darkening of the urine when exposed to air?
Ligamentum venosum
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
Lateral compartment of the leg - superficial peroneal nerve
3 months of symptoms in 2 consecutive years

6. What is the most common one? - Form of vasculitis
Creutzfeldt - Jakob's disease. Patients first develop vague somatic complaints and anxiety - rapidly followed by dysarthria - myoclonus - ataxia - and choreoathetosis.
Plasmodium vivax
Riboflavin (B2) deficiency
Temporal arteritis

7. What is the most common condition leading to an intracerebral bleed?
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
HTN
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
Proximal to distal progression

8. Name the most common type or cause - Chronic metal poisoning
Lead
IDL
H 2
IL-8 (IL-1 and TNF- gamma also)

9. Gas gangrene is associated with which Clostridium species?
Narcissistic
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Diphyllobothrium latum
Clostridium perfrigens

10. What is the most common one? - Cancer of the vulva
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.
Kawasaki disease
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Squamous cell carcinoma

11. What mineral - via excessive depositions in the liver - causes hemochromatosis?
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.
Negative
Vancomycin
Iron (Fe)

12. What cerebral vessel size is affected in patients with vascular dementia?
DiGeorge syndrome
Small to medium - sized cerebral vessels
Hypoxia
Treacher Collins syndrome

13. What is the term when the brachial artery is compressed - resulting in ischemic contracture of the hand?

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14. What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord?
Acarbose
Stretch receptors prevent overdistension of the lungs during inspiration.
The fasciculus cuneatus
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.

15. What enzyme catalyzes the rate - limiting step in purine synthesis?
CD40
Excess estradiol in the blood
PRPP aminotransferase
Alzheimer disease

16. Name the associated chromosome - Albinism
ACh; think about the ANS.
Cystadenocarcinoma
Chromosome 11p
Osteosarcoma

17. Name the most common reported STD - In females
Mannitol
Early collecting duct
Chlamydia
Compliance (think of it as distensibility)

18. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
Dihydrotestosterone
The T- test (used when comparing two groups)
Terminal bronchioles. (No gas exchange occurs here.)
Mitral valve prolapse

19. What is the term for the round intracytoplasmic eosinophilic inclusions containing ?- synuclein found in the dopaminergic neurons of the substantia nigra?
HMP shunt
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Lewy bodies
Excretion is greater than filtration for net secretion to occur.

20. When the ECF osmolarity increases - what happens to cell size?
Granulosa/thecal cell tumor of the ovary
Class II
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.
Liver

21. What bacterium is responsible for woolsorter's disease?
Bacillus anthracis
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
Intrinsic factor (IF)
The first trimester

22. What Ig mediates ADCC via K cells - opsonizes - and is the Ig of the secondary immune response?
Urinary 17- OH steroids
Combined metabolic and respiratory acidosis
IgG
Amnesia. (The person is aware of the memory loss.)

23. Name these narcissistic defense mechanisms: x Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.
Catechol - O- methyl transferase (COMT)
Splitting
Marrow failure - cancer - and leukemia
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.

24. Name the eukaryotic RNA polymerase based on the following: x Synthesizes 28S - 18S and 5.8S rRNAs
Gout
6 ATPs (remember 2 pyruvates per glucose are produced - and 2 NADHs result from production of acetyl CoA - so 6 ATPs)
RNA polymerase I
Hemophilia B

25. What disorder is defined by inability of the lower esophageal sphincter to relax with swallowing and a bird beak barium swallow result?
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
C1 esterase inhibitor (C1INH)
Ceramide
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)

26. What artery supplies the left ventricle - left atrium - and interventricular septum?
Myasthenia gravis
Left coronary artery
Crohn disease
Proto - oncogenes

27. Name the insulin preparation based on the peak effect and duration of action - Peak - 8 to 16 hours; duration - 24 to 36 hours
Hairy cell leukemia
Thyroid hormones are necessary for conversion of carotene to vitamin A.
Ultralente
Hypercortisolism (Cushing syndrome)

28. What embryonic structure forms the adult female structures? - Gartner's duct
Mesonephric duct
Aminoglycosides
AT II
Pyruvate carboxylase

29. What are the two absolute requirements for the cytochrome P450 enzyme system?
Radial Immuno Diffusion (RID) for Ig levels.
NADPH and molecular O 2
Gametocytes
Merkel cells (Merkel's tactile cells)

30. What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
Intrapleural pressure decreases (becomes more negative).
Amanita phalloides
Ethacrynic acid
Beta- Galactosidase

31. What rate is indicated by 1- specificity?
False - positive rate
Osteosarcoma
Sporozoites
Mesonephric duct

32. What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
Marrow failure - cancer - and leukemia
SER
5- hydroxyindoleacetic acid (5- HIAA)
Primitive atrium

33. Which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida?
EF- Tu and EF- Ts of the 30S ribosomal subunit
Median nerve lesion
Carbamazepine
A decrease in Ca2+ and an increase in PO4

34. Name the antidote - Ethylene glycol
8 weeks (response to a face)
Carbamazepine
Enterobius vermicularis
Ethyl alcohol

35. Are the following major or minor Jones criteria of rheumatic fever? - Arthralgias
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Sorbitol (resulting in cataracts)
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
Minor

36. What term describes the reflex that increases the curvature of the lens - allowing near vision?
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Osteoporosis
Accommodation

37. Which HPV serotypes are associated with condyloma acuminatum?
Systematic desensitization
Arginine
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
HPV serotypes 6 and 11

38. What form of GN is characteristically associated with crescent formation?
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
Rapidly progressive glomerulonephritis (RPGN)
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.

39. What four factors shift the Hgb - O2 dissociation curve to the right? What is the consequence of this shift?
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Acute toxic or viral nephrosis

40. Name the valve abnormality based on the following criteria: x Diastolic murmur - increased right ventricular pressure - left atrial pressure - and atrial to ventricular pressure gradient; decreased left ventricular filling pressure
Tibial nerve
RU 486
Mitral stenosis
AML- M3

41. What is the most common one? - Tumor in men aged 15 to 35
Terminal bronchioles. (No gas exchange occurs here.)
Operant conditioning (reinforcement is after a response)
Osteopetrosis (Albers - Sch
Testicular tumors

42. What are the four muscles of mastication?
The triad of respiratory depression - pinpoint pupils - and coma in an IV drug abuser suggests opioid overdose (e.g. - heroin) - and you should give naloxone.
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid
Antigenic determinant (epitope)
Edinger - Westphal nucleus (via CN III)

43. What is the label given to an individual whose IQ is x 130
Very superior (<2.5% of the population)
Vesicular stomatitis virus
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.
Sensory

44. What is the most common one? - Proliferative abnormality of an internal organ
IgM
Howell - Jolly bodies
ASA
BPH

45. What form of estrogen is of placental origin?
Estriol
Concrete operations (6-12 years)
IgM; IgD follows shortly thereafter.
Lateral fissure (fissure of Sylvius)

46. What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?
Emphysematous bleb
Filiform papillae
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Jejunum (upper)

47. What component of the ETC is inhibited by the following? - Oligomycin
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
No. It is abnormal only if it interferes with normal sexual or occupational function.
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
Fo/F1 complex

48. What reflex increases TPR in an attempt to maintain BP during a hemorrhage?
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
Birds
The carotid sinus reflex
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.

49. What classical conditioning therapy or modification is described as x Pairing noxious stimuli to an inappropriate behavior?
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.
Aversive conditioning
NH4+(ammonium)
Central sulcus (sulcus of Rolando)

50. What cytoplasmic pathway produces NADPH and is a source of ribose 5- phosphate?
IgM; IgD follows shortly thereafter.
HMP shunt
Chromosome 5p
Brucella and Listeria (has tumbling motility)