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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 prostaglandin is associated with maintaining patency of the ductus arteriosus?
Alcohol. Nearly 10% of adults have a problem with alcohol.
Emphysema
PGE (along with low oxygen tension)
Neuroblastoma

2. Name the type of hypersensitivity reaction based on the following properties - IgG or IgM Abs against a specific target cell or tissue; complement - dependent or ADCC.
Type II hypersensitivity (cytotoxic)
Ritodrine and terbutaline
Neutrophils - eosinophils - and basophils
REM and stage 4 sleep; they decrease.

3. What vascular pathology is associated with HTN in the upper extremities - hypotension in the lower extremities - and a radial - femoral delay?
Penicillin G (benzylpenicillin)
Foods rich in tyramine (e.g. - cheese - dried fish - sauerkraut - chocolate - avocados - and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
Postductal coarctation of the aorta (adult)
CD19

4. What cell surface marker do all T cells have?
CD3
Thyroid gland
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
H 1

5. When the ECF osmolarity increases - what happens to cell size?
Lente insulin and either NPH or protamine zinc insulin (PZI)
Parental assignment and culture (not biology)
Nicotine (but it sure has a nasty withdrawal!)
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.

6. Name the B- cell CD marker: x Required for class switching signals from T cells
Guanethidine and bretylium
Femoral hernias
CN V - VI - VII - and VIII
CD40

7. If you report a suspected case of child abuse and are wrong - are you protected from legal liability?
Epidural hematoma
Right nasal hemianopsia
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.
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.

8. Name the compartment of the mediastinum associated with the following thoracic structures: Pulmonary artery and veins
Stable
Middle
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
Mumps and influenza virus

9. What is the site of action of the following? - Thiazide diuretics
Early distal tubule
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result) - these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease - when obstructive symptoms begin to occur.
Mitochondrial inheritance
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts

10. If capillary hydrostatic pressure is greater than oncotic pressure - is filtration or reabsorption promoted?
McArdle's syndrome
Ergotamines
Mitosis
Filtration; if hydrostatic pressure is less than oncotic pressure - reabsorption is promoted.

11. What is the most common one? - Tumor arising within the bone
CD15 and CD30
Chromosome 19
Vitreous humor
Multiple myeloma

12. At what stage of cognitive development (according to Piaget) do children x Lack law of conservation and be egocentric?
Adenosine deaminase
Molindone
Preoperational (2-6 years)
Site 1

13. What is the most common one? - Primary CNS tumor in children
IF and GTP (eIF for eukaryotes)
Medulla blastoma
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
Chromosome 15

14. What skin type on the palms and soles is characterized by the absence of hair follicles and presence of stratum lucidum?
C3a - C4a - C5a
Metronidazole
Thick skin
IL-3 (3 face down is an M)

15. Have analgesic - antipyretic - anti - inflammatory - and antiplatelet activities.
Alveolar dead space
Varicella virus and influenza virus
NSAIDs
Tylosis

16. What is the most common one? - Testicular tumor in men over 50 years old
Residual volume (RV)
Testicular lymphoma
Foramen of Monro
Arterioles have the largest drop - whereas the vena cava has the smallest pressure drop in systemic circulation.

17. What agent antagonizes the effects of heparin?
No - it is never acceptable to lie.
Yes
Protamine sulfate
Ulcerative colitis

18. Stimulate hair cells at the base of the cochlea.
Hypotonia (rag doll appearance)
Emphysematous bleb
High - frequency sound waves
Macula densa

19. When does the primitive gut herniate out of the embryo? When does it go back into the embryo?
6 weeks 10 weeks
Ribonucleotide reductase
Chromosome 1
Leukemias

20. Name the most common type or cause - Hypoxia
Ischemia
Fat necrosis
TCA cycle.
Metaproterenol and albuterol

21. What is the leading cause of school dropout?
Monocytosis
Negative
CD40 ligand
Pregnancy

22. Inhibition of peripheral COMT - allowing increased CNS availability of L- dopa - is accomplished by What two agents?
Hepatitis D
Tolcapone and entacapone
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
CN IX - X - and XII

23. What family do the following viruses belong to? - California encephalitis
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
Testicular lymphoma
Bunyavirus
Antigenic determinant (epitope)

24. The lack of dopamine production in the substantia nigra leads to the ______________ - characteristically seen in patients with Parkinson's disease.
extrapyramidal dysfunction
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.

25. Where in the GI tract does the reabsorption of bile salts take place?
Smooth muscle
Prevalence increases.
Bile salts are actively reabsorbed in the distal ileum.
Eosin

26. Name the type of graft described by these transplants: x From one site to another on the same person
The tsetse fly
Celecoxib
Autograft
Dihydrofolate reductase

27. What region of the brain houses the central chemoreceptors responsible for control of ventilation?
It both begins and ends at T4 (sternal angle [of Louis]).
Metastatic calcification
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.
The surface of the medulla

28. What disorder is due to a deficiency in the enzyme glucocerebrosidase?
Gaucher disease
Transmembrane potential (an absolute number)
31 pairs
Odds ratio. (Case control studies deal with prevalence.)

29. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Pancreas
Chlortetracycline
Stable
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
Ventricular contraction Atrial - Contraction - Venous

30. Without ADH the collecting duct would be...
Quinolones
Acral - lentiginous melanoma
impermeable to water
Male pseudo - intersexuality (hermaphrodite); these individuals are 46XY.

31. What phase of the cell cycle are the following antineoplastic agents specific for? - 6- Mercaptopurine
Hydatidiform mole
Gilbert's syndrome
Leukemias
S phase

32. Inhibits glucose uptake in skeletal muscle.
Cortisol
Demeclocycline
Confabulation; it is commonly seen in Korsakoff's syndrome.
Tetany

33. What level of mental retardation is characterized by x Being self - supportive with minimal guidance and able to be gainfully employed (includes 85% of the mentally retarded)?
Mild (50-70)
Astrocytoma
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
Entamoeba histolytica (treat with metronidazole)

34. What are the three major functions of secretory IgA?
Trypanosoma cruzi
Infection
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases
VLDLs

35. What is the term for tissue - based basophils?
The triad of respiratory depression - pinpoint pupils - and coma in an IV drug abuser suggests opioid overdose (e.g. - heroin) - and you should give naloxone.
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)
Flocculonodular lobe (one of my favorite words in all of medicine!)
Mast cells

36. What is the only tongue muscle innervated by CN X?
Atropine - 2- PAM (pralidoxime)
The time it takes ACh to diffuse to the postjunctional membrane
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
C- peptide levels

37. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x N- myc
T lymphocyte
Neuroblastoma
P wave
Somatoform pain disorder

38. What is the name of the force that develops in the wall of the lungs as they expand?
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.
First M PITS for pharyngeal pouch derivatives
Allopurinol

39. Which dimorphic fungus is found as hyphae with nondescript conidia in rotting wood in the Upper Great Lakes - Ohio - Mississippi - eastern seaboard of the United States - and southern Canada?
Blastomyces dermatitidis
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
Mean corpuscular volume (MCV)
T lymphocyte

40. Name the correct artery - The left recurrent laryngeal nerve passes around it.
Chromosome 11 - 22
Ipsilateral loss at and below the level of the lesion
Arch of the aorta
Breast

41. What is the term for days 15 to 28 in the female cycle?
Luteal phase
alpha - Motor neurons innervate extrafusal muscle fibers (a motor unit) - whereas gamma - motor neurons innervate intrafusal muscle fibers.
Posterior
Western blot

42. What is the term for a schizophrenic episode lasting longer than 30 days with full return to former functioning capacity?
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
Foramen of Monro
Axis IV
At least 15%

43. What pancreatic islet cell secretes glucagons?
Familial polyposis coli
alpha - Cells; glucagon has stimulatory effects on - cells and inhibitory effects on - cells.
Neutrophils - eosinophils - and basophils
Sucralfate

44. What enzyme converts androgens to estrogens?
EF-1 and GTP
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Macula densa
Aromatase

45. Induces the cytochrome P-450 enzymes.
The gut rotates clockwise around the superior mesenteric artery.
Superior Oblique (CN IV) (LR6 SO4)3
Ethyl alcohol
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)

46. Name these mature defense mechanisms: x Converting an unacceptable impulse to a socially acceptable form (Hint: it is the most mature of all defense mechanisms)
Sublimation
SHIP: Shifting of the aorta - Hypertrophy of the right ventricle - Interventricular septal defect - Pulmonary stenosis
1. Big 2. Bilateral 3. Berry aneurysm
Exposure

47. 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?
Negative
90% of benign myxomas arise within the left atrium near the fossa ovalis.
<2
Unipolar disorder (major depression)

48. What AR syndrome is due to a deficiency of glycoprotein Ib - resulting in a defect in platelet adhesion?
Aldosterone
Bernard - Soulier syndrome
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
3 months of symptoms in 2 consecutive years

49. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Asbestos
Stratum spinosum
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
Varicocele
Mesothelioma and bronchogenic carcinoma

50. What cerebral vessel size is affected in patients with vascular dementia?
Chemotaxis
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Small to medium - sized cerebral vessels