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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 term for the negative resting membrane potential becoming more negative?
Hyperpolarization (i.e. - K+ influx)
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
CN IX - X - and XI; sigmoid sinus
Nitroprusside

2. Name the antidote - Isoniazid
Pyridoxine
The parasympathetic nervous system
Thiamine
QRS complex

3. What color do fungi stain with PAS? Silver stain?
Hot pink with PAS and grey to black with silver stain
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
Ampicillin and amoxicillin
Left coronary artery

4. What enzyme catalyzes the rate - limiting step of the urea cycle?
Vitamin C
1. Liver 2. Muscle 3. Adipose tissue
Carbamoyl phosphate synthetase I
Chi - square (when you are in doubt and have nominal data - use chi - square)

5. What is the name of the superficial subcutaneous fascia of the abdomen containing fat?

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6. How is velocity related to the total cross - sectional area of a blood vessel?
HPV serotypes 1 and 4
prior to birthThe foramen ovale closes just...
Velocity is inversely related to cross - sectional area.
PGE (along with low oxygen tension)

7. Which phenotype of osteogenesis imperfecta is incompatible with life?
Lipoprotein lipase
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
Site 1
Type II

8. What complex is needed for propionyl CoA carboxylase?
Biotin - ATP - and CO2
C1 esterase inhibitor (C1INH)
Mesothelioma and bronchogenic carcinoma
Chylomicrons

9. What viral infection is known to cause intracerebral calcifications?
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
Buerger disease (thromboangiitis obliterans)
42 L - 67% of body weight
Primase

10. Name the T- cell CD marker: x Interacts with MHC class II molecules
CD4
No. It is abnormal only if it interferes with normal sexual or occupational function.
Testicular tumors
1. Large sample size 2. Large effect size 3. Type I error is greater

11. What reflex enables the eyes to remain focused on a target while the head is turning?
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.
Gaucher disease
The vestibulo - ocular reflex
No - unsaturated fatty acids have double bonds.

12. Causes of avascular necrosis of bone.
Concentration gradient
Altruism
Direct; in males less than 50 years old indirect hernias are the most common type.
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease

13. What is associated with prolonged lithium use?
Pedophilia
Type IV hypersensitivity (cell - mediated)
Hypothyroidism. (TSH levels must be monitored.)
reflexes

14. What is the major Ab of the primary immune response?
1. Iliocostalis 2. Longissimus 3. Spinalis ('I Love Science' muscles)
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
IgM
Zollinger - Ellison syndrome

15. When do hCG concentrations peak in pregnancy?
CN X
In the first 3 months
Allograft
Acral - lentiginous melanoma

16. Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Chlortetracycline
ACh
Clostridium perfrigens

17. What area of the hypothalamus is responsible for recognizing a decrease in body temperature and mediates the response to conserve heat?

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18. Name the antidote - Heparin
Coronary circulation
Axis III
Protamine sulfate
Intellectualization

19. What negative sense RNA virus is associated with intracytoplasmic inclusion bodies called Negri bodies?
Hypothyroidism. (TSH levels must be monitored.)
Rabies
Streptococcus pneumoniae
Schizoid

20. What phase of the female cycle occurs during days 1 to 15?
Arnold - Chiari malformation type 2
pI (isoelectric point)
Follicular phase
Middle meningeal artery

21. What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ?
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Autoimmune hemolytic anemia
Aminophylline
Herpesvirus

22. What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
Pseudogout
Arthroconidia with hyphae
Phallus

23. What is the FiO2 of room air?
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.
0.21; it is a fancy way of saying 21% of the air is O2.
TXA2
The energy of activation (Ea)

24. What is the central issue regarding the Roe vs. Wade decision (legalization of abortion)?
Vmax
Kidney
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
Listeria monocytogenes

25. What AR disorder is due to a deficiency in glycoprotein IIb - IIIa - resulting in a defect in platelet aggregation?
Glanzmann syndrome
Medial collateral ligament
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon

26. What enzyme catalyzes the rate - limiting step in gluconeogenesis?
Fructose -1 - 6- bisphosphatase
CN IX - X - and XI; sigmoid sinus
Nucleus pulposus
Class IV

27. What type of questions should you begin with when a patient seeks your medical opinion?
Molindone
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.
Axon hillock

28. In What area of the GI tract does iron get absorbed?
Ixodes (also the vector for Lyme disease)
Foramen of Monro
Duodenum
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)

29. What two AAs have a pKa of 10?
Lysine and tyrosine
Congenital heart disease
Zanamivir and oseltamivir
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 CNS tumor arises from Rathke's pouch?
HTN
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
Ischemic heart disease (MIs)
Craniopharyngioma

31. What rare disorder presents as a large - hard - irregular thyroid gland due to fibrous proliferation of connective tissue in the thyroid gland and extends to adjacent structures?
Plasmodium vivax
Foramen of Monro
Riedel thyroiditis
The carotid sinus is a pressure - sensitive (low) receptor - while the carotid body is an oxygen - sensitive (low) receptor. (Remember 'Sinus Pressure').

32. What is the precursor of all sphingolipids?
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
2 ATPs by oxidative phosphorylation
Ceramide
Bacillus cereus

33. What glycogen storage disease is due to the following enzyme deficiencies? - Glucose -6- phosphatase

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34. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol decreased - ACTH decreased
Helicobacter pylori
Secondary hypocortisolism (pituitary)
Dendrites receive information - whereas axons send information.
Average

35. Where is the cupola of the lung in relation to the subclavian artery and vein?
Dilation of afferent arteriole
Stibogluconate
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.
Right coronary artery

36. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH decreased - Ca2+ decreased - Pi increased
Ceramide
Aspiration pneumonia
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
Primary hypoparathyroidism

37. Name the most common type or cause - GN in the world
Hepatitis E
Squamous cell carcinoma
IgA nephropathy
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.

38. What is used as an index of cortisol secretion?
excites the neuron
Mycobacterium marinum
Urinary 17- OH steroids
1. Glycine 2. Aspartate 3. Glutamine

39. Name the RNA subtype based on the following: x RNA molecules with enzymatic activity
Splitting
Laminin
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.
Ribozymes

40. Signet ring cells
Plasma cell (mature B lymphocyte)
Factitious disorder
N- formyl - methionine LTB4 C5a IL-8
Gastric carcinoma

41. What is the difference between a Ghon focus and a Ghon complex?
Osteogenesis imperfecta
a -1 - 6 transferase
Giardia lamblia (treat with metronidazole)
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.

42. What is the classic triad of TB?
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Normal values
Fever - night sweats - and hemoptysis
Onion skinning

43. What is the vector of African sleeping sickness?
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Integrase
Adrenarche
The tsetse fly

44. What toxicities are caused by the following agents? - Halothane
Amyotrophic lateral sclerosis (Lou Gehrig's disease) is a LMN lesion at the level of the lesion and UMN lesion below the level of the lesion.
Hepatitis - with or without necrosis
Succinate dehydrogenase
The carotid body - which monitors arterial blood directly

45. What are the two ways that nitrogen can enter into the urea cycle?
Conjugated (direct) hyperbilirubinemia
NE
Aspartate and carbomoyl PO4
Integument (skin and its derivatives)

46. Which acid - fast rod is an obligate intracellular parasite?
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
HPV
No change in length
Mycobacterium leprae

47. What happens to the following during skeletal muscle contraction? - I band
Shortens
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
Internal 3' - 5' PDE bonds
60%

48. What urinary metabolite is elevated in pheochromocytoma?
Sphingosine
CN XI and X
Vanillylmandelic acid (VMA)
Acetyl CoA (pyruvate to acetyl CoA)

49. What excitatory fibers arise from the inferior olivary nuclei on the contralateral side of the body?
Edward syndrome (trisomy 18)
Chromosome 21
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
Varicella

50. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol increased - ACTH increased
Secondary hypercortisolism (pituitary)
Breast cancer
Ethacrynic acid
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.