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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. Birbeck granules
Histiocytosis X
Antidigoxin Fab fragments
Axillary nerve and posterior humeral artery
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.

2. Name the most common one - Heart defect in Down syndrome
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA
14 days in most women (Remember - the luteal phase is always constant.)
Endocardial cushion defect
Biotin - ATP - and CO2

3. Goodpasture Ag is a component of What type of collagen?
Type IV collagen
MEN I (or Wermer syndrome)
Elevated ASO titers and serum complement levels
Supraoptic nuclei; lesions here result in diabetes insipidus.

4. In What three areas of the body are sympathetics the predominant tone?
Escherichia coli
Quaternary structure
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
1. Sweat glands 2. Arterioles 3. Veins

5. With what stage of sleep are night terrors associated?
CN X
NREM sleep. Night terrors are dreams that we are unable to recall.
The T- test (used when comparing two groups)
Conduction aphasia

6. What cells are atypical on a peripheral blood smear in heterophil - positive mononucleosis?
T cells - not B cells
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.
Free - unprocessed Ag
Demeclocycline

7. What are the three branches of the lateral cord of the brachial plexus?
Berry aneurysm
Common and internal carotid arteries
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
snRNA

8. How many ATPs per glucose are generated from glycolysis in RBCs?
2 ATPs - because RBCs use only anaerobic metabolism.
Plasma concentration and excretion rate
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.

9. Name the three postganglionic sympathetic ganglia that receive input from thoracic splanchnics.

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10. What is the most common one? - Renal calculus type
Third week; they are derived from the wall of the yolk sac.
1. Tinea coli 2. Haustra 3. Epiploic appendages
Calcium oxylate
Hepatic glycogen phosphorylase

11. Which virus is the MCC of a cold in the summer and fall? Winter and spring?
Yolk sac tumor
>10 mm
Rhinoviruses for summer and fall; coronaviruses for winter and spring
Phallus - urogenital folds - and labioscrotal swellings

12. Are reabsorbed in the gallbladder.
Bile pigments and bile salts
Emphysema
Lung and bronchus cancer
Primary follicle (in the white pulp)

13. What is the DOC for treating torsade de pointes?
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma
Erythromycin
Magnesium
Masochism

14. What are the two functions of the thymus in T- cell differentiation?
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself
Histidine
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
Primary hypocortisolism (Addison's disease)

15. Should you refer a patient to a form of folk medicine even if you don't believe in it?

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16. What is the most common one? Esophageal cancer in the United States
Yes
Adenocarcinoma (because of Barrett esophagus)
Superior and posterior
Single - strand DNA binding protein

17. Is DM a contraindication to use of a Beta- blocker in a patient who is having an MI?
Melatonin. It is a light - sensitive hormone that is associated with sleepiness.
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
During REM sleep
Hepatitis B

18. What term describes the volume of plasma From which a substance is removed over time?
Clearance
The parasympathetic nervous system
Stable
Dissociative fugue. (Patients are unaware of memory loss.)

19. What is the stimulus for the classical pathway activation?
Since they are independent events - their probabilities would be multiplied.
Propranolol
Liquids - CHO - protein - fat
Ag - Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.

20. What is the name of the postganglionic parasympathetic ganglion that innervates x The parotid gland?
Loose association
Linoleic acid and linolenic acid
This is the triad of renal cell carcinoma
The otic ganglion. (These fibers are carried in CN IX. Remember it like this: the - oti - is in both otic ganglion and parotid gland.)

21. Both submandibular and sublingual glands are innervated by CN VII (facial) and produce mucous and serous secretions. Which one mainly produces serous secretions?
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
Goodpasture disease
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.

22. What hormone is characterized by the following renal effects? - Calcium reabsorption - phosphate reabsorption
Vitamin D3
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.

23. What is the name of the process that ensures that each B cell produces only one heavy- chain variable domain and one light chain?
Budd - Chiari syndrome
Resorb CSF into the blood
Zona fasciculata and zona reticularis
Allelic exclusion. It is to ensure that one B cell produces only one Ab.

24. How are flow through the loop of Henle and concentration of urine related?
Acute cystitis
Male pseudohermaphrodite (dude looks like a lady!)
As flow increases - the urine becomes more dilute because of decreased time for H2O reabsorption.
Uricosuric

25. What component of an ECG is associated with the following? - Atrial depolarization
Conidia
Hemiballismus
P wave
Free form determines hormone activity and is responsible for the negative feedback loop.

26. What is the most common one? - Primary tumor metastasis to the bone
Raloxifene
Constriction of efferent arteriole
The lung will expand; also the opposite is true.
Breast

27. From what pharyngeal pouch is the following structure derived? - Inferior parathyroid gland and thymus
Good Samaritan Law. (Physicians are not required to stop and help.)
H 1
Low average
Third M PITS for pharyngeal pouch derivatives

28. What operant conditioning therapy or modification is described as x Stopping the reinforcement that is leading to an undesired behavior?
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Factors II - VII - IX - and X and proteins C and S.
Extinction
Persistent truncus arteriosus

29. Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?
High - frequency sound waves
Isotypes
PGI 2
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)

30. Name the most common type or cause - Breast lump in females
Nominal scale (categorical - e.g. - male or female)
Fibrocystic change of the breast
Chromosome 18
The small subunit (40S) binds first.

31. What adrenal enzyme deficiency results in hypertension - hypernatremia - increased ECF volume - and decreased adrenal androgen production?
The splenic vein
REM sleep. Nightmares are frightening dreams that we recall.
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA
17- alpha - Hydroxylase deficiency

32. What benign cardiac tumor is associated with tuberous sclerosis?
Production of oxygen free radicals
ELISA. It detects anti - p24 IgG.
Rhabdomyoma
Intrinsic factor (IF)

33. What non - spore - forming gram - positive aerobic rod produces bull neck - sore throat with pseudomembranes - myocarditis - and sometimes respiratory obstructions?
1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors
Peau d'orange
Corynebacterium diphtheriae
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.

34. What X- linked recessive disorder that is due to an abnormality in the dystrophin gene - has onset by age 5 with progressive proximal muscle weakness - calf pseudohypertrophy - and elevated CPK levels?

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35. What ocular muscle x Depresses and abducts the eyeball?
Superior Oblique (CN IV) (LR6 SO4)3
Expiratory reserve volume (ERV)
M
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.

36. During What embryonic week does the intraembryonic coelom form?
Curling ulcers (think curling iron = burn)
Biofeedback
Sublimation
Third week

37. What type of personality test is the Rorschach inkblot test - objective or projective?
Gastric carcinoma
Hereditary spherocytosis
Subarachnoid hematoma
Projective test. Most tests with a wide range of possibilities for the answers are projective.

38. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Diencephalon
Gabapentin
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
Ulcerative colitis
Proencephalon

39. What is the major pulmonary side effect of
Dysgerminoma
Respiratory depression
Metronidazole
Corynebacterium diphtheriae

40. What basic reflex regulates muscle tone by contracting muscles in response to stretch of that muscle?
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling
The myotatic reflex is responsible for the tension present in all resting muscle.
Superoxide dismutase - glutathione peroxidase - catalase
Churg - Strauss syndrome

41. For what disease are SS- A(Ro) - SS- B(La) - and R- ANA diagnostic markers?
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP
Chromosome 4p
Sj
hnRNA

42. What muscle or muscles are innervated by the following nerves? - Upper subscapularis nerve
61 codons code for AAs and 3 codons (UAA - UGA - UAG) code for the termination of translation.
Subscapularis
Superior rectus (CN III) (LR6 SO4)3
Ischemic heart disease (MIs)

43. What is the site of action of the following? - Thiazide diuretics
Early distal tubule
Sphingomyelinase
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
Dimercaprol

44. What enzyme is blocked by hydroxyurea?
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
First - pass metabolism and acid lability
Ribonucleotide reductase
Teeth grinding is associated with stage 2 sleep.

45. What is the drug of choice for threadworm - trichinosis - and larva migrans?
Cauda equina
Hematoxylin
Thiabendazole
Dopamine antagonists

46. What papillae send their senses via chorda tympani of CN VII?
Neutropenia - splenomegaly - and rheumatoid arthritis
Unipolar disorder (major depression)
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood
Fungiform papillae

47. Name the form of spina bifida - An open neural tube lying on the surface of the back
2 ATPs by oxidative phosphorylation
Progressive multifocal leukoencephalopathy
Oblique fissure
Myeloschisis All except occulta cause elevated - fetoprotein levels.

48. What immunologic test checks for a reaction between Abs and a particular Ag? (hint: ABO typing)
Zona fasciculata and zona reticularis
IgA
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.
Agglutination test

49. Which region of the variable domain comprises the Ag - binding site of the Ab?
Phototherapy
Paroxysmal nocturnal hemoglobinuria
Hypervariable region (three per light chain; three per heavy chain)
The CD4 T cell; the APC is the first cell in the immune response.

50. What happens to free hormone levels when the liver decreases production and release of binding proteins?
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.
Id
Astrocytes
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.