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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. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Pineal gland
Thrush
Proencephalon diencephalon derivative
Streptococcus pyogenes
Type IV hypersensitivity (cell - mediated)

2. What are the three surrogate criteria?

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3. What term describes the inability to recall personal information - commonly associated with trauma?
Rifampin
Positive predictive value
Minor
Amnesia. (The person is aware of the memory loss.)

4. What three organs can be affected by Trypanosoma cruzi?
Prevalence rate
Heart - esophagus - and colon. Remember - you get megas: cardiomegaly - megaesophagus - and megacolon.
Humor
Achondroplasia

5. What enzyme catalyzes the rate - limiting step of the urea cycle?
Pulmonary infections
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
Carbamoyl phosphate synthetase I
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).

6. ______________ that slow bacterial growth are bactericidal.
Astrocytoma
Antimicrobial agents
Secondary hypocortisolism (pituitary)
IgG

7. What are the three functions of surfactant?
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
Multiple myeloma

8. Based on operant conditioning - What type of reinforcement is described when x Adding a stimulus reinforces a behavior?
Internal carotid artery and sympathetic plexus
Glioblastoma multiforme
Crigler - Najjar syndrome
Positive reinforcement

9. What AR disease involves a decreased amount of sphingomyelinase - massive organomegaly - zebra bodies - and foamy histiocytes and is associated with chromosome 11p?
Niemann - Pick disease
Moderate (35-49)
Sphingomyelin
Burr cells (echinocytes)

10. What disease is described by the following characteristics: multiple motor and vocal tics - average age of onset 7 - a M:F ratio of 3:1 - and association with increased levels of dopamine?

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11. What is the amount in liters and percent body weight for the following compartments? - ICF
28 L - 40% of body weight
Order of attachment is site 1 - 2 - 3 - 4 - and for release is 4 - 3 - 2 - 1.
Medullary carcinoma of the thyroid
Odds ratio. (Case control studies deal with prevalence.)

12. Where is most of the body's Ca2+ stored?
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
F- Met - Peptides
Pedophilia
One - and it provides the energy for mechanical contraction.

13. Are the following responses associated with histamines H1 or H2 receptor activation? - Inotropic action and automaticity
Risk factors for breast cancer
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
H 2
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.

14. Where is the greatest venous PO2 in resting tissue?
Iatrogenesis
Renal circulation
Menses
Mitosis

15. What happens to dopamine levels when we awaken?
Dopamine levels rise with waking; dopamine is associated with wakefulness.
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.
Expiratory reserve volume (ERV)
Need 3 panic attacks over 3 weeks (remember - they come out of the blue.)

16. At the D2A receptor have the capacity to induce pseudoparkinsonism.
Rifampin
Dopamine antagonists
Smoking
RNA polymerase III

17. What enzyme is deficient in acute intermittent porphyria?
Atracurium
Familial hypercholesterolemia
Androgen - binding protein
Uroporphyrinogen I synthetase

18. Name the most common type or cause - Bronchiolitis in children
RSV
Cleft lip
Thymine
Motor nucleus of CN V

19. 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)
Superior
Myeloperoxidase
REM

20. What cerebral vessel size is affected in patients with vascular dementia?
Catalase - negative bacteria secrete H2O2 as a byproduct (remember - catalase breaks down H2O2) - allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase - positive bacterial infect
Arterioles
Ultralente
Small to medium - sized cerebral vessels

21. What antifungal agent is used in the treatment of androgen receptor - positive cancers?
Ketoconazole
It increases REM and total sleep time.
Neologisms. Thomas Jefferson noted - 'Necessity obliges us to neologize.' (Abnormal use of neologisms is known as neolalism.)
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)

22. What enzyme of the purine salvage pathway is deficient in the following? - Selective T- cell immunodeficiency
Purine nucleoside phosphorylase
Biotin (only if eaten in large quantities)
Because creatinine is filtered and a small amount is secreted
Cystadenocarcinoma

23. Where is the lesion that produces these symptoms when a patient is asked to look to the left? - Right eye can't look left - left eye nystagmus - and convergence is intact
Right medial longitudinal fasciculus
Vitamin A
Anorgasmia. (The overall prevalence is 30%.)
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.

24. Movement disorders are associated with what dopamine pathway (What part of the brain)?
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
GM2 ganglioside Caused by a deficiency of Beta- hexosaminidase A
Nigrostriatal pathways (basal ganglia)
Seminoma

25. What enzyme catalyzes the rate - limiting step in cholesterol metabolism?
D- Penicillamine
Enkephalins
HMG- CoA reductase
Histidine - because of the imidazole ring found in the R group - is basic.

26. There is an inverse relationship between fat content and...
total body water
Frameshift
Phase 2
They block the midcycle surge of LH.

27. Name the pattern of genetic transmission: both M and F are affected; M- to - M transmission may be present; both parents must be carriers; the trait skips generations; two mutant alleles are needed for disease; and affected children may be born of un
Necrotizing enterocolitis
Autosomal recessive
RU 486
The inner cortex (paracortex) contains the T cells - so it is considered the thymic - dependent area.

28. Name the type of necrosis - Due to lipase activity and has a chalky white appearance
extrapyramidal dysfunction
Cell - mediated immunity
a - Methyldopa (Guanabenz or clonidine is also used.)
Fat necrosis

29. Name the valve abnormality based on the following criteria: x Diastolic murmur; increased preload - stroke volume - and aortic pulse pressure; decreased coronary blood flow; no incisura; and peripheral vasodilation
Hirschsprung disease (aganglionic megacolon)
>10 mm
Beta2- integrins
Aortic insufficiency

30. What enzyme is deficient in the following glycogen storage disease? - Hers' disease
Hepatic glycogen phosphorylase
80S ribosomes (because they are eukaryotic)
Neuroblastoma
Bunyavirus

31. Is a marker for increased bone formation.
Probenecid
An elevated serum osteocalcin level
Cefamandole - cefoperazone - and moxalactam
Coombs test

32. What is the term for precipitation of calcium phosphate in dying or necrotic tissue?
Case fatality rate
Diazepam is longest acting and midazolam is shortest acting.
Stable
Dystrophic calcification

33. What branch off the vertebral artery supplies x The ventrolateral two - thirds of the cervical spinal cord and the ventrolateral part of the medulla?
Down syndrome
Idiotypes
Case control studies cannot assess incidence or prevalence - but they can determine causal relationships.
Anterior spinal artery

34. What are the three reasons for the effectiveness of the blood - brain barrier?
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.
Interval scale (a ruler - for example)
The inner membrane of the mitochondria (cristae)

35. From what pharyngeal pouch is the following structure derived? - Palatine tonsil
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Second M PITS for pharyngeal pouch derivatives
The central vein of the liver lobule
MGN

36. Name the lipoprotein based on the following characteristics - apo E
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Thyroid hormones are necessary for conversion of carotene to vitamin A.
IDL
Ungated channels

37. What is the most common one? - Complication of PDA
Subacute bacterial endocarditis
Erythromycin
Afterload
Clonidine

38. What is the most common one? - Malignant germ cell tumor in women
Membranoproliferative glomerulonephritis (MGN)
Choriocarcinoma
C4 (the upper border of the thyroid cartilage)
Factor XII for the intrinsic; factor VII for the extrinsic pathway

39. When a person goes from supine to standing - what happens to the following? - Dependent venous pressure
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Burkitt lymphoma
Areas 44 and 45
catalase - negative

40. What phase of the menstrual cycle is dominated by estrogen? Progesterone?
Oxazepam - temazepam - and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation - not via the cytochrome p450 system.
Being a white male
Strongyloides stercoralis is treated with thiabendazole.
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.

41. What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
Remember the mnemonic PAM SMIDT P - (hyper) Parathyroid/ Paget disease A - Addison's disease M - Milk - alkali syndrome/metastatic cancer S - Sarcoidosis M - Multiple myeloma I - Immobilization/idiopathic D - Vitamin D intoxication T - Tumors
Alcoholics Anonymous
>5 mm
Duodenal ulcer

42. What are the three posttranscriptional modifications?

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43. What aneurysm of the circle of Willis is associated with polycystic kidney disease?
Berry aneurysm
They are all formed by the fifth month of fetal life.
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
At 8 to 9 years of age. Prior to this age they view death as a form of punishment.

44. What type of scheduled reinforcement states that after a desired response - the reinforcement is given x On a set time schedule?
Fixed interval
DiGeorge's syndrome
Chromium (Cr)
Free - unprocessed Ag

45. What component of the vascular system is most sensitive to the effects of calcium channel blockers?
Chlamydia trachomatis
Arterioles
Fungi
Nimodipine

46. What papillae are responsible for sweet taste?
Agglutination test
The basilar artery is formed at the pontomedullary junction.
Circumvallate papillae
Pneumothorax

47. What is the only CN nucleus found in the cervical spinal cord?
Expressive aphasia
Without children (but don't think about this one for too long)
Rhabdovirus
Accessory nucleus

48. Which three CNs send sensory information to the solitary nucleus?
Large intestine. Water is passively removed from the lumen.
Negative selection. This helps to prevent autoimmune diseases.
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.
Decreases

49. Is a membranous septal defect more commonly interventricular or interatrial?
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.
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.
Superficial spreading melanoma

50. What is the size of a positive PPD test for the following? (Reactive) x Posttransplantation patient taking immunosuppressive agents
Medullary carcinoma of the thyroid
>5 mm
17- alpha - Hydroxylase deficiency
Graves disease