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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. In a topographical arrangement of the cerebellar homunculus map - What area or lobe x Controls balance and eye movements?
Rapid efflux of potassium
Rigors - leukopenia - decrease in blood pressure - and increase in temperature
Adenocarcinoma (30% to 35%)
Flocculonodular lobe (one of my favorite words in all of medicine!)

2. At ovulation - In what stage of meiosis II is the secondary oocyte arrested?
Burr cells (echinocytes)
Metaphase II
QRS complex
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.

3. What AA is substituted for glutamic acid at position 6 on the Beta - chain in patients with sickle cell anemia?
Posterior
Valine
Postinfectious GN
Effective dose for 50% of drug takers (median effective dose)

4. What chemical can be dangerous if you work in the aerospace industry or in nuclear plants?
VIPoma
Lithium
By causing rebound insomnia and decrease in REM sleep
Beryllium

5. Name the thalamic nucleus based on its input and output - Input from globus pallidus and the cerebellum; output to the primary motor cortex
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
p -53
Ventral lateral nucleus
Thymus gland. (Thymus gland is essential for T cell maturation.)

6. What disorder is characterized by an alternating pattern of depressed mood with periods of hypomania for more than 2 years?
GH and prolactin are produced by acidophils; all others are by basophils.
Janeway lesions
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
Familial hypercholesterolemia

7. What is the term for the number of individuals who have an attribute or disease at a particular point in time?
Fixation (arrested development)
Akathisia
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
Prevalence rate

8. Is ACh associated with bronchoconstriction or bronchodilation?
Shortens
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
Achondroplasia
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

9. What area of the nephron is sensitive to the effects of ADH?
Increased secretion of GH postpuberty leading to acromegaly.
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
Collecting ducts - which make them readily permeable to water reabsorption.
Choriocarcinoma

10. What sphingolipid is formed by the union of serine and palmitoyl CoA?
CD8
Sphingosine
Flumazenil
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T

11. Do the following structures pick up stain from hematoxylin or eosin? - Nuclei
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Internal abdominal oblique
Hematoxylin
Superior vena cava

12. What are the four most common causes of femoral head necrosis?
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
Aminophylline
When calcium is removed from troponin and pumped back into the SR - skeletal muscle contraction stops.
Seminoma

13. Name the compartment of the mediastinum associated with the following thoracic structures: Left common carotid artery
Diacylglycerols and phosphatidic acid
Puberty
Being awake
Superior

14. Increased urinary excretion of what substance is used to detect excess bone demineralization?
ydroxyproline
X- linked recessive
Streptococcus pyogenes
Increased leukocyte alkaline phosphatase (LAP)

15. What part of the 30S ribosome binds to the Shine - Dalgarno sequence?
Plasmodium falciparum
16S subunit
Haemophilus ducreyi
Streptococcus pneumoniae

16. Regarding the Lac operon - for What do the following genes code? - A gene
Clear cell
1. Fructose -6- phosphate 2. Glucose -6- phosphate 3. Glyceraldehyde -3- phosphate
1. Skin 2. Liver 3. Kidney
Thiogalactoside transacetylase

17. What sex cell tumor causes precocious puberty - masculinization - gynecomastia in adults - and crystalloids of Reinke?
Leydig cell tumor
Benign lentigo
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)
Clofazimine

18. What connects the lateral ventricles to the third ventricle?
Nodular melanoma
Foramen of Monro
>3.5 g/day of protein - along with generalized edema - hypoalbuminemia - and hyperlipidemia
Astrocytoma

19. Name the thalamic nucleus based on its input and output - Input from the optic tract; output projects to the primary visual cortex of the occipital lobe
Cytochrome a/a3
LGB (think EYES)
Bunyavirus
Permanent

20. What syndrome is due to a deficiency of surfactant?
There would be two Fab and Fc regions.
Ependymal cells
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.

21. Causes of avascular necrosis of bone.
Transverse abdominis
Sickle cell anemia - Caisson disease - chronic steroid use - and Gaucher disease
Acral - lentiginous melanoma
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)

22. What muscle of the middle ear is innervated by the mandibular division of CN V?
P = .05; P < .05 rejects the null hypothesis
Celecoxib
Tensor tympani
impermeable to water

23. What two factors influence low oral bioavailability?
Duchenne muscular dystrophy (Remember - Becker's is slower in progress - less severe - later in onset - and lacks cardiac involvement.)
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Primary spermatocyte
First - pass metabolism and acid lability

24. Which organism causes trench mouth?
Reticulocyte
Negative
Facial expression (the second is vocal intonation)
Fusobacterium

25. What protective covering adheres to the spinal cord and CNS tissue?
HBsAb IgG
G1 phase (gap 1)
Are inactivated vaccines available in the United States
Pia mater

26. What form of angina is characterized by x Coronary artery nonocclusive thrombus; symptom occurrence with increasing frequency - duration - intensity - and decreasing activity - frequently at rest?
Testicular lymphoma
The venae recta maintain the gradient via countercurrent flow.
Unstable (crescendo) angina
Omega -3; linoleic is omega -6

27. Is the bound form or free form of a lipid - soluble hormone responsible for the negative feedback activity?
Dimorphic
Amyloidosis
Free form determines hormone activity and is responsible for the negative feedback loop.
Hodgkin lymphoma

28. What cell type involves humoral immunity?
B lymphocyte
Phototherapy
Nystagmus and ataxia
Latissimus dorsi

29. Name the type of necrosis - The most common form of necrosis; denatured and coagulated proteins in the cytoplasm
Epstein - cardiac anomaly of the tricuspid valve
Coagulative necrosis
V wave
Excretion is greater than filtration for net secretion to occur.

30. What hormone is secreted by the placenta late in pregnancy - stimulates mammary growth during pregnancy - mobilizes energy stores from the mother so that the fetus can use them - and has an amino acid sequence like GH?
The liver (in the mitochondria)
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
Because they do not block D2A receptors - they are antagonists of 5HT2 receptors.
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)

31. What is the second arrested stage of development in the female reproductive cycle?
Alveolar dead space
Voltage - gated calcium channel
Metaphase of meiosis II (in the oocyte of the graafian follicle)
Hot pink with PAS and grey to black with silver stain

32. There are no persistent infections with...
Isotypes
Clonorchis sinensis
Disseminated intravascular coagulation (DIC)
naked viruses

33. What are the vitamin K- dependent coagulation factors?
Factors II - VII - IX - X - and proteins C and S
Left anterior descending artery
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
Zollinger - Ellison syndrome

34. What is the name of the SER of striated muscle?
Gonococcus
Sarcoplasmic reticulum
The hallmarks of LMN lesion injury are absent or decreased reflexes - muscle fasciculations - decreased muscle tone - and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget - LMN lesions are ipsilateral at the level of the
REM latency; normally it is about 90 minutes.

35. With what stage of sleep are nightmares associated?
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.
Protamine sulfate
Chromosome 17
REM sleep. Nightmares are frightening dreams that we recall.

36. Who is responsible for passing on mitochondrial DNA genetic disorders?
Giant cell bone tumor (osteoclastoma)
Mitochondria - linked disorders are always inherited from the mother.
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Eosinophilic exudates

37. Name the following descriptions associated with bacterial endocarditis: x Painless hyperemic lesions on the palms and soles
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
Janeway lesions
HBeAb
MEN I (or Wermer syndrome)

38. What structure or structures cross the diaphragm at x T8 level?
Pulmonary alveolar macrophages
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
IVC Remember: 1 at T8 - 2 at T10 - and 3 at T12
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.

39. What component of the trigeminal nuclei x Forms the sensory component of the jaw jerk reflex?
Neutropenia - splenomegaly - and rheumatoid arthritis
Autograft
Mesencephalic nucleus
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)

40. Is there a difference between mathematical and clinical steady states? If so - What are their values (half - lives)?
There is a difference; it takes about 7 to 8 half - lives to reach mathematical steady state and 4 to 5 half - lives to reach clinical steady state.
Superior rectus (CN III) (LR6 SO4)3
Sigma factor
Membranous glomerulonephritis

41. What syndrome is associated with the following brainstem lesions? - Occlusion of the PICA - resulting in ipsilateral limb ataxia - ipsilateral facial pain and temperature loss - contralateral pain and body temperature loss - ipsilateral Horner's synd

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42. Name the most common cause - Chronic pancreatitis
Clostridium perfrigens
Alcohol abuse
Brain abscess
Libman - Sacks endocarditis

43. Name the three hormones produced by pinealocytes.
Melatonin - serotonin - and CCK
Indirect pathway (Tourette syndrome for example)
F- Met - Peptides
Alendronate

44. What three factors increase simple diffusion?
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
GP IIb and IIIa receptors
Glanzmann syndrome

45. Which is the conditioned response - the conditioned stimulus - the unconditioned response - the unconditioned stimulus in this case? A patient has blood withdrawn and faints. The next time she goes to have blood taken - she faints at the sight of the
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.
It increases REM and total sleep time.
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting). The needle is part of the blood - drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in th
Common and internal carotid arteries

46. The closure of what valve indicates the beginning of the isovolumetric relaxation phase of the cardiac cycle?
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
Musculophrenic and superior epigastric arteries
Catechol - O- methyl transferase (COMT)
GH

47. What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?
PKU
almitate
Gastric cancer
Basal cell carcinoma

48. Name the type of mutation: x Unequal crossover in meiosis with loss of protein function
Large segment deletions
Left abducens nucleus or right cerebral cortex
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Aldolase B deficiencies are treated by eliminating fructose from the diet.

49. What is the pancreatic action of CCK?
CCK stimulates the pancreas to release amylase - lipase - and proteases for digestion.
Effective dose for 50% of drug takers (median effective dose)
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.
DiGeorge syndrome - Which is due to a failure of the third and fourth pharyngeal pouch development. Remember - B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections

50. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Concentration of CHO - AA - ketones - peptides
No CHO - AA - ketones - or peptides are left in the tubular lumen.
Para - aminohippurate (PAH)
Transketolase and transaldolase. The reactions they catalyze are reversible.
Amphotericin B