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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 venous and arterial stretch receptors' function regarding the secretion of ADH?
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.
Cholera toxin
Abs to HBsAg
Hypospadia

2. What adult structures are derived from preotic somites?
Muscles of the internal eye
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Left coronary artery
The primitive streak grows caudal to rostral.

3. Why is the clearance of creatinine always slightly greater than the clearance of inulin and GFR?
Prevalence increases. (Incidence does not change.)
Inhibited orgasm
Because creatinine is filtered and a small amount is secreted
G0 phase

4. What vein is formed by the union of the right and left brachiocephalic veins?
Intraductal papilloma
MGB
Alanine cycle
Superior vena cava

5. What MAOI does not cause a hypertensive crisis?
Phase 1
The enzyme phenyl ethanolamine N- methyltransferase (PNMT) - used in the conversion of epinephrine - is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Selegiline

6. With which DNA virus are Guarnieri bodies associated?
Variola (smallpox)
Multiple sclerosis
90% of benign myxomas arise within the left atrium near the fossa ovalis.
Nucleus ambiguus - resulting in the uvula deviating away from the side of the lesion.

7. What are the glycoprotein receptors that platelets and fibrinogen cross - link to when forming a thrombus?
Utricle and saccule
Ego syntonic
Pancreatic insufficiency
GP IIb and IIIa receptors

8. What is the most common one? - Congenital heart defect in adults
ASD
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex) - but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only c
The alveoli at the base are small and very compliant - so there is a large change in their size and volume and therefore a high level of alveolar ventilation.
CD4+ T cells (helper)

9. What is the neurotransmitter at the
Cryptococcus
Beta- Endorphin
Operant conditioning (reinforcement is after a response)
They are all formed by the fifth month of fetal life.

10. What is the major hormone produced in the following areas of the adrenal cortex? - Zona glomerulosa
Rhombencephalon
EBV
Breast cancer
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

11. What is the most common one? - Complication of nasogastric tube feeding
Aspiration pneumonia
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.
Sickle cell disease
Granulosa cell tumor of the ovary

12. What is the major cell membrane sterol found in fungi?
Voltage - gated sodium channel
Rifampin
Calcitriol
Ergosterol

13. What enzyme catalyzes the rate - limiting step in the TCA cycle?
Isocitrate dehydrogenase
Flutamide
Impaired ejaculation
Huntington disease

14. What is the term for failure of the testes to descend into the scrotum?
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
Cystadenocarcinoma
The Beta- subunit; remember - the a - subunit is nonspecific.
Staphylococcus aureus

15. What area of the retina consists of only cones and has the greatest visual acuity?
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available - but the renal collecting ducts are impermeable to its actions.
Fovea
ACh
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

16. Name the most common type or cause - Cystitis
Homeodomain proteins
HHV 8
Legionella
Escherichia coli

17. With what stage of sleep are nightmares associated?
Hemostasis
Puberty
REM sleep. Nightmares are frightening dreams that we recall.
Fibrinoid necrosis

18. What antimuscarinic is used as an inhalant for asthma?
Ipratropium
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)
Simple diffusion; it does not use protein - mediated transport
Superior and posterior

19. What vessels in the systemic circulation have the greatest and slowest velocity?
Cohort studies determine incidence and causality - not prevalence.
HPV
The aorta has the greatest velocity and the capillaries have the slowest velocity.
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).

20. What artificial sweetener must patients with PKU avoid?
Aspartame
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
Proportionate mortality rate
Gonads

21. What element is needed for the proper alignment of tropocollagen molecules?
Contralateral loss below and bilateral loss at the level of the lesion
Copper (Cu+)
Biofeedback
5HT1D

22. At What age does a child develop x Endogenous smile?
At birth (reflex)
Helicase (requires ATP for energy)
Chromosome 15 - 17
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.

23. Most sleep time is spent In what stage of sleep?
C1 inhibitor (C1- INH)
Stage 2 - which accounts for approximately 45% of total sleep time - with REM occupying 20%.
Glycerol kinase
Anticipation - associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.

24. What is the most common one? - Vasculitis
CN III - IV - and VI
Haemophilus influenzae type B
Temporal arteritis
Glucagon

25. What two pituitary hormones are produced by acidophils?
GH and prolactin are produced by acidophils; all others are by basophils.
Endometriosis
produce bile
Rhabdovirus

26. What type of muscle contraction occurs when the muscle shortens and lifts the load placed on it?
Isotonic contraction
Pneumocystis carinii
Fixed ratio (rewards set behaviors)
CN III - IV - and VI

27. Describe the loss for each of the following in a hemisection of the spinal cord. (Brown - S
GnRH pulsatile infusion
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
Ipsilateral loss below the level of the lesion
Leukemias

28. What is the term for the number of Ag - binding sites on an Ig?
Valence
Type IV collagen
Borderline
IL-10

29. What is the most common one? - Primary malignant tumor of the female genital tract in the United States
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
Mentally disabled
Adenocarcinoma of the cervix
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP

30. What disease is associated with the HLA- DR2 and HLA- DR3 alleles
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)
Week four - and they remain dormant there until puberty.
Systemic lupus erythematosus
The sensory limb is via CN IX - and the motor limb is from CN X.

31. What direct - pathway basal ganglia disease is described by masklike facies - stooped posture - cogwheel rigidity - pill - rolling tremor at rest - and a gait characterized by shuffling and chasing the center of gravity?

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32. Name the hormone
Glucagon
2 NADPHs per acetyl CoA
Stable angina
All are lactose fermenters except Yersinia and Proteus.

33. What cell type involves humoral immunity?
B lymphocyte
1. 7- methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns
1. Liver 2. Kidney 3. Pituitary gland (via 5'- deiodinase enzyme)
Dysgerminoma

34. What cell in the heart has the highest rate of automaticity?
Depolarization (i.e. - Na+ influx)
SA node; it is the reason it is the primary pacemaker of the heart.
Leuprolide
Ovarian cancer

35. Name the antidote - Warfarin
Urogenital folds
Pearson correlation
Vitamin K
Megaloblasts

36. Have analgesic - antipyretic - anti - inflammatory - and antiplatelet activities.
Regardless of the rate of infusion - it takes 4 to 5 half - lives to reach steady state.
NSAIDs
Pneumotaxic center (short - fast breaths)
No - unsaturated fatty acids have double bonds.

37. What splanchnic carries preganglionic parasympathetic fibers that innervate the hindgut and the pelvic viscera?
Pelvic splanchnics (They all begin with P.)
Dorsal prefrontal cortex
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.)
Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine.

38. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Naphthylamine
Coxsackie A
Rheumatoid arthritis
Bladder cancer
Multiple myeloma

39. What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade?
After the latent period
They prevent mast cell degranulation.
Subclavian vein
In the tuberoinfundibular pathway - dopamine release will decrease prolactin release - Which is why dopamine agonists are used in the treaatment of hyperprolactinemic states.

40. What are the two leading causes of cancer - related death in women?
EBV
Breast and lung cancer - respectively.
16S subunit
Hepatocellular carcinoma is associated with hepatitis B and C infections - not with EBV.

41. 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?
Dorsal motor nucleus of CN X
The resistance increases 16- fold.
Celiac - aorticorenal - and superior mesenteric ganglias. (Remember all ' Splanchnics' are Sympathetic except for the Pelvic splanchnics - which are Preganglionic Parasympathetic fibers.)
Hot pink with PAS and grey to black with silver stain

42. From What do catalase - superoxide dismutase - and glutathione peroxidase defend the cell?
Production of oxygen free radicals
Site 4
Actinomyces israelii
Hypocalcemia and hypophosphatemia

43. What is the period between falling asleep and REM sleep called?
HPV serotypes 1 and 4
Transposons
Hydralazine
REM latency; normally it is about 90 minutes.

44. What is the term for ascending bacterial infection of the renal pelvis - tubules - and interstitium causing costovertebral angle tenderness - fever - chills - dysuria - frequency - and urgency?
Potency
From age 5 onward IQ stabilizes.
T9
Pyelonephritis

45. Name the area of the cerebral cortex with the function described: x Recall of objects - distances - and scenes; visual input processed here
Strongyloides stercoralis is treated with thiabendazole.
Apneustic center (deep breathing place)
Pulmonary infections
Occipital lobe

46. What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
The granule cell. Its neurotransmitter is glutamic acid - Which is also the principal neurotransmitter of the visual pathways.
Raloxifene
Suprachiasmatic nucleus
Mesonephric duct

47. What parasite found in raw fish can produce vitamin B12 deficiency?
Diphyllobothrium latum
M
SER
1. Propranolol 2. Timolol 3. Carteolol

48. What is the only organ in the body supplied by preganglionic sympathetic fibers?
Metanephros
Lithium
Adrenal medulla
Non - Hodgkin lymphoma

49. What is used as an index for both adrenal and testicular androgens?
C3a - C4a - and C5a
Cholesterolosis
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.
Urinary 17- ketosteroids

50. What is the DOC for CMV retinitis?
DNA polymerase - a
Ganciclovir
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
Free polysomes. Membrane - associated polysomes are the site of protein synthesis destined to leave the cell.