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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 is the fastest - conducting fiber of the heart? Slowest conduction fiber in the heart?
Pseudomonas
embranoproliferative glomerulonephritis (MPGN)
Purkinje cell is the fastest - and the AV node is the slowest.
Kl

2. Anatomical and alveolar dead spaces together constitute what space?
Membranous glomerulonephritis
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.
Physiologic dead space is the total dead space of the respiratory system.

3. What viral infection in patients with sickle cell anemia results in aplastic crisis?
Parvovirus B 19
P wave
GnRH pulsatile infusion
At least 30% blast in the bone marrow

4. What stromal tumor in males is characterized histologically with crystalloids of Reinke?
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
Leydig cell tumor
Superior
Gonorrhea

5. What two Beta2- agonists cause myometrial relaxation?
Ritodrine and terbutaline
Intussusception
Serocystadenoma
Pneumococcus (Streptococcus pneumoniae)

6. A patient has to prove his or her...
Celiac sprue (gluten - sensitive enteropathy)
Subthreshold potential
H 2
competency

7. What two viruses get their envelope not from budding but from coding?
HIV and poxvirus
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
Resistance increases as resistors are added to the circuit.
Fructose -1 - 6- bisphosphatase

8. In the alveoli - what cell type is x responsible for producing surfactant?
Alcoholic cirrhosis
Type II pneumocytes
Inhibited orgasm
Variola (smallpox)

9. What epidermal layer's function is to release lipids to act as a sealant?
Conjugated (direct) hyperbilirubinemia
Cyanocobalamin (B12)
Hemophilia A
Stratum granulosum

10. What AA is a precursor of the following substances? - Creatine
Medullary carcinoma of the thyroid
Chromosome 15q
Glycine/arginine
igantism

11. What condition is characterized by a 46XY karyotype - testes present - and ambiguous or female external genitalia?
Male pseudohermaphrodite (dude looks like a lady!)
Succinate dehydrogenase
Hepatoma and nonseminomatous testicular germ cell tumors
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.

12. How can a deficiency in adenosine deaminase be a bone marrow suppressor?
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.
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
Low average
Ethambutol

13. Where in the GI tract does the reabsorption of bile salts take place?
Aminoglycosides
Beta2- Adrenergic agents
Serocystadenocarcinoma
Bile salts are actively reabsorbed in the distal ileum.

14. What form of anxiety - appearing at 6 months - peaking at 8 months - and disappearing by 1 year of age - is seen in the presence of unfamiliar people?
Stranger anxiety
Zanamivir and oseltamivir
Bernard - Soulier syndrome
G2 phase

15. What branch off the vertebral artery supplies x The cerebellum and the dorsolateral part of the medulla?
PICA
Vital capacity (VC)
Phototherapy
CSF

16. What is the MCC of death in black males aged 15 to 24?
Coxiella burnetii
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
ACTH
Homicide. It is also the leading cause of death in black females aged 15 to 24.

17. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Liver
RSV
Reinforcement
Stable
Beta- Galactosidase

18. What is it called when levels of sex steroids increase - LH increases - and FSH increases?
cDNA - when it is made from mRNA
Areas 5 and 7
GnRH pulsatile infusion
Borrelia recurrentis

19. A patient with a history of epilepsy goes to the ER with sedation - gait ataxia - diplopia - and vertical nystagmus. Which anticonvulsant overdose resulted in the patient's symptoms?
Displacement
A positive PPD skin test
During stage 3 and 4 (remember - it is called deep sleep.)
Phenytoin

20. Which three CNs send sensory information to the solitary nucleus?
Silicosis - Coal worker's pneumoconiosis is synonymous with black lung disease - an upper lobe occupational disorder
Kayser - Fleischer ring
Ipratropium
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.

21. What type of erythema do you see in x Rheumatic fever?
Metaplasia (usually to a more protective cell type)
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.
There are no valves and no smooth muscle in the walls of the veins in the face.
Erythema marginatum

22. What are the three microscopic pathologic changes seen in Alzheimer's disease?
Substance P. (Opioids relieve pain in part by blocking substance P.)
enveloped
EF-1 and GTP
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons

23. The surge of what hormone induces ovulation?
Hyperventilation - which decreases CO2 - shifting the reaction to the left and decreasing H+
Hepatitis B and hepatitis C
LH
White muscle; short term too

24. Why is the cell's resting membrane potential negative?
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
Yolk sac tumor
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Anterior spinal artery

25. Which of the following is not a risk factor for cholesterol gallstones: pregnancy - OCP use - female gender - hemolytic anemia - cirrhosis - and obesity? (May be more than one answer.)
Gastric carcinoma
Cirrhosis and hemolytic anemia - which are risk factors for pigmented gallstones.
S1 nuclease
MI

26. What are the two factors that affect alveolar PCO2 levels?
Sinus venosus
Squamous cell carcinoma
Metabolic rate and alveolar ventilation (main factor)
Being a white male

27. The faster the ___________ - the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).
HBcAb IgG and HBsAb IgG
Rate of absorption
Cytochrome b/c1
80S ribosomes (because they are eukaryotic)

28. Name the antidote - Carbon monoxide (CO)
Staphylococcus aureus
Oxygen
Pseudomonas
Beryllium

29. What is the most common fungal infection in HIV?
1. Propranolol 2. Timolol 3. Carteolol
Candida
Eosin
Panacinar

30. Name the compartment of the lower extremity and the nerve based on its movements - Extend the hip and flex the knee
Ea (activation energy)
Posterior compartment of the thigh - tibial nerve
apo B-48
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero - order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than i

31. What is the major hormone produced in the following areas of the adrenal cortex? - Zona fasciculata
rRNA
Succinate dehydrogenase
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
LGB (think EYES)

32. What form of the Plasmodium species is ingested by mosquitoes?
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Stapedius muscle
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
Gametocytes

33. Are the following major or minor Jones criteria of rheumatic fever? - Pericarditis
The limbic system
Major
Plasmodium vivax
Myeloschisis All except occulta cause elevated - fetoprotein levels.

34. Which acid - fast rod is an obligate intracellular parasite?
Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle.
Mycobacterium leprae
The anterior nucleus of the thalamus
Omega -3 fatty acids

35. What enzyme is blocked by methotrexate/ trimethoprim?
Propionibacterium acnes
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
Dihydrofolate reductase
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)

36. What vasculitis is characterized by systemic vasculitis in small to medium - size vessels (except the lung); affecting young males; 30% HBsAg - positive; P- ANCA and autoantibodies against myeloperoxidase?
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Air flows into the respiratory system.
Residual volume (RV)
Polyarteritis nodosa

37. What Ab is an indication of low transmissibility for hepatitis?
Internal carotid artery
HBeAb
Constriction of afferent arteriole
Zonula occludens (tight junctions)

38. What CN is associated with the sensory innervation of x Oropharynx?
Type IV collagen
Glossopharyngeal nerve
Blastoconidia
Giant cell tumor of the bone

39. What determines the effective osmolarity of the ICF and the ECF compartments?
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Nystagmus and ataxia
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.
Free ionized Ca2+

40. Which bacteria are associated with the following pigment production? - Black - gray pigmentation
Wernicke's encephalopathy
Melanoma - cancer of the stomach and bladder
Corynebacterium diphtheriae
Altruism

41. What enzyme of heme synthesis is deficient in the autosomal dominant disorder acute intermittent porphyria?
Internal iliac nodes
Uroporphyrinogen - I synthase
reflexes
Membranoproliferative glomerulonephritis (MGN)

42. What happens to blood flow and pressure downstream with local arteriolar constriction?
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
With arteriolar constriction both the flow and pressure downstream decrease.
T cells - B cells - and macrophages
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)

43. WBC casts in the urine
Type 2
Acute pyelonephritis
Type III hypersensitivity reaction
Polyarteritis nodosa

44. What complement factor deficiency leads to x Recurrent gonococcal infections?
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
Iodine - resulting in congenital hypothyroidism
C5- C8 deficiency

45. Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid?
Sublimation
Childhood
Temporal lobes
Doxycycline

46. What DNA virus is associated with exanthem subitum (roseola)?
No CHO - AA - ketones - or peptides are left in the tubular lumen.
HHV 6
Dopamine
P = .05; P < .05 rejects the null hypothesis

47. Name these narcissistic defense mechanisms: x Person takes his or her own feelings - beliefs - wishes - and so on and thinks they are someone else's. (e.g. - a cheating man thinks his wife is unfaithful)
Projection
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
Plasmin
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell

48. What is the primary risk factor for suicide?
Previous suicide attempt
Plasmodium malariae
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus

49. Which cestode infection results in alveolar hydatid cyst disease?
Preload (the load on the muscle in the relaxed state)
B- cell Ag receptors
Mesencephalon
Echinococcus multilocularis

50. What is the relationship between chance of error and x Standard deviation?
Systemic lupus erythematosus
Amphotericin B
Listeria monocytogenes
As the standard deviation increases - the greater the chance of error.