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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 is the name of the process in which cells migrate toward an attractant along a concentration gradient?
Trapezius and sternocleidomastoid
Plasmodium falciparum
28 L - 40% of body weight
Chemotaxis

2. What are the long microvilli in the inner ear and male reproductive tract called?
Dimercaprol
Primase
Stereocilia
Nucleolus. Ribosomal assembly also takes place in the nucleolus.

3. What type of acute metal poisoning involves stomach and colon erosion and acute tubular necrosis?
Vitamin B12 deficiency and folate deficiency
Hemostasis
The triad of respiratory depression - pinpoint pupils - and coma in an IV drug abuser suggests opioid overdose (e.g. - heroin) - and you should give naloxone.
Mercury

4. What is the second cell involved in the immune response?
The CD4 T cell; the APC is the first cell in the immune response.
Prostate and lung cancer - respectively
Vitelline fistula
Humor

5. What is the name of the bullet - shaped virus?
Androgens are 19- carbon steroids.
Diverticulosis
Rhabdovirus
Adult tapeworms develop in the definitive host - whereas cysticerci or larvae develop in the intermediate host.

6. What glial cell is derived from mesoderm and acts as a scavenger - cleaning up cellular debris after injury?
2 ATPs - because RBCs use only anaerobic metabolism.
Microglia (Microglia and mesoderm both begin with M)
Catechol - O- methyl transferase (COMT)
Primary hyperaldosteronism (Conn syndrome)

7. What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
1. Big 2. Bilateral 3. Berry aneurysm
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
ACE inhibitors (the - pril agents)

8. What causes an increase in bone mineralization and Ca2+ along with PO4- absorption from the GI tract and kidney tubules?
K1 capsule
Intussusception
Vitamin D
Trichophyton

9. What vitamin deficiency produces angular stomatitis - glossitis - and cheilosis?
Lateral collateral ligament
Riboflavin (B2) deficiency
Retinoblastoma
Chromosome 11p

10. What component of the ETC is inhibited by the following? - Azide
Gubernaculum
Cleft lip
Cytochrome a/a3
Hemosiderin

11. Name the associated chromosome - Cri - du - chat
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
Chromosome 5p
Histrionic
Aedes (the same for yellow fever)

12. What apoprotein on HDL activates lecithin - cholesterol acyltransferase (LCAT)?
Malassezia furfur (treat with selenium sulfide)
apo A-1
Temporal arteritis
Diazoxide

13. Do the following structures pick up stain from hematoxylin or eosin? - Thyroid colloid
Eosin
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
The outer cortex contains most of the germinal centers and therefore also most B cells.
Ampulla

14. What cell in chronic inflammation is derived from blood monocytes?
LVEDV and LVEDP (left ventricular end - diastolic volume and end - diastolic pressure - respectively)
Mycoplasma
Osteoarthritis
Macrophages

15. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH decreased - Ca2+ increased - Pi increased
Common peroneal nerve
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.
Secondary hypoparathyroidism (vitamin D toxicity)
urease positive

16. What IL is important in myeloid cell development?
Thrush
Duchenne muscular dystrophy (Remember - Becker's is slower in progress - less severe - later in onset - and lacks cardiac involvement.)
IL-3 (3 face down is an M)
5HT1D

17. Name the macrophages by location: x Kidney
Type II pneumocytes
In the first 3 months
gag gene
Mesangial macrophages

18. In an adult - Where does the spinal cord terminate and What is it called?
The conus medullaris terminates at the level of the second lumbar vertebra.
Left colic - superior rectal - and sigmoidal arteries
Sarcoidosis
From age 5 onward IQ stabilizes.

19. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Clinical disorders (e.g. - schizophrenia)?
Major
CN III
Axis I
Cystadenocarcinoma

20. The first area affected during hypoxia.
Popliteus
Reinforcement
Hepatitis D
The central vein of the liver lobule

21. What gluconeogenic mitochondrial enzyme requires biotin?
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.
Pyruvate carboxylase
Xanthine oxidase
Pimozide

22. What muscles make up the rotator cuff?
The venae recta maintain the gradient via countercurrent flow.
Prolactinoma
SITS
H1 histones

23. What is the only tongue muscle innervated by CN X?
Paroxysmal nocturnal hemoglobinuria
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
Purulent exudates
1. Cefamandole 2. Cefoperazone 3. Moxalactam

24. What segment of the small intestine is associated with Brunner's glands?
CD28
Histiocytes
Ethacrynic acid
Duodenum

25. What are the genetic variants of a molecule within members of the same species?
Acanthosis nigricans
The Beta -2- microglobin. It is the separately encoded Beta - chain for class I Ags.
Allotypes
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.

26. What three factors do Sertoli cells produce for normal male development?
Melanoma - cancer of the stomach and bladder
Anopheles mosquito
Inhibin - m
Posterior compartment of the thigh - tibial nerve

27. When a person goes from supine to standing - what happens to the following? - BP
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Glucosyl cerebroside
Ventral posteromedial nucleus

28. What syndrome results if the enzyme ?-1- iduronidase is deficient? L- iduronate sulfatase deficiency?
Increases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
Hurler syndrome and Hunter syndrome - respectively

29. What portion of the intervertebral disk is a remnant of the notochord?
Plasmodium malariae; the others are tertian.
Nucleus pulposus
Argyll Robertson pupils
Without children (but don't think about this one for too long)

30. What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex- mediated; and is seen as lumpy- bumpy subepithelial deposits?
Glucose
Postinfectious GN
Aedes mosquito
Thyroid gland

31. Blood and its vessels form During What embryonic week?
Third week; they are derived from the wall of the yolk sac.
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
They innervate skeletal muscle.
GLUT 4

32. What type of muscle is characterized by no myoglobin - anaerobic glycolysis - high ATPase activity - and large muscle mass?
Primary hyperparathyroidism
White muscle; short term too
Pontocerebellar angle syndrome
Borderline

33. What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?
Volvulus
Schizoid
Smoking
Toxoplasmosis

34. What is the physiologically active form of Ca2+?
Free ionized Ca2+
DiGeorge's syndrome
Membranous glomerulonephritis
Impotence

35. Increases your risk factor for testicular cancer.
Streptococcus pyogenes
The CD4 T cell; the APC is the first cell in the immune response.
Being a white male
Dilation of afferent arteriole

36. What AD disorder is characterized by degeneration of GABA neurons in the caudate nucleus resulting in atrophy - chorea - dementia - and personality changes?
Superior olivary nucleus
Stapes artery
Huntington disease
Liquids - CHO - protein - fat

37. What hereditary bone disorder is due to decreased osteoclast function - resulting in thick - sclerotic bones that fracture easily?
Adrenarche
Osteopetrosis (Albers - Sch
Left homonymous hemianopsia
Antisocial personality

38. What is the name of the major chemotactic agent released from x Neutrophils?
Cori cycle
Leukotriene B4 (LTB4)
The basilar artery is formed at the pontomedullary junction.
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors

39. Name the product or products of arachidonic acid: x Chemotactic for neutrophils
LTB4
Pyrantel pamoate
Microglial cells
Lingual nerve of CN V3

40. What type of mortality rate is defined as the number of deaths x From a specific cause per number of persons with the disease?
C3 - C4 - and C5 keep the diaphragm alive!
FSH
GLUT 4
Case fatality rate

41. Name the DNA virus x Linear dsDNA; nuclear envelope; icosahedral; replicates in the nucleus
Herpes virus
First - pass effect
Streptococcus viridans
Pearson correlation

42. What type of saliva is produced under parasympathetic stimulation?
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Parvovirus
1. The child poses an imminent danger to self or others. 2. The child is unable to self - care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety e

43. What deep cerebellar nuclei receive Purkinje cell projections in x The flocculonodular lobe?
Ascaris lumbricoides
The lateral vestibular nucleus
Latency stage (6-12 years)
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids

44. What enzyme of the purine salvage pathway is deficient in the following? - Lesch - Nyhan syndrome
Chromosome 14 - 18
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
C- peptide levels
HGPRT

45. What two glycolytic enzymes catalyze the substrate - level phosphorylations?
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
Glutamate dehydrogenase
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)

46. What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs?
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
Chromosome 5 - 21
Ligamentum venosum
Auspitz sign

47. What naturally occurring substances mimic the effects of opioids?
Enkephalins
hCS and serum estriol - which are produced by the fetal liver and placenta - respectively - are used as estimates of fetal well - being.
Idiotypes
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)

48. What phase of the menstrual cycle is dominated by estrogen? Progesterone?
Squamous cell carcinoma (skin - lung) and angiosarcoma of the liver
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Medial medullary syndrome
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.

49. Name the RNA subtype based on the following: x Carries AA to the ribosome for protein synthesis
tRNA
Squamous cell carcinoma
LH
On the superior body of the posterior wall of the uterus

50. What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
The respiratory system
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
CD40