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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 area of the hypothalamus is responsible for recognizing a decrease in body temperature and mediates the response to conserve heat?

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2. What day of the menstrual cycle does ovulation take place?
TCA cycle.
Prevalence increases. (Incidence does not change.)
Stimulus control
Day 14

3. Name the antimicrobial agent whose major side effect is listed - Cartilage abnormalities
Glycine and succinyl - CoA
Quinolones
Medial collateral ligament
Lactose must be present and glucose must be absent

4. From What embryonic structure are the following structures derived? - The right and left atria
Copper
Primitive atrium
Paramesonephric ducts
Listeria monocytogenes

5. What components of the coagulation cascade are affected by estrogen?
Hypervariable region (three per light chain; three per heavy chain)
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Bactericidal
Blood clots

6. What is the name of the protein coat that surrounds the nuclear envelope?
Paramyxovirus
Vimentin
Constrictor pupillae and ciliary muscles
Pentoxifylline

7. Name the most common type or cause - Anovulation
Streptomycin
Polycystic ovaries
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Ulnar and radial arteries (ulnar is the main supplier)

8. What area of the limbic system is responsible for attaching emotional significance to a stimulus?
Ganglioside
Hypoparathyroidism
Amygdala; it helps imprint an emotional response in memory.
RSV

9. What four factors affect diffusion rate?
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe
Nigrostriatal pathways (basal ganglia)
Copper (Cu+)
Dopamine

10. Do the following structures pick up stain from hematoxylin or eosin? - Nucleoli
Hematoxylin
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
Apoptosis (Remember - there is a lack of inflammatory response.)

11. What agent is used IM to treat acute dystonias?
Diphenhydramine
Depolarization (i.e. - Na+ influx)
Filiform papillae
Clonidine

12. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol increased - ACTH decreased
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
Patau syndrome (trisomy 13)
Primary hypercortisolism
Negative selection. This helps to prevent autoimmune diseases.

13. A chronic alcohol abuser goes to the ER with weakness - a sore - beefy red tongue - loss of vibration and position sense - arm and leg dystaxia - elevated levels of methylmalonic acid in the urine - and anemia with an MCV above 105 fL. What is your d
Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.
Pyridoxine (B6) deficiency
Yes
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working - you will see an increased reticulocyte count on the peripheral smear in about 5 days.

14. What are the CAGE questions?
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
Schizoid
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.
Embolism

15. What muscle or muscles are innervated by the following nerves? - Suprascapular nerve
Short - chain fatty acids
Gluteus maximus
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
Supraspinatus and infraspinatus

16. What two factors determine the clearance of a substance?
Lentigo maligna melanoma
With arteriolar constriction both the flow and pressure downstream decrease.
Burkitt lymphoma
Plasma concentration and excretion rate

17. Is a nicotinic receptor agonist.
Succinylcholine
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia
Stretch receptors prevent overdistension of the lungs during inspiration.
Escherichia coli

18. Two weeks after her son has a throat infection - a mother takes the boy to the ER because he has fever - malaise - HTN - dark urine - and periorbital edema. What is your diagnosis?
Mycoplasma
Gastric cancer
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Poststreptococcal GN

19. What is the triad of NPH?
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.
Metabolic rate and alveolar ventilation (main factor)
HPV serotypes 1 and 4
Dementia Urinary incontinence Gait apraxia (NPH wet - wacky - wobbly)

20. What paraphilia is defined as x Having a recurrent desire to expose the genitals to strangers?
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c
Edward syndrome (trisomy 18)
Exhibitionism
Maxillary artery

21. What three substances stimulate glycogenolysis?
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
Fluconazole
Carbidopa and benserazide
Nephrotoxicity

22. What components of the complement cascade form the MAC?
C5b - C9
Filiform papillae
Phosphorylation of mannose residues
Stage 3 and 4

23. You would not prescribe __________ for a patient with gout who is an overexcretor of uric acid.
Probenecid
Exhibitionism
Fluconazole
ll

24. What is the bone marrow maturation time for a phagocytic cell?
Hypersegmented neutrophils
Free - unprocessed Ag
14 days
The raphe nuclei

25. At the end of each round of Beta- oxidation - What is released?
Benign nevus (mole)
Regression
Acetyl CoA - FADH2 - and NADH
UMP

26. What happens to the following during skeletal muscle contraction? - H zone
C- peptide levels
Shortens
Hepatitis A
Reverse transcription

27. What is the most common one? - Cardiac anomaly in Turner syndrome
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
Direct fluorescent Ab test
Coarctation of the aorta
Liquefaction necrosis

28. What nephrotic syndrome has effacement of the epithelial foot processes without immune complex deposition?
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.
Minimal change disease
CD16 and CD56

29. What determines the Vmax of skeletal muscle?

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30. What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ?
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.
Aminophylline
S2 - S3 - S4
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.

31. Is splenomegaly more commonly associated with intravascular or extravascular hemolysis?
Clostridium perfringens
Low interstitial free Ca2+ concentrations
Extravascular hemolysis if it occurs in the spleen; if in the liver - it results in hepatomegaly.
p -53

32. What CN is associated with the sensory innervation of x Nasopharynx?
Escherichia coli
Since they are independent events - their probabilities would be multiplied.
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.
Maxillary division of CN V and glossopharyngeal nerves

33. Name the insulin preparation based on the peak effect and duration of action - Peak - 8 to 16 hours; duration - 24 to 36 hours
Ultralente
Plummer - Vinson syndrome
AT II
Factor XII for the intrinsic; factor VII for the extrinsic pathway

34. What is the FiO2 of room air?
Median nerve lesion
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Niemann - Pick disease
0.21; it is a fancy way of saying 21% of the air is O2.

35. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Vinyl chloride
Repression
Proteus
Anterior compartment of the thigh - femoral nerve
Angiosarcoma of the liver

36. Name the type of mutation: x Unequal crossover in meiosis with loss of protein function
Inulin
Lac repressor protein
Large segment deletions
Sensitivity (it deals with the sick)

37. How many oogonia are present at birth?
Methionine (start) and tryptophan are the only two AAs with only one codon.
None; they are not formed until a girl reaches puberty.
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
Asparagine

38. Regarding the Lac operon - for What do the following genes code? - I gene
Variable interval
Lac repressor protein
Wilms tumor
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)

39. What two ligaments of the uterus are remnants of the gubernaculum?
300 mOsm/L
Arterioles have the largest drop - whereas the vena cava has the smallest pressure drop in systemic circulation.
Reserpine
Round and ovarian ligaments

40. What is the rate - limiting step in the synthetic pathway of NE at the adrenergic nerve terminal?
Intussusception
The conversion of tyrosine to dopamine in the cytoplasm
Transcription (C comes before L in the alphabet - and transCription comes before transLation)
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.

41. What three vitamin deficiencies are associated with homocystinemia?
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum
Folate - vitamin B12 - and vitamin B6
Melanoma
Selegiline

42. What is the name of the superficial subcutaneous fascia of the abdomen containing fat?

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43. Mandibular hypoplasia - down - slanted palpebral fissures - colobomas - malformed ears - and zygomatic hypoplasia are commonly seen In what pharyngeal arch 1 abnormality?
Treacher Collins syndrome
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.
Fat necrosis
Bactericidal

44. What happens to REM - REM latency - and stage 4 sleep during major depression?
extrapyramidal dysfunction
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Umbilical vein and ductus venosus (80%)
The Beta- subunit; remember - the a - subunit is nonspecific.

45. The vertebral artery is a branch of What artery?
The subclavian artery
The small subunit (40S) binds first.
Down syndrome (trisomy 21)
ELISA. It detects anti - p24 IgG.

46. What is the term for pupils that react normally to accommodation but have bilateral loss of constriction in response to light?
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Red blood cell distribution width index (RDW)
Argyll Robertson pupils
IgG

47. Why is there an increase in FF if the GFR is decreased under sympathetic stimulation?
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Reaction formation
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA
Isoleucine - leucine - and valine

48. What CNs are affected if there is a lesion in x The midbrain?
Henoch - Sch
Hepatocellular carcinoma
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.
CN III and IV

49. Is a subdural hematoma an arterial or venous bleed?
RNA polymerase I
Zoophilia
Methyldopa
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.

50. What are the five effects of insulin on fat metabolism?
Mycobacterium marinum
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
CN III and IV
Adult polycystic kidney disease