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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. What segments of the lumbosacral plexus form the following nerves? - Femoral nerve
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. Beta- Agonists 6. ACh
Alcohol abuse

2. Aschoff bodies
EBV
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
Rheumatic fever
Hematoxylin

3. What is the drug of choice for treating a patient with hyperuricemia due to overproduction of uric acid?
Allopurinol
Negative
Th2
Gastric cancer

4. What is the second cell involved in the immune response?
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis - or IHSS)
The CD4 T cell; the APC is the first cell in the immune response.
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12
Fever - night sweats - and hemoptysis

5. Which benzodiazepine has the longest half - life?
Merkel cells (Merkel's tactile cells)
Enterobius vermicularis
Flurazepam
Sympathetic nervous system

6. What is the most common one? - Location of ependymomas in children
Galactitol
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Proton pump inhibitors
Gubernaculum

7. What acid form of H+ in the urine cannot be titrated?
Proencephalon
IgM
NH4+(ammonium)
Knee

8. What 11- amino acid peptide is the neurotransmitter of sensory neurons that conveys pain from the periphery to the spinal cord?
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.)
Ureaplasma urealyticum
Mitral (bicuspid) valve
Substance P. (Opioids relieve pain in part by blocking substance P.)

9. What component of the vascular system is most sensitive to the effects of calcium channel blockers?
Herpes virus I and II
FSH and testosterone
HBcAb IgG and HBsAb IgG
Arterioles

10. What enzyme of the TCA cycle catalyzes the production of the following: x NADH (hint: 3 enzymes)
Dysgerminoma
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase
TXA2
Parvovirus (it is the only ssDNA virus)

11. ______________ that slow bacterial growth are bactericidal.
Antimicrobial agents
L2 to L4 (L2 to L4 - thigh; L4 to S3 - leg)
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
M12 strains

12. What is the fastest - conducting fiber of the heart? Slowest conduction fiber in the heart?
DiGeorge syndrome
Purkinje cell is the fastest - and the AV node is the slowest.
Onion skinning
Urachus

13. What protein allows Mycoplasma to attach to the respiratory epithelium?
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
1. Skin 2. Liver 3. Kidney
Latency stage (6-12 years)
P1 protein

14. What is the term for ejaculation before or immediately after vaginal penetration on a regular basis?
Rhombencephalon
Premature ejaculation
Arcuate line
Accessory nucleus

15. What are the most common causes of osteomyelitis x In neonates?
Hemorrhagic exudates
Streptococcus agalactiae
Haemophilus influenzae type B
Removal of the ileum

16. What three cephalosporins inhibit vitamin K- dependent factors?
Type I hypersensitivity (anaphylactic)
Cefamandole - cefoperazone - and moxalactam
Decreasing potassium conductance - which results in increased excitability
Superior and middle

17. What are the three benzodiazepines that do not undergo microsomal oxidation?
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
14 days in most women (Remember - the luteal phase is always constant.)
Hypochondriasis (they will begin with 'I think I have...')
Oxazepam - temazepam - and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation - not via the cytochrome p450 system.

18. What androgen receptor blocker is used in the treatment of prostatic cancer?
Flutamide
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
GLUT 3 and 4
Superior Oblique (CN IV) (LR6 SO4)3

19. What is the most common one? - Malignant germ cell tumor in women
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
Diacylglycerols and phosphatidic acid
Single - strand DNA binding protein
Choriocarcinoma

20. Replacing normal affect with 'brain power'
Acute glomerulonephritis
Intellectualization
Hemorrhagic exudates
They innervate LMNs.

21. What ovarian carcinoma is characterized by psammoma bodies?
Aminoglycosides
Upper third skeletal muscle - middle third both skeletal and smooth muscle - and lower third smooth muscle
Cystadenocarcinoma
Schistosoma haematobium

22. What cell in the heart has the highest rate of automaticity?
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
Inactivated
SA node; it is the reason it is the primary pacemaker of the heart.
Coma - convulsions - and cardiotoxicity

23. Name the antidote - Organophosphates
No enzymes are needed. When the stop codon reaches the A site - it results in termination.
Sigmoid colon
Atropine - 2- PAM (pralidoxime)
Folic acid deficiency

24. What are the three platelet aggregating factors?
Tetracycline
1. ADP 2. PG 3. TXA2
Brain - spleen - and kidney
Pyelonephritis

25. Name the antidote - Carbon monoxide (CO)
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Homocysteine methyl transferase
Oxygen
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa - resulting in a narrowed pyloric outlet

26. What is the term for the round intracytoplasmic eosinophilic inclusions containing ?- synuclein found in the dopaminergic neurons of the substantia nigra?
Lewy bodies
Utricle and saccule
Calicivirus
Membrane conductance (think conductance = channels open)

27. How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle?
3 ATPs by oxidative phosphorylation
IgA nephropathy
Squamous cell carcinoma (skin - lung) and angiosarcoma of the liver
Secondary hypercortisolism (pituitary)

28. What is the most common one? - Benign GI tumor
Leiomyoma
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.
Superior olivary nucleus
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.

29. What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
S phase
Klinefelter syndrome
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.
Ventromedial nucleus; lesions here result in obesity.

30. What somatoform disorder is described as x Unrealistic negative opinion of personal appearance - seeing self as ugly?
Correlation. No - correlation does not imply causation.
Body dysmorphic disorder
EBV
Regular insulin

31. What are the only two picornaviruses that do not lead to aseptic meningitis?
Rhinovirus and hepatitis A virus
Occulta All except occulta cause elevated - fetoprotein levels.
Right atrium
Osteopetrosis (Albers - Sch

32. What bone cell has receptors for PTH?
Osteoblasts (Remember - they modulate the function of osteoclasts.)
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Superior vena cava
Distal convoluted tubules

33. What encapsulated gram - negative - lactose - fermenting rod is associated with pneumonia in patients with alcoholism - diabetes - and chronic lung disease?
Mitosis
>5 mm
Palms and soles of the feet. Sebaceous glands are associated with hair follicles - which are lacking on the palms and soles of the feet.
Klebsiella pneumoniae

34. From What aortic arch are the following structures derived?
Common and internal carotid arteries
Mantle cell lymphoma
ELISA. It detects anti - p24 IgG.
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get

35. What two Beta- blockers decrease serum lipids?
Proencephalon diencephalon derivative
Thyroarytenoid muscles
Acebutolol and Pindolol
Superior

36. When referring to a series circuit - what happens to resistance when a resistor is added?
Astrocytoma
Resistance increases as resistors are added to the circuit.
Neomycin
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes

37. What type of error is made if you reject the null hypothesis when it is true?

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38. What is the only sphingolipid that contains choline and PO4?
Ipratropium
Sphingomyelin (lecithin also - but it is not a sphingolipid)
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
Duodenal atresia

39. What operant conditioning therapy or modification is described as x Removing a reinforcement (without the patient knowing) gradually over time to stop a condition?
Coxsackie A
Fading
Brain abscess
After the latent period

40. Do high levels of estrogen and progesterone block milk synthesis?
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Metronidazole
Yes - they stimulate the growth of mammary tissue but block milk synthesis. At parturition - the decrease in estrogen lifts the block on milk production.
Edinger - Westphal nucleus (via CN III)

41. If the family member of a patient asked you to withhold information - would you?
PTH
For the USMLE Step 1 the answer is no - but if the information would do more harm than good - withhold. This is very rare but it does occur.
Metaproterenol and albuterol
REM sleep. Nightmares are frightening dreams that we recall.

42. To what host cell receptor does the rabies virus attach?
Glutamate dehydrogenase
ACh receptor
Being awake
Alveolar macrophages

43. What two CD cell surface markers do Reed - Sternberg cells stain positive for?
CD15 and CD30
If positive - hypotonic urine (osmolarity <300 mOsm/L); if negative - hypertonic urine (osmolarity > 300 mOsm/L)>>
Shine - Dalgarno sequence
Dihydrotestosterone

44. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Denial of illness - hemineglect - construction apraxia (can't arrange matchsticks)
Central. Remember - there is a deficiency in ADH production in the central form.
Nondominant parietal lobe
Propionibacterium acnes
Cytochrome b/c1

45. What Enterobacteriaceae are prone to produce osteomyelitis in sickle cell patients?
Stranger anxiety
Salmonella
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
No - therapeutic indices can tell which drug is safer - not more toxic.

46. What cells contribute to the blood - brain barrier and proliferate in response to CNS injury?
Metastatic
Transitional cell carcinoma
Menses
Astrocytes

47. Which kidney is lower? Why?
Microglia (Microglia and mesoderm both begin with M)
Zinc (Zn) deficiency
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
DNA polymerases

48. How does sympathetic stimulation to the skin result in decreased blood flow and decreased blood volume? (Hint: what vessels are stimulated - and how?)
Superior and posterior
A decrease in cutaneous blood flow results from constriction of the arterioles - and decreased cutaneous blood volume results from constriction of the venous plexus.
urease positive
Catechol - O- methyl transferase (COMT)

49. It degenerates 4 to 5 days post fertilization - and implantation occurs __ days post fertilization!
Repression
Bacterial meningitis
7
The fasciculus cuneatus

50. What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls?
Bronchioloalveolar carcinoma
Infection
CD4
Isotypes