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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 is the term for edema that has LDH below 200 - protein level 2.5 - and a specific gravity below 1.020?
Transudative; exudative has the opposite values and has an elevated cellular content.
Unstable (crescendo) angina
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
gp120

2. What is the rate - limiting step of the following? - Cholesterol synthesis
G0 phase
Jejunum (upper)
Mature B cell; the memory B cell can have IgG - IgA - or IgE on its surface.
HMG CoA reductase

3. What disorder is associated with decreased platelet count - prolonged PT and PTT - decreased fibrinogen - and increased fibrin split products (D- dimers)?
Disseminated intravascular coagulation (DIC)
On the superior body of the posterior wall of the uterus
Meningococcus (Gonococcus does not)
Specificity (it deals with the healthy)

4. What Ab is an indication of recurrent disease for hepatitis?
Anticentromere Abs
HBc Ab
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Substance P. (Opioids relieve pain in part by blocking substance P.)

5. Regarding neuroleptics - What is the relationship between potency and anticholinergic side effects?
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
4 years old
Good Samaritan Law. (Physicians are not required to stop and help.)

6. Name the associated chromosome - VON Hippel - Lindau disease
Huntington disease
Chromosome 3p
Cefuroxime and cefaclor
Factitious disorder

7. What pulmonary disease - most commonly associated with smoking - results in enlarged - overinflated lungs owing to the destruction of the alveolar walls with diminished elastic recoil?
Emphysema
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Ampicillin and amoxicillin
Broca's aphasia

8. What hormone - stimulated by epinephrine - results in an increase in lipolysis?
Epinephrine
Rhombencephalon
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
They are in the grey matter of the CNS.

9. What virus causes hoof - and - mouth disease?
Positive
NE - via its vasoconstrictive action on blood vessels
Vesicular stomatitis virus
In men it is prostate cancer - and in women it is breast cancer.

10. Name the bony articulations of the following sites. Be specific. Elbow
Hypnozoite
Metastatic
Humerus with ulna (major) and radius (minor)
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon

11. What CNs are affected if there is a lesion in x The upper medulla?
Endometrial cancer
Degenerates
CN IX - X - and XII
Medial meniscus

12. What enzyme of the purine salvage pathway is deficient in the following? - Selective T- cell immunodeficiency
Purine nucleoside phosphorylase
Albendazole
G2 phase
MGB

13. If the radius of a vessel is decreased by half - what happens to the resistance?
Oligodendroglioma
Dissociation
The resistance increases 16- fold.
HMG- CoA reductase

14. Does the direct or indirect basal ganglia pathway result in a decreased level of cortical excitation?
Chronic end - stage renal disease
Although both pathways are associated with disinhibition - the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Radial Immuno Diffusion (RID) for Ig levels.
Nystagmus and ataxia

15. What component of the trigeminal nuclei x Receives sensory input (all but pain and temperature) from the face - scalp - dura - and the oral and nasal cavities?
Spinal trigeminal nucleus
Mycosis fungoides (cutaneous T- cell lymphoma)
Secondary hypocortisolism (pituitary)
The dentate nucleus

16. What rate is indicated by 1- sensitivity?
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
ACE inhibitors (- pril)
False - negative rate
a - and Beta- chains are on most T cells.

17. What five pathways use SAM (S- adenosylmethionine) as the methyl donor?
Lateral pontine syndrome
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA
Nodes of Ranvier
Coxiella burnetii

18. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Aschoff bodies of rheumatic fever
Ipsilateral loss below the level of the lesion
Eosinophils
Iodine - resulting in congenital hypothyroidism

19. What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Gastrin - releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)
Borrelia recurrentis
Nephroblastoma

20. The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.
Free form determines hormone activity and is responsible for the negative feedback loop.
Coxiella burnetii

21. What law states that an enlarged - palpable gallbladder is more likely due to cancer than stone obstruction?

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22. What is the term for a unit of DNA that encodes a particular protein or RNA molecule?
A gene (a rather simple definition but accurate)
IgA nephropathy
Motor
Berger disease (IgA nephropathy)

23. Name the most common type or cause - Nephritic syndrome in adults
MGN
Gabapentin
Calcarine sulcus
Adenosine (it is an excellent agent to use in emergencies because its half - life is 30 seconds)

24. In what stage of sleep is GH secreted?
Stages 3 and 4 (NREM)
Left anterior descending artery
PRPP aminotransferase
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.

25. What urease - producing gram - negative curved rod is associated with PUD and chronic gastritis?
Helicobacter pylori - Which is also associated with an increased risk of gastric carcinoma
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
Log - kill hypothesis (follows first order kinetics)
Missense

26. What fungus is characterized by hypopigmented spots on the thorax - spaghetti - and - meatball KOH staining - and pityriasis or tinea versicolor?
Malassezia furfur (treat with selenium sulfide)
Low molecular weight heparin (LMWH)
Haemophilus influenzae type B
Vitamin D

27. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Diencephalon
Left atrium
Naloxone or naltrexone
Proencephalon
>15 mm

28. What is the triad of Horner's syndrome?
Granulosa cells
Ampulla
Severe combined immunodeficiency disease
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.

29. What type of spore is asexual and formed of hyphae?
Eosin
CN V2
Conidia
Myasthenia gravis

30. What is the term for ejaculation before or immediately after vaginal penetration on a regular basis?
MEN IIa (or Sipple syndrome)
Premature ejaculation
The increased H+ moves intracellularly and is buffered by K+ leaving the cells - resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis - even though the serum
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)

31. What tumor marker is associated with seminomas?
Kimmelstiel - Wilson disease
Placental alkaline phosphatase
Left eye anopsia (left nasal and temporal hemianopsia)
Mycoplasma pneumoniae

32. What four substances increase the rate of gluconeogenesis?
Frotteurism
REM and stage 4 sleep; they decrease.
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
well - fed and fasting

33. What subtype of IgG does not bind to staphylococcal A protein?
CD19
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
IgG3
RNA polymerase III

34. What condition results in the following CSF results? - Opening pressure 100 mm H2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17
Major
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma
Viral meningitis

35. Which antihistamine is one of the DOCs for treatment of vertigo?
Meclizine
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
Chromosome 5

36. What thyroid carcinoma is associated with radiation exposure - psammoma bodies - and Orphan Annie eye nuclei?
Paranoid schizophrenia
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Papillary carcinoma of the thyroid
Yes - it decreases fat and muscle uptake of glucose - thereby increasing blood glucose levels.

37. With what stage of sleep are nightmares associated?
Without children (but don't think about this one for too long)
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
REM sleep. Nightmares are frightening dreams that we recall.
Hematoxylin

38. What family do the following viruses belong to? - Ebola
t the end of the PCT 25% of Na+ - Cl - - K+ is left
Resistance decreases as resistors are added in parallel.
Filovirus
Abs to HBsAg

39. Name the most common type or cause - Chancre
Haemophilus ducreyi
The muscle's ATPase activity
Rickets prior to fusion - osteomalacia if the deficiency occurs after epiphyseal fusion.
Myasthenia gravis

40. What is the most common one? - Sites for abdominal aorta aneurysm
Smooth muscle
Simple diffusion; it does not use protein - mediated transport
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
Between the renal arteries and at the bifurcation of the abdominal aorta

41. Is masturbation considered an abnormal sexual practice?
Lesser curvature of the antrum of the stomach
No. It is abnormal only if it interferes with normal sexual or occupational function.
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
Voyeurism

42. Are seen in medullary carcinoma of the thyroid.
Progressive multifocal leukoencephalopathy
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
Psammoma bodies
Microglia (Microglia and mesoderm both begin with M)

43. Which streptococcal species is associated with dental caries and infective endocarditis in patients with poor oral hygiene?
Histidine - because of the imidazole ring found in the R group - is basic.
Streptococcus viridans
No - it is never acceptable to lie.
ATP/ADP Translocase

44. Name the associated chromosome - Chronic lymphocytic leukemia (CLL)
0.2
Chromosome 12
Gonococcus
Eosin

45. What is the name of the tumor when gastric carcinoma spreads to the ovaries?
The conversion of tyrosine to dopamine in the cytoplasm
Aminophylline
Krukenberg tumor
Obturator nerve

46. Which serotypes of HPV are associated with plantar warts?
Para - aminohippurate (PAH)
HPV serotypes 1 and 4
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)

47. What DNA viral disease is associated with aplastic crisis in patients with sickle cell anemia?
Superior and posterior
Parvovirus B-19
NREM sleep. Night terrors are dreams that we are unable to recall.
Terminal ileum

48. The gallbladder functions to...
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
produce bile
Thoracic and sacral
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol

49. What component of the pelvic diaphragm forms the rectal sling (muscle of continence)?
Hypochondriasis (they will begin with 'I think I have...')
Tidal volume (VT)
Puborectalis
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III) - B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.

50. What is the site of action for carbonic anhydrase inhibitors?
Sucralfate
2 to 4 hours
Proximal tubule
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile