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USMLE Step 1 Prep

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
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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 are the two chains of the TCR that are mainly found on the skin and mucosal surfaces?
Rectum
Treacher Collins syndrome
gamma and delta chains
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.

2. What cells of the thyroid gland are stimulated in response to hypercalcemia?
Vanillylmandelic acid (VMA)
An elevated serum osteocalcin level
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.

3. Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
Borderline
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm
M 2
Stratum corneum (keratinized)

4. Name the stages of sleep with these EEG patterns: x Sawtooth waves - random low voltage pattern
Nodular melanoma
Vitamin B12 deficiency and folate deficiency
Endocardial cushion defect
REM

5. Name the most common cause - Blindness in the United States
Diabetes mellitus
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell
hypophosphatemia

6. Name the compartment of the lower extremity and the nerve based on its movements - Dorsiflex the foot - extend the toes - and invert the foot
GABA and glutamic acid
Arterial PCO2 levels are proportional to cerebral blood flow.
Afterload
Anterior compartment of the leg - deep peroneal nerve

7. Name the macrophages by location: x CNS
EBV
Microglial cells
HBeAb
Glioblastoma multiforme

8. What does hepatitis D virus need from hepatitis B virus to be infective?
HBsAg as its envelope
Anaerobes
The anterior nucleus of the thalamus
CN IX - X - and XII

9. What is the most common serotype of enterohemorrhagic Escherichia coli?
Agranulocytosis; approximately 2% develop this side effect.
Prodrugs
0157:H7
Glucose and galactose

10. What two factors result in the base of the lung being hyperperfused?
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
Chromosome 11p
Neisseria meningitidis
Large segment deletions

11. What term describes the inability to recall personal information - commonly associated with trauma?
Hepatitis - with or without necrosis
Third M PITS for pharyngeal pouch derivatives
MHC class II Ags. This is accomplished via CD4 T cells.
Amnesia. (The person is aware of the memory loss.)

12. What facultative intracellular fungus is associated with hepatosplenomegaly?
NH4+(ammonium)
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.

13. What fissure of the cerebral cortex runs perpendicular to the lateral fissure and separates the frontal and the parietal lobes?
Chromosome 15 - 17
Atracurium
Central sulcus (sulcus of Rolando)
Transient protein C deficiency - because of its relatively short half - life - may result if warfarin is instituted alone.

14. What are the three reasons for the effectiveness of the blood - brain barrier?
Paget disease of the breast
Obturator nerve
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
Duchenne muscular dystrophy

15. What syndrome is seen in iron - deficient middle - aged women with esophageal webs?
True hermaphrodism
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.
Plummer - Vinson syndrome
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.

16. What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
Thyroid gland
greater
Size
Porcelain gallbladder

17. What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? - Cortisol decreased - ACTH increased

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18. What is the rate - limiting step in a conduction of a NMJ?
The time it takes ACh to diffuse to the postjunctional membrane
GnRH pulsatile infusion
Afterload
Borrelia recurrentis

19. Name the form of spina bifida - An open neural tube lying on the surface of the back
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
Enterococcus faecalis
Myeloschisis All except occulta cause elevated - fetoprotein levels.
CN III and IV

20. What is the most likely causative organism for a patient with folliculitis after spending time in a hot tub?
Pseudomonas aeruginosa
HPV
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
Middle

21. What cerebral lobes are most commonly affected in herpes encephalitis?
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high - step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
Temporal lobes

22. What are the adult remnants of the following structures? - Ductus arteriosus
IgA nephropathy
Ligamentum arteriosum
Respiratory alkalosis (summary: low CO2 - low H+ - slightly low HCO3-)
Mycoplasma

23. What is the PO2 of aortic blood in fetal circulation?
Chemotaxis
Regression
60%
Urogenital sinus

24. What area of the nephron is sensitive to the effects of ADH?
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Streptococcus pneumoniae
Collecting ducts - which make them readily permeable to water reabsorption.
Papule

25. What syndrome is associated with the following brainstem lesions? - Posterior cerebral artery occlusion resulting in a contralateral corticospinal tract signs - contralateral corticobulbar signs to the lower face - and ipsilateral CN III palsy

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26. Development of what T cell line follows low affinity for self - MHC class II Ags in the thymus?
PGE (along with low oxygen tension)
CD4+T cells
GH. The largest output of GH in a 24- hour period is during stage 4 sleep.
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)

27. Where is the action potential generated on a neuron?
Osteomalacia. Osteoporosis has normal levels of calcium - phosphorus - and alkaline phosphatase.
Ultraviolet B (UVB) sunlight
Right - sided
Axon hillock

28. Name the compartment of the mediastinum associated with the following thoracic structures: Splanchnic nerves
Protamine sulfate
Posterior
DNA polymerase -?
Inferior rectus (CN III) (LR6 SO4)3

29. What eukaryotic translation enzyme is associated with the following: x Termination
Parietal lobe
Sleep latency
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
Physostigmine

30. What is the size of the prokaryotic ribosome?
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
HBcAb IgM - HBV- DNA - HBeAg - HBsAg
ELISA screens and Western blot confirms the diagnosis.
Ampulla

31. Name the ventricular muscle membrane channel: x Closed at rest; depolarization causes channels to open quickly; will not respond to a second stimulus until cell is repolarized.
Upper outer quadrant (left more than right)
Voltage - gated sodium channel
Ependymoma
HIV and poxvirus

32. What is the only specific Ag - presenting cell?
Triazolam
B cells; macrophages and dendritic cells are nonspecific.
Hemangioblastoma
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.

33. What is the name of the tremor that occurs during movements and is absent while the person is at rest?
Type III
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e. - pill rolling) is seen in basal ganglia lesions.
Testicular lymphoma
Medulla blastoma

34. What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
Astrocytoma
Syphilitic
Hydroxyproline
CML

35. 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.
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
Staphylococcus aureus
LC4 - LD4 - and LE 4

36. Can advance directives be oral?
MEN II and III syndromes
Inactivated
Yes
Hydroxyproline

37. Name the antidote - Arsenic
CN V2
No - it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
The Purkinje cell
Dimercaprol - D- penicillamine

38. How many months in How many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
CD16 and CD56
Coxiella burnetii
Gaucher disease
3 months of symptoms in 2 consecutive years

39. Which type of cerebral herniation is associated with CN III palsy?
Schistocytes
Hemangioma (benign)
Transtentorial (uncal)
Sympathetic chain ganglion

40. What is the only encapsulated fungal pathogen?
Ethyl alcohol
Cryptococcus
Raloxifene
At birth (reflex)

41. All negative sense RNA viruses are...
Asbestosis and silicosis
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
enveloped
EBV

42. What is the term to describe a man who has x Used to be able to achieve an erection but now cannot?
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
Good Samaritan Law. (Physicians are not required to stop and help.)
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade

43. Name the type of mutation: x New codon specifies for a stop codon
An internal elastic lamina
CN VI - VII - and VIII
Nonsense
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.

44. What sulcus divides the occipital lobe horizontally into a superior cuneus and inferior lingual gyrus?
pH of 2 and 9
REM latency; normally it is about 90 minutes.
Spironolactone
Calcarine sulcus

45. What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?
The anterior nucleus of the thalamus
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
TLC - FRC - and RV have to be calculated. (Remember - any volume that has RV as a component has be calculated.)
Carnitine acyltransferase I

46. How many ATPs per glucose are generated in glycolysis?
38 ATPs if aerobic - 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
Kayser - Fleischer rings
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III) - B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.
Lateral part of the hemispheres

47. What is the term for failure of the testes to descend into the scrotum?
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
von Hippel - Lindau syndrome
Edinger - Westphal nucleus (via CN III)
Dihydrofolate reductase

48. What IL is essential for lymphoid cell development?
1. Short attention span 2. Impulsivity 3. Hyperactivity
The anterior nucleus of the thalamus
IL-7 (A 7 upside down is an L; L is for Lymphoid)
Processed antigenic peptides bound in the groove of the MHC molecule

49. What lymphoma is associated with bleeding and cryoglobulin precipitation at low temperatures - headache and confusion due to hyperviscosity - IgM M- protein spike on serum electrophoresis - and Russell bodies?
APocrinE glands (APES is my memory aid) Axilla - Areola - and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production) - and if confronted by an APE - your Adrenergic nervous system would be firing (innerva
Waldenstr
Vesicular stomatitis virus
None; they are the storage sites for ADH and oxytocin.

50. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF normal - capillary pressure ?
Sacrococcygeal teratoma
Conversion disorder
Constriction of afferent arteriole
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.

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USMLE Step 1 Prep

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