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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 nematode is known as whipworms? What is the treatment?
X- linked recessive
Hemolytic uremic syndrome
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.
Trichuris trichiura is treated with albendazole.

2. What is the order of fuel use in a prolonged fast?
Astrocytoma
Leiomyoma
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
Chemotaxis

3. What three substances stimulate glycogenolysis?
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
7 to 14 days
S phase
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon

4. What serves as a marker of endogenous insulin secretion?
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Streptomycin
Minoxidil (orally and topically - respectively!)
C- peptide levels

5. What is the name of the spinal cord passing within the subarachnoid space and forming the spinal nerves that exit the lumbar and sacral foramina?
Cauda equina
Glucose -6- phosphatase
gram positive
Patau syndrome (trisomy 13)

6. Name the most common cause - Blindness worldwide
Early distal tubule
Chlamydia trachomatis
Acetoacetate - acetone - and Beta- hydroxybutyrate
VSD - RVH - overriding aorta - and pulmonary stenosis

7. From What aortic arch are the following structures derived?
Stapes artery
Nondominant temporal lobe
Labile
P = .05; P < .05 rejects the null hypothesis

8. What happens to the intrapleural pressure when the diaphragm relaxes?
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
HPVs 16 and 18
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
Purine nucleoside phosphorylase

9. What is the most widely used class of antidepressants?
Superior and anterior
To provide attachment between contiguous cells and to maintain a semipermeable barrier
SSRIs
Cytosine

10. What sphingolipid is formed by the union of serine and palmitoyl CoA?
Mitral valve stenosis
C5- C8 deficiency
Sphingosine
BPH

11. What is the drug of choice for penicillin - resistant gonococcal infections?
Stages 3 and 4 (NREM)
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Menstruation
Spectinomycin

12. What cell in chronic inflammation is derived from blood monocytes?
Macrophages
Proencephalon
Dopamine
SA node; it is the reason it is the primary pacemaker of the heart.

13. What substrate builds up in Tay- Sachs disease?
Candida albicans
CD19
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Bridging veins draining into the sagittal sinus

14. Name the most common type or cause - Meningitis in adults
M- cells
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2 - reducing the carrying capacity and shifting the curve to the left - making it difficult to remove the CO molecule from Hgb.
Proximal to distal progression
Pneumococcus

15. Name the hormone
ater flows from a low - solute to high - solute concentrations.
Pentoxifylline
Zinc (Zn) deficiency
Insulin

16. What protein of the HIV virus does ELISA detect to determine whether a patient is HIV positive?
At least 30% blast in the bone marrow
Phosphorylation of mannose residues
12 days after ovulation
P24

17. What is the term for the external urethra opening onto the dorsal surface of the penis?
Pro - opiomelanocortin (POMC) is cleaved into ACTH and Beta- lipotropin.
Scrotal cancer - due to the high exposure to polycyclic aromatic hydrocarbons
Epispadia
Primary hyperparathyroidism

18. Regarding the venous system - what happens to blood volume if there is a small change in pressure?
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical - psychological - and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
Because the venous system is more compliant than the arterial vessels - small changes in pressure result in large changes in blood volume.
Copper (Cu+)

19. At what stage of sleep is GH output elevated?
Venous pressure above the heart is subatmospheric - so a puncture there has the potential to introduce air into the system.
Stage 4
Cytochrome c
Depolarization (i.e. - Na+ influx)

20. Name the associated chromosome - Cystic fibrosis
Chromosome 7
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.
Chromosome 11 - 22
The rectouterine pouch (of Douglas)

21. Which bacteria are associated with the following pigment production? - Black - gray pigmentation
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Corynebacterium diphtheriae
C5- C8 deficiency
Apneustic center (deep breathing place)

22. What nematode is known as pinworms? What is the treatment?
H2PO4- (dihydrogen phosphate)
Week four - and they remain dormant there until puberty.
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
Enterobius vermicularis; the treatment is albendazole.

23. Has very little effect on arteriolar dilation or constriction.
The parasympathetic nervous system
Conn syndrome (primary hyperaldosteronism)
Moving objects - along with large bright objects with curves and complex designs.
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS

24. What form of nephritic syndrome is associated with celiac sprue and Henoch - Sch
IgA nephropathy
Yellow fever (flavivirus)
Churg - Strauss syndrome
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.

25. Match the chromosome and haploid number with the stage of sperm development - spermatid - spermatocyte (primary or secondary) - spermatogonia (type A or B): x 23/2n
Childhood
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
Projection
Secondary spermatocyte

26. What type of potential is characterized as being an all - or - none response - propagated and not summated?
Acetaldehyde dehydrogenase
Action potential
Superior and middle
IgA - IgD - IgE - IgG - and IgM

27. What large - spore - forming - gram - positive anaerobic rod is associated with infections due to puncture wounds and trauma?
Vitelline fistula
Mesonephric duct (ureteric bud)
Medial nuclear group (limbic system)
Clostridium tetani

28. Should information flow from the patient to the family or vice versa?

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29. What are the four DNA oncogenic viruses?
Fluconazole
A patent processus vaginalis
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
IgG

30. What is the formula to calculate IQ?
Caisson disease
Enkephalins
(MA/CA) x 100 = IQ score - where MA = mental age and CA = chronological age
Lateral collateral ligament

31. What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
Operant conditioning (reinforcement is after a response)
Microvillus
HBcAb and HBeAb. You see the antibodies c and e.
300 mOsm/L

32. What is the most common one? - Primary malignant tumor of the lungs
Chloramphenicol
Adenocarcinoma (30% to 35%)
Eclipse period
Graves disease

33. Name these narcissistic defense mechanisms: x Not allowing reality to penetrate because afraid of becoming aware of painful aspect of reality.
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
Denial
Corticosteroid
AML- M3

34. Which antihypertensive class is used to help stop the progression of microalbuminuria?
IL-4 - IL-10 - and IL-13
ACE inhibitors (- pril)
Legionella
Hepadnavirus

35. What form of the Plasmodium species are injected into humans by mosquitoes?
Humerus with ulna (major) and radius (minor)
Sporozoites
ICF volume decreases when there is an increase in osmolarity and vice versa.
Rhinovirus and hepatitis A virus

36. Which way will the O2 dissociation curve shift with the addition of 2 - 3- bisphosphoglycerate (2 - 3- BPG) to adult hemoglobin (Hgb)?
Serratia
Biotin - ATP - and CO2
Clearance
Shifts it to the right

37. Name the type of exudate - given the following examples - Parasitic infection
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
Uricosuric
Eosinophilic exudates
Alveolar macrophages (dust cells)

38. Insulin - induced hypoglycemia is the most reliable (by far not the safest) test For what hormone deficiency?
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)
Zinc (Zn) deficiency
Type III hypersensitivity (immune complex)
GH deficiency

39. What Ig prevents bacterial adherence to mucosal surfaces?
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
Myasthenia gravis
IgA
The tsetse fly

40. What receptor is in the smooth muscle cells of the small bronchi - is stimulated during inflation - and inhibits inspiration?
Stretch receptors prevent overdistension of the lungs during inspiration.
Minoxidil (orally and topically - respectively!)
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol

41. Name the DNA virus: x ssDNA; naked; icosahedral; replicates in the nucleus
Nodes of Ranvier
The greater the myelination - the greater the conduction velocity.
Parvovirus
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.

42. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Chromium and nickel
Beta- Blockers
Bronchogenic carcinoma
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Digoxin is renally eliminated; digitoxin is hepatically eliminated.

43. What limb of the internal capsule is not supplied by the middle cerebral artery?
For males - HTN; for females - pregnancy.
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
Hematogenous
HMG- CoA reductase

44. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Osmolarity
Tip of the loop of Henle (1200 mOsm/L)
These are the gross pathologic changes associated with Alzheimer's disease.
300 mOsm/L
Dysthymia - Which is also known as nonpsychotic depression. (Think of it as the car running but not well.)

45. What somatoform disorder is described as x La belle indiff
Thymine (B1)
The poly(A) site on the DNA
Conversion disorder
Atropine with pralidoxime

46. What is the only organ in the body supplied by preganglionic sympathetic fibers?
Adrenal medulla
Degenerates
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.
Labioscrotal swelling

47. Name the associated chromosomal translocation - Follicular lymphoma
Uracil
Clostridium botulinum
Chromosome 14 - 18
Coccidioides immitis

48. Name the most common type or cause - Right heart failure
Left heart failure
Postinfectious GN
Primary hypocortisolism (Addison's disease)
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.

49. What AR disorder is due to a deficiency in glycoprotein IIb - IIIa - resulting in a defect in platelet aggregation?
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
MEN IIa (or Sipple syndrome)
The rectouterine pouch (of Douglas)
Glanzmann syndrome

50. When a drug is administered orally and enters into portal circulation - it undergoes hepatic metabolism. What is the name of this effect?
The parasympathetic nervous system
First - pass effect
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
Bridging veins draining into the sagittal sinus