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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. If a peripheral blood smear shows schistocytes - reticulocytes - and thrombocytopenia - is it more commonly seen in patients with ITP or TTP?
V wave
Broca's aphasia
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
Omphalocele and gastroschisis

2. What virus causes hoof - and - mouth disease?
Vesicular stomatitis virus
Cyanide
Alzheimer disease
Average

3. Is increased in 21-Beta- hydroxylase deficiency.
Removal of the ileum
No CHO - AA - ketones - or peptides are left in the tubular lumen.
Renin secretion
Topoisomerase I (Relaxase)

4. The ophthalmic artery is a branch of what vessel?
Kayser - Fleischer rings
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Internal carotid artery
LGB (think EYES)

5. How can a genetic deficiency of carbamoyl phosphate synthetase be differentiated from an ornithine transcarbamoylase deficiency?
EBV
Embolic
Recall bias. These problems arise in retrospective studies.
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.

6. What pyrimidine base is found x Only in DNA?
Musculocutaneous nerve
Acute rejection
Single - strand DNA binding protein
Thymine

7. What area of the nephron is sensitive to the effects of ADH?
Posterior chamber
Collecting ducts - which make them readily permeable to water reabsorption.
NADPH oxidase
Unconjugated (indirect)

8. Is a brush border enzyme.
Clostridium tetani
Enterokinase
Positive
Plasmodium malariae; the others are tertian.

9. What is the largest nucleus in the midbrain?
Superior Oblique (CN IV) (LR6 SO4)3
Elongation factor - G and GTP
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
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.

10. What dementia is associated with dilated ventricles with diffuse cortical atrophy - decreased parietal lobe blood flow - and a decrease in choline acetyl transferase activity?

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11. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF ? - capillary pressure ?
Constriction of efferent arteriole
2 ATPs - via the amino acyl tRNA synthase enzyme
Osteoblast (Remember - blasts make - clasts take)
Keloid

12. What family do the following viruses belong to? - California encephalitis
Bunyavirus
In the RBC; remember - you need carbonic anhydrase for the conversion - and plasma does not have this enzyme.
DNA polymerases
Malingering

13. What cytoplasmic organelle carries the enzymes for elongation and desaturation of fatty acyl CoA?
Superior and middle
SER
Scrofula
Ionized drugs are water soluble - and since only lipid - soluble drugs can cross biomembranes - an ionized drug cannot cross them without the help of a carrier.

14. In what stage of psychosexual development - according to Freud - do children resolve the Oedipus complex?
Body dysmorphic disorder
Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.
Latency stage (6-12 years)
Nasopharynx

15. Increases the effect of digoxin.
Osteoporosis
Hyperkalemia
Dimercaprol - penicillamine
CN V

16. Name the antimicrobial agent whose major side effect is listed - Cholestatic hepatitis
Erythromycin
Elongation factor - G and GTP
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
epithelial lining

17. What are the five tissues in which glucose uptake is insulin independent?
IL-3 (3 face down is an M)
Loose association
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
Insulin

18. Is most of the coronary artery blood flow during systole or diastole?
From age 5 onward IQ stabilizes.
CN V
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Achondroplasia

19. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Alkylating agents
HHV 8
Leukemias and lymphomas
CD40
Residual volume (RV)

20. What is the MCC of the following meningitides? - In neonates to 3 months of age
Streptococcus agalactiae and Escherichia coli
Postductal coarctation of the aorta (adult)
Tyrosine
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.

21. What is the name of the major chemotactic agent released from x Neutrophils?
Gaucher disease
Arterial PCO2 levels are proportional to cerebral blood flow.
Plummer - Vinson syndrome
Leukotriene B4 (LTB4)

22. What is found in the R group if the AA is acidic? Basic?
Squamous cell carcinoma
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
refuse
Multiple myeloma

23. What is the most common form of inherited dwarfism?
Superior
Superior and posterior
Achondroplasia
Male pseudohermaphrodite (dude looks like a lady!)

24. What is the direction of growth for the primitive streak - caudal to rostral or rostral to caudal?
F- Met - Peptides
Syphilitic
The primitive streak grows caudal to rostral.
Proteus

25. What is the pancreatic action of CCK?
Disorganized schizophrenia
The stomach
CCK stimulates the pancreas to release amylase - lipase - and proteases for digestion.
The poly(A) site on the DNA

26. What obligate extracellular fungus is silver stain - positive and is associated with pneumonia in patients with AIDS?
Duchenne muscular dystrophy
Pneumocystis carinii
Stercobilin
Herpes virus I and II

27. What is the term for a single isolated antigenic determinant?
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
Hapten (not immunogenic)
Femoral hernias
Beta- Oxidation of fatty acids

28. What virus is associated with the Norwalk agent?
Ultralente
Calicivirus
When the intra - alveolar pressure equals zero - there is no airflow.
Primitive neuroectodermal tumors (i.e. - medulloblastomas and retinoblastomas)

29. Should not be treated with (beta) Beta- blockers.
Stage 4
Free form determines hormone activity and is responsible for the negative feedback loop.
Multiple myeloma
Cocaine - induced coronary ischemia

30. What is the term for the difference between the highest and the lowest score in a population?
Action potential
Kinesins. Dynein generates retrograde transportation of information.
Range
Renin

31. The duodenal - jejunal flexure is suspended from the posterior abdominal wall by what?
urease positive
Reaction formation
PICA
Ligament of Treitz

32. What must be supplemented in patients with medium - chain acyl CoA dehydrogenase (MCAD) deficiency?
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Ch
Seminoma
Short - chain fatty acids

33. What cardiomyopathy is due to a ventricular outflow obstruction as a result of septal hypertrophy and leads to sudden cardiac death in young athletes?
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis - or IHSS)
Methanol
Breast and lung cancer - respectively.
Sheehan syndrome

34. What is the vector for yellow fever?
Giant cell tumor of the bone
Spermatogonia (type B)
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
Aedes mosquito

35. Name the antimicrobial agent whose major side effect is listed - Dental staining in children
Rabies
Tetracycline
Day 14
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.

36. What is the DOC for the following protozoal infections? - Giardiasis
PTH
Metronidazole
Between the renal arteries and at the bifurcation of the abdominal aorta
Invasive ductal carcinoma

37. What cells of the retina see in black and white and are used for night vision?
absorption
Atrial contraction Atrial - Contraction - Venous
Penicillin V
Rods

38. In what organelle does the TCA cycle occur?
Parietal cells (Remember - they secrete HCl - too.)
Mitochondria
The Palmar interosseus ADducts - whereas the Dorsal interosseus ABducts (PAD and DAB)
Positive

39. A unilateral lesion In what nucleus will produce ipsilateral paralysis of the soft palate?
G-6- PD
Somatomedins
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.
Plummer - Vinson syndrome

40. What enzyme is inhibited by trimethoprim?
Streptococcus agalactiae
Group A Beta- hemolytic streptococci
Dihydrofolate reductase
Choriocarcinoma

41. What two pathologic conditions occur when the gut does not return to the embryo?
SSRIs
Omphalocele and gastroschisis
Zero correlation
Leiomyoma

42. What subtype of IgG does not activate complement cascade?
Inhibin - m
IgG4
EF-2 and GTP
C- peptide levels

43. What is the PO2 of aortic blood in fetal circulation?
Pheochromocytoma
Axis I
60%
Rhombencephalon

44. Acts as the vertebral body of C1 allowing lateral rotation of the head. The first cervical vertebra has no vertebral body.
Hairy cell leukemia
The odontoid process of C2
Pheochromocytoma
CN V

45. By What age should children be able to draw the following figures? - Triangle
Excision endonuclease - which removes thiamine dimers from DNA
Fibrocystic change of the breast
6 years old
LH

46. What toxicities are caused by the following agents? - Halothane
Increased androgen secretion at puberty drives the increased GH secretion.
Pneumotaxic center (short - fast breaths)
Hepatitis - with or without necrosis
Herpes II

47. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol increased - ACTH increased
Small cell cancer of the lung
Secondary hypercortisolism (pituitary)
Somatomedins
Thymine (B1)

48. What two areas of the skin do not contain sebaceous glands?
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Muscle spindles
Minocycline
Type I symptoms (positive); schizophrenics have them - but otherwise healthy persons do not.

49. Who is responsible for passing on mitochondrial DNA genetic disorders?
Tryptophan
Mitochondria - linked disorders are always inherited from the mother.
A positive PPD skin test
None; they are not formed until a girl reaches puberty.

50. What mineral deficiency involves blood vessel fragility?
Copper deficiency
Increase in erythropoietin and increase in 2 - 3- BPG - also called 2 - 3- diphosphoglycerate (2 - 3- P2Gri) (increase in glycolysis)
Right medial longitudinal fasciculus
Resistance increases as resistors are added to the circuit.