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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 are the five penicillinase - resistant penicillins?
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Mitosis
Raloxifene
Leiomyoma (fibroids)

2. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - aggression - inability to learn new material - and memory problems
Lung and bronchus cancer
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
Limbic system
Aortic stenosis

3. In the water deprivation test - does a patient with reduced urine flow have primary polydipsia or diabetes insipidus?
Proximal to distal progression
CD15 and CD30
LTB4
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.

4. With what stage of sleep is enuresis associated?
Proencephalon
C5- C9
Hepatoma and nonseminomatous testicular germ cell tumors
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.

5. Why will turbulence first appear in the aorta in patients with anemia?
Coccidioides immitis
Because it is the largest vessel and has the highest velocity in systemic circulation
Progestin
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.

6. A suspected dermatophyte infection is stained with KOH. What spore type do you expect to see?
Maxillary artery
Arthroconidia with hyphae
Sarcoplasmic reticulum
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.

7. What are the five F's associated with gallstones?
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
Ipratropium
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.
CN V

8. What parasite is associated with squamous cell carcinoma of the urinary bladder?
Bronchogenic carcinoma
Schistosoma haematobium
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
S1 nuclease

9. What is the term for hyphae with constrictions at each septum that are commonly seen in Candida albicans?
Arthroconidia with hyphae
Reticulocyte
Fungiform papillae
Pseudohyphae

10. Name the laryngeal muscle described by the following: x Only muscle to abduct the vocal cords
Posterior cricoarytenoid muscles
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Week four - and they remain dormant there until puberty.
Inspiratory capacity

11. At high doses aspirin has ________ properties.
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
Uricosuric
Conjugated (direct) hyperbilirubinemia
Pirenzepine

12. What is the only DNA virus that does not replicate its DNA in the nucleus of the host cell?
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Poxvirus replicates its DNA in the cytoplasm.
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
Acute rejection

13. What type of erythema do you see in x Stevens - Johnson syndrome?
Erythema multiforme
Minocycline
CN X
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

14. What enzyme is needed to activate the following reactions? - Chymotrypsinogen to chymotrypsin
Positive
Trypsin
Stage 3 and 4
Alveolar dead space

15. At What age does a child develop x Endogenous smile?
CD3
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
At birth (reflex)
Pertussis toxin

16. Clarke's nucleus is the second ascending sensory neuron of which spinocerebellar tract?
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
hnRNA
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.
Decreases

17. What statistical test compares the means of groups generated by two nominal variables by using an interval variable?
Streptomycin
Diffuse proliferative GN
2 ATPs by oxidative phosphorylation
Two - way ANOVA. It allows the test to check several variables at the same time.

18. Name one of the ADP receptor antagonists used in patients who are post - MI - have had TIAs - have unstable angina - and are allergic to ASA?
PGE (along with low oxygen tension)
7
Ticlopidine or clopidogrel
RSV

19. Prolactin levels can serve as a rough indicator of...
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius
overall dopamine activity
Zero - order elimination
The thyroid gland

20. Name the most common type or cause - Rectal bleeding
Diverticulosis
Secondary spermatocyte
d - Tubocurarine
Chromosome 11p

21. What thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 increased
An elevated serum osteocalcin level
Reverse transcriptase
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis - or IHSS)
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)

22. In what syndrome does the patient have angiomatosis; renal cell carcinomas; pheochromocytomas; retinal - cerebellar - medulla - or spinal cord hemangioblastomas; and epidermal cysts?
Proton pump inhibitors
von Hippel - Lindau syndrome
Labile
Lesch - Nyhan syndrome

23. What is the direction of growth for the primitive streak - caudal to rostral or rostral to caudal?
Neuroleptic malignant syndrome is a potentially life - threatening condition Which is treated with symptomatic support - bromocriptine - and dantrolene.
The primitive streak grows caudal to rostral.
With arteriolar constriction both the flow and pressure downstream decrease.
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)

24. All spore formers are...
Herpes virus I and II
gram positive
Berger disease (IgA nephropathy)
Patients with unilateral cerebellar lesions fall toward the side of the lesion.

25. How many covalent bonds per purine - pyrimidine base pairing are broken during denaturation of dsDNA?
Hydrolysis
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.
CD40 ligand

26. What are the three main components of amyloid?
2 and 5HT3 receptors
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid - shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase

27. Which group of antihypertensive agents best decreases left ventricular hypertrophy?
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
Thiazide diuretics
ACh; think about the ANS.

28. What component of an ECG is associated with the following? - Atrial depolarization
epithelial lining
Being a female physician increases the risk of suicide nearly four times the general population.
P wave
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm

29. What hormone controls relaxation of the lower esophageal sphincter during swallowing?
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Atropine with pralidoxime
Eclipse period
Gastrinoma

30. Councilman bodies
Latissimus dorsi
Displacement
2 NADPHs per acetyl CoA
Toxic or viral hepatitis

31. Name the area of the cerebral cortex with the function described: x Language - memory - and emotion (Hint: herpesvirus infects here commonly)
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.
Temporal lobe
TXA2
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12

32. What serves as a marker of endogenous insulin secretion?
C- peptide levels
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.
Bcl -2
Vitamin K

33. What epidermal layer's function is to release lipids to act as a sealant?
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
The CD4 T cell; the APC is the first cell in the immune response.
Stratum granulosum
Benign lentigo

34. What nucleus of the hypothalamus is the satiety center - regulating food intake?
Tetanospasmin (also called tetanus toxin)
Cancer of the lung - stomach - colon - and breast
Ventromedial nucleus; lesions here result in obesity.
Mycoplasma pneumoniae

35. 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?
Squamous cell carcinoma
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
Glucose
Plummer - Vinson syndrome

36. Name the most common type or cause - Diarrhea in children
Pneumococcus
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
Concentration force and electrical force
Rotavirus

37. What condition results in the following CSF results? - Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
Bacterial meningitis
Schistosoma haematobium
Palms - up before palms - down maneuvers
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+

38. What organ must metastasize for carcinoid heart disease to occur?
G0 phase
Liver
Decreases
Mycobacterium leprae

39. What is the rate - limiting step in a conduction of a NMJ?
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
Duchenne muscular dystrophy
The time it takes ACh to diffuse to the postjunctional membrane
Bender Visual Motor Gestalt Test

40. What type of GN - associated with celiac disease and dermatitis herpetiformis - has mesangial deposits of IgA - C3 - properdin - IgG - and IgM?
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).
Goodpasture disease
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Berger disease (IgA nephropathy)

41. Paranoid and catatonic schizophrenia are good...
Right - sided valves
Increase enzyme concentrations
prognostic predictors
Squamous cell carcinoma

42. What cerebral vessel size is affected in patients with vascular dementia?
Small to medium - sized cerebral vessels
Agranulocytosis; approximately 2% develop this side effect.
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.
Peutz - Jeghers syndrome

43. What statistical method do you use when analyzing x Cross - sectional studies?
Chi - square.
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients - their O2 content is increased because of the excess Hgb concentrations.
Scrofula
Rhombencephalon

44. What type of spore is asexual and formed of hyphae?
Conidia
Bender Visual Motor Gestalt Test
Nodular sclerosis
Mixed (both cholesterol and calcium)

45. The nucleus is the site of...
transcription
Acanthosis nigricans
Stage 3 and 4
HIV and poxvirus

46. What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
Fentanyl
MstII; changing codon 6 (from A to T) destroys the restriction site.
apo B-48
Four Ms and a U 1. Median 2. Medial antebrachial 3. Medial pectoral 4. Medial brachial cutaneus 5. Ulnar

47. In What area of the brain can an excess of dopamine lead to psychotic symptoms?
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
One day after the LH surge and 2 days after the estrogen peak.
Lingual nerve of CN V3
Mesocortical area

48. What is the second leading cause of cancer deaths in males? In females?

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49. How can a deficiency in adenosine deaminase be a bone marrow suppressor?
Gardner syndrome
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
It causes a buildup of dATP - which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate - a precursor of DNA - resulting in overall bone marrow suppression.
G0 phase

50. Which agent used in the treatment of asthma is a selective inhibitor of the lipoxygenase pathway?
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
Zileuton
Stibogluconate
Scrofula