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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 four reasons for hypochromic microcytic anemia with a low MCV?
1. Sideroblastic anemias (i.e. - porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
5- hydroxyindoleacetic acid (5- HIAA)
Glioblastoma multiforme
Schistocytes

2. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
Alanine and glutamine
Permanent
rRNA
enveloped

3. What form of hemophilia is X- linked recessive and due to a deficiency in factor VIII?
Galactoside permease
Isoniazid treatment
Fibrocystic change of the breast
Hemophilia A

4. What form of estrogen is of placental origin?
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
Pimozide
Estriol
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.

5. From What aortic arch are the following structures derived?
Paranoid schizophrenia
Common and internal carotid arteries
Accidents
Pompe's disease

6. Fluoroquinolones are...
Chemotaxis
T lymphocyte
The courts. These are legal - not medical terms.
Bactericidal

7. How can you differentiate between a medial temporal lobe and a hippocampal lesion based on memory impairment?
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)
Complex I
GLUT 2
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.

8. What three organs are necessary for the production of vitamin D3(cholecalciferol)?
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
Histidine
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Skin - liver - and kidneys

9. What region of the brain houses the central chemoreceptors responsible for control of ventilation?
The surface of the medulla
Enterococcus faecalis
Down syndrome
Invasive ductal carcinoma

10. Name the nephritic disease based on the immunofluorescent staining - Granular deposits of IgG - IgM - and C3 throughout the glomerulus
Arginine
Postinfectious GN
Labioscrotal swelling
Rho (D) immune globulin (RhoGAM) - an anti - RhD IgG antibody - prevents generation of RhD- specific memory B cells in the mother.

11. What is the name for the following RBC indices? - Average Hgb concentration/given volume of packed RBCs
Galactoside permease
Mean corpuscular hemoglobin concentration (MCHC)
Adenovirus
Test - retest reliability

12. What are the four exceptions to requirements for informed consent?
Immature B cells
Down syndrome
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency
Hepatitis E

13. What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
Inhibin - m
C2 deficiency
Southern blot
Adrenarche

14. Used in the treatment of barbiturate overdose.
Subacute combined degeneration - Which is bilateral below the level of the lesion.
Disseminated intravascular coagulation (DIC)
Preoperational (2-6 years)
Flumazenil

15. Is bone deposition or resorption due to increased interstitial Ca2+concentrations?
Brushfield spots
Osteitis fibrosa cystica (von Recklinghausen disease)
Wiskott - Aldrich syndrome
Bone deposition increases with increased Ca2+ or PO 4- concentrations - whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.

16. Starry sky pattern
Burkitt lymphoma
Adenovirus
Astrocytoma
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.

17. What is the most common one? - Skin tumor in the United States
In men it is prostate cancer - and in women it is breast cancer.
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.
Basal cell carcinoma
Pseudogout

18. Name the stages of sleep with these EEG patterns: x Sawtooth waves - random low voltage pattern
Afterload
Cortisol levels increase. Lymphocyte levels decrease in sleep - deprived individuals.
REM
Edrophonium

19. Name the MCC - Pneumonia in an HIV- positive patient with CD4 less than 200
CHF
Impotence
Pneumocystis carinii
Positive

20. The clearance of what substance is the gold standard of renal plasma flow?
Para - aminohippurate (PAH)
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
Arsenic - thorotrast - and vinyl chloride

21. What is the most common form of non - Hodgkin lymphoma in the United States?
Chylomicrons
VLDLs
Follicular lymphoma
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.

22. What malignant neoplasm of the bone has a soap bubble appearance on radiograph?
Giant cell bone tumor (osteoclastoma)
Stroke volume
Relative refractory period
Ribonucleotide reductase

23. Which medication requires an acidic gastric pH for activation to form a protective gel - like coating over ulcers and GI epithelium?
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
Microvillus
Sucralfate
Primitive ventricle

24. What excitatory fibers arise from the inferior olivary nuclei on the contralateral side of the body?
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
Carbidopa and benserazide
Rhombencephalon

25. What is the most potent stimulus for glucagon secretion? Inhibition?
Fructose -1 - 6- bisphosphatase
Hypoglycemia for secretion and hyperglycemia for inhibition
Transferrin
Phenytoin

26. The proportion of truly diseased persons in the screened population who are identified as diseased refers to?
LH
One day after the LH surge and 2 days after the estrogen peak.
Sensitivity (it deals with the sick)
Guanethidine and bretylium

27. Lack platelets.
Vmax
Labioscrotal swelling
FSH and testosterone
Blood clots

28. Name the macrophages by location: x Lungs
Coprophilia
Filtration; if hydrostatic pressure is less than oncotic pressure - reabsorption is promoted.
Alveolar macrophages
Thymidylate synthetase

29. What are the three characteristics of ADHD?
Conidia
1. Short attention span 2. Impulsivity 3. Hyperactivity
Foscarnet
Chromosome 4p

30. What three factors increase simple diffusion?
Ureaplasma urealyticum
IL-4 - IL-10 - and IL-13
Accessory nucleus
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane

31. If a drug is ionized - is it water or lipid soluble? Can it cross a biomembrane?
Substantia nigra
Melanoma - cancer of the stomach and bladder
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.
Chromosome 6

32. Name the most common one - Chromosomal disorder involving sex chromosomes
Left homonymous hemianopsia
Mesocortical area
Smooth muscle
Klinefelter syndrome

33. What Enterobacteriaceae are prone to produce osteomyelitis in sickle cell patients?
Salmonella
Ostium secundum defects
Musculocutaneous nerve
Klinefelter syndrome

34. What bone disorder is characterized by brown tumors - bone pain - deformities - and fractures due to excessive PTH?
Alzheimer disease
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.
Osteitis fibrosa cystica (von Recklinghausen disease)
Pia mater

35. Name the most common type or cause - Cirrhosis in the United States
Succinylcholine
Alcohol consumption
Ungated channels
Turner syndrome

36. Name the antidote - Lead
Serratus anterior
PGI 2
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol
Unipolar disorder (major depression)

37. What triggers phase 0 of the action potential in a ventricular pacemaker cell?
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
GH deficiency
Calcium influx secondary to slow channel opening
Prodrugs

38. What sex cell tumor causes precocious puberty - masculinization - gynecomastia in adults - and crystalloids of Reinke?
Leydig cell tumor
Menstruation
A gene (a rather simple definition but accurate)
Kartagener's syndrome (also known as immotile cilia syndrome) -------------------------------------------------------------------------------

39. What encapsulated lymphoid organ is characterized by presence of Hassall's corpuscles - and absence of germinal centers and B cells?
Carbamazepine
Sympathetic nervous system
Thymus gland. (Thymus gland is essential for T cell maturation.)
Scleroderma

40. From what pharyngeal pouch is the following structure derived? - Superior parathyroid gland and ultimobranchial body of the thyroid
naked viruses
Fourth M PITS for pharyngeal pouch derivatives
Inhibin - m
CN X (Remember - the vagus nerve supplies the parasympathetic information from the tip of the pharynx to the end of the midgut and all between.)

41. Measles - mumps - varicella zoster - and Francisella tularensis.
Roth spots - and they are seen in bacterial endocarditis.
Dihydropteroate synthetase
Chromosome 4p
Are live attenuated vaccines available in the United States

42. Upon seeing negatively birefringent needle - shaped crystals from a joint aspiration of the great toe - what form of arthritis do you diagnose?
Zero - order elimination
Treacher Collins syndrome
Gout
Peyer's patch

43. What phase of the cell cycle are the following antineoplastic agents specific for? - Hydroxyurea
Toxoplasma gondii
M
S phase
Duodenal atresia

44. What is the primary risk factor for suicide?
nef and tat genes
Previous suicide attempt
Tibial nerve
1. Decrease alpha -1 activity 2. Increase Beta -2 activity 3. Increase ACh levels

45. What urinary metabolite is increased in patients with carcinoid syndrome?
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
Projective test. Most tests with a wide range of possibilities for the answers are projective.
Glucokinase
5- hydroxyindoleacetic acid (5- HIAA)

46. What condition results in the following CSF results? - Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
Since they are independent events - their probabilities would be multiplied.
Microglia. All others are neuroectodermal derivatives.
Streptococcus pneumoniae
Bacterial meningitis

47. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x erb -1
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
Separation anxiety
Squamous cell carcinoma of the lung
Obturator nerve

48. What is determined by the secondary structure of an AA?
The folding of an AA chain
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
Cross - sectional studies determine prevalence - not incidence or cause and effect.
Carcinoid tumor

49. With an increase in arterial systolic pressure - what happens to x Stroke volume?
Metaphase of meiosis II (in the oocyte of the graafian follicle)
They innervate skeletal muscle.
Increases
Right coronary artery

50. What is the drug of choice for early Parkinson's disease?
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.
Selegiline
Enterohemorhagic Escherichia coli
Anterior hypothalamic zone; lesions here result in hyperthermia.