Test your basic knowledge |

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 most common one? - Route of spread in pyogenic osteomyelitis
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
2.0 or greater
Hematogenous
Pyridoxine (B6)

2. 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?
Uroporphyrinogen III cosynthase
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
Systematic desensitization

3. If a patient asks you a question and you do not know the answer - do you tell a white lie or simply not respond?
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
Metanephros
Absolutely not! Answer any question you are asked.

4. Name the associated chromosome - Cystic fibrosis
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Correlation. No - correlation does not imply causation.
Chromosome 7
Varicocele

5. What antifungal agent is used in the treatment of androgen receptor - positive cancers?
Ketoconazole
The limbic system
Cholera toxin
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.

6. What pancreatic islet cell secretes glucagons?
B cells; macrophages and dendritic cells are nonspecific.
alpha - Cells; glucagon has stimulatory effects on - cells and inhibitory effects on - cells.
Ampulla
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci

7. Which anticonvulsant causes gingival hyperplasia?
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
LVEDV and LVEDP (left ventricular end - diastolic volume and end - diastolic pressure - respectively)
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Thymine

8. What is the term for drug removal per unit of time in a given volume of blood?
Orotic acid (purine metabolism)
Clearance
Variable interval
The central vein of the liver lobule

9. Which leukotrienes are associated with the late - phase inflammatory response?
After the latent period
Obesity - DM - HTN - multiparity - early menarche - and late menopause
LTC4 and LTD4
Inactivated

10. What is the effect of T3 on heart rate and cardiac output?
Thymic epithelial cells - dendritic cells - and macrophages
Blastomyces dermatitidis
Glutamate dehydrogenase
T3 increases both heart rate and cardiac output by increasing the number of Beta - receptors and their sensitivity to catecholamines.

11. What CN is associated with the sensory innervation of x Laryngopharynx?
Basal cell carcinoma
Vagus nerve
Positive predictive value
PGI 2

12. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Calcitonin
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.
Omega -3; linoleic is omega -6
Magnesium ammonium phosphate (struvite)
Medullary carcinoma of the thyroid

13. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Mucosal epithelium
Neutrophils - eosinophils - and basophils
Labile
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
Crigler - Najjar syndrome

14. What is a plasma cell's life expectancy?
Intermediate part of the hemispheres
Early collecting duct
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
7 to 14 days

15. How much dietary iodine is necessary to maintain normal thyroid hormone secretion?
Vitamin B 6 (pyridoxine)
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
HDL
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.

16. What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
Transient ischemic attack
Alzheimer disease
Adrenarche
Left ventricle and auricle of left atrium

17. What T cell deficiency syndrome is associated with facial anomalies - hypoparathyroidism - thymic hypoplasia - and recurrent viral and fungal infections?
Conjugated (direct) hyperbilirubinemia
Anterior compartment of the thigh - femoral nerve
Superior rectus (CN III) (LR6 SO4)3
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections

18. What is the most common one? - Neurotransmitter in the brain
8 weeks (response to a face)
Prostate cancer
GABA - quantitatively
1. Large sample size 2. Large effect size 3. Type I error is greater

19. 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?
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.
eIF-2 in the P site
Mycosis fungoides (cutaneous T- cell lymphoma)
Superior rectus (CN III) (LR6 SO4)3

20. What Brodmann area is associated with x Wernicke's area?
Lac repressor protein
Cocaine
S phase
Area 22 and occasionally 39 and 40

21. Name the most common cause - Croup
Parainfluenza virus
Osteoblasts (Remember - they modulate the function of osteoclasts.)
Menses. (Ovulation occurs 14 days before the beginning of menses.)
No enzymes are needed. When the stop codon reaches the A site - it results in termination.

22. Metformin is contraindicated in ________ because of weight gain as its side effect.
Aldolase B deficiencies are treated by eliminating fructose from the diet.
Lateral part of the hemispheres
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
Obese patients

23. What component of the pelvic diaphragm forms the rectal sling (muscle of continence)?
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
Puborectalis
The energy of activation
GH- producing adenoma

24. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol increased - ACTH decreased
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
Primary hypercortisolism
Pyruvate carboxylase
Northern blot

25. Name the B- cell CD marker: x Receptor for EBV
Desipramine
Rapidly progressive glomerulonephritis (RPGN)
Venlafaxine. (It also has a mild dopaminergic effect.)
CD21; it is a complement receptor for cleaved C3

26. Name the most common type or cause - Nonorganic pneumoconiosis
Chief cells
Asbestosis
Recall bias. These problems arise in retrospective studies.
Pancreatic cancer

27. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CA-125
Dilation of efferent arteriole
Where the cell bodies for the DCML and spinothalamic sensory systems are...
Ovarian cancer
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.

28. What is the most common one? - Type of melanoma
Limbic system
Clonorchis sinensis
Superficial spreading melanoma
Mumps and influenza virus

29. What signals are used to direct an enzyme to a lysosome?
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Phosphorylation of mannose residues
Prevalence rate
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)

30. Projectile nonbilious vomiting and a small knot at the right costal margin (olive sign) are hallmarks of What embryonic disorder?
Melatonin - serotonin - and CCK
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet
Radial Immuno Diffusion (RID) for Ig levels.
Dapsone

31. What are the four Ds of niacin deficiency?
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean) - resulting in a force to collapse the alveoli.
Membrane conductance (think conductance = channels open)

32. What are the four functions of SER?
Arginine
Poliomyelitis; it is a bilateral LMN lesion.
N-5- methyl THF
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling

33. On what layer of the epidermis does all mitosis occur?
Rabies
Rheumatoid arthritis
Mesonephric duct
Malpighian layer (made up of the stratum basale and stratum spinosum)

34. What pattern of genetic transmission affects only M and has no M- to - M transmission - and mother is usually an unaffected carrier?
X- linked recessive
Splitting
Hypocalcemia and hypophosphatemia
Type II error (beta error). (Remember it as saying something doesn't work when it does.)

35. With What two pathologies is a honeycomb lung associated?
Mikulicz syndrome
Asbestosis and silicosis
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.
Mean

36. Name the macrophages by location: x Liver
Kupffer cells
Cyanocobalamin (B12)
The JG cells
Pons

37. What enzyme is needed to activate the following reactions? - Trypsinogen to trypsin
Pyridoxine
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Enterokinase
Arginine

38. Name the aphasia based on these characteristics: x Lesion in the prefrontal cortex; inability to speak spontaneously; unimpaired ability to repeat
Transcortical aphasia
Superoxide dismutase - glutathione peroxidase - catalase
almitate
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.

39. What is the most common one? - Malignant tumor in the bone of teenagers
The vestibulo - ocular reflex
Mycoplasma pneumoniae
Osteosarcoma
Mitral (bicuspid) valve

40. What is the most common one? - Site for carcinoid tumors
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
Appendix (second is terminal ileum)
Candida albicans
Corticospinal tract

41. Name the most common type or cause - Neonatal septicemia and meningitis
F- Met - Peptides
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma
Sphingomyelin (lecithin also - but it is not a sphingolipid)
Streptococcus agalactiae (Group B Streptococcus - or GBS)

42. Name the most common type or cause - Bronchiolitis in children
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
Stable
RSV
Treacher Collins syndrome

43. Name the antidote - Digoxin
Antidigoxin Fab fragments
Type III
Fat necrosis
Loose association

44. Name the bony articulations of the following sites. Be specific. Elbow
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.
Primary hyperaldosteronism (Conn syndrome)
Coxiella burnetii
Humerus with ulna (major) and radius (minor)

45. What is the most common one? - Primary malignant tumor of the ovary
Serocystadenocarcinoma
Prevalence increases. (Incidence does not change.)
Volkmann's contracture
Eaton - Lambert syndrome

46. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Acellular; some are enveloped; replicate within the host cell; no cell walls
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
IF
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
Viruses

47. What is the rate - limiting enzyme on glycolysis?
Phosphofructokinase -1 and costs 1 ATP
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
Exposure
Nucleolus. Ribosomal assembly also takes place in the nucleolus.

48. What is the term for taking an mRNA molecule and arranging the AA sequence forming a protein?
Ependymal cells
Constipation and miosis
Translation
Acetyl CoA and propionyl CoA (in odd chain fatty acids)

49. What is the most common one? - Helminth parasitic infection in the United States
Chlortetracycline
Histidine
6 weeks 10 weeks
Enterobius vermicularis

50. What embryonic structure forms the adult male structure? - Gubernaculum testes
Flurazepam
Pancreatic delta - cell tumors inhibit CCK secretion
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.)
Gubernaculum