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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. Which way will the O2 dissociation curve shift with the addition of 2 - 3- bisphosphoglycerate (2 - 3- BPG) to adult hemoglobin (Hgb)?
Shifts it to the right
embranoproliferative glomerulonephritis (MPGN)
Amantadine
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)

2. What skin carcinoma is a superficial dermal infiltrate of T lymphocytes seen in males more than 40 years old and presents as scaly red patches or plaques?
An elevated serum osteocalcin level
They are preganglionic sympathetic axons. They are white because they are myelinated.
Mycosis fungoides (cutaneous T- cell lymphoma)
Impotence

3. What wave is the cause of the following venous pulse deflections? - The rise in right atrial pressure secondary to blood filling and terminating when the tricuspid valves opens
Saltatory conduction
Glucagon
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
V wave

4. What is the primary end product of pyrimidine synthesis?
White muscle; short term too
Renal circulation
Squamous cell carcinoma
UMP

5. What is the name of the urinary bladder where the ureters enter and the urethra exits?
CN V
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)
Lateral collateral ligament
Urinary trigone

6. Which B- cell neoplasm has the following cell surface markers: CD19 - CD20 - CD5 (T- cell marker) - CD23; and are CD10- negative?
Succinylcholine
NH4+(ammonium)
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
CLL (B- cell origin)

7. In regard to motor development during infancy - choose the motor response that happens first - Radial or ulnar progression
>5 mm
Ulnar to radial progression
Hemolytic uremic syndrome
Red muscle

8. What embryonic structure forms the adult female structures? - Gartner's duct
Tyrosine
Spinal trigeminal nucleus
Mesonephric duct
Recovery and death

9. What is the most common one? - Inflammatory arthritis
Job syndrome
Rheumatoid arthritis
Round and ovarian ligaments
Albumin

10. Use of an outlet for emotions (stuff flows downhill).
Displacement
Stimulus control
Cystic fibrosis
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages

11. Which extravascular chemoreceptor detects low NaCl concentrations?
Macula densa
Neisseria meningitidis
Chi - square.
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)

12. In a positively skewed curve the mean is ______ than the mode.
Antidigoxin Fab fragments
greater
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Hepatic adenomas

13. What are the three exceptions to the rule of codominant gene expression?
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci
Spectinomycin

14. What congenital small bowel outpouching is a remnant of the vitelline duct?
Meckel diverticulum
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>
Specificity (it deals with the healthy)
Coccidioides immitis

15. What is the most common one? - Primary malignant tumor in the liver
Shortens
Hepatocellular carcinoma
Tryptophan
Systematic desensitization

16. Name the most common one - Heart defect in Down syndrome
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling
Endocardial cushion defect
Reject it
Ferritin

17. What aneurysm of the circle of Willis is associated with polycystic kidney disease?
ACh - histamine - and gastrin
Substituted judgment. It is made by the person who best knows the patient - not the closest relative.
SER
Berry aneurysm

18. What CN carries preganglionic parasympathetic fibers that innervate the viscera of the neck - thorax - foregut - and midgut?
Fever - night sweats - and hemoptysis
Galactoside permease
CN X (Remember - the vagus nerve supplies the parasympathetic information from the tip of the pharynx to the end of the midgut and all between.)
Glutamine

19. What Beta- blocker is also a membrane stabilizer?
Gonads
Propranolol
Adenocarcinoma
Hematogenous

20. What hormone level increases in the first 3 hours of sleep?
Coombs test
Prolactin
Enterokinase
Bile pigments and bile salts

21. What liver enzyme - for triglyceride synthesis - converts glycerol to glycerol -3- phosphate?
Glycerol kinase
Anopheles mosquito
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
Osteogenesis imperfecta

22. Name the most common type or cause - Liver transplantation in adults
Primase
emancipates
Filtration is greater than excretion for net reabsorption to occur.
Alcoholic cirrhosis

23. What is the PO2 of aortic blood in fetal circulation?
Lingual nerve of CN V3
DNA ligase
60%
Schizoid

24. How can a deficiency in adenosine deaminase be a bone marrow suppressor?
Hurler syndrome and Hunter syndrome - respectively
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
It causes a buildup of dATP - which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate - a precursor of DNA - resulting in overall bone marrow suppression.
ELISA screens and Western blot confirms the diagnosis.

25. What cestode causes cysticercosis?
Taenia solium
EF- Tu and EF- Ts of the 30S ribosomal subunit
It increases Ca2+ excretion from the kidney and increases bone mineralization.
Giant cell bone tumor (osteoclastoma)

26. Which gram - negative diplococcus ferments maltose?
Labile
Meningococcus (Gonococcus does not)
Opposite the second upper molar tooth
Increased erection and libido

27. What cell type of the epidermis originates from the neural crest?
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Melanocytes
Tryptophan
LDL

28. What is the term for the strength of association between multiple Abbinding sites and multiple antigenic determinants?
Avidity (more than one binding site)
1 day prior to ovulation
Filtration is greater than excretion for net reabsorption to occur.
Atropine with pralidoxime

29. What disorder is described as having x Conscious symptoms with conscious motivation?
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
Phallus
Factors II - VII - IX - X - and proteins C and S
Malingering

30. What are the three branches of the celiac trunk?
absorption
Streptococcus viridans
The left gastric - splenic - and common hepatic arteries
CN XI and X

31. In the classical conditioning model - when a behavior is learned - what must occur to break the probability that a response will happen?
Glutamate dehydrogenase
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
The biofeedback model is based on the parasympathetic nervous system.
Arginine

32. What blotting technique uses the following for analysis? - RNA
In the mouth with salivary a - amylase (ptyalin)
An internal elastic lamina
Northern blot
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.

33. During What embryonic week do somites begin to form?
H 2
Motilin
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
Third week

34. At what stage of cognitive development (according to Piaget) do children x Have abstract thinking?
Mercury
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
Formal operations (> 12 years)
Truncus arteriosus

35. What embryonic structure forms the adult female structures? - Glans clitoris - corpus cavernosus - and spongiosum
Parvovirus B-19
Solved as 30% T + 30% A = 60%; therefore - C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
Phallus
Direct; in males less than 50 years old indirect hernias are the most common type.

36. What is the major inorganic component of bone?
Hydroxyapatite
Corticosteroid
Processed antigenic peptides bound in the groove of the MHC molecule
M

37. Name the type of exudate - given the following examples - Sunburn
Boutonni
Coagulative necrosis
Hepatitis C
Serous exudates

38. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Benzenes
Osteopetrosis (Albers - Sch
Leukemias
Acral - lentiginous melanoma
Posterior

39. What is the physiologically active form of Ca2+?
Free ionized Ca2+
Oxazepam - temazepam - and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation - not via the cytochrome p450 system.
An internal elastic lamina
Interval scale (a ruler - for example)

40. Aschoff bodies
Heroin
Superior
Rheumatic fever
Cefamandole - cefoperazone - and moxalactam

41. Name the most common type or cause - Nephritic syndrome in adults
MGN
Minor
At the end of the PCT 25% of the original volume is left
Negative correlation

42. Name the hepatitis virus based on the following information - Small circular RNA virus with defective envelope
5 years old
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes - but the accommodation - convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
Hepatitis D
Polycystic kidney disease of childhood

43. What B- cell neoplasm is seen in males with massive splenomegaly - produces dry tap on bone marrow aspirations - and stains positive for tartrate - resistant acid phosphatase (TRAP)?
Hairy cell leukemia
For males - HTN; for females - pregnancy.
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)

44. With what stage of sleep is enuresis associated?
0.2
Constipation and miosis
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
Penicillin V

45. Which two negative sense RNA viruses have neuraminidase enzymes?
Streptococci
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
Mumps and influenza virus
Molindone

46. What is the MCC of the following meningitides? - In neonates to 3 months of age
Pseudohyphae
Constrictor pupillae and ciliary muscles
Streptococcus agalactiae and Escherichia coli
Ischemia

47. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral hemispheres
Thrombus
Proencephalon
C5b - C9
Mean corpuscular hemoglobin (MCH)

48. What is the term for the amount of blood in the ventricle after maximal contraction?
Areas 44 and 45
Transtentorial (uncal)
Receptive aphasia is due to a lesion in Brodmann areas 22 - 39 - and 40; generally the patient is unaware of the deficit.
Residual volume

49. What condition results in the following CSF results? - Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
Chromosome 4p
Bacterial meningitis
Cortisol - a 21- carbon steroid - has a - OH group at position 17.
G1 phase (gap 1)

50. What happens to REM - REM latency - and stage 4 sleep during major depression?
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Subarachnoid hemorrhage
Erythema nodosum