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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 term for drug removal per unit of time in a given volume of blood?
Chromosome 21
Epidural hematoma
Adhesions and hernias
Clearance

2. What structure of the knee is described thus? - Prevents posterior displacement and has medial - to - lateral attachment on the tibia
Serotonin
True hermaphrodism
Hapten; if it is coupled with a carrier - it may become immunogenic.
Posterior cruciate ligament

3. What is the term for a benign melanocytic tumor associated with sun exposure that presents as tan - to - brown colored and has sharply defined well - circumscribed borders?
Benign nevus (mole)
3 ATPs by oxidative phosphorylation
Reliability (think of it as 'nice grouping' or 'precise')
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)

4. What enzyme is inhibited by sulfonamides?
Dihydropteroate synthetase
Multiple sclerosis
CML
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.

5. What area of the GI tract has the highest activity of brush border enzymes?
Factors II - VII - IX - X - and proteins C and S
Jejunum (upper)
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells
Variola virus (Smallpox)

6. What happens to muscle tone and stretch reflexes when there is a LMN lesion?

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7. Name the T- cell CD marker: x Essential for Ab isotype switching (for B cell binding)
CD40 ligand
Hemorrhagic exudates
Kayser - Fleischer rings
Facial expression (the second is vocal intonation)

8. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Dorsal root?
Keloid
Chronic alcoholic
Osteosarcoma
Sensory

9. What are the three branches of the lateral cord of the brachial plexus?
Staphylococcus saprophyticus
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Procainamide
Arsenic

10. What are the three characteristics of autoregulation?
Hemolytic uremic syndrome
The thyroid gland
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)

11. Name the product or products of arachidonic acid: x Vasodilation
PGD2 - PGE2 - and PGF 2
Internal carotid artery
>5 mm
Cricothyroid muscles

12. What are the four segmented RNA viruses?
Goodpasture syndrome
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
Competitive antagonist
hyperventilation

13. Via what cell surface receptor does HDL cholesterol from the periphery enter hepatoceles?
Scavenger receptor (SR- B1)
Paget disease (osteitis deformans)
Placental alkaline phosphatase
Pernicious anemia

14. What area of the hypothalamus is responsible for recognizing a decrease in body temperature and mediates the response to conserve heat?

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15.
prior to birthThe foramen ovale closes just...
gag gene
Major basic protein
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.

16. What is the drug of choice for penicillin - resistant gonococcal infections?
Renal plasma flow (decrease flow - increase FF)
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia
SSRIs
Spectinomycin

17. Which parasitic organism - when it crosses the placenta - results in intracerebral calcifications - chorioretinitis - microcephaly - hydrocephaly - and convulsions?
Caseous necrosis
Albendazole
Conn syndrome (primary hyperaldosteronism)
Toxoplasma gondii

18. What happens to the Ab specificity when class switching occurs in mature B cells?
As the isotype is switched - the Ab specificity does not change because it does not affect the variable chains.
1. Short attention span 2. Impulsivity 3. Hyperactivity
Glucose -6- phosphatase
Accuracy (think of it as all the trues - because they are the ones correctly identified)

19. What area of the small intestine is characterized by Peyer's patches?
Filtration; if hydrostatic pressure is less than oncotic pressure - reabsorption is promoted.
Ileum
Metronidazole
Chromosome 5p

20. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Eukaryotic cell - 15 to 25 microns - 80S ribosomes - no cell walls - replicates via cytokinesis with mitosis and meiosis
Double - blind study. It is the most scientifically rigorous study known.
Parasites
3 years old
300 mOsm/L

21. Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery?
catalase - negative
Esophagus - SVC - vagus nerve - azygos vein - thoracic duct - thymus - and phrenic nerve
Propofol
Beta- Oxidation of fatty acids

22. Which prophylactic asthmatic agent is an antagonist of LTD4?
Rickets
Transketolase and transaldolase. The reactions they catalyze are reversible.
Zafirlukast
Healing by secondary intention

23. Name the most common one - Heart defect in Down syndrome
Celecoxib
Endocardial cushion defect
Stable
Ethyl alcohol

24. How many milliliters of O2 per milliliter of blood?
0.2
Class IV
90% as HCO3- - 5% as carbamino compounds - and 5% as dissolved CO2
Hypotonic - because NaCl is reabsorbed in the salivary ducts

25. Objective tests that base the result of the examination on a preset standard use what form of reference?
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Doxycycline
Gardnerella vaginalis
Bainbridge reflex

26. What projective test asks the patient to tell a story about What is going on in the pictures - evaluating the conflicts - drives - and emotions of the individual?
Anemia
Antimicrobial agents
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero - order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than i
TAT (Thematic apperception test)

27. Do the following structures pick up stain from hematoxylin or eosin? - Calcium
Hematoxylin
Liver
Small cell carcinoma (oat cell)
Proencephalon

28. To differentiate central from nephrogenic diabetes insipidus - after an injection of ADH - which will show a decreased urine flow?
Site 4
Central. Remember - there is a deficiency in ADH production in the central form.
Retinoblastoma
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice

29. What cytokine do CD4 T cells secrete to activate B cells when the specific peptide in the groove of the MHC II molecule interacts with the TCR?
Epinephrine
Glycogen phosphorylase
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
It decreases insulin secretion.

30. What encephalitis is associated with the JC virus?
Iron (Fe)
Vibrio vulnificus
Progressive multifocal leukoencephalopathy
Eosin

31. On the right lung the ___________ divides the middle from the inferior lobe and the horizontal fissure further divides the middle from the upper lobe. On the left the oblique divides the superior from the inferior lobe.
Corynebacterium diphtheriae
EF- Tu and EF- Ts of the 30S ribosomal subunit
Oblique fissure
Pheochromocytoma

32. Name the macrophage based on its location: x Epidermal macrophages
Papovavirus
HBeAb
common variable hypogammaglobinemia
Langerhans cells

33. Which protozoal parasitic vaginal infection produces a positive whiff test with KOH staining?
Reinforcement
Trichomonas vaginalis (treat with metronidazole)
Central sulcus (sulcus of Rolando)
They are in the grey matter of the CNS.

34. What is used as an index of the number of functioning carriers for a substance in active reabsorption in the kidney?
They are in the grey matter of the CNS.
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
Rhombencephalon

35. What embryonic structure forms the adult female structures? - Ovary - follicles - rete ovarii
Vitamin A
Porcelain gallbladder
Gonads
Hirschsprung's disease (colonic gangliosus)

36. Which subset of MEN syndrome is associated with the following? - Medullary carcinoma of the thyroid - pheochromocytoma - and mucocutaneous neuromas
HMG CoA reductase
MEN III (or IIb)
common variable hypogammaglobinemia
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.

37. What segment of the small intestine is associated with Brunner's glands?
Caisson disease
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
Duodenum
Fructose; both glucose and galactose are actively absorbed via secondary active transport.

38. What ovarian disease involves psammoma bodies?
IgA - IgD - IgE - IgG - and IgM
P wave
alpha - Motor neurons innervate extrafusal muscle fibers (a motor unit) - whereas gamma - motor neurons innervate intrafusal muscle fibers.
Serocystadenocarcinoma

39. Birbeck granules
HDL
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency
Histiocytosis X

40. Name these mature defense mechanisms: x Easing anxiety with laughter
mRNA
HBeAg
Bronchioloalveolar carcinoma
Humor

41. Name the stages of sleep with these EEG patterns: x Sleep spindles - K- complexes
TXA2
Albinism
Allotypes
Stage 2

42. What is the karyotype in Turner syndrome?
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Resistance increases as resistors are added to the circuit.
45XO
It is rare with normal grief; however - it is relatively common in depression

43. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Ipsilateral loss below the level of the lesion
PGI 2
RSV
Inferior rectus (CN III) (LR6 SO4)3

44. Can incidence - prevalence - and cause and effect be assessed in x Cohort studies?
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs - TCADs - dextromethorphan - and meperidine. Treat it with cyproheptadine.
Coagulative
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
Cohort studies determine incidence and causality - not prevalence.

45. What small - facultative gram - negative intracellular rod's transmission is associated with unpasteurized dairy products and undulant fever?
Risk factors for breast cancer
Small to medium - sized cerebral vessels
Brucella
Major

46. What type of membrane channel opens in response to depolarization?
Erythema nodosum
Immature B cells
Voltage - gated channel
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane

47. What fissure of the cerebral cortex separates the frontal and temporal lobes rostrally and partially separates the parietal and temporal lobes?
Phototherapy
Anorgasmia. (The overall prevalence is 30%.)
Lateral fissure (fissure of Sylvius)
ATP production

48. What ribosomal subunit binds first to the mRNA strand?
The small subunit (40S) binds first.
K1 capsule
Sympathetic nervous system
IDL

49. Name the macrophage based on its location: x Lung macrophages
Streptococcus viridans
Left ventricle and auricle of left atrium
Pulmonary alveolar macrophages
Measurement bias

50. What term describes how an action potential is propagated along an axon?
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
All
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
Saltatory conduction