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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. Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?
hCG can be detected in the blood by day 8 and in the urine by day 10.
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
PGI 2
ACh receptor

2. What type of muscle is characterized by no myoglobin - anaerobic glycolysis - high ATPase activity - and large muscle mass?
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
White muscle; short term too
Tetracycline
The greater the myelination - the greater the conduction velocity.

3. Why should opioid analgesics be avoided for patients with head trauma?
Gonorrhea
The larger the volume of distribution - the lower the plasma concentration of a drug.
Indirect pathway (Tourette syndrome for example)
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.

4. What phase of the cell cycle are the following antineoplastic agents specific for? - 6- Mercaptopurine
Hepatoma and nonseminomatous testicular germ cell tumors
S phase
Nephroblastoma
Huntington disease

5. What is the term for any region of the respiratory system that is incapable of gas exchange?
Left homonymous hemianopsia
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
Terbinafine
Anatomical dead space - which ends at the level of the terminal bronchioles.

6. What cells are atypical on a peripheral blood smear in heterophil - positive mononucleosis?
T cells - not B cells
IF
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.
No. It is abnormal only if it interferes with normal sexual or occupational function.

7. What is the Ig associated with the primary immune response?
Hyperventilation - which decreases CO2 - shifting the reaction to the left and decreasing H+
IgM
Standardized rate
Proencephalon

8. What component of the ETC is inhibited by the following? - CO
Malignancy
Cytochrome a/a3
Pyridoxine (B6)
G0 phase

9. What is the name of the postganglionic parasympathetic ganglion that innervates x The papillary sphincter and ciliary muscle of the eye?
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
Poxvirus

10. Name the thalamic nucleus based on its input and output - Input from medial lemniscus and the spinocerebellar tracts; output to the primary somatosensory cortex
DiGeorge's syndrome
Negative selection. This helps to prevent autoimmune diseases.
Diazoxide
Ventral posterolateral nucleus

11. What element is needed for the proper alignment of tropocollagen molecules?
Copper (Cu+)
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.
Proline and lysine
Terminal bronchioles. (No gas exchange occurs here.)

12. What is the term for recurrent and persistent pain before - after - or during sexual intercourse?
Borrelia recurrentis
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Relative refractory period

13. Where is the cupola of the lung in relation to the subclavian artery and vein?
The subclavian artery
CN V3 and the lesser petrosal nerve
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.
Amphotericin B

14. What is the only dsRNA virus?
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
Albumin
Reovirus
Homocysteine methyl transferase and methylmalonyl CoA transferase

15. In skeletal muscle ________ is an active event.
relaxation
Blastomyces dermatitidis
Eosin
Metaphase of meiosis II (in the oocyte of the graafian follicle)

16. What skin carcinoma is a superficial dermal infiltrate of T lymphocytes seen in males more than 40 years old and presents as scaly red patches or plaques?
HPV serotypes 1 and 4
Alveolar macrophages
Mycosis fungoides (cutaneous T- cell lymphoma)
Impotence

17. Name the two purine bases found in both DNA and RNA.
Valine
Adenine and guanine
AT II
Diethylcarbamazine

18. What type of resistance system - high or low - is formed when resistors are added in a series?
A high - resistance system is formed when resistors are added in a series.
Adrenarche
Dihydropteroate synthetase
HBcAb IgG - HBV- DNA - HBeAg - HBsAg

19. What TCAD causes sudden cardiac death in children?
Spermatogonia (type A)
Neuroblastoma
Desipramine
Axon hillock

20. What type II hypersensitivity disorder is defined as x Autoantibodies directed against platelet integrin?
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.
IgA
Phase II
Autoimmune thrombocytopenia purpura

21. Name these mature defense mechanisms: x Helping others without expecting any return
Keratinocytes - the most numerous cells in the epidermis - carry melanin and produce keratin.
Altruism
Amantadine
Staphylococcus

22. Serum concentration of what substance is used as a clinical measure of a patient's GFR?
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
Ipsilateral loss below the level of the lesion
Creatinine

23. What is the term for the unidirectional attraction of cells toward a chemical mediator released during inflammation?
CLL (B- cell origin)
Chemotaxis
GABA - quantitatively
Endometrial cancer

24. Clue cells are associated with which organism that causes vaginal discharge?
Prostate and lung cancer - respectively
Gardnerella vaginalis
Hepatitis D
P1 protein

25. Are the following conditions associated with a negative or positive nitrogen balance? - Recovery from injury
Histamine
Relative refractory period
Positive
Hypoglycemia for secretion and hyperglycemia for inhibition

26. In a ventricular pacemaker cell - what phase of the action potential is affected by ACh?
Aspiration pneumonia
X- linked recessive
Accidents
Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance - taking longer to reach threshold and slowing the rate of firing.

27. What lipoprotein is formed if an IDL particle acquires cholesterol from a HDL particle?
Confidence interval. It is a way of admitting estimation for the population.
LDL
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
CD8+ T cells (cytotoxic) Remember - 8

28. Which anticonvulsant causes gingival hyperplasia?
Parietal cells (Remember - they secrete HCl - too.)
Xanthine oxidase
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Triazolam

29. What T cell line arises from low affinity for self - MHC class I Ags in the thymus?
CD8+ T cells
Congenital heart disease
Arsenic
Specific rate (e.g. - men aged 55-60)

30. What is the most common one? - Benign tumor of the ovary
Serocystadenoma
Sphingosine
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
GP IIb and IIIa receptors

31. What does failure of PaO2 to increase with supplemental O2 indicate?
Pulmonary shunt (i.e. - pulmonary embolism)
Edrophonium
Hemostasis
Tetany

32. What fructose metabolism enzyme is deficient in patients with vomiting - apathy - diarrhea - jaundice - proximal renal tubular acidosis - hypoglycemia - and hyperuricemia?
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.
Bordetella pertussis
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
Aldolase B deficiencies are treated by eliminating fructose from the diet.

33. What is the name of the postganglionic parasympathetic ganglion that innervates x The lacrimal gland and oral and nasal mucosa?
Tolcapone and entacapone
Expressive aphasia
Pterygopalatine ganglion (I remember this as the only ganglion left.)
Permanent

34. What mixed a - antagonists are used for patients with pheochromocytoma?
Alteplase
Homeodomain proteins
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies
Phentolamine and phenoxybenzamine

35. In What area of the brain can an excess of dopamine lead to psychotic symptoms?
Mesocortical area
Bacteria
Foramen of Winslow
Mitochondrial inheritance

36. What embryonic structure forms the adult female structures? - Labia minora
Cell - mediated immunity
Pott disease
Aortic stenosis
Urogenital folds

37. What pneumoconiosis is associated with exposure to the following occupations or materials? - Aerospace industry - nuclear reactors
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Berylliosis
Thalassemia minor

38. What is the only local anesthetic to produce vasoconstriction?
80S ribosomes (because they are eukaryotic)
Cocaine
Complex 4
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.

39. What bronchogenic carcinoma is associated with an elevated level of Ca2+ - involves keratin pearls - occurs in men more than women - is associated with smoking - occurs in the major bronchi - and is seen in the central areas of the lung?
Caisson disease
Complex I
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Squamous cell carcinoma

40. All aluminum - containing antacids can cause...
hypophosphatemia
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
Tamoxifen
von Gierke's disease

41. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
Taenia solium
rRNA
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
Cyanocobalamin (B12)

42. Do the following structures pick up stain from hematoxylin or eosin? - RBCs
Transketolase and transaldolase. The reactions they catalyze are reversible.
CD8+ T cells
Coma - convulsions - and cardiotoxicity
Eosin

43. What is the rule of one - third regarding muscle type of the esophagus?
Toxic dose for 50% of drug takers (median toxic dose)
Procainamide
Bronchiectasis
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle

44. Which integrin mediates the adhesion to endothelial cells for migration in and out of the blood during an immune response?
Beta2- integrins
Ciliary ganglion
Epinephrine
2 ATPs - because RBCs use only anaerobic metabolism.

45. What type of GN - associated with celiac disease and dermatitis herpetiformis - has mesangial deposits of IgA - C3 - properdin - IgG - and IgM?
Acanthosis nigricans
H 2
3 years old
Berger disease (IgA nephropathy)

46. What two CNs are responsible for the carotid body and sinus reflexes?
C3 - C4 - and C5 keep the diaphragm alive!
CN IX and X
Afterload
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.

47. What intrauterine deficiency leads to failure to thrive - mental retardation - motor incoordination - and stunted growth?
They innervate LMNs.
Iodine - resulting in congenital hypothyroidism
Hodgkin lymphoma
Kayser - Fleischer rings

48. What is the costliest health care problem in the United States?
Alcohol and its related problems cost the country approximately $100 billion a year.
Thalassemia minor
The CD4 T cell; the APC is the first cell in the immune response.
BPH

49. What is the MCC of the following meningitides? - In military recruits
Neisseria meningitides
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
Staphylococcus aureus
Agglutination test

50. What CN is associated with the sensory innervation of x Laryngopharynx?
Vagus nerve
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
Courvoisier's law
Embolic