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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 a2- antagonist is used to treat impotence and postural hypotension?
Left homonymous hemianopsia
Enterobius vermicularis; the treatment is albendazole.
Yohimbine
prior to birthThe foramen ovale closes just...

2. What gram - positive rod is distinguished by its tumbling motility?
Enterobius vermicularis; the treatment is albendazole.
Listeria
Hepatitis E
Chromium (Cr)

3. What is the DOC for CMV retinitis?
Ganciclovir
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma
Corticospinal tract

4. Where are the tonsillar tissues?

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5. What are the three effects of insulin on protein metabolism?
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
Middle
The optic disk is the blind spot.
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)

6. What enzyme does HIV use to integrate the proviral dsDNA into the host?
The urine becomes hypertonic because of water reabsorption in the collecting duct.
Squamous cell carcinoma
Integrase
Mitosis

7. Which hepatitis B serology markers
Catatonic schizophrenia
Factors II - VII - IX - X - and proteins C and S
HBcAb IgG - HBV- DNA - HBeAg - HBsAg
JC virus

8. What muscles in the hand adduct the fingers?
Nodular sclerosis
Pheochromocytoma
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
Achondroplasia

9. What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?
Syringomyelia
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).
Progressive multifocal leukoencephalopathy
Acid is needed for the activation of pepsin and therefore needed for protein digestion.

10. What enzyme catalyzes the rate - limiting step in fatty acid oxidation?
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive - compulsive disorder and learning disabilities.
Hemostasis
Ribozymes
Carnitine acyltransferase - I

11. What condition results from a 46XX karyotype and female internal organs with virilized external genitalia?
Frontal lobe
Female pseudohermaphrodite
Proencephalon
There would be two Fab and Fc regions.

12. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Metencephalon
Obsessive - compulsive
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Id (pleasure principle)
Rhombencephalon

13. What three chemical agents are associated with angiosarcomas of the liver?
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Arsenic - thorotrast - and vinyl chloride
Prefrontal cortex; it is in front of the premotor area.
Uracil

14. What is the only way to increase the Vmax of a reaction?
Direct; in males less than 50 years old indirect hernias are the most common type.
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
PR interval
Increase the concentration of enzymes

15. What virus is associated with both nasopharyngeal carcinoma and Burkitt lymphoma?
RBCs
Staphylococcus aureus
EBV
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.

16. What is the only CN nucleus found in the cervical spinal cord?
Mesonephric duct
The energy of activation
Accessory nucleus
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)

17. What artery travels with the following veins? - Small cardiac vein
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)
Hepadnavirus
Right coronary artery
Molybdenum (Mb)

18. What ovarian carcinoma is characterized by psammoma bodies?
Cystadenocarcinoma
Third week
Glucagon and epinephrine
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.

19. Name the three enzymes that protect the cell from oxygen - derived free radicals.
Myelofibrosis with myeloid metaplasia
Orbitomedial frontal lobe
Superoxide dismutase - glutathione peroxidase - catalase
Squamous cell carcinoma

20. What is the most common one? - Malignant tumor of the esophagus
11- Beta - Hydroxylase deficiency results in excess production of 11- deoxycorticosterone - a weak mineralocorticoid. It increases BP - Na+ - and ECF volume along with production of adrenal androgens.
Propionic acid
Squamous cell carcinoma
Ovulation

21. What is the most common one? - Complication of PDA
Edrophonium
The Beta -2- microglobin. It is the separately encoded Beta - chain for class I Ags.
Direct pathway; a good example is Parkinson's disease.
Subacute bacterial endocarditis

22. What water - soluble - vitamin deficiency is associated with cheilosis and magenta tongue?
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Buerger disease (thromboangiitis obliterans)
Riboflavin (B2)
Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone - produced by Leydig cells - is needed for spermatogenesis.

23. Name the aphasia based on these characteristics: x Lesion in Brodmann area 22; impaired comprehension; incoherent rapid - fluent speech; verbal paraphrasias; trouble repeating statements

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24. What are the two reasons for megaloblastic anemia with elevated MCV?
Pituitary adenoma
Squamous cell carcinoma (skin - lung) and angiosarcoma of the liver
Vitamin B12 deficiency and folate deficiency
CLL (B- cell origin)

25. Name the cluster C personality disorder: x Orderly - inflexible - perfectionist; makes rules - lists - order; doesn't like change - has a poor sense of humor - and needs to keep a routine
Obsessive - compulsive
More than 75% of the vessel
Pons
Obturator nerve

26. What embryonic structure forms the adult male structure? - Corpus cavernosus - corpus spongiosum - and glans and body of the penis
prior to birthThe foramen ovale closes just...
Inulin
Phallus
Rheumatoid arthritis

27. What embryonic structure forms the adult female structures? - Ovary - follicles - rete ovarii
Gonads
Persistent truncus arteriosus
Vitamin D
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.

28. What diseases are associated with the HLA- B27 allele

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29. If you double the infusion rate of a drug - how long will it take to reach steady state?
Aedes (the same for yellow fever)
Medial nuclear group (limbic system)
Rhinovirus
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.

30. What obligate extracellular fungus is silver stain - positive and is associated with pneumonia in patients with AIDS?
Ceramide
Clostridium botulinum
Pneumocystis carinii
Labioscrotal swelling

31. In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
Arnold - Chiari malformation type 2
Pneumocystis carinii
Malignant mesothelioma
Neutropenia - splenomegaly - and rheumatoid arthritis

32. What is the term for the day after the LH surge in the female cycle?
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)
DiGeorge's syndrome
Zileuton
Ovulation

33. Clue cells are associated with which organism that causes vaginal discharge?
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Gardnerella vaginalis
Alcohol consumption
IGF-1

34. What pancreatic islet cell secretes somatostatin?
HBeAb
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
Atrial filling (venous filling) Atrial - Contraction - Venous
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.

35. Name the RNA subtype based on the following: x The most abundant form of RNA in the cell
Trichuris trichiura is treated with albendazole.
Squamous cell carcinoma of the lung
rRNA
Free ionized Ca2+

36. Is the hydrophobic or hydrophilic end of the phospholipids of the cell membrane facing the aqueous environment?
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
Scavenger receptor (SR- B1)
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.
Staphylococcus aureus

37. How are resistance and length related regarding flow?
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.
Hydrolysis
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
1. Short attention span 2. Impulsivity 3. Hyperactivity

38. What pneumoconiosis is associated with exposure to the following occupations or materials? - Aerospace industry - nuclear reactors
The rate of infusion
Berylliosis
Isoniazid treatment
G0 phase

39. In a negatively skewed curve is the mean greater than the mode?
Helicase (requires ATP for energy)
Caseous necrosis
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.

40. What is the signal to open the voltage - gated transmembrane sodium channels?
Cholesterol biosynthesis
Chromosome 8 - 14
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Th2 cells

41. What tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum - helping monitor and modulate muscle movements?
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
Bronchogenic carcinoma
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
Hemophilia B

42. Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?
Papovavirus
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.
Mycosis fungoides (cutaneous T- cell lymphoma)
Chlamydia psittaci

43. What is the major difference between the veins in the face and the veins in the rest of the body?
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
There are no valves and no smooth muscle in the walls of the veins in the face.
Insulin increases total body stores of protein - fat - and CHOs. When you think insulin - you think storage.
C2 deficiency

44. What syndrome arises from mutation in the fibrillin gene (FBN1) on chromosome 15q21?
Group A Beta- hemolytic streptococci
Kinesins. Dynein generates retrograde transportation of information.
Marfan syndrome
Plasmodium malariae

45. Name the compartment of the mediastinum associated with the following thoracic structures: SVC
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
Superior and middle
Utricle and saccule
Wilson disease

46. What is the major stimulus for cell division in chondroblasts?
Extracellular
Adenosine deaminase
The gut rotates clockwise around the superior mesenteric artery.
IGF-1

47. How does ventricular depolarization take place - base to apex or vice versa?
Indirect or unconjugated
Depolarization is from apex to base and from endocardium to epicardium.
Phenytoin
Two - way ANOVA. It allows the test to check several variables at the same time.

48. What renal side effect is commonly seen in patients taking lithium?
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
At least 15%
Dominant parietal lobe (Gerstmann's syndrome)
FSH

49. What phase of Interphase is haploid (N)?
G1 phase; G2 and S phase are diploid (2N).
Passive - aggressive
Ataxia - telangiectasia
PPRF

50. What two PGs are used to induce labor?
Depression
Ulcerative colitis
Carbamazepine
PGE2 and PGF2a