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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 these mature defense mechanisms: x Converting an unacceptable impulse to a socially acceptable form (Hint: it is the most mature of all defense mechanisms)
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell
Sublimation
Hepadnavirus
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)

2. What Ig is associated with ADCC for parasites?
IgE
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Brain abscess
Heart rate determines the diastolic interval - and contractility determines the systolic interval.

3. What disorder is characterized by an alternating pattern of depressed mood with periods of hypomania for more than 2 years?
1. Sweat glands 2. Arterioles 3. Veins
Native Americans
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
Sporothrix schenckii

4. What subunit of hCG is used to detect whether a patient is pregnant?
Positive
LC4 - LD4 - and LE 4
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
The Beta- subunit; remember - the a - subunit is nonspecific.

5. What segments of the lumbosacral plexus form the following nerves? - Common peroneal nerve
Plasmodium malariae; the others are tertian.
They are directly related; the greater the preload - the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
Lateral medullary (Wallenberg's) syndrome
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)

6. What signals are used to direct an enzyme to a lysosome?
Myelofibrosis with myeloid metaplasia
Phallus
Phosphorylation of mannose residues
Extrahepatic biliary atresia

7. What two AAs have a pKa of 4?
RNA polymerase I
Aspartic acid and glutamic acid
Down syndrome
Superior rectus (CN III) (LR6 SO4)3

8. What virus lies dormant in the x Sensory ganglia of S2 and S3?
Down syndrome
Specific rate (e.g. - men aged 55-60)
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
Herpes II

9. What is the most common one? - Primary malignant tumor in the liver
Hepatocellular carcinoma
Outside the cell
Hodgkin lymphoma
Diazepam is longest acting and midazolam is shortest acting.

10. Which type of cerebral herniation is associated with CN III palsy?
Left abducens nucleus or right cerebral cortex
H 1
Transtentorial (uncal)
Squamous cell carcinoma of the lung

11. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
300 mOsm/L
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum
pI (isoelectric point)
The T- test (used when comparing two groups)

12. RBCs in the urine
A patent processus vaginalis
Gilbert's syndrome
Bladder carcinoma
Splenic flexure

13. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x CDK4
Melanoma
Chi - square (when you are in doubt and have nominal data - use chi - square)
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
Fixed ratio (rewards set behaviors)

14. Name these mature defense mechanisms: x Helping others without expecting any return
Pterygopalatine ganglion (I remember this as the only ganglion left.)
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Acute CO poisoning
Altruism

15. What form of bilirubin is carried on albumin?
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.
HTN
Prevalence increases. (Incidence does not change.)
Unconjugated (indirect)

16. What prostaglandin is associated with maintaining patency of the ductus arteriosus?
Meclizine
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
PGE (along with low oxygen tension)
Stranger anxiety

17. What happens to plasma concentration of a drug if there is a large volume of distribution?
The larger the volume of distribution - the lower the plasma concentration of a drug.
Lymphoblastic lymphoma
Pergolide
At least six

18. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Eukaryotic cell - 15 to 25 microns - 80S ribosomes - no cell walls - replicates via cytokinesis with mitosis and meiosis
Parasites
Wernicke's encephalopathy
Hypoparathyroidism
Parietal lobe

19. Are the following major or minor Jones criteria of rheumatic fever? - Arthralgias
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.
Fat necrosis
Minor
Goodpasture syndrome

20. What is the only specific Ag - presenting cell?
Isotonic contraction
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
B cells; macrophages and dendritic cells are nonspecific.
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.

21. What is the only DNA virus that is not icosahedral?
Axis V
Poxvirus
Acarbose
Superior rectus (CN III) (LR6 SO4)3

22. What enzyme is inhibited by disulfiram?
Ceramide
Acetaldehyde dehydrogenase
Right coronary artery
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage - removing the causative agent - and giving cyproheptadine.

23. What autoimmune liver disease is characterized by affecting a middle - aged woman with jaundice - pruritus - fatigue - xanthomas - increased direct bilirubin levels - and antimitochondrial Abs?
IL-8. It not only is chemotactic - it also acts as an adhesive for neutrophils.
Nitrates
Hypothyroidism. (TSH levels must be monitored.)
Primary biliary cirrhosis

24. 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)?
IL-4
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
Mild (50-70)
C2 deficiency

25. What two arteries join to form the superficial and deep palmar arches of the hand?
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
CN III and IV
Panacinar
Ulnar and radial arteries (ulnar is the main supplier)

26. What component of the corneal reflex is lost in a CN VII deficit?
Motor aspect
Carbamazepine
Zanamivir and oseltamivir
Social learning theory

27. What syndrome is due to anti - GBM Abs directed against the lung and kidneys?
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.
Negative
IgG4
Goodpasture syndrome

28. What is the term for gastric ulcers associated with severely burned or traumatic patients?
Serratus anterior
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
Hypertrophy
Curling ulcers (think curling iron = burn)

29. What malignant neoplasm of the skin is associated with keratin pearls?
All (nearly 15-20 times the normal risk)
Squamous cell carcinoma
Catechol - O- methyl transferase (COMT)
Convergence

30. Which serotypes of HPV are associated with plantar warts?
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.
More than 75% of the vessel
HPV serotypes 1 and 4

31. Name the pattern of genetic transmission characterized thus: both M and F are affected; M may transmit to M; each generation has at least one affected parent; and one mutant allele may produce the disease.
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.
Variable interval
Autosomal dominant
Mitochondrial inheritance

32. What mast cell mediator is a chemotactic agent?
emancipates
TCA cycle.
Eosinophil chemotactic factor A
Superior and posterior

33. Regarding muscle mechanics - How is passive tension produced?
Hepatitis C
Cingulate gyrus herniation (subfalcine)
Nodes of Ranvier
It is produced by the preload on the muscle prior to contraction.

34. What area of the hypothalamus is the feeding center?
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
Bitemporal heteronymous hemianopsia
The tsetse fly
Ependymoma

35. What enzyme of purine synthesis is inhibited by allopurinol and 6- mercaptopurine?
PRPP aminotransferase
300 mOsm/L
C5- C8 deficiency
CN X (Remember - the vagus nerve supplies the parasympathetic information from the tip of the pharynx to the end of the midgut and all between.)

36. Name the macrophage based on its location: x Liver macrophages
Kupffer cells
catalase - negative
ACh - histamine - and gastrin
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.

37. When attempting to make up sleep - what stage of sleep is recovered?
Entamoeba histolytica
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells
The systemic veins have the largest blood volume - and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.
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.

38. What HPV serotypes are associated with increased risk of cervical cancer?
Luteal phase
HPV serotypes 16 - 18 - 31 - and 33
Basal cell carcinoma
No. Heparin is safe in pregnancy - but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.

39. What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
Haemophilus influenzae type B
The carotid sinus is a pressure - sensitive (low) receptor - while the carotid body is an oxygen - sensitive (low) receptor. (Remember 'Sinus Pressure').
Raloxifene
Spermatogonia (type B)

40. Name the type of mutation: x New codon specifies for a stop codon
Compliance; the more compliant a lung is - the easier it is to inflate.
Plasma cell (mature B lymphocyte)
Nonsense
nef and tat genes

41. What cell type of the epidermis functions as antigen - presenting cells?
Klatskin tumor
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Langerhans cells (found in the stratum spinosum)
Cholesterol biosynthesis

42. How does myelination affect conduction velocity of an action potential?
3 ATPs by oxidative phosphorylation
Hyperacute rejection
Phallus - urogenital folds - and labioscrotal swellings
The greater the myelination - the greater the conduction velocity.

43. Name these cluster A personality disorders: x Odd - strange; has magical thinking; socially isolated - paranoid - lacks close friends; has incongruous affect
common variable hypogammaglobinemia
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.
Schizotypal
Histidine - because of the imidazole ring found in the R group - is basic.

44. Name the period described by the following statement: no matter how strong a stimulus is - no further action potentials can be stimulated.
Early collecting duct
Hepatitis B and hepatitis C
ASD
Absolute refractory period is due to voltage inactivation of sodium channels.

45. Upon seeing negatively birefringent needle - shaped crystals from a joint aspiration of the great toe - what form of arthritis do you diagnose?
Gout
Aldehyde dehydrogenase
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Rochalimaea quintana (now called Bartonella quintana)

46. What is the term for how well a drug produces its desired response?
Efficacy
Carnitine acyltransferase - I
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons
1. Sartorius 2. Gracilis 3. Semitendinous

47. What does Candida albicans do that distinguishes it from other fungi?
Spleen
In early- morning sleep - usually between the sixth and eighth hours
The cat
It forms a germinal tube at 37

48. Name the structure that enters or exits the following foramina: x Cribriform plate
Histamine
Calcium influx secondary to slow channel opening
Respiratory depression
CN I

49. At What age does a child develop x Exogenous smile?
8 weeks (response to a face)
Stratum spinosum
Dihydrotestosterone
Homogentisic oxidase

50. In prokaryotes - What is the name of the RNA sequence that ribosomes bind to so translation can occur?
Carbamoyl phosphate synthetase I
Shine - Dalgarno sequence
Cystic fibrosis
Norm reference (i.e. - 75% of the students in the class will pass)