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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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. Which hepatitis B Ag correlates with infectivity and viral proliferation?
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
14 days
HBeAg
Carnitine acyltransferase - I

2. What type of cell can never leave the lymph node?
FSH and testosterone
All
Negative selection. This helps to prevent autoimmune diseases.
Plasma cell

3. Name the most common cause - Croup
Parainfluenza virus
M12 strains
Somatomedins (IGF-1)
Global aphasia

4. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - CNS neurons
LGB (think EYES)
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
Mitral stenosis
Permanent

5. What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
First - pass metabolism and acid lability
Tylosis
positive correlation
Cocaine

6. Name the nephritic disease based on the immunofluorescent staining - Mesangial deposits of IgA and C3
Frotteurism
NADPH - O2 - and cytochrome b5
IgA nephropathy (Berger disease)
16S subunit

7. What is the MCC of the following meningitides? - In military recruits
Estrogen use
Staphylococcus aureus
Pergolide
Neisseria meningitides

8. What three muscles constitute the pes anserinus?
Stage 1
Poxvirus
1. Sartorius 2. Gracilis 3. Semitendinous
4.7 L - 5% of body weight

9. From What aortic arch are the following structures derived?
Reovirus
Osteoporosis
Right and left pulmonary arteries and the ductus arteriosus
Direct fluorescent Ab test

10. Name the thalamic nucleus based on its input and output - Input from the amygdala - prefrontal cortex - and temporal lobe; output to the prefrontal lobe and the cingulated gyrus
The dentate nucleus
PGD2 - PGE2 - and PGF 2
Ketamine
Medial nuclear group (limbic system)

11. What preganglionic sympathetic fibers are responsible for innervating the smooth muscle and glands of the pelvis and the hindgut?
Valine
Lumbar splanchnics
HMG- CoA reductase
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c

12. Name the stages of sleep with these EEG patterns: x Delta waves
Emphysematous bleb
Streptococcus pyogenes
Superior gluteal nerve
Stage 3 and 4

13. What lysosomal enzyme is deficient in x Tay- Sachs disease?
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
Hexosaminidase A
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Medullary carcinoma of the thyroid

14. What is the most common one? - Site of Crohn disease
Biotin - ATP - and CO2
Terminal ileum
Chorda tympani of CN VII
Exposure

15. What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
Duodenal ulcer
Projection
A patent processus vaginalis
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid

16. Name the four components of the narcoleptic tetrad.
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
Dimercaprol - penicillamine
IgG
1. Sleep paralysis 2. Hypnagogic hallucinations (while falling asleep) 3. Sleep attacks with excessive daytime sleepiness 4. Cataplexy (pathognomonic) Narcolepsy is a disorder of REM sleep - with REM occurring within 10 minutes of sleep.

17. A patient can ______ a feeding tube.
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
Albinism
Cardiac muscle
refuse

18. What Brodmann area is associated with x Primary auditory cortex?
Staphylococcus aureus (but they are more prone to salmonella infections)
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
Areas 41 and 42

19. What vitamin deficiency produces homocystinuria and methylmalonic aciduria?
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
Frotteurism
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
An elevated serum osteocalcin level

20. What enzyme is deficient in the following glycogen storage disease? - Pompe's disease
Stretch receptors prevent overdistension of the lungs during inspiration.
Blocking
Lysosomal a -1 - 4- glucosidase
Narcissistic

21. Are the following conditions associated with a negative or positive nitrogen balance? - Infection
Negative
Exhibitionism
Lateral collateral ligament
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.

22. What portion of the intervertebral disk is a remnant of the notochord?
Nucleus pulposus
MEN III (or IIb)
Deferoxamine - penicillamine
Right coronary artery

23. In What type of circuit is the total resistance always less than that of the individual resistors?
Parallel circuit
CN I - II - III - VI - and XII Add 1 + 1 = 2 - 1 + 2 = 3 - 1 + 2 + 3 = 6 - 1 + 2 + 3 + 6 = 12
PRPP aminotransferase
Cysticerci

24. What is the most common one? - Tumor on sun - exposed sites
Basal cell carcinoma
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)
IgG3
Cytochrome a/a3

25. What two forces affect movement of ions across a membrane?
Integument (skin and its derivatives)
Concentration force and electrical force
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).

26. What CNs arise from x The pons?
Serocystadenocarcinoma
GH- producing adenoma
CN V - VI - VII - and VIII
Mitosis

27. What is the only CN nucleus found in the cervical spinal cord?
Displacement
Accessory nucleus
Measurement bias
Wiskott - Aldrich syndrome

28. What are the two most common chains of the TCR?
Inulin
Chief cells
a - and Beta- chains are on most T cells.
Insulinoma

29. What area of the small intestine is characterized by Peyer's patches?
Prefrontal cortex; it is in front of the premotor area.
1. Short attention span 2. Impulsivity 3. Hyperactivity
Ileum
Anticipation

30. What law was adopted to shield physicians from liability when helping at the scene of an accident?
Dysplasia
Good Samaritan Law. (Physicians are not required to stop and help.)
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.

31. What axis I disorder is characterized by a clinically significant syndrome that affects social - occupational - and/or academic achievement; occurs less than 3 months after a stressor; and abates less than 6 months after the stressor is removed?
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).
P1 protein
Ipsilateral loss at and below the level of the lesion

32. Neurofibrillary tangles
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns
Alzheimer disease
Gabapentin
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)

33. What is the term to describe how easily a vessel stretches?
Compliance (think of it as distensibility)
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.
Propranolol
CD8

34. Name the type of mutation: New codon specifies a different AA
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Shifts it to the right
Enterohepatic cycling
Missense

35. Are contraindicated in patients with SCID.
Live vaccines
Type III hypersensitivity (immune complex)
Because it is the largest vessel and has the highest velocity in systemic circulation
The raphe nuclei

36. What happens to affinity if you increase Km?
Intercellular adhesion molecule (ICAM) 1
Breast cancer
Hepatitis C
Affinity decreases; they are inversely proportional.

37. The proportion of truly diseased persons in the screened population who are identified as diseased refers to?
HBsAg and HBeAg
Ventral posterolateral nucleus
Purulent exudates
Sensitivity (it deals with the sick)

38. What type of erythema do you see in x Stevens - Johnson syndrome?
Erythema multiforme
Bulla
Parasympathetic
Alanine and glutamine

39. Name the most common type or cause - Spontaneous pneumothorax
Toxoplasmosis
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N- methyl cap of mRNA
Liquids - CHO - protein - fat
Emphysematous bleb

40. Name three opsonins.
Fc portion of IgG - C3b - and mannose - binding proteins
Berger disease (IgA nephropathy)
DNA polymerase -?
Superior and posterior

41. What cytoplasmic pathway produces NADPH and is a source of ribose 5- phosphate?
Hemolytic uremic syndrome
Volume of distribution is decreased when a large percentage of drug is protein bound.
Increase in erythropoietin and increase in 2 - 3- BPG - also called 2 - 3- diphosphoglycerate (2 - 3- P2Gri) (increase in glycolysis)
HMP shunt

42. What classical conditioning therapy or modification is described as x Triage of a hierarchy of fears (from least to most) - then teaching muscle relaxation techniques in the presence of those fears until the subject is not afraid anymore?
Eosinophil
Systematic desensitization
Embolic
Idiotypes

43. Why should opioid analgesics be avoided for patients with head trauma?
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Testicular lymphoma
Chromosome 21
Secondary lysosome (think of the primary as inactive and secondary as active)

44. What are the five F's associated with gallstones?
Hypersegmented neutrophils
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
Dihydrofolate reductase
Right - sided

45. What genetic defect is characterized by coarse facial features - gingival hyperplasia - macroglossia - psychomotor and growth retardation - club foot - claw hand - cardiorespiratory failure - and death in the first decade of life?
igantism
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
CN III - VII - IX - and X

46. What is the vector for Chagas disease?
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.
The reduviid bug
Factitious disorder
Bordetella pertussis

47. What is the term for the pH range where the dissociation of H+ occurs?
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
pK (think of it as where half is base and half is acid)
Enterobius vermicularis; the treatment is albendazole.
With arteriolar constriction both the flow and pressure downstream decrease.

48. What protective covering adheres to the spinal cord and CNS tissue?
Pneumocystis carinii
1. Cough 2. Coryza 3. Conjunctivitis
Pia mater
Rods

49. What IL is essential for lymphoid cell development?
NH4+(ammonium)
Adult polycystic kidney disease
TCR
IL-7 (A 7 upside down is an L; L is for Lymphoid)

50. Name the cluster B personality disorder: x Criminal behavior; lacking friends - reckless - and unable to conform to social norms
Erythema multiforme
Leydig cell tumor
There would be two Fab and Fc regions.
Antisocial

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USMLE Step 1 Prep

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