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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 is the DOC for CMV retinitis?
Carbidopa and benserazide
Ganciclovir
SLE; ANA - anti - dsDNA and anti - Sm (anti - Smith)
Plasmodium vivax

2. Metformin is contraindicated in ________ because of weight gain as its side effect.
Gabapentin
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
Obese patients
Hemangioblastoma

3. What type of cerebral bleed is due to a rupture of a berry aneurysm in the circle of Willis?
Subarachnoid hematoma
Mode
Preductal (infantile)
Combined metabolic and respiratory acidosis

4. What parasympathetic nucleus is found on the floor of the fourth ventricle and supplies preganglionic fibers innervating the terminal ganglias of the thorax - foregut - and midgut?
Conn syndrome (primary hyperaldosteronism)
Areas 18 and 19
Hypertrophic scar
Dorsal motor nucleus of CN X

5. What are the five hormones produced by Sertoli cells?
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Free ionized Ca2+
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).

6. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Pons
Rhinovirus and hepatitis A virus
Gynecomastia
Embolism
Rhombencephalon

7. Which four bacteria require cysteine for growth?
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)
Adrenal medulla
Staphylococcus aureus
They prevent mast cell degranulation.

8. Name the associated chromosome - Marfan disease
Chromosome 15
Homocysteine methyl transferase and methylmalonyl CoA transferase
Propionic acid
Interval scale (a ruler - for example)

9. Increased levels of what neurotransmitter - in the hippocampus - decrease the likelihood of learned helplessness?
Antimicrobial agents
Increased GABA levels decrease the likelihood of learned helplessness.
Echinococcus multilocularis
Healing by secondary intention

10. Males are more likely to develop _______ than females.
Femoral hernias
Surface tension - the force to collapse the lung - is greatest at the end of inspiration.
Adhesions and hernias
The aorta has the greatest velocity and the capillaries have the slowest velocity.

11. How many pairs of spinal nerves are associated with x Sacral vertebrae?
Erythromycin
Chromosome 7
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
Malassezia furfur (treat with selenium sulfide)

12. Which form of melanoma carries the worst prognosis?
Raloxifene
RBCs. That is why it is called red pulp.
Nodular melanoma
Yolk sac tumor

13. What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency - glucocorticoid deficiency - and an excess of adrenal androgens?
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
Type II error (beta error). (Remember it as saying something doesn't work when it does.)
Leukemias and lymphomas
Negative

14. Is CO2 a perfusion - or diffusion - limited O2 gas?
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
Protein A
The Beta- subunit; remember - the a - subunit is nonspecific.
Since CO2 is 24 times as soluble as O2 - the rate at which CO2 is brought to the membrane determines its rate of exchange - making it perfusion - limited a gas. For O2 the more time it is in contact with the membrane - the more likely it will diffuse

15. What disease involves microcephaly - mental retardation - cleft lip or palate - and dextrocardia?
Prostate cancer
Patau syndrome (trisomy 13)
Projection
Very superior (<2.5% of the population)

16. What family do the following viruses belong to? - Ebola
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
Wiskott - Aldrich syndrome
Negative correlation
Filovirus

17. Are the following conditions associated with a negative or positive nitrogen balance? - Infection
MEN IIa (or Sipple syndrome)
Hypocalcemia and hypophosphatemia
Musculophrenic and superior epigastric arteries
Negative

18. More Ag is needed to produce a ____________ than a first immune response.
Anterior compartment of the thigh - femoral nerve
secondary immune response
Cestodes
Middle meningeal artery

19. What is the only nonmotile pathogenic Clostridium species?
CD4+T cells
Clostridium perfringens
The vestibulo - ocular reflex
Popliteus

20. Name the stages of sleep with these EEG patterns: x Sleep spindles - K- complexes
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.
C5- C9
CN VII
Stage 2

21. Arrange the following layers in the correct sequence through which a needle must pass in a lumbar puncture - Skin x Subarachnoid space x Interspinous ligament x Dura mater x Deep fascia x Epidural space x Superficial fascia x Interlaminar space x Su
Protease - integrase - and reverse transcriptase
Hepadnavirus
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
Plasmodium vivax

22. Why would a puncture to a vein above the heart have the potential to introduce air into the vascular system?
IgM
CD40 ligand
Rotavirus
Venous pressure above the heart is subatmospheric - so a puncture there has the potential to introduce air into the system.

23. What branch of the immune system is acquired in response to an Ag?
Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.
Amiloride
Phase 1
H 2

24. How much of a vessel must be stenosed to cause sudden cardiac death?
Cancer of the lung - stomach - colon - and breast
Glucose -6- phosphatase
More than 75% of the vessel
IgM; IgD follows shortly thereafter.

25. What are the five AAs that are both ketogenic and glucogenic?
Size
Mitral valve prolapse
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
3 to 4 days

26. Four - fifths of those who attempt suicide first...
LC4 - LD4 - and LE 4
give a warning
HBc Ab
Berry aneurysm in the circle of Willis

27. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Polycyclic aromatic hydrocarbons
Bronchogenic carcinoma
Ribozymes
Bronchial asthma (whorled mucous plugs)
total body water

28. Which thrombolytic agent - activated in the presence of fibrin - is manufactured by recombinant DNA process?
LGB (think EYES)
Alteplase
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
Chromosome 15

29. Call - Exner bodies
p -53
CN VI - VII - and VIII
Granulosa/thecal cell tumor of the ovary
Melanin

30. T3 increases bone ossification through synergistic effect with what hormone?
The DCML system. (Remember - everything but pain and temperature.)
Positive reinforcement
GH
Meningioma

31. What are the four posttranslational modifications done by the Golgi apparatus?
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
Prostate and lung cancer - respectively
Public speaking (Remember: stage fright)

32. What is the DOC for the following protozoal infections? - Amebiasis
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
Eisenmenger syndrome - which can also occur with any left - to - right shunt
Vibrio vulnificus
Metronidazole

33. What type of skin carcinoma occurring on sun - exposed sites has a low level of metastasis?
Pernicious anemia
Neisseria gonorrhoeae
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
Squamous cell carcinoma

34. Name the MCC of death - In SLE
Tetanospasmin (also called tetanus toxin)
Renal failure
The Purkinje cell
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.

35. What is the term for repetitive actions blocking recurring bad thoughts?
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
wave
Internal 3' - 5' PDE bonds
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.

36. What is the term for an increase in the number of cells in a tissue?
Shortens
Spermatogonia (type A)
Hyperplasia
Paramyxovirus

37. What is the central chemoreceptor's main drive for ventilation?
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
CSF H+ levels - with acidosis being the main central drive - resulting in hyperventilation (the opposite being true with alkalosis)
HBcAb IgM
Uroporphyrinogen III cosynthase

38. What two requirements must be met for the Lac operon to be activated?
Lactose must be present and glucose must be absent
Cancer
Liver
Proencephalon

39. Are the following major or minor Jones criteria of rheumatic fever? - Arthralgias
Group A Beta- hemolytic streptococci
None; they are not formed until a girl reaches puberty.
Minor
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.

40. What is the amount in liters and percent body weight for the following compartments? - ICF
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
N-5- methyl THF
28 L - 40% of body weight
Cyanocobalamin (B12)

41. Which dimorphic fungus is endemic in the Ohio - Mississippi - Missouri - and Eastern Great Lakes - is found in soil with bird and bat feces - and is associated with infections in spelunkers and chicken coop cleaners?
Histoplasma capsulatum
Uric acid
Denial Anger Bargaining Depression Acceptance No - they can be skipped - repeated - and completed out of sequence.
Areas 44 and 45

42. What is the major hormone produced in the following areas of the adrenal cortex? - Zona reticularis
DHEA (androgens) Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Adenocarcinoma
Rheumatoid arthritis
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.

43. Are contraindicated in patients who present to the hospital with CHF.
Beta- Blockers
Phallus - urogenital folds - and labioscrotal swellings
Latissimus dorsi
Brucella and Listeria (has tumbling motility)

44. What Brodmann area is associated with x Premotor cortex?
Aminophylline
Mural infarct
Area 6
Vancomycin

45. Are used in diagnosing CREST syndrome.
Scrofula
CD40
Anticentromere Abs
When it crosses the teres major

46. Name the compartment of the mediastinum associated with the following thoracic structures: Thoracic duct
Achalasia
Eosin
Superior and posterior
Production of oxygen free radicals

47. What operant conditioning therapy or modification is described as x Having a stimulus take over the control of the behavior (unintentionally)?
Hemiballismus
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Confidence interval. It is a way of admitting estimation for the population.
Stimulus control

48. What are the four muscles of mastication?
Pancreas and colon
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase
Cortisol levels increase. Lymphocyte levels decrease in sleep - deprived individuals.
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid

49. What two vitamins are inactivated when they come in contact with acetaldehyde?
Thiamine and folate
Cauda equina
Parvovirus (it is the only ssDNA virus)
Crohn disease

50. What aspects of sleep are affected during benzodiazepine use?
Coronary circulation
Auspitz sign
REM and stage 4 sleep; they decrease.
Renal circulation

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USMLE Step 1 Prep

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