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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. Megaloblastic anemia and thrombocytopenia are signs of what vitamin deficiency?
Diethylcarbamazine
ATP production
Folic acid deficiency
Hepatic adenomas

2. The opening of what valve indicates the termination of isovolumetric relaxation phase of the cardiac cycle?
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
2 - 4- Dinitrophenol
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns
Insulin

3. Name the associated chromosome - Chronic lymphocytic leukemia (CLL)
Chromosome 12
Metastatic
Antisocial
Smooth muscle

4. What is the name of the tremor that occurs during movements and is absent while the person is at rest?
Astrocytes
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e. - pill rolling) is seen in basal ganglia lesions.
In men it is prostate cancer - and in women it is breast cancer.
hCG

5. In the mitochondria - what complex is needed for pyruvate carboxylase to catalyze the reaction from pyruvate to OAA?
Biotin - ATP - and CO2
No change in length
Shortens
Chromosome 19

6. What is the maximum rate possible with a given amount of enzyme?
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Third M PITS for pharyngeal pouch derivatives
Viruses
Vmax

7. What is the amount in liters and percent body weight for the following compartments? - Interstitial fluid
9.3 L - 15% of body weight
hCS and serum estriol - which are produced by the fetal liver and placenta - respectively - are used as estimates of fetal well - being.
Left homonymous hemianopsia
igantism

8. What antiviral agent for ganciclovir - resistant infections has limited utility because of its nephrotoxic side effect?
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
Foscarnet
Proencephalon
Eclipse period

9. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Skeletal muscle
Permanent
Carnitine acyltransferase I
prior to birthThe foramen ovale closes just...
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).

10. On what chromosome is the adenomatous polyposis coli gene?
Prefrontal cortex; it is in front of the premotor area.
Chromosome 5q21
Fructose -1 - 6- bisphosphatase
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)

11. 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)
In the JG cells of the kidney
Depolarization is from apex to base and from endocardium to epicardium.
Nondominant parietal lobe
Enkephalins

12. What happens to the following during skeletal muscle contraction? - Sarcomere
Sheehan syndrome
Shortens
Gastric carcinoma
Intussusception

13. What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin?
Griseofulvin
Ipratropium
Chi - square (when you are in doubt and have nominal data - use chi - square)
ater flows from a low - solute to high - solute concentrations.

14. What cells of the retina sees in color and needs bright light to be activated?
Calcium oxylate
Aortic insufficiency
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
Cones (C for color and cones)

15. Gas gangrene is associated with which Clostridium species?
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion - patients sway with eyes closed. (Don't forget this one.)
Collecting ducts - which make them readily permeable to water reabsorption.
Ag - Ab binding
Clostridium perfrigens

16. Which protein prevents internal binding of self proteins within an MHC class II cell?
Smoking
Invariant chain
Plasmodium vivax
Fluconazole

17. What type II hypersensitivity disorder is defined as x Autoantibodies directed against the TSH receptor?
The thyroid gland
G-6- PD deficiency; pyruvate kinase deficiency is second.
Dilator pupillae muscle
Graves disease

18. What subtype of schizophrenia is characterized by x Stuporous mute echopraxia and automatic obedience - waxy flexibility with rigidity of posture?
Primary intention
Catatonic schizophrenia
There are 10 bronchopulmonary segments on the right and 8 on the left.
Stranger anxiety

19. Name the T- cell CD marker: Is a costimulatory molecule in T cell activation
Chloramphenicol
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
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
CD28

20. What is the term for hypoperfusion of an area involving only the inner layers?
Mural infarct
Inferior rectus (CN III) (LR6 SO4)3
Decreases
Epstein - cardiac anomaly of the tricuspid valve

21. Which bacteria are associated with the following pigment production? - Black - gray pigmentation
Water
Syphilitic
Corynebacterium diphtheriae
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.

22. What is the most common one? - Organism associated with mastitis
Type III hypersensitivity (immune complex)
Staphylococcus aureus
Epstein - cardiac anomaly of the tricuspid valve
Carbamazepine

23. What leukemia affects a 4-year - old child with 3 months of fever - fatigue - generalized lymphadenopathy - CNS involvement - hepatosplenomegaly - bleeding - and platelet count below 100 - 000?
ll
Two - way ANOVA. It allows the test to check several variables at the same time.
Metastatic carcinoma
Albendazole

24. What enzyme deficiency results in darkening of the urine when exposed to air?
Chromosome 19
Chlamydia
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
cDNA - when it is made from mRNA

25. What direction would the tongue protrude in a left CN XII lesion?
Tetany
Astrocytes
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).
The urea cycle

26. What aerobic branching rod that is gram positive and partially acid - fast is associated with cavitary bronchopulmonary disease in immunosuppressed patients?
Cause - specific mortality rate
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Nocardia asteroides
Public speaking (Remember: stage fright)

27. What is the only excitatory neuron in the cerebellar cortex - and What is its neurotransmitter?
Chlamydia
Dopamine
a1- Receptors
The granule cell is the only excitatory neuron in the cerebellar cortex - and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons - and they use GABA as their neurotransmitter.

28. What vitamin deficiency is evidenced by poor wound healing - loose teeth - bleeding gums - petechiae - and ecchymosis?
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
Third week
Silicosis - Coal worker's pneumoconiosis is synonymous with black lung disease - an upper lobe occupational disorder
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.

29. To What does failure to resolve separation anxiety lead?
Homeodomain proteins
Frontal lobe
14 L - 33% of body weight
School phobia

30. What type of bias is it when the information is distorted because of the way it is gathered?
Lateral collateral ligament
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)
Lewy bodies
Measurement bias

31. What cells of the thyroid gland are stimulated in response to hypercalcemia?
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Membranous glomerulonephritis
Increased GABA levels decrease the likelihood of learned helplessness.
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.

32. Has very little effect on arteriolar dilation or constriction.
Neisseria gonorrhoeae
Clearance
The parasympathetic nervous system
Pertussis toxin

33. What is the term for an increase in the number of cells in a tissue?
Hyperplasia
Job syndrome
Thiabendazole
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent

34. What is the term for severe and protracted vomiting resulting in linear lacerations at the gastroesophageal junction?
Mallory- Weiss syndrome
The fast component is directed toward the affected side of a cerebellar lesion.
Circumvallate papillae
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain

35. Name the most common cause - Croup
Umbilical vein and ductus venosus (80%)
Stable angina
Parainfluenza virus
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)

36. Name the associated chromosome - Cystic fibrosis
Chromosome 7
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
IgG
Pseudogout

37. Are the following conditions associated with a negative or positive nitrogen balance? - AA deficiency
Epinephrine
Negative
Dimercaprol
Aspiration pneumonia

38. What structure of the knee is described thus? - Prevents anterior displacement and has lateral - to - medial attachment on the tibia
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
ACL
Bile pigments and bile salts
Nephroblastoma

39. Which type of cerebral herniation is associated with CN III palsy?
Transtentorial (uncal)
Stratum lucidum
Astrocytoma
Carbamazepine

40. A Japanese man has weight loss - anorexia - early satiety - epigastric abdominal pain - and a palpable left supraclavicular lymph node. On endoscopy you find a large - irregular ulcer with elevated margins on the lesser curvature of the stomach. What
Duchenne muscular dystrophy (Remember - Becker's is slower in progress - less severe - later in onset - and lacks cardiac involvement.)
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
Gastric carcinoma
Anemia of chronic disease

41. Councilman bodies
VIPoma
C3a - C4a - and C5a
In the medulla; all the other structures are cortical.
Toxic or viral hepatitis

42. What disorder is defined by inability of the lower esophageal sphincter to relax with swallowing and a bird beak barium swallow result?
Corticosteroid
The central vein of the liver lobule
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
Atracurium

43. Do you monitor heparin's therapeutic levels by PT or PTT?
Mebendazole
Temporal arteritis (giant cell arteritis)
Heparin - intrinsic pathway - PTT; warfarin - extrinsic pathway - PT (mnemonic: hPeT - wPiTT)
Adult polycystic kidney disease

44. What type of bias is it when the sample population is not a true representative of the population?
Odds ratio. (Case control studies deal with prevalence.)
Selection bias
Lipoid nephrosis
Lispro insulin

45. What part of the inner ear contains the gravity receptors for changes in the position of the head?
Corynebacterium diphtheriae
Blastoconidia
Saccule and utricle
Buerger disease (thromboangiitis obliterans)

46. What is the first branch of the abdominal artery?
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
Inferior phrenic artery
Schatzki ring

47. What gluconeogenic mitochondrial enzyme requires biotin?
Pyruvate carboxylase
VLDL
2 ATPs by oxidative phosphorylation
The fastigial nucleus

48. What vitamin is necessary for epithelial health?
Squamous cell carcinoma
Vitamin A is responsible for vision and epithelial health.
Risk factors for cervical cancer
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.

49. What is the physiologically active form of Ca2+?
Free ionized Ca2+
Axis IV
The vermis
Chromosome 15 - 17

50. What neuroleptic agent causes retinal deposits - hypotension - and torsades de pointes?
Thioridazine
Chromosome 5 - 21
Chlamydia
Primary sclerosing cholangitis