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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 DNA virus is associated with heterophile - negative mononucleosis?
CMV; remember - EBV is associated with heterophile - positive mononucleosis.
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
Translation
Primary follicle of the cortex

2. Damage to what nerve will give you winged scapula?
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
Chromosome 13
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
Areas 44 and 45

3. Orphan Annie cells
Tryptophan
Papillary carcinoma of the ovary
EBV
Calcium oxylate

4. How many pairs of spinal nerves are associated with x Cervical vertebrae?
Alendronate
Eosin
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
Pedophilia

5. Which two antipsychotic drugs create a high risk for developing extrapyramidal syndrome (EPS) side effects?
PALS (Parietolateral lymphocytic sheath)
Haloperidol and fluphenazine (but use of any high - potency phenothiazine runs the risk of EPS)
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase
CN V3 and the lesser petrosal nerve

6. What area of the hypothalamus is the feeding center?
Pyruvate carboxylase
The promoter indicates where transcription will begin.
Hypertension
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)

7. Which subset of MEN syndrome is associated with the following? - Medullary carcinoma of the thyroid - pheochromocytoma - and parathyroid adenomas (or hyperplasia)
Inferior phrenic artery
Hemophilia A
MEN IIa (or Sipple syndrome)
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.

8. What fungus is seen as colored cauliflower lesions?
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
HPVs 16 and 18
Lesser curvature of the antrum of the stomach
Chromomycosis

9. What is the drug of choice for steroid - induced osteoporosis?
Alendronate
Seminoma
Southern blot
Frotteurism

10. Neurofibrillary tangles
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)
Ovarian cancer
Alzheimer disease
The raphe nuclei

11. What lower extremity nerve is described by the following motor loss? - Loss of abduction of the hip resulting in Trendelenburg gait
Superior gluteal nerve
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
None; it degenerates.
Type II error (beta error). (Remember it as saying something doesn't work when it does.)

12. Is the coding or the template strand of DNA identical to mRNA (excluding the T/U difference)?
Adhesions and hernias
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
Nondominant parietal lobe
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.

13. What happens to free hormone levels when the liver decreases production and release of binding proteins?
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.
Conidia
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
Physostigmine

14. Which gram - negative diplococcus ferments maltose?
Phase 0
Meningococcus (Gonococcus does not)
Megaloblasts
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.

15. Name the most common cause - Dementia in persons aged 60 to 90 years
Doxycycline
Concentration force and electrical force
Superego
Alzheimer disease

16. What blotting technique uses the following for analysis? - Protein
1. VSD 2. ASD 3. PDA
PICA
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.
Western blot

17. Inhibits glucose uptake in skeletal muscle.
Chromosome 15 - 17
Cortisol
Beta2- Adrenergic agents
Reverse transcriptase

18. What is the term for a schizophrenic episode lasting longer than 30 days with full return to former functioning capacity?
Purine nucleoside phosphorylase
Site 3
Xanthine - hypoxanthine - theophylline - theobromine - caffeine - and uric acid are all purines.
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)

19. Starry sky pattern
Isoleucine - leucine - and valine
Burkitt lymphoma
Fo/F1 complex
Physiologic antagonism

20. What is the name of the exotoxin Shigella dysenteriae produces - which interferes with the 60S ribosomal subunit and results in eukaryotic protein synthesis inhibition?
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin - Which is quite similar to shiga toxin)
At the end of the PCT 25% of the original volume is left
Trypanosoma cruzi
Phosphofructokinase -1 and costs 1 ATP

21. What naturally occurring substances mimic the effects of opioids?
Enkephalins
CD14
Major
Retinoblastoma

22. Bloody tap on lumbar puncture
Subarachnoid hemorrhage
Occulta All except occulta cause elevated - fetoprotein levels.
Range
Malignancy

23. What are the most common causes of osteomyelitis x Overall?
Roth spots
Staphylococcus aureus
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
The optic disk is the blind spot.

24. At what vertebral levels does the aortic arch begin and end?
It both begins and ends at T4 (sternal angle [of Louis]).
Adenine and guanine
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.
Duodenal atresia

25. What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
Tylosis
ydroxyproline
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.
1. Liver 2. Kidney 3. Pituitary gland (via 5'- deiodinase enzyme)

26. The closure of what valve indicates the beginning of the isovolumetric relaxation phase of the cardiac cycle?
Cortisol
Stage fright (discrete performance anxiety)
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
Euchromatin - the dark stuff in the nucleus on an electron microscope image.

27. What is the main type of cell involved in cellular immunity?
2 NADPHs per acetyl CoA
When showing two pictures in rapid succession - you split the pictures half a second apart - resulting in the second picture masking the first (indicating poor short - term memory). This is seen in nearly 33% of schizophrenic patients.
T lymphocyte
Arginine

28. What are the two absolute requirements for the cytochrome P450 enzyme system?
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
Ligamentum arteriosum
NADPH and molecular O 2
Corticosteroid

29. Regarding muscle mechanics - How is passive tension produced?
A decrease in Ca2+ and an increase in PO4
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)
Opposite the second upper molar tooth
It is produced by the preload on the muscle prior to contraction.

30. Name the Hgb - O2 binding site based on the following information: x Remains attached under most physiologic conditions
Luteal phase
Superior rectus (CN III) (LR6 SO4)3
Site 1
Mixed (both cholesterol and calcium)

31. In What trimester is the fetus most vulnerable to congenital rubella syndrome?
Adenovirus
The first trimester
Membrane conductance (think conductance = channels open)
H 1

32. What CN is associated with the x Third pharyngeal arch?
The aorta has the greatest velocity and the capillaries have the slowest velocity.
Elongation factor - G and GTP
CN IX
Naloxone or naltrexone

33. Insulin - induced hypoglycemia is the most reliable (by far not the safest) test For what hormone deficiency?
GH deficiency
alpha - Cells; glucagon has stimulatory effects on - cells and inhibitory effects on - cells.
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius
Palindrome

34. Two weeks after her son has a throat infection - a mother takes the boy to the ER because he has fever - malaise - HTN - dark urine - and periorbital edema. What is your diagnosis?
Chloramphenicol
Poststreptococcal GN
0.2
Prolactin

35. What is the term for the difference between systolic and diastolic pressures?
Pulse pressure
Megaloblasts
Hemophilia A
H 1

36. Name the type of necrosis - Seen as dead tissue with coagulative necrosis
Dominant parietal lobe (Gerstmann's syndrome)
Pantothenic acid
Gangrenous necrosis
Ventromedial nucleus; lesions here result in obesity.

37. What are effects of PTH in the kidney?
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
Conjugated (direct) hyperbilirubinemia - a transport defect
Dantrolene
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.

38. Name the associated chromosome - Cri - du - chat
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).
Al - Anon
Chromosome 5p

39. What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb - containing area?
HPV serotypes 6 and 11
Target cell
Transferrin
V wave

40. How are pulse pressure and compliance related?
They innervate LMNs.
Klebsiella pneumoniae
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
HBc Ab

41. Is Dubin - Johnson or Rotor syndrome associated with black pigmentation of the liver?
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
MEN IIa (or Sipple syndrome)
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Medial compartment of the thigh - obturator nerve

42. All Proteus species are...
Alcohol consumption
Cytochrome a/a3
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
urease positive

43. Is increased in 21-Beta- hydroxylase deficiency.
Complex I
Cholera toxin
Renin secretion
Skeletal muscle

44. In an adrenergic nerve terminal - Where is dopamine converted to NE? By what enzyme?
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament
The short arm of chromosome 6
Methanol (wood alcohol)
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.

45. What cardiac reflex is characterized by stretch receptors in the right atrium - afferent and efferent limbs via the vagus nerve - and increased stretch leading to an increase in heart rate via inhibition of parasympathetic stimulation?
Hydroxyproline (breakdown product of collagen)
Bainbridge reflex
At birth (reflex)
Psoriasis - ankylosing spondylitis - inflammatory bowel disease - and Reiter's syndrome

46. What chromosome codes for HLA gene products?
Seminoma
Decreases
Bulla
The short arm of chromosome 6

47. Does the zygote divide mitotically or meiotically?
The zygote divides mitotically; only germ cells divide meiotically.
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
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.
CD15 and CD30

48. What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100 - 00); decreased LAP levels; and nonspecific symptoms of fatigue - malaise - weight loss - and anorexia?
CML
Uric acid
Mild (50-70)
Fibrinous exudates

49. What general pattern of sleep is described by slowing of EEG rhythms (high voltage and slower synchronization) - muscle contractions - and lack of eye movement or mental activity?
NREM sleep. Remember awake body - sleeping brain
EF-2 and GTP
Moderate (35-49)
Superior and middle

50. What component of the inner ear x Contains endolymph and responds to head turning and movement?
Hepatitis A
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
Semicircular duct
Arboviruses (bunyavirus - flavivirus - and togavirus)