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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 is the most common one? - Tumor of the female genital tract
Chlamydia trachomatis
Leiomyoma (fibroids)
Klinefelter syndrome
Meckel diverticulum

2. What is the most common one? - Malignant carcinoma of the ovaries
Wilson disease
Antidigoxin Fab fragments
Cystadenocarcinoma
Serratia

3. With a decrease in arterial diastolic pressure - what happens to x TPR?
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
Tetanospasmin (also called tetanus toxin)
Decreases
Microglia

4. What are the two side effects of opioids to which the user will not develop tolerance?
7 to 14 days
Carbamazepine
GH deficiency
Constipation and miosis

5. What is the name of the benzodiazepine antagonist used in the treatment of an overdose?
Phallus - urogenital folds - and labioscrotal swellings
Lateral rectus (CN VI) (LR6 SO4)3
Flumazenil
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T

6. What is the name of the 12- step program believed to be the most successful for the treatment of alcohol abuse?
Alcoholics Anonymous
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
ACTH

7. What is the only drug that does not have an intoxication?
Nicotine (but it sure has a nasty withdrawal!)
Listeria monocytogenes
Erythromycin
Lethal dose for 50% of drug takers (median lethal dose)

8. Which tetracycline is used in the treatment of SIADH?
Demeclocycline
Sciatic nerve
Priapism
Leydig cell tumor

9. What are the three components of amyloid?
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
Monocytosis
CD14
Primary spermatocyte

10. What three circumstances allow a child to be committed to institutional care?

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11. What is the most common complement deficiency?
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.
MEN III (or IIb)
C2 deficiency
Androgen - binding protein

12. Are used in the management of an acute asthmatic attack.
Negative
Gubernaculum
Beta2- Adrenergic agents
Ribozymes

13. What cestode causes cysticercosis?
Ergosterol
Sadism
S phase
Taenia solium

14. In skeletal muscle ________ is an active event.
Emphysematous bleb
relaxation
Rods
Methyldopa

15. What are the three rules governing a secondary immune response?
1. Covalent bonding between the hapten and carrier 2. B- cell exposure to hapten twice 3. T- cell exposure to carrier twice
Early distal tubule
8 to 25 hours
Crohn disease

16. What is the relationship between preload and the passive tension in a muscle?
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
VSD - RVH - overriding aorta - and pulmonary stenosis
Gout
Hepatoma and nonseminomatous testicular germ cell tumors

17. In what rare AR disorder do you see neutropenia - defective degranulation - and delayed microbial killing due to a problem in chemotaxis and migration?
Yolk sac tumor
Creatinine
IL-2. T cells express IL-2 receptors on their surface to induce self - expression.
Ch

18. What bilateral AR disorder seen in infancy as progressive renal failure has multiple small cysts at right angles to the cortical surface?
Polycystic kidney disease of childhood
The aorta has the greatest velocity and the capillaries have the slowest velocity.
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh

19. What antiarrhythmic agent is the DOC for treating and diagnosing paroxysmal supraventricular tachycardia (PSVT) and AV nodal arrhythmias?
Listeria
Vesicular stomatitis virus
Hydatidiform mole
Adenosine (it is an excellent agent to use in emergencies because its half - life is 30 seconds)

20. From What aortic arch are the following structures derived?
Dimercaprol - D- penicillamine
Virchow triad - associated with the formation of a thrombus.
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.
Degenerates

21. What Ig activates the alternate pathway - neutralizes bacterial endotoxins and viruses - and prevents bacterial adherence?
Affinity (one of each)
Internal carotid artery and sympathetic plexus
IgA
Ribonucleotide reductase

22. What enzyme is blocked by 5- FU?
Cytochrome c
Imipenem and meropenem
Type IV collagen
Thymidylate synthetase

23. Name the type of exudate - given the following examples - Rickettsial infection
Carnitine acyl CoA transferase II
Chromosome 11p
Hemorrhagic exudates
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids

24. How many milliliters of O2 per milliliter of blood?
Superior and middle
PGE2
p -53
0.2

25. How does ventricular repolarization take place - base to apex or vice versa?
Repolarization is from base to apex and from epicardium to endocardium.
Thymidylate synthase
Meclizine
Myasthenia gravis

26. Do the PO2 peripheral chemoreceptors of the carotid body contribute to the normal drive for ventilation?
Midazolam
Meclizine
Under normal resting conditions no - but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg - resulting in increased ventilatory drive.
All are lactose fermenters except Yersinia and Proteus.

27. What is the most common one? - Kidney stone type
Pregnancy
Axillary nerve and posterior humeral artery
Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle.
Calcium oxalate

28. What statistical test - using nominal data only - checks whether two variables are independent events?
Phallic stage (4-6 years)
C3a - C4a - and C5a
18 years old (except if emancipated)
Chi - square (when you are in doubt and have nominal data - use chi - square)

29. What is the most common one? - Germ cell tumor of the ovary
Follicular lymphoma
Dysgerminoma
Transmembrane potential (an absolute number)
CD8+ T cells (cytotoxic) Remember - 8

30. What component of the ETC is inhibited by the following? - CO
Cytochrome a/a3
Bulbus cordis
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
The vestibulo - ocular reflex

31. What diseases are associated with the HLA- DR3 allele

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32. What is the only glycosaminoglycan (GAG) that binds to the linker portion of the proteoglycan?
Humor
Schistocytes
Bulla
Hyaluronic acid (all sulfates bind to the core protein)

33. Has a sodium - conserving action in the distal colon.
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
1. Cough 2. Coryza 3. Conjunctivitis
Aldosterone
Nucleus pulposus

34. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ decreased - Pi decreased
Massive influx of calcium
Secondary hyperparathyroidism (vitamin D deficiency - renal disease)
Diphenhydramine
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia

35. What fissure of the cerebral cortex runs perpendicular to the lateral fissure and separates the frontal and the parietal lobes?
Central sulcus (sulcus of Rolando)
Gastric carcinoma
A transport maximum (Tm) system
Niemann - Pick and Tay- Sachs diseases

36. What three major cell lines participate in the acquired immune system?
Arsenic
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.
T cells - B cells - and macrophages
AML- M3

37. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - poor grooming - poor ability to think abstractly - decreased drive - poor attention span (Hint: if the lesion is in the
Dopamine
Rhinovirus and hepatitis A virus
Ciliary ganglion
Dorsal prefrontal cortex

38. What three organs participate in production of vitamin D?
Myelofibrosis with myeloid metaplasia
Glutamate dehydrogenase
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
1. Skin 2. Liver 3. Kidney

39. What is the name of the protein coat that surrounds the nuclear envelope?
CN III - IV - and VI
Proencephalon diencephalon derivative
Vimentin
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.

40. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebral aqueduct
Mesencephalon
Proline and lysine
Carnitine acyl CoA transferase II
Simple diffusion; it does not use protein - mediated transport

41. What three cephalosporins inhibit vitamin K- dependent factors?
Cefamandole - cefoperazone - and moxalactam
Axis IV
Necator americanus is treated with mebendazole and iron therapy.
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)

42. What type of symptoms in schizophrenia are associated with x Muscarinic receptors (ACh)?
Pseudomonas aeruginosa
Type II symptoms (negative); otherwise healthy persons have them - but schizophrenics do not.
Site 2
Coma - convulsions - and cardiotoxicity

43. What portion of the pericardium adheres to the tunica adventitia of the great vessels?
Fibrous pericardium
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.
4.7 L - 5% of body weight
Preoperational (2-6 years)

44. What type of collagen is associated with keloid formation?
Insulinoma
Yes
Type III
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.

45. What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels?
Renal circulation
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
Breast cancer
Ataxia - telangiectasia

46. Reinke crystals
The Beta -2- microglobin. It is the separately encoded Beta - chain for class I Ags.
Lisch nodules
PPRF
Leydig cell tumor

47. What three factors do Sertoli cells produce for normal male development?
The negative charge inhibits the filtration of protein anions.
Pneumocystis carinii
Laminin
Inhibin - m

48. What adrenal enzyme deficiency results in hypertension - hypernatremia - increased ECF volume - and decreased adrenal androgen production?
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
17- alpha - Hydroxylase deficiency
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.
Rathke's pouch; they can result in compression of the optic chiasm.

49. What small gram - negative aerobic rod requires Regan - Lowe or Bordet - Gengou medium for growth?
Breast cancer
Negative
Ordinal scale (e.g. - faster/slower - taller/shorter)
Bordetella pertussis

50. What is the order of fuel use in a prolonged fast?
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Histiocytosis X
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
Estrogen