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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. If the pH is low with increased CO2 levels and decreased HCO3- levels - What is the acid - base disturbance?
Combined metabolic and respiratory acidosis
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
Chromosome 15 - 17
Hyperplasia

2. What are the three Beta - lactamase inhibitors?
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Huntington disease
Middle meningeal artery
2 to 4 hours

3. What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
Seminoma
Proencephalon diencephalon derivative
Papillary carcinoma
Porcelain gallbladder

4. What is the term for days 15 to 28 in the female cycle?
Crossover study
Akathisia
Bulbus cordis
Luteal phase

5. How many days prior to ovulation does LH surge occur in the menstrual cycle?
They are in the grey matter of the CNS.
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
>15 mm
1 day prior to ovulation

6. What are the first signs of overdose from phenobarbitals?
Methyldopa
Nystagmus and ataxia
The carotid sinus reflex
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.

7. Name the area of the cerebral cortex with the function described: x Language - memory - and emotion (Hint: herpesvirus infects here commonly)
Niacin (B3)
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
Streptococci
Temporal lobe

8. Where is the cupola of the lung in relation to the subclavian artery and vein?
Gonorrhea
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.
Chromosome 19
Insulinoma

9. What is used as an index of the number of functioning carriers for a substance in active reabsorption in the kidney?
C3 - C4 - and C5 keep the diaphragm alive!
To provide attachment between contiguous cells and to maintain a semipermeable barrier
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
Magnesium

10. What are the primary neurotransmitters at the following sites? - All motor neurons - postganglionic parasympathetic neurons
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
ACh
Splitting
Beta2- integrins

11. Name the most common type - Learning disability
Type III
Granulosa cells
Dihydrofolate reductase
Dyslexia

12. What is the longest and most convoluted segment of the nephron?
Filiform papillae
Being a white male
PCT
Risperidone

13. What four conditions result in secondary hyperaldosteronism?
Acetyl CoA - FADH2 - and NADH
Asbestosis and silicosis
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
Direct fluorescent Ab test

14. What is the vector for Leishmania infections?
Axis II
Physiologic dead space is the total dead space of the respiratory system.
The sandfly
Tropomyosin

15. What test uses p24 protein when diagnosing HIV?
Sheehan syndrome
ELISA test
Chromosome 20q (deficiency in adenosine deaminase)
Follicular lymphoma

16. What is the stimulus for the classical pathway activation?
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
Nitroprusside
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.

17. What paraphilia is defined as x Sexual fantasies or practices with animals?
IGF-1 (somatomedin C)
Mesencephalon
Asparagine
Zoophilia

18. What is it called when levels of sex steroids increase - LH increases - and FSH increases?
Phase II
Ristocetin
Factor XII for the intrinsic; factor VII for the extrinsic pathway
GnRH pulsatile infusion

19. Which organism causes Weil's disease?
Leptospira
Antigenic determinant (epitope)
Superego
Short - chain fatty acids

20. Name the most common type or cause - Reversible HTN in the United States
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
Large intestine. Water is passively removed from the lumen.
Alcohol abuse
F- Met - Peptides

21. A Japanese man has weight loss - anorexia - early satiety - epigastric abdominal pain - and a palpable left supraclavicular lymph node. On endoscopy you find a large - irregular ulcer with elevated margins on the lesser curvature of the stomach. What
Dihydrofolate reductase
Gastric carcinoma
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get
Turner syndrome

22. What negative sense RNA virus is associated with parotitis - pancreatitis - and orchitis?
7
Mumps
Shortens
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)

23. As what AAs do muscles send nitrogen to the liver?
Alanine and glutamine
Incidence rate
Chloral hydrate
Mitochondria

24. What is the term for the first 3 to 5 days of the female reproductive cycle?
Menses. (Ovulation occurs 14 days before the beginning of menses.)
Ischemia
As sample size increases - the lower the chance of error.
Separation anxiety

25. What is the only subtype of Hodgkin's lymphoma that is most commonly seen in females?
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
Right nasal hemianopsia
Nodular sclerosis
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).

26. Name the most common type or cause - Acute renal failure in the United States
Chromosome 4p
Acute tubular necrosis
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
2 - 4- Dinitrophenol

27. On the venous pressure curve - What do the following waves represent? - V wave?
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)
Arginine
Atrial filling (venous filling) Atrial - Contraction - Venous
Sj

28. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 23/1n
Thoracic and sacral
Rickets
Spermatid
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme

29. Are the following major or minor Jones criteria of rheumatic fever? - Sydenham chorea
G-6- PD deficiency
tRNA
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Major

30. Name the most common type or cause - Nephritic syndrome in adults
MGN
Dihydrofolate reductase
Guanethidine and bretylium
Parasympathetics (parasympathetics point - sympathetics shoot)

31. Name the most common type or cause - Acute tubular necrosis
Ischemic
Negative
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Streptococcus pyogenes

32. What is the major hormone produced in the following areas of the adrenal cortex? - Zona fasciculata
Aspiration
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
a - Blockers (- zosins)
G0 phase

33. What is the most common one? - Bone tumor
Metastatic
Pancreatic cancer
Areas 18 and 19
Asbestosis and silicosis

34. What are the most common causes of osteomyelitis x In neonates?
FSH
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.
No. Prions are infectious proteins - so antibiotics are useless.
Streptococcus agalactiae

35. What is the term to describe homosexuals who x Are comfortable with their own person and agree with their sense of self?
Ego syntonic
Nasal polyps - rhinitis - and aspirin hypersensitivity
CD8
Zona fasciculata and zona reticularis

36. Which way will the O2 dissociation curve shift with the addition of 2 - 3- bisphosphoglycerate (2 - 3- BPG) to adult hemoglobin (Hgb)?
QRS complex
Lithium
Shifts it to the right
TAT (Thematic apperception test)

37. What HPV serotypes are associated with increased risk of cervical cancer?
HPV serotypes 16 - 18 - 31 - and 33
Prophase of meiosis I (between 12th and 22nd week in utero)
Reinforcement
Osteoarthritis

38. What is the most common form of inherited dwarfism?
Priapism
Chromosome 5 - 21
Achondroplasia
Hemophilia B

39. Name the MCC - Aspiration pneumonia in an alcoholic
Friedreich ataxia
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
Klebsiella pneumoniae
Chromophobe adenoma

40. The probability that a person with a negative test result is truly disease free refers to what value?
Cocaine
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Negative predictive value
Osteosarcoma

41. Name these immature defense mechanisms: x Inability to remember a known fact (aware of forgetting)
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
MEN IIa (or Sipple syndrome)
Blocking
HBeAg

42. What is the name of the postganglionic parasympathetic ganglion that innervates x The submandibular and sublingual glands?
At birth (reflex)
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Hirschsprung disease (aganglionic megacolon)
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.

43. What renal pathology involves uniform thickening of the glomerular capillary wall - granular appearance under the microscope - and effacement of foot processes?
Exhibitionism
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
Membranous glomerulonephritis
von Hippel - Lindau syndrome

44. Name the most common type or cause - Nephritic syndrome in children
Streptococcus agalactiae (Group B Streptococcus - or GBS)
Absolute refractory period is due to voltage inactivation of sodium channels.
REM
Minimal change disease

45. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CEA
Cancer of the lung - stomach - colon - and breast
Heroin
Combined metabolic and respiratory acidosis
Goodpasture syndrome

46. What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
Calcitriol
Decrease (5- HT and dopamine levels do the same)
Hepatitis D
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.

47. What embryonic structure forms the adult female structures? - Glans clitoris - corpus cavernosus - and spongiosum
Id
Phallus
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)
Riboflavin (B2) deficiency

48. What is the MCC of death in black males aged 15 to 24?
Celiac sprue (gluten - sensitive enteropathy)
Glutamate dehydrogenase
Homicide. It is also the leading cause of death in black females aged 15 to 24.
Mesencephalic nucleus

49. What three structures increase the surface area of the GI tract?
Foramen of Winslow
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
7

50. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral hemispheres
Proencephalon
C3 - C4 - and C5 keep the diaphragm alive!
Streptococcus agalactiae
Cause - specific mortality rate