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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 AR disease involves a defect in AA 508 on chromosome 7 - causing a defect in Cl - transportation that leads to recurrent pulmonary infections and an increase in viscid mucoid secretions along with pancreatic insufficiencies?
Granulosa cell
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
The fast component is directed toward the affected side of a cerebellar lesion.
Meningococcus (Gonococcus does not)

2. What neurotransmitter is associated with sedation and weight gain?
Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle.
Histamine
C5a
Marfan syndrome

3. Which PG is associated with maintaining a PDA?
Crigler - Najjar syndrome
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands - it compresses the fibers from the upper temporal fields of the optic chiasm - producing bitemporal inferior quadrantanopia
Rhinovirus and hepatitis A virus
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.

4. Is seen in TB.
2.0 or greater
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)
Monocytosis
Capillaries

5. Which kidney is lower? Why?
Residual volume
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
Type 2
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).

6. Which class of antiarrhythmics are calcium channel blockers?
Edrophonium
The CD4 T cell; the APC is the first cell in the immune response.
Class IV
Integrase

7. What happens to O2 affinity with a decrease in p50?
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
Krukenberg tumor
Yolk sac tumor
Hematoxylin

8. What AR disorder is due to a deficiency in glycoprotein IIb - IIIa - resulting in a defect in platelet aggregation?
The sandfly
Arboviruses (bunyavirus - flavivirus - and togavirus)
Glanzmann syndrome
Arginine

9. What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
Kimmelstiel - Wilson disease
Altruism
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
Pott disease

10. What type of mortality rate is defined as the number of deaths x From a specific cause per all deaths?
Zafirlukast
Proportionate mortality rate
Gastric carcinoma
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.

11. What is the most common one? - Primary CNS tumor in children
Medulla blastoma
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
TAT (Thematic apperception test)
Vitamin C

12. What enzyme is inhibited by disulfiram?
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.
Acetaldehyde dehydrogenase
Conversion disorder

13. What part of the ANS is affected in the biofeedback model of operant conditioning?
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
Stratum spinosum
The biofeedback model is based on the parasympathetic nervous system.
Lateral rectus (CN VI) (LR6 SO4)3

14. What urinary metabolite is increased in patients with carcinoid syndrome?
Clostridium botulinum
Subacute bacterial endocarditis
5- hydroxyindoleacetic acid (5- HIAA)
Tetracycline

15. What ocular muscle x Abducts the eyeball and is involved in horizontal conjugate gaze?
Diphyllobothrium latum
Chromosome 3p
Lateral rectus (CN VI) (LR6 SO4)3
Succinylcholine

16. What vector is associated with malaria?
Anopheles mosquito
Positive
Leukemias and lymphomas
ELISA test

17. What cancer is particularly likely to affect English chimney sweeps?
Scrotal cancer - due to the high exposure to polycyclic aromatic hydrocarbons
Beta- Blockers
G-6- PD deficiency
The conversion of CHO to pregnenolone via the enzyme desmolase

18. What enzyme is deficient in alkaptonuria?
Hapten (not immunogenic)
Acute tubular necrosis
Absolutely not! Answer any question you are asked.
Homogentisic oxidase

19. What disease is seen in the 20- to 40-year - old age group - is more prevalent in women than men - involves diarrhea with or without bloody stools - starts in the rectum and ascends without skipping areas - includes pseudopolyps - and has a thickness
Liquefaction necrosis
Ulcerative colitis
Stages 3 and 4 (NREM)
Arch of the aorta

20. What is the most common circulation Ig in the plasma?
Dyslexia
Lingual nerve of CN V3
1 day prior to ovulation
IgG

21. Name the cluster B personality disorder: x In a constant state of crisis - promiscuous - unable to tolerate anxiety- causing situations - afraid of being alone - and having intense but brief relationships
Anterior wall of the first part of the duodenum
Male pseudohermaphrodite (dude looks like a lady!)
Borderline
X- linked recessive

22. Name the T- cell CD marker: x Interacts with MHC class II molecules
CD4
Superior
Breast
Cardiac muscle

23. What is the only neuroglial cell of mesodermal origin?
Serum 25- hydroxy- vitamin D (25- OH- D)
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)
Microglia. All others are neuroectodermal derivatives.
Clonidine

24. What is the most common one? - Bone tumor
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Metastatic
Sertoli cell
Null hypothesis (what you hope to disprove)

25. What is the function of white rami communicantes?
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.
They are preganglionic sympathetic axons. They are white because they are myelinated.
Escherichia coli
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.

26. In a topographical arrangement of the cerebellar homunculus map - What area or lobe x Is involved in motor planning?
Lateral part of the hemispheres
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Severe combined immunodeficiency disease
Herpes virus I and II

27. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x Ki - ras and erb -2
2 ATPs - because RBCs use only anaerobic metabolism.
Plasmodium ovale
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Lung cancer

28. Which of the following Enterobacteriaceae family members
Kinesins. Dynein generates retrograde transportation of information.
All are lactose fermenters except Yersinia and Proteus.
Reverse transcriptase
Myeloperoxidase

29. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x alpha - Fetoprotein
Hepatoma and nonseminomatous testicular germ cell tumors
>5 mm
Medial medullary syndrome
Yes - by three to four times. Having multiple sexual partners - being overweight - and pelvic pain and/or inflammatory disorders are also likely to be seen in sexually abused females.

30. What GN is highly associated with hepatitis B and C infections?
Accommodation
Carbamazepine
No - therapeutic indices can tell which drug is safer - not more toxic.
embranoproliferative glomerulonephritis (MPGN)

31. With what stage of sleep are nightmares associated?
Marfan syndrome
REM sleep. Nightmares are frightening dreams that we recall.
Prostate and lung cancer - respectively
C4 (the upper border of the thyroid cartilage)

32. What vitamin is an important component of rhodopsin?
eIF-2 in the P site
CD21; it is a complement receptor for cleaved C3
Labile
Vitamin A

33. What class of pharmaceuticals are inactive until they are metabolized to their active products?
Prodrugs
Mebendazole
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
Chondroitin sulfate and keratan sulfate

34. Cherry red intoxication is associated with what form of poisoning?
Yes - by three to four times. Having multiple sexual partners - being overweight - and pelvic pain and/or inflammatory disorders are also likely to be seen in sexually abused females.
The liver (in the mitochondria)
Tryptophan
CO

35. What do low levels of Ca2+ and PO4- along with neuromuscular irritability indicate?
Osteoblast (Remember - blasts make - clasts take)
Thymus - independent Ags
Hypoparathyroidism
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels

36. How many milliliters of O2 per milliliter of blood?
Undoing
0.2
Vmax
HBeAb

37. What are the primary neurotransmitters at the following sites? - Brainstem cells
Molybdenum (Mb)
NE
Serotonin
NH4+(ammonium)

38. What drug is being given to HIV- positive mothers during labor and to the children after birth to decrease the risk of mother - to - child HIV transmission?
Microglia (Microglia and mesoderm both begin with M)
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.
Ventral posteromedial nucleus
Aspartic acid and glutamic acid

39. What two vessels in fetal circulation have the highest PO2 levels?
S phase
common variable hypogammaglobinemia
Umbilical vein and ductus venosus (80%)
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)

40. What staphylococcal species is positive for Beta - hemolysis and coagulase?
GP41
Glycogen synthase
Staphylococcus aureus
Tyrosine

41. What is the term for gastric ulcers associated with increased intracranial pressure?

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42. What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia - tetany - and T- cell deficiency?
DiGeorge syndrome
Parkinson disease
Paracortex
Macula densa

43. What is the respiratory compensation mechanism for metabolic acidosis?
Corynebacterium diphtheriae
Syphilitic
Hyperventilation - which decreases CO2 - shifting the reaction to the left and decreasing H+
Membranous glomerulonephritis

44. Can committed mentally ill patients refuse medical treatment?
Yes. The only civil liberty they lose is the freedom to come and go as they please.
Lentigo maligna melanoma
Reserpine
Lewy bodies

45. What somatoform disorder is described as x Preoccupied with illness or death - persisting despite reassurance - lasting longer than 6 months?

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46. What is the most common one? - Primary tumor of the liver
The lung will expand; also the opposite is true.
Hemangioma (benign)
Ipsilateral loss below the level of the lesion
IL-10

47. What is the term to describe a man who has x Used to be able to achieve an erection but now cannot?
Puborectalis
C3a - C4a - C5a
Early collecting duct
Secondary erectile disorder (Male erectile disorder is the same as impotence.)

48. Which integrin mediates the adhesion to endothelial cells for migration in and out of the blood during an immune response?
Beta2- integrins
Lateral collateral ligament
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.
Physostigmine

49. What is the term for increased iron deposition resulting in micronodular cirrhosis - CHF - diabetes - and bronzing of the skin?
Dependent
Hemochromatosis
Hypoglycemia for secretion and hyperglycemia for inhibition
Ulnar nerve

50. What is the stimulus for the classical pathway activation?
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.
Area 8
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember - for major articulations - wrist/radius and humerus/ulna = elbow)