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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? - Cardiac anomaly in children
IgM
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Biofeedback
PDA

2. What paraphilia is defined as x Having a recurrent desire to expose the genitals to strangers?
Hormone - sensitive lipase
Invariant chain
Exhibitionism
Potency

3. Why does carbon monoxide diffusion in the lung (DLCO) decrease in emphysema and fibrosis but increase during exercise?
Unstable (crescendo) angina
LCO - an index of lung surface area and membrane thickness - is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is
Acute tubular necrosis
Dihydrofolate reductase

4. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Cerebellum
Rhombencephalon
hCG
Galactoside permease
Ego dystonic

5. What phase of the female cycle occurs during days 1 to 15?
Autoimmune hemolytic anemia
Follicular phase
C5a
Urachus

6. What four factors affect diffusion rate?
The aorta
Rationalization
Kartagener's syndrome (also known as immotile cilia syndrome) -------------------------------------------------------------------------------
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe

7. What signals are used to direct an enzyme to a lysosome?
Inulin
1. Big 2. Bilateral 3. Berry aneurysm
Phosphorylation of mannose residues
Two - way ANOVA. It allows the test to check several variables at the same time.

8. The first area to be oxygenated in the liver.
Enterobius vermicularis
The portal tract of the liver lobule
Glucocerebrosidase
Breast

9. The surge of what hormone induces ovulation?
Ritodrine and terbutaline
LH
Serotonin
Cones (C for color and cones)

10. What term describes the inability to recall personal information - commonly associated with trauma?
Amnesia. (The person is aware of the memory loss.)
Marfan syndrome
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
The small subunit (40S) binds first.

11. What is the major hormone produced in the following areas of the adrenal cortex? - Zona reticularis
Galactoside permease
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.
naked viruses
DHEA (androgens) Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

12. Name the associated chromosomal translocation - M3 AML
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
Chromosome 15 - 17
Duchenne muscular dystrophy

13. What female genital tract disorder is characterized by obesity - hirsutism - infertility - amenorrhea - elevated LH and testosterone levels - and low FSH levels?
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
Polycystic ovary disease (Stein - Leventhal syndrome)
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Primary hyperparathyroidism

14. What term describes senseless repetition of words or phrases?
Rigors - leukopenia - decrease in blood pressure - and increase in temperature
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Malignant mesothelioma
Verbigeration

15. Regarding the Lac operon - for What do the following genes code? - A gene
Water soluble
enveloped
Pyruvate - acetyl CoA - and propionyl CoA carboxylase
Thiogalactoside transacetylase

16. What diseases are associated with HLA- DR4
Neonatal respiratory distress syndrome (NRDS)
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
Mild (50-70)

17. What syndrome is characterized by the triad of renal tubular acidosis - nephrosis - and amino aciduria?
Fanconi - like syndrome
Mannitol
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.
Lipoprotein lipase

18. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Hematopoietic cells
Osteosarcoma
Labile
Sarcoplasmic reticulum
Osteosarcoma

19. Charcot - Leyden crystals
Carbamazepine
Erectile dysfunction
CD40 ligand
Bronchial asthma (eosinophil membranes)

20. What is the most likely causative organism for a patient with folliculitis after spending time in a hot tub?
Mannitol
Median nerve
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.
Pseudomonas aeruginosa

21. How are resistance and viscosity related regarding flow?
Viscosity and resistance are proportionally related. The greater the viscosity - the greater the resistance is on the vessel.
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia
Type II error (beta error). (Remember it as saying something doesn't work when it does.)

22. What thyroid abnormality has the following? - TRH decreased - TSH decreased - T4 increased
Bacillus anthracis
Right coronary artery
Neuroblastoma
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)

23. What happens to the resistance of the system when a resistor is added in a series?
Resistance of the system increases. (Remember - when resistors are connected in a series - the total of the resistance is the sum of the individual resistances.)
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.
1. Sweat glands 2. Arterioles 3. Veins
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.

24. Is used to detect Abs in a patient?
HTLV-1
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
Krukenberg tumor
Direct fluorescent Ab test

25. What transports iron in the blood?
Omega -3; linoleic is omega -6
Yes
Transferrin
LGB (think EYES)

26. What assay is used to identify MHC class I molecules?
Hypertension
Microcytotoxic assay
Vitamin K
Large intestine. Water is passively removed from the lumen.

27. What is the function of the basal ganglia?
Gonorrhea
The small subunit (40S) binds first.
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
Initiate and manage gross skeletal muscle movement control

28. Name the reaction that appears in babies who are temporarily deprived of their usual caretaker. (This reaction usually begins around 6 months of age - peaks around 8 months - and decreases at 12 months.)
Agranulocytosis; approximately 2% develop this side effect.
Separation anxiety
Left heart failure
Allograft

29. What type of damage to the kidneys is caused by drinking ethylene glycol (antifreeze)?
Nephrotoxic oxylate stones
Pseudomembranous exudates
Spleen
Leydig cell tumor

30. What syndrome is characterized by bilateral medial temporal lobe lesion - placidity - hyperorality - hypersexuality - hyperreactivity to visual stimuli - and visual agnosia?
Azathioprine
Kl
Limbic system
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.

31. What are the five hormones produced by Sertoli cells?
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
MGN
Leukemias
Uroporphyrinogen III cosynthase

32. What is the only muscle of the soft palate that is innervated by CN V3?
Flocculonodular lobe (one of my favorite words in all of medicine!)
Excision endonuclease - which removes thiamine dimers from DNA
Invasive ductal carcinoma
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.

33. What happens to intracellular volume when there is an increase in osmolarity?
2 ATPs by oxidative phosphorylation
ICF volume decreases when there is an increase in osmolarity and vice versa.
Serum 25- hydroxy- vitamin D (25- OH- D)
Kayser - Fleischer rings

34. Name the compartment of the mediastinum associated with the following thoracic structures: Pulmonary artery and veins
Rationalization
Middle
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Third week; they are derived from the wall of the yolk sac.

35. What is the most common one? - Cardiac pathology in patients with SLE
Wernicke's encephalopathy
Lipoid nephrosis
Libman - Sacks endocarditis
It forms a germinal tube at 37

36. Should not be treated with (beta) Beta- blockers.
Systemic lupus erythematosus
Cocaine - induced coronary ischemia
300 mOsm/L
Convergence

37. What branches of CN X are the sensory and motor components of the cough reflex? Be specific.
Caisson disease
Third week
Meningococcus (Gonococcus does not)
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

38. Name the most common reported STD - In males
Third week; they are derived from the wall of the yolk sac.
Diazepam is longest acting and midazolam is shortest acting.
Gonorrhea
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)

39. Name the structure that enters or exits the following foramina: x Foramen ovale
The basilar artery is formed at the pontomedullary junction.
CN V3 and the lesser petrosal nerve
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.
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.

40. What primary acid - base disturbance is caused by a gain in fixed acid forcing the reaction to shift to the left - decreasing HCO3- and slightly increasing CO2?
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
Metabolic acidosis (summary: low pH - high H+ - and low HCO3-)
GLUT 4
At least 5 lobes

41. Name the product or products of arachidonic acid: x Pain and fever
Proencephalon
The time it takes ACh to diffuse to the postjunctional membrane
PGE2
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion

42. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
Trapezius and sternocleidomastoid
Contralateral loss below and bilateral loss at the level of the lesion
School phobia
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)

43. What prokaryotic positioning enzyme in translation is blocked by the following? - Tetracycline
Positive reinforcement
1. Big 2. Bilateral 3. Berry aneurysm
Riboflavin (B2) deficiency
EF- Tu and EF- Ts of the 30S ribosomal subunit

44. What is the most common one? - Type of hernia seen in males more than 50 years old
Gain of hypertonic fluid (mannitol or hypertonic saline)
Left atrial myxoma
Direct; in males less than 50 years old indirect hernias are the most common type.
Pasteurella multocida

45. What pathology is associated with podagra - tophi in the ear - and PMNs with monosodium urate crystals?
PRPP aminotransferase
Melanosis coli
Gout
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain

46. Name the lung measurement based on the following descriptions: x Additional air that can be taken in after normal inspiration
Renshaw neuron
Obturator nerve
Crossover study
Inspiratory reserve volume (IRV)

47. What is the most superficial layer of the epidermis?
Friedreich ataxia
Stratum corneum (keratinized)
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
Onion skinning

48. Close before the valves on the left side of the heart.
Chylomicrons
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Right - sided valves
Dopamine antagonists

49. Where is the greatest venous PO2 in resting tissue?
Down syndrome
Biotin - ATP - and CO2
Renal circulation
High average

50. What is the drug of choice for filariasis and onchocerciasis?
Diethylcarbamazine
Parvovirus B 19
Ergosterol
prior to birthThe foramen ovale closes just...