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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 most common one? - Route of spread in pyogenic osteomyelitis
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
Hematogenous
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
Cytosine

2. What family do the following viruses belong to? - Measles
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Turner syndrome
a -1 - 6 transferase
Paramyxovirus

3. What is the function of the arachnoid granulations?
Reovirus
Streptomycin
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
Resorb CSF into the blood

4. Which is the conditioned response - the conditioned stimulus - the unconditioned response - the unconditioned stimulus in this case? A patient has blood withdrawn and faints. The next time she goes to have blood taken - she faints at the sight of the
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting). The needle is part of the blood - drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in th
ACh; think about the ANS.
Anterior compartment of the thigh - femoral nerve
Friedreich ataxia

5. Which a - blocking agent is used to treat refractory hypertension and baldness?
Isovolumetric contraction
The vaccine contains 23 capsular polysaccharides.
Minoxidil (orally and topically - respectively!)
extrapyramidal dysfunction

6. What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
Heroin
It is rare with normal grief; however - it is relatively common in depression
EF- G of the 50S subunit

7. What triad consists of endothelial injury - changes in laminar flow - and hypercoagulation?
Hypochondriasis (they will begin with 'I think I have...')
Fusobacterium
Translation
Virchow triad - associated with the formation of a thrombus.

8. At what vertebral level does the trachea bifurcate?
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
Purkinje cell is the fastest - and the AV node is the slowest.
Amyloidosis

9. What two CNs are responsible for the carotid body and sinus reflexes?
CN IX and X
Sympathetic nervous system
They are preganglionic sympathetic axons. They are white because they are myelinated.
Lateral fissure (fissure of Sylvius)

10. At the level of rib 6 - the internal thoracic artery divides into What two arteries?
Antithyroglobulin and antimicrosomal Abs
Musculophrenic and superior epigastric arteries
d - ALA synthase
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see - can't wee - can't kick with your knee

11. What structure of the knee is described thus? - Prevents anterior displacement and has lateral - to - medial attachment on the tibia
C4 (the upper border of the thyroid cartilage)
ACL
Iron (Fe)
Bacillus cereus

12. What muscle is the chief flexor of the hip?
Glucose -6- phosphatase
Regression
CMV retinitis and HSV-2
Psoas major

13. What form of anemia is diagnosed with sucrose lysis test and Ham test?
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
Paroxysmal nocturnal hemoglobinuria
IF
Down syndrome

14. What do UMNs innervate?
Methionine (start) and tryptophan are the only two AAs with only one codon.
They innervate LMNs.
Thiamine
Prolactin

15. What stage of sleep is associated with somnambulism?
Rheumatoid arthritis
Disseminated intravascular coagulation (DIC)
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed - thereby increasing the secretion of prolactin.
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.

16. What are the six substances that promote the secretion of insulin?
Areas 18 and 19
HPV infection
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
Isotypes

17. Name the ocular lesion; be specific - A right lateral compression of the optic chiasm (as in aneurysms in the internal carotid artery)
Cohort studies determine incidence and causality - not prevalence.
Bridging veins draining into the sagittal sinus
G-6- PD
Right nasal hemianopsia

18. What major side effect of neuroleptics is characterized by pill rolling - shuffling gait - and tremors that abate during sleep?
Amygdala; it helps imprint an emotional response in memory.
Pseudogout
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
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

19. Name the structure that enters or exits the following foramina: x Cribriform plate
CN I
MEN II and III syndromes
Venous pressure above the heart is subatmospheric - so a puncture there has the potential to introduce air into the system.
M12 strains

20. Name the type of exudate - given the following examples - Parasitic infection
Granulosa cells
Eosinophilic exudates
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Acetyl CoA carboxylase

21. A 20-year - old woman goes to the ER with ptosis - diplopia - weakness in her jaw muscles when chewing - and muscle weakness with repeated use. What is your diagnosis?
Axis IV
Amnesia. (The person is aware of the memory loss.)
Aldosterone
Myasthenia gravis

22. Place in order from fastest to slowest the rate of gastric emptying for CHO - fat - liquids - and proteins.
Liquids - CHO - protein - fat
1. Sleep paralysis 2. Hypnagogic hallucinations (while falling asleep) 3. Sleep attacks with excessive daytime sleepiness 4. Cataplexy (pathognomonic) Narcolepsy is a disorder of REM sleep - with REM occurring within 10 minutes of sleep.
5 years old
Mast cells

23. At What three sites can the HMP shunt enter into glycolysis?
Schistosoma have separate males and females.
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
Malpighian layer (made up of the stratum basale and stratum spinosum)
Monocytosis

24. At which three sites in the body is T4 converted to T3?
Acute tubular necrosis
Carbamazepine
1. Liver 2. Kidney 3. Pituitary gland (via 5'- deiodinase enzyme)
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive - compulsive disorder and learning disabilities.

25. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Placental alkaline phosphatase
Thrombocytopenia - eczema - and immunodeficiency is the triad of this X- linked recessive disorder.
Histiocytes
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
Seminoma

26. Name the form of spina bifida - Meninges and spinal cord project through a vertebral defect
Bell pad
Muscle glycogen phosphorylase
Meningomyelocele All except occulta cause elevated - fetoprotein levels.
Superior

27. What paraphilia is defined as x Sexual fantasies or practices with animals?
Zoophilia
Aversive conditioning
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Lipoid nephrosis

28. What component of the corneal reflex is lost in a CN VII deficit?
Sigma factor
Motor aspect
Pia mater
Antimicrobial agents

29. Under normal conditions - What is the main factor that determines GFR?
Maxillary artery
Scavenger receptor (SR- B1)
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
Hypervariable region (three per light chain; three per heavy chain)

30. What type of potential is characterized as being an all - or - none response - propagated and not summated?
refractory sexual periods
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
Action potential
Inferior phrenic artery

31. What is the most common form of dementia?
Dysgerminoma
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
Intellectualization
Phenylephrine

32. What protein deficiency results in respiratory distress syndrome of newborns?
Necrotizing enterocolitis
Deficiency in surfactant
CN III and IV
Plasmodium vivax

33. Name the type of hypersensitivity reaction based on the following properties - Circulating Ab - Ag immune complexes deposited in the tissue result in neutrophil attraction and the release of lysosomal enzymes.
Superego
Type III hypersensitivity (immune complex)
Ependymal cells
ASD

34. What is the most common one? - Site for atherosclerotic plaques in the abdominal aorta
Streptokinase
The bifurcation of the abdominal aorta
Catalase - negative bacteria secrete H2O2 as a byproduct (remember - catalase breaks down H2O2) - allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase - positive bacterial infect
Bender Visual Motor Gestalt Test

35. By What age should children be able to draw the following figures? - Rectangle
Labile
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
Keloid

36. What is the name for inability to stop a movement at the intended target?
apo A-1
Bladder cancer
Dysmetria; this is seen in a finger - to - nose test.
Axillary nerve and posterior humeral artery

37. Name the thalamic nucleus based on its input and output - Input from medial lemniscus and the spinocerebellar tracts; output to the primary somatosensory cortex
Parasympathetic
Ventral posterolateral nucleus
Left heart failure
Myeloperoxidase

38. What viral infection in patients with sickle cell anemia results in aplastic crisis?
Parvovirus B 19
Posterior hypothalamic zones; lesions here result in poikilothermy (environmental control of one's body temperature).
Target cell
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).

39. Name the form of spina bifida - Defect in the vertebral arch
Occulta All except occulta cause elevated - fetoprotein levels.
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)
The number of Ags that the Ab can bind
Type IV hypersensitivity (cell - mediated)

40. What is the name of demyelination of the corticospinal tract and the dorsal column in the spinal cord due most commonly to a vitamin B12 deficiency?
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Prolactinoma
CHF
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.

41. What is the most common genetic deficiency resulting in hemolytic anemia?
Gluteus maximus
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
The small subunit (40S) binds first.
G-6- PD deficiency; pyruvate kinase deficiency is second.

42. What three complement fragments are also anaphylatoxins?
Arch of the aorta and right subclavian artery
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol
C3a - C4a - and C5a
BPH

43. What enzyme catalyzes the rate - limiting step in the TCA cycle?
NADPH - O2 - and cytochrome b5
Eosin
Campylobacter jejuni
Isocitrate dehydrogenase

44. What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
External 3' - 5' PDE bonds
Operant conditioning (reinforcement is after a response)
Shortens
HGPRT

45. Cherry red intoxication is associated with what form of poisoning?
Sacrococcygeal teratoma
CO
Mikulicz syndrome
C1 - C2 - or C4 deficiency

46. Name the phase of the ventricular muscle action potential based on the following information: x Slight repolarization secondary to potassium and closure of the sodium channels
Chromosome 21
CN XI - vertebral arteries
Aortic stenosis
Phase 1

47. What are the four ways to increase TPR?
Ribavirin
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels
Thalassemia minor

48. What subset of CD4 helper T- cell function is helping the development of CD8 T cells?
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
Th1; they are also responsible for delayed - type hypersensitivity (type IV)
Brain abscess
MEN II and III syndromes

49. What Ag is needed to diagnose an infectious patient with hepatitis B?
CD40 ligand
HBeAg
Lispro insulin
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.

50. Patients with _______________ have B cells in the peripheral blood.
Ferritin
Primary follicle of the cortex
Clear cell
common variable hypogammaglobinemia

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