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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 microaerophile is a motile gram - negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)?
Streptococcus viridans
Campylobacter jejuni
Axis III
Epstein - cardiac anomaly of the tricuspid valve

2. If you report a suspected case of child abuse and are wrong - are you protected from legal liability?
Minimal change disease
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
Yes
Postductal coarctation of the aorta (adult)

3. Aschoff bodies
Rheumatic fever
Humerus with ulna (major) and radius (minor)
Homocysteine methyl transferase and methylmalonyl CoA transferase
Atelectasis

4. What enzyme is deficient in patients with CGD?
Permanent
NADPH oxidase is deficient - resulting in an inability to produce toxic metabolites.
Ventral lateral nucleus
Schatzki ring

5. What type II hypersensitivity disorder is defined as x Autoantibodies directed against the TSH receptor?
PRPP aminotransferase
Brucella and Listeria (has tumbling motility)
Graves disease
Waterhouse - Friderichsen syndrome

6. What is the only DNA virus that does not replicate its DNA in the nucleus of the host cell?
Erythema nodosum
Thrombocytopenia - eczema - and immunodeficiency is the triad of this X- linked recessive disorder.
Poxvirus replicates its DNA in the cytoplasm.
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.

7. What has occurred to the renal arterioles based on the following changes in the GFR - RPF - FF - and glomerular capillary pressure? - GFR ? - RPF ? - FF ? - capillary pressure ?
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
Dilation of efferent arteriole
Dopamine antagonists
TAT (Thematic apperception test)

8. Name the most common type or cause - Chancre
Shifts it to the right
Haemophilus ducreyi
Atrial contraction Atrial - Contraction - Venous
Microglial cells

9. Progesterone has __________ activities.
Thermogenic
Flucytosine
Avidity. There is a positive correlation between valence numbers and avidity.
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.

10. What is the drug of choice for hypertensive patients with a decreased renal function?
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore - they are not used if a patient has hypertriglyceridemia.
CN XII
a - Methyldopa (Guanabenz or clonidine is also used.)
Trapezius and sternocleidomastoid

11. What are the two MCC of acute epididymitis in males? - More than 35 years old
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
Ischemic heart disease (MIs)
Escherichia coli and Pseudomonas sp.
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.

12. What is the first Ab a baby makes?
Meckel diverticulum
Bell pad
Cardiac muscle
IgM

13. What are the adult remnants of the following structures? - Left umbilical vein
Preload. It is the load on a muscle Prior to contraction.
Ciliary ganglion producing a tonic pupil
Malassezia furfur (treat with selenium sulfide)
Ligament teres

14. What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?
Syringomyelia
Gonads
Gaucher disease
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).

15. What substrate gets built up in Gaucher's disease?
Alcoholics Anonymous
Glucosyl cerebroside
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern - my senior resident asked me this question more times than I would like to remember.)
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.

16. What term describes the volume of plasma From which a substance is removed over time?
Ergotamines
Posterior hypothalamic zones; lesions here result in poikilothermy (environmental control of one's body temperature).
Clearance
Free ionized Ca2+

17. What form of diabetes insipidus is due to an insufficient amount of ADH for the renal collecting ducts?
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available - but the renal collecting ducts are impermeable to its actions.
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
Hapten; if it is coupled with a carrier - it may become immunogenic.
Aspiration

18. Acts as the vertebral body of C1 allowing lateral rotation of the head. The first cervical vertebra has no vertebral body.
The odontoid process of C2
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).

19. What are the five F's associated with gallstones?
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
Yes
By asking a patient to close the eyes while standing with feet together
White muscle; short term too

20. Which diuretic is used as an adrenal steroid antagonist?
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
Spironolactone
Autosomal dominant
Ferrochelatase

21. What is the size of the prokaryotic ribosome?
Sphingosine
Cardiac muscle
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes

22. Name the associated chromosome - Niemann - Pick disease
Burkitt lymphoma
Site 1
Chromosome 11p
Minimal change disease

23. What testicular tumor of infancy is characterized by elevated - fetoprotein levels and Schiller - Duval bodies?
Yolk sac tumor
Gonads
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.
prior to birthThe foramen ovale closes just...

24. What subtype of schizophrenia is characterized by x Stuporous mute echopraxia and automatic obedience - waxy flexibility with rigidity of posture?
Gastric ulcer
Middle
Pyrantel pamoate
Catatonic schizophrenia

25. Name the area of the cerebral cortex with the function described: x Recall of objects - distances - and scenes; visual input processed here
Occipital lobe
The CD4 T cell; the APC is the first cell in the immune response.
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
Naloxone or naltrexone

26. What disorder of aldosterone secretion is characterized by x Increased total body sodium - ECF volume - plasma volume - BP - and pH; decreased potassium - renin and AT II activity; no edema?
Estrogen use
Mycobacterium leprae
embranoproliferative glomerulonephritis (MPGN)
Primary hyperaldosteronism (Conn syndrome)

27. What cytokine do CD4 T cells secrete to activate B cells when the specific peptide in the groove of the MHC II molecule interacts with the TCR?
IL-4 is secreted to activate B cells. This begins the second step in the immune response - known as Activation. CD4 T cells secrete INF- alpha to activate macrophages
Serratus anterior
False - positive rate
Small cell carcinoma (oat cell)

28. A patient goes to the ER with signs and symptoms of biliary colic. Which opioid analgesic do you choose?
Vitamin B 6 (pyridoxine)
12 days after ovulation
Thoracic and sacral
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.

29. Can advance directives be oral?
Arthroconidia with hyphae
Yes
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)
Basal ganglia

30. Movement disorders are associated with what dopamine pathway (What part of the brain)?
Nigrostriatal pathways (basal ganglia)
Succinyl CoA
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis - or IHSS)
Pyrantel pamoate

31. Which of the following is not part of the conducting portion of the respiratory system: trachea - bronchi - alveoli - or larynx?
Subarachnoid hemorrhage
Alveoli; they are part of the respiratory portion.
Negative selection. This helps to prevent autoimmune diseases.
HPV infection

32. What is the relationship between ventilation and PCO2 levels?
ASD
They are inversely related. If ventilation increases - there will be a decrease in PCO2 levels and vice versa.
True hermaphrodism
Desipramine

33. Which PG is associated with maintaining a PDA?
Erythema multiforme
No change in length
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin - ACh - and catecholamines promote closure of the ductus arteriosus.
Aspartate transcarbamylase

34. What embryonic structure forms the adult female structures? - Uterine tube - uterus - cervix - and upper third of the vagina
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.
Liquefaction necrosis
Paramesonephric ducts
Diverticulosis

35. What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?
Pseudogout
Eaton - Lambert syndrome
Labile
Infliximab

36. What is the best measure of total body vitamin D if you suspect a deficiency?
PGE (along with low oxygen tension)
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
Serum 25- hydroxy- vitamin D (25- OH- D)
Dissecting aortic aneurysm. MI is also high on the list - but these are buzzwords to look for dissection.

37. Schiller - Duval bodies
Rheumatoid arthritis
Yolk sac tumor
Riboflavin (B2) deficiency
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine

38. Which IL increases IgA synthesis?
gram positive
4.5 years old (Alphabetic order except with a diamond last: circle - cross - rectangle - square - triangle)
None; they are not formed until a girl reaches puberty.
IL-5. It also stimulates eosinophil proliferation.

39. Blue - domed cysts
Fibrocystic change of the breast
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
Decreases
CD14

40. What is the most common one? - Pituitary adenoma
Axis II
Preload (the load on the muscle in the relaxed state)
Prolactinoma
Diabetes mellitus

41. Name the most common type or cause - Restrictive cardiomyopathy
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
Streptomycin
Amyloidosis
Area 6

42. Is DM a contraindication to use of a Beta- blocker in a patient who is having an MI?
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Maxillary artery
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
Physostigmine

43. What lysosomal enzyme is deficient in x Tay- Sachs disease?
Lactose must be present and glucose must be absent
Proencephalon
Hexosaminidase A
DiGeorge's syndrome

44. What type of bilirubin is found in neonatal jaundice?
Indirect or unconjugated
Diphenhydramine
Ductus epididymis - Which is lined by pseudostratified epithelium with stereocilia.
Leukotriene B4 (LTB4)

45. What seronegative spondyloarthropathy is seen in HLA- B27- positive young females and presents with the triad of conjunctivitis - urethritis - and arthritis affecting the knees and ankles?
Nodular sclerosis
Physostigmine
Reiter syndrome
Tetracycline

46. During What embryonic week does the intraembryonic coelom form?
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
Third week
Valine
Doxycycline

47. Name the compartment of the mediastinum associated with the following thoracic structures: Brachiocephalic vein
AT II
Vancomycin
CD4
Superior

48. Are the following responses associated with histamines H1 or H2 receptor activation? - Edema
Sacrococcygeal teratoma
H 1
Squamous cell carcinoma
Acting out

49. What are the five pieces of information considered necessary for fully informed consent?

50. What slow - growing CNS tumor in 30- to 50-year - old patients with a long history of seizures has fried egg cellular appearance in a network of chicken wire?
Increase the concentration of enzymes
Excision endonuclease - which removes thiamine dimers from DNA
Oligodendroglioma
Fluconazole