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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 pneumoconiosis is associated with exposure to the following occupations or materials? - Aerospace industry - nuclear reactors
Berylliosis
ELISA. It detects anti - p24 IgG.
5' deiodinase
Tetany

2. What artery travels with the following veins? - Small cardiac vein
Right coronary artery
The bifurcation of the abdominal aorta
Healing by secondary intention
ELISA. It detects anti - p24 IgG.

3. What is the vector of African sleeping sickness?
At 8 to 9 years of age. Prior to this age they view death as a form of punishment.
The first trimester
The tsetse fly
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.

4. What oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis?
gag gene
Chlamydia trachomatis
No change in length
Metformin

5. What two regions of the vertebral column are considered primary curvatures?
LDL
Birds
Thoracic and sacral
Duchenne muscular dystrophy

6. Name the correct artery - The left recurrent laryngeal nerve passes around it.
Arch of the aorta
CN IX - X - and XI; sigmoid sinus
Streptococcus pneumoniae
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.

7. What encapsulated lymphoid organ is characterized by presence of Hassall's corpuscles - and absence of germinal centers and B cells?
HPV
Chromosome 11 - 22
Thymus gland. (Thymus gland is essential for T cell maturation.)
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.

8. What AA has a pKa of 13?
Marfan syndrome
Arginine
Coccidioides immitis
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.

9. Do newborns have a preference for still or moving objects?
Maxillary artery
Biofeedback
Moving objects - along with large bright objects with curves and complex designs.
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)

10. At what stage of cognitive development (according to Piaget) do children x Have abstract thinking?
Splitting
Nodular melanoma
CD21; it is a complement receptor for cleaved C3
Formal operations (> 12 years)

11. Results in vitamin B12 malabsorption.
Pancreatic insufficiency
Median (think of it as the halfway point)
Voltage - gated channel
Leukemias and lymphomas

12. Waxy casts
Chronic end - stage renal disease
Measurement bias
Breast
CMV - Toxoplasma gondii - and Listeria

13. What is the term for the inherent ability to induce a specific immune response?
Mumps
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
HPVs 16 and 18

14. What is the drug of choice for treating a patient with hyperuricemia due to overproduction of uric acid?
S phase
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available - but the renal collecting ducts are impermeable to its actions.
Allopurinol
IgA

15. What happens to cortisol levels in sleep - deprived individuals?
Cortisol levels increase. Lymphocyte levels decrease in sleep - deprived individuals.
Cauda equina
IgA
Microglia (Microglia and mesoderm both begin with M)

16. What determines the effective osmolarity of the ICF and the ECF compartments?
Hereditary spherocytosis
Schistosoma have separate males and females.
Sadism
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.

17. What hormone controls relaxation of the lower esophageal sphincter during swallowing?
Plasma concentration and excretion rate
At least 15%
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.

18. What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
Third week
8 to 25 hours
Fitz - Hugh - Curtis syndrome
Flow cytometric analysis

19. Name the antimicrobial agent whose major side effect is listed - Teratogenicity
Metronidazole
Vitamin B6
Type III hypersensitivity (immune complex)
Positive correlation

20. Preeclampsia in the first trimester - hCG levels above 100 - 00 mIU/mL - and an enlarged bleeding uterus are clinical signs of what?
RBCs
Ganciclovir
Hydatidiform mole
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.

21. What is the term for thymic induction of T cells with high - affinity Ag receptors for self that are programmed to undergo apoptosis?
Fovea
Negative selection. This helps to prevent autoimmune diseases.
Hemangioblastoma
S phase

22. What enzyme of pyrimidine synthesis is inhibited by the following? - Methotrexate
Toxoplasma gondii
Dihydrofolate reductase
MEN I (or Wermer syndrome)
3 months of symptoms in 2 consecutive years

23. What is the only DNA virus that has the reverse transcriptase enzyme?
Vibrio cholera
Hepadnavirus
Melatonin - serotonin - and CCK
Heroin

24. What chromosome 4 - AD disorder is a degeneration of GABA neurons in the striatum of the indirect pathway of the basal ganglia?

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25. What form of sunlight is the most carcinogenic?
Coxsackie B
Uricosuric
Ultraviolet B (UVB) sunlight
Live vaccines

26. What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?
Short - chain fatty acids
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
Boutonni
Doxycycline and minocycline

27. Which leukotriene
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
Schistosoma haematobium
LTB4

28. Name the four ventral mesentery derivatives.
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.
Rhombencephalon
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.
HPV serotypes 6 and 11

29. Name the ventricular muscle membrane channel: x Closed at rest; depolarization causes channels to open quickly; will not respond to a second stimulus until cell is repolarized.
Dopamine
Henoch - Sch
Total ventilation (minute ventilation or minute volume)
Voltage - gated sodium channel

30. If a virus has positive sense RNA - can it be used as mRNA or is a template needed?
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.
1. Tinea coli 2. Haustra 3. Epiploic appendages
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.
Oxytocin

31. Name the associated chromosomal translocation - Acute promyelocytic leukemia (M3)
4 years old
Constriction of afferent arteriole
Chromosome 15 - 17
Succinate dehydrogenase

32. From what pharyngeal groove is the external auditory meatus derived?
First pharyngeal groove; all others degenerate.
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
almitate
IgA

33. What type of correlation is defined as x One variable that diminishes in the presence of the other?
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Negative correlation
X- linked recessive
Turner syndrome

34. How many pairs of spinal nerves are associated with x Cervical vertebrae?
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
VSD
C3 - C4 - and C5 keep the diaphragm alive!
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.

35. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Weeks to months after transplantation; abrupt onset of oliguria and azotemia; seen as neutrophilic vasculitis and interstitial lymphocytes
In early- morning sleep - usually between the sixth and eighth hours
Acute rejection
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus

36. Anhedonia - lack of motivation - feelings of worthlessness - decreased sex drive - insomnia - and recurrent thoughts for at least 2 weeks - representing a change from previous level of function - describes what disorder?
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.
Vitamin A
Unipolar disorder (major depression)

37. What is the most common one? - Subtype of Hodgkin lymphoma
Altruism
PRPP aminotransferase
Molybdenum (Mb)
Nodular sclerosis

38. What causes the lysis of RBCs by oxidizing agents in a G-6- PD deficiency?
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.
Postductal coarctation of the aorta (adult)
extrapyramidal dysfunction

39. Do the following structures pick up stain from hematoxylin or eosin? - Cytoplasm
M
Generalized anxiety disorder
Eosin
Patients with unilateral cerebellar lesions fall toward the side of the lesion.

40. ADH is secreted in response to What two stimuli?
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
wave
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
Cancer

41. What do the following values indicate? - ED50
Effective dose for 50% of drug takers (median effective dose)
Hepatocellular carcinoma
H 2
Avidity. There is a positive correlation between valence numbers and avidity.

42. What inflammatory bowel disorder is continuous - with extensive ulcerations and pseudopolyps - and is associated with HLA- B27?
Case control studies cannot assess incidence or prevalence - but they can determine causal relationships.
Dantrolene
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Ulcerative colitis

43. What CNS demyelinating disease is characterized by diplopia - ataxia - paresthesias - monocular blindness and weakness - or spastic paresis?
Class 1 (1A - 1B - and 1C)
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.
Multiple sclerosis

44. Is most of the coronary artery blood flow during systole or diastole?
Neisseria meningitidis
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Rhinovirus and hepatitis A virus
Coprophilia

45. What is the most common complement deficiency?
The rectouterine pouch (of Douglas)
C2 deficiency
IgA
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.

46. Name the hepatitis virus based on the following information - Naked capsid RNA picornavirus
Middle cerebral artery
Hormone - sensitive lipase - Which breaks down triglyceride into glycerol and free fatty acid
Red pulp (Remember - Red pulp and RBCs begin with R.)
Hepatitis A

47. Name the hormone
Type I pneumocytes
Glucagon
Trazodone
Francisella tularensis

48. What is the label given to an individual whose IQ is 70 to 79
PALS (Parietolateral lymphocytic sheath)
Borderline
Plasmodium malariae
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.

49. Name the thalamic nucleus based on its input and output - Input from globus pallidus and the cerebellum; output to the primary motor cortex
The vestibulo - ocular reflex
When the pH is more acidic than the pI - it has a net positive charge - and when the pH is more basic than the pI - it has a net negative charge.
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.
Ventral lateral nucleus

50. What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?
Fixed ratio (rewards set behaviors)
The poly(A) site on the DNA
Metaphase II
Filiform papillae