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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 type of questions should you begin with when a patient seeks your medical opinion?
>5 mm
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.
Squamous cell carcinoma

2. What phase of the cell cycle are the following antineoplastic agents specific for? - 6- Mercaptopurine
S phase
Dynorphin
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II - VII - IX - and X.
Carbidopa and benserazide

3. In What area of the GI tract does iron get absorbed?
Teratoma (dermoid cyst)
Duodenum
Amiloride
Diacylglycerols and phosphatidic acid

4. What syndrome is characterized by dynein arm abnormality resulting in chronic sinusitis - recurrent pulmonary infections - and infertility?

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5. What is the term for hypoperfusion of an area involving only the inner layers?
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae
Obsessive - compulsive
Displacement
Mural infarct

6. What CN transmits sensory information from the cornea?
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
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.
Anticentromere Abs
PALS (Parietolateral lymphocytic sheath)

7. What three organs are necessary for the production of vitamin D3(cholecalciferol)?
Class 1 (1A - 1B - and 1C)
1:1. Remember - the flow through the pulmonary circuit and the systemic circuit are equal.
Skin - liver - and kidneys
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle

8. What is the MCC of death in children aged 1 to 14 in the United States?
Yes - because they both activate the BZ1- receptors - which can be reversed by flumazenil.
Accidents
No. It is abnormal only if it interferes with normal sexual or occupational function.
CN XI - vertebral arteries

9. Describe the organism based on the following information: x Beta - Hemolytic Streptococcus; positive cAMP test; hydrolyzes hippurate
Atrial filling (venous filling) Atrial - Contraction - Venous
produce bile
Streptococcus agalactiae
Area 17

10. A mother takes her 2- week - old infant to the ER because the baby regurgitates and vomits after eating and has peristaltic waves visible on the abdomen and a palpable mass in the right upper quadrant. What is your diagnosis?
Pyloric stenosis
Turner syndrome
Propionic acid
Epstein - cardiac anomaly of the tricuspid valve

11. What is the precursor of all sphingolipids?
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.
Cytochrome c
Ceramide
Dopamine is converted into NE in the vesicle via the enzyme dopamine - Beta - hydroxylase.

12. In what pathway of the basal ganglia do lesions result in an underactive cortex with hypokinetic - slow - or absent spontaneous movement?

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13. Regarding skeletal muscle mechanics - What is the relationship between velocity and afterload?
Variable ratio If it is based on time - it is an interval - and if it is based on the number of responses - it is a ratio.
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
Brucella
Lateral pontine syndrome

14. Describe What type of fluid is either gained or lost with the following changes in body hydration for the ECF volume - ICF volume - and body osmolarity - respectively: x ECF - decrease; ICF - no change; body - no change
16S subunit
Chromosome 5p
Anatomical dead space - which ends at the level of the terminal bronchioles.
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)

15. What pyrimidine base is found x Only in DNA?
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
Ergotamines
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:- ili - in ciliary ganglion looks like the III of CN III.)
Thymine

16. What is the DOC for the following protozoal infections? - Leishmaniasis
Stibogluconate
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
Latency stage (6-12 years)
Chemotaxis

17. What is the only class of diuretics to retain Cl - used in the short - term treatment of glaucoma and of acute mountain sickness?
Metaproterenol and albuterol
Acetazolamide
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone - whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
Klinefelter syndrome

18. What three major cell lines participate in the acquired immune system?
T cells - B cells - and macrophages
Hypercortisolism (Cushing syndrome)
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Phase III. It is considered the definitive test.

19. A chronic alcohol abuser goes to the ER with weakness - a sore - beefy red tongue - loss of vibration and position sense - arm and leg dystaxia - elevated levels of methylmalonic acid in the urine - and anemia with an MCV above 105 fL. What is your d
Homocysteine methyl transferase and methylmalonyl CoA transferase
refuse
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working - you will see an increased reticulocyte count on the peripheral smear in about 5 days.
Direct; in males less than 50 years old indirect hernias are the most common type.

20. Deficiencies In what enzyme result in insoluble glycogen synthesis formation?
Clearance
Primitive atrium
a -1 - 6 transferase
Psoas major

21. What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord?
Toxoplasmosis
The fasciculus cuneatus
Decreases
S1 nuclease

22. What is the name of the 12- step program believed to be the most successful for the treatment of alcohol abuse?
Pantothenic acid
Listeria
Alcoholics Anonymous
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

23. What enzyme is deficient in patients with PKU?
Phenylalanine hydroxylase
Third week
Omphalocele and gastroschisis
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.

24. If a peripheral blood smear shows schistocytes - reticulocytes - and thrombocytopenia - is it more commonly seen in patients with ITP or TTP?
Foscarnet
Posterior
Medial collateral ligament
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.

25. Why will turbulence first appear in the aorta in patients with anemia?
Dimorphic
Because it is the largest vessel and has the highest velocity in systemic circulation
Langerhans cells
VIPoma

26. What happens to NE levels in x Bipolar disorder?
Increase (5- HT and dopamine levels do the same)
Cocaine - induced coronary ischemia
Mast cells
Leiomyoma (fibroids)

27. Name the Hgb - O2 binding site based on the following information: x Remains attached under most physiologic conditions
H 2
2 and 5HT3 receptors
Site 1
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.

28. What CN is associated with the sensory innervation of x Oropharynx?
Glossopharyngeal nerve
Target cell
Carbidopa and benserazide
Rectum

29. What phobia is described as the fear of open spaces?
Dilator pupillae muscle
Agoraphobia. It also means having a sense of humiliation or hopelessness.
The basilar artery is formed at the pontomedullary junction.
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.

30. What is the DOC for treating torsade de pointes?
Magnesium
Urachus
C5a
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe

31. What type of correlation is defined as x Two variables that go together in the same direction?
Positive correlation
Chromophobe adenoma
Stereocilia
Atropine and 2- PAM (pralidoxime)

32. Without ADH the collecting duct would be...
>5 mm
impermeable to water
3' end. Phosphate (PO4) is at the 5' end.
Acting out

33. Which serotypes of HPV are associated with plantar warts?
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Phallus
Cancer of the lung - stomach - colon - and breast
HPV serotypes 1 and 4

34. What is the most common chromosomal abnormality associated with CLL?
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)
One - and it provides the energy for mechanical contraction.
HPV serotypes 16 - 18 - 31 - and 33
HBcAb IgM - HBV- DNA - HBeAg - HBsAg

35. What glycogen storage disease is due to the following enzyme deficiencies? - Muscle phosphorylase

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36. What is the term for the same results achieved again on testing a subject a second or third time?
VSD - RVH - overriding aorta - and pulmonary stenosis
Test - retest reliability
Helicase (requires ATP for energy)
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.

37. Which acid - fast rod is an obligate intracellular parasite?
Mycobacterium leprae
hnRNA
Invariant chain
Guillain - Barr

38. What type of erythema do you see in x Rheumatic fever?
Cryptococcus
C3a - C4a - and C5a
Erythema marginatum
Amanita phalloides

39. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Skeletal muscle
Liver - kidneys - and pituitary gland via 5' deiodinase enzyme
Glycogen phosphorylase
Permanent
Fibrillary protein - amyloid protein - and glycosaminoglycans (heparin sulfate mainly)

40. Name the associated chromosome - Familial hypercholesterolemia
Chromosome 19
Leydig cell tumor
Third week
Left abducens nerve

41. Name the type of necrosis - Seen as dead tissue with coagulative necrosis
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
The right and left pulmonary arteries - the only arteries that carry deoxygenated blood
Gangrenous necrosis
No - it is never acceptable to lie.

42. Regarding the viral growth curve - is the internal virus present before or after the eclipse period?
After the eclipse period
Eosin
Pearson correlation
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.

43. What is the most common one? - Esophageal carcinoma
Turner syndrome
Bone deposition increases with increased Ca2+ or PO 4- concentrations - whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
Lymph nodes
Squamous cell carcinoma

44. What cell transports IgA - is secreted by plasma cells - and is in Peyer's patches to the gastrointestinal lumen?
60%
Primary hyperparathyroidism
M- cells
Decreases

45. What is the most common precipitin test used in clinical medicine?
Areas 5 and 7
Radial Immuno Diffusion (RID) for Ig levels.
Selective erectile disorder
It forms a germinal tube at 37

46. Name the most common type or cause - Hematuria
Quinolones
Toxic dose for 50% of drug takers (median toxic dose)
Infection
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.

47. What is the most common STD?
Fluconazole
HPV
Protein A
Hypoxia

48. What primary acid - base disturbance is caused by a loss in fixed acid forcing the reaction to shift to the right - thereby increasing HCO3- levels?
They are preganglionic sympathetic axons. They are white because they are myelinated.
Gain of hypertonic fluid (mannitol or hypertonic saline)
Staphylococcus aureus
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)

49. What AA is a precursor of the following substances? - Histamine
Histidine
Microglial cells
Staphylococcus aureus
Superficial spreading melanoma

50. What is the DOC for Beta- blocker - induced bronchospasms?
Insulin
Decreases
Ipratropium
Endometrial cancer