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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 most common one? - Acquired GI emergency of infancy
Mesolimbic system
BPH
Procainamide
Necrotizing enterocolitis

2. What pyrimidine base is found x Only in DNA?
Diethylcarbamazine
Thymine
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent - so no one knew What the patient would have wanted. Therefore - the decision was based on What a 'reasonable' person would have w
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.

3. What is the most common one? - Histologic variant of breast cancer
Oxazepam - temazepam - and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation - not via the cytochrome p450 system.
Oxytocin
IgA
Infiltrating ductal carcinoma

4. When does cortisol secretion peak?
Phase 3
Truncus arteriosus
McArdle's syndrome
In early- morning sleep - usually between the sixth and eighth hours

5. What inhibitor of microtubule synthesis is the drug of choice for whipworm and pinworm?
Mebendazole
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
Listeria monocytogenes
The V/Q ratio increases - since the area is ventilated but hypoperfused as a result of the occlusion.

6. What hormone is characterized by the following renal effects? - Calcium reabsorption - phosphate excretion
Vibrio parahaemolyticus
Azathioprine
G0 phase
PTH

7. What hormone controls relaxation of the lower esophageal sphincter during swallowing?
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
Transcription factor IID
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
Rochalimaea quintana (now called Bartonella quintana)

8. Fluoroquinolones are...
Bactericidal
Benign lentigo
Social learning theory
Menstruation

9. In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
Asbestosis and silicosis
Malignant mesothelioma
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.
Cestodes

10. What term is an index of the effort needed to expand the lungs (i.e. - overcomes recoil)?
Bronchogenic carcinoma
Posterior cricoarytenoid muscles
Compliance; the more compliant a lung is - the easier it is to inflate.
Cirrhosis

11. If a mother delivers a Rho - positive baby - she should receive...
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.
Rho-immunoglobin
Projective test. Most tests with a wide range of possibilities for the answers are projective.
Flucytosine

12. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Myelencephalon
Anterior wall of the first part of the duodenum
Rhombencephalon
Sj
Correlation. No - correlation does not imply causation.

13. The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?
CD28
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.
Positive correlation
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.

14. In a topographical arrangement of the cerebellar homunculus map - What area or lobe x Controls the axial and proximal musculature of the limbs?
The vermis
Mitochondria
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Erythromycin

15. What thyroid enzyme is needed for oxidation of I- to I'?
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA- dependent RNA polymerases.
Peroxidase - Which is also needed for iodination and coupling inside the follicular cell
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e. - pill rolling) is seen in basal ganglia lesions.
Isocitrate dehydrogenase

16. What are the three left - to - right shunts?
1. VSD 2. ASD 3. PDA
Avidity. There is a positive correlation between valence numbers and avidity.
secondary immune response
High average

17. What is the amount in liters and percent body weight for the following compartments? - ECF
Excision endonuclease - which removes thiamine dimers from DNA
Oncotic pressure increases because of the removal of water.
14 L - 33% of body weight
T cells - B cells - and macrophages

18. What are the two most important features in the diagnosis of malaria?
Splenomegaly and anemia (with a high index of suspicion)
Substituted judgment. It is made by the person who best knows the patient - not the closest relative.
Sertoli cell
EBV

19. Do the following structures pick up stain from hematoxylin or eosin? - Collagen
Eosin
Breast
Aspiration pneumonia
Osteogenesis imperfecta

20. Name the type of exudate - given the following examples - Parasitic infection
Inferior Oblique (CN III) (LR6 SO4)3
Type II hypersensitivity (cytotoxic)
2 to 4 hours
Eosinophilic exudates

21. What disorder is associated with loss of polarity - anaplasia - pleomorphism - discohesiveness - increase in the nuclear:cytoplasmic ratio - hyperchromasia - and increase in the rate of mitosis?
Hepadnavirus
Malignancy
Bender Visual Motor Gestalt Test
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.

22. What is the second cell involved in the immune response?
Accessory nucleus
The CD4 T cell; the APC is the first cell in the immune response.
Ristocetin
Clostridium botulinum

23. How many months in How many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
NE
3 months of symptoms in 2 consecutive years
PICA
Biofeedback

24. 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 ?
Mitosis
Nephroblastoma
Constriction of afferent arteriole
CN VII and VIII

25. What is the most common one? - Form of necrosis
Shine - Dalgarno sequence
Isovolumetric contraction
Small cell cancer of the lung
Coagulative

26. What are known as jumping genes?
Hypervariable region (three per light chain; three per heavy chain)
Follicular lymphoma
Parasympathetic
Transposons

27. At What age does IQ stabilize?
Malignancy
enveloped
Glucuronidation
From age 5 onward IQ stabilizes.

28. Name the antidote - Heparin
Protamine sulfate
Dorsal prefrontal cortex
Chromium (Cr)
Macule (e.g. - a freckle)

29. What segment of the nephron has the highest concentration of inulin? Lowest concentration of inulin?

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30. What protein catalyzes the formation of the last PDE bond between the Okazaki fragments to produce a continuous strand?
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
DNA ligase
Eisenmenger syndrome - which can also occur with any left - to - right shunt
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)

31. Name the hepatitis virus based on the following information - Enveloped DNA hepadnavirus
HBcAb IgM
Plasmodium falciparum
Hepatitis B
T cells - B cells - and macrophages

32. What are the two essential fatty acids?
1. Decrease alpha -1 activity 2. Increase Beta -2 activity 3. Increase ACh levels
Erythema multiforme
Linoleic acid and linolenic acid
Sympathetic nervous system

33. What is the second leading cause of death in children aged 1 to 14 in the United States?
Poststreptococcal GN
Clostridium botulinum
Cancer
HBc Ab

34. What is the major Ig of the secondary immune response in the mucosal barriers?
300 mOsm/L
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius
IgA

35. With a decrease in arterial diastolic pressure - what happens to x TPR?
Frontal lobe
Antisocial personality
Decreases
Popliteus

36. What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
Xanthine oxidase
Positive reinforcement
Heroin
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.

37. What two muscles do you test to see whether CN XI is intact?
Trapezius and sternocleidomastoid
Abs to HBsAg
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
Janeway lesions

38. What are the three sites where CSF can leave the ventricles and enter the subarachnoid space? (Name the lateral and the medial foramina.)
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)
Stage 4
Thymic epithelial cells - dendritic cells - and macrophages
Hepatitis B

39. What is the name of the postganglionic parasympathetic ganglion that innervates x The submandibular and sublingual glands?
Collecting ducts - which make them readily permeable to water reabsorption.
Estrogen use
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Appendix (second is terminal ileum)

40. What embryonic structure forms the following adult structures? - Urinary bladder and urethra
Menses
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Urogenital sinus
Hepatitis - with or without necrosis

41. What cells of the kidney are extravascular chemoreceptors for decreased Na+ - Cl - - and NaCl?
Macula densa
The bifurcation of the abdominal aorta
Job syndrome
Adenocarcinoma (because of Barrett esophagus)

42. What two glycolytic enzymes catalyze the substrate - level phosphorylations?
Mode
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Parietal cells (Remember - they secrete HCl - too.)
Posterior cricoarytenoid muscles

43. Name the reaction that appears in babies who are temporarily deprived of their usual caretaker. (This reaction usually begins around 6 months of age - peaks around 8 months - and decreases at 12 months.)
Separation anxiety
CMV retinitis and HSV-2
Expressive aphasia
Copper

44. What is the most common diagnosis made (or missed!) resulting in a malpractice suit?
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
Breast cancer
Fibrous pericardium
T cells - B cells - and macrophages

45. Ophthalmic artery is a branch of What artery?
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
Protein A
Internal carotid artery
Climbing fibers; - they are monosynaptic input on Purkinje cells. Mossy fibers - also excitatory - are axons of all other sources and synapse on granule cells.

46. What is the term for different classes and subclasses of the same gene products?
Isotypes
Displacement
Streptolysin O
Case fatality rate

47. What are the rules of 10 regarding pheochromocytoma?
Eosin
10% are bilateral - 10% malignant - and 10% familial - 10% in children - and 10% outside the adrenal gland
Type III hypersensitivity (immune complex)
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).

48. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Dorsal root?
Sensory
Introjection (a sports fan is a good example)
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose -1 - 6- bisphosphatase 8. Glucose -6- phosphatase
Probenecid

49. What potentially lethal side effect of clozapine should be monitored with frequent blood drawing?
Alteplase
Right atrium
Agranulocytosis; approximately 2% develop this side effect.
Hormone secretion for T- cell differentiation and T- cell education to recognize self from nonself

50. What is the most common one? - Site for carcinoid tumors
Unconjugated free bilirubin
Obturator nerve
Pons
Appendix (second is terminal ileum)