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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. Are white rami preganglionic or postganglionic fibers?
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
Folate deficiency (very common in the elderly)
Takayasu arteritis (medium - size to large vessels)

2. What area of the lymph node is considered the thymic - dependent area?
The inner cortex (paracortex) contains the T cells - so it is considered the thymic - dependent area.
AT II
G1 phase; G2 and S phase are diploid (2N).
Riedel thyroiditis

3. Upon seeing negatively birefringent needle - shaped crystals from a joint aspiration of the great toe - what form of arthritis do you diagnose?
Urinary trigone
S2 - S3 - S4
Molluscum contagiosum
Gout

4. What bonds are broken by exonucleases?

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5. Why is there a decrease in the production in epinephrine when the anterior pituitary gland is removed?
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.
Hemostasis
alpha - Motor neurons innervate extrafusal muscle fibers (a motor unit) - whereas gamma - motor neurons innervate intrafusal muscle fibers.
CD19

6. What is the most common one? - Location of a duodenal ulcer
Lung cancer
Anterior wall of the first part of the duodenum
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).
Pseudomonas aeruginosa

7. Name three products of HIV's pol gene.
Protease - integrase - and reverse transcriptase
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
Flumazenil

8. What antitubercular agent causes a red - orange tinge to tears and urine?
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
Rifampin
Leiomyoma (fibroids)
Goodpasture syndrome

9. What is the only pharyngeal muscle not innervated by CN X?
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
GP Ib
Bipolar disorder (manic - depressive disorder)
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.

10. What are the adult remnants of the following structures? - Foramen ovale
Fossa ovale
Permanent
Vitamin B 6 (pyridoxine)
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.

11. What enzyme catalyzes the rate - limiting step in glycogenolysis?
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Translation
Lysine and tyrosine
Glycogen phosphorylase

12. What benign bone tumor is associated with Gardner syndrome?
CO
Four
Osteoma
Voltage - gated sodium channel

13. What factors are needed for translocation in eukaryotes?
Common peroneal nerve
Rapid cycling bipolar disorder
EF-2 and GTP
NE

14. What is the term for the strength of association between multiple Abbinding sites and multiple antigenic determinants?
Medulla blastoma
Type II pneumocytes
The conus medullaris terminates at the level of the second lumbar vertebra.
Avidity (more than one binding site)

15. What somatoform disorder is described as x La belle indiff
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
Conversion disorder
Resorb CSF into the blood

16. How are drugs that are excreted via the biliary system resorbed by the GI tract?
Adrenal medulla
Liver
Enterohepatic cycling
hCG

17. What is the tetrad of tetralogy of Fallot?
Where the cell bodies for the DCML and spinothalamic sensory systems are...
VSD - RVH - overriding aorta - and pulmonary stenosis
Bulla
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.

18. What type of pleura is adherent to the surface of the organ?
Visceral pleura
Phase 4
The small subunit (40S) binds first.
The aorta

19. In what compartment of the thigh is the profundus femoris artery found?

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20. With what stage of sleep are nightmares associated?
Denial
REM sleep. Nightmares are frightening dreams that we recall.
Silicosis - Coal worker's pneumoconiosis is synonymous with black lung disease - an upper lobe occupational disorder
Squamous cell carcinoma

21. What subset of T cells recognizes the MHC class I Ags?
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
HMP shunt
Nominal scale (categorical - e.g. - male or female)
CD8+ T cells (cytotoxic) Remember - 8

22. Marriage ______ a child less than 17 years old.
emancipates
Beta- Blockers
Sphingosine
Dantrolene

23. All spore formers are...
gram positive
Gubernaculum
I- cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
They chronically inhibit ADH secretion; when there is a decrease in the blood volume - the stretch receptors send fewer signals - and ADH is secreted.

24. What is the monoamine oxidase B (MAOB) inhibitor?
Selegiline
Alcohol and its related problems cost the country approximately $100 billion a year.
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Isocitrate dehydrogenase

25. What disease is associated with the HLA- DR2 and HLA- DR3 alleles
Systemic lupus erythematosus
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.
ELISA test
epithelial lining

26. What vessels have the largest total cross - sectional area in systemic circulation?
Folic acid deficiency
a -1 - 6 transferase
Capillaries
well - fed and fasting

27. 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
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
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.
Case control studies cannot assess incidence or prevalence - but they can determine causal relationships.
Acute rejection

28. Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it?
Metronidazole
Chromosome 19
Factors II - VII - IX - and X and proteins C and S.
Epstein - cardiac anomaly of the tricuspid valve

29. Where are the LMN cell bodies of the corticospinal tract?
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.
Inversely proportional: the higher the potency - the lower the anticholinergic side effects.
Peyer's patch
Formal operations (> 12 years)

30. What urinary metabolite is increased in patients with carcinoid syndrome?
Bronchial asthma (eosinophil membranes)
ACE inhibitors (the - pril agents)
Rapidly progressive glomerulonephritis (RPGN)
5- hydroxyindoleacetic acid (5- HIAA)

31. Which leukotriene
LTB4
Polycystic ovary disease (Stein - Leventhal syndrome)
A transport maximum (Tm) system
Yes

32. What type of error is made if you accept the null hypothesis when it is false?

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33. What operant conditioning therapy or modification is described as x Removing a reinforcement (without the patient knowing) gradually over time to stop a condition?
Fading
Renshaw neuron
A right CN V lesion results in weakened muscles of mastication - and the jaw deviates to the right.
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).

34. What is the second cell involved in the immune response?
2 ATPs - because RBCs use only anaerobic metabolism.
Ristocetin
The CD4 T cell; the APC is the first cell in the immune response.
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)

35. What cell type of the bone has PTH receptors?
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)
Eosinophil chemotactic factor A
Leiomyoma
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)

36. What neuroleptic agent causes retinal deposits - hypotension - and torsades de pointes?
Schistosoma haematobium
Tibial nerve
Thioridazine
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)

37. Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
Glycine/arginine
Phase 4
Right and left pulmonary arteries and the ductus arteriosus
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime

38. At what stage of cognitive development (according to Piaget) do children x See death as irreversible?
Concrete operations (6-12 years)
VSD - RVH - overriding aorta - and pulmonary stenosis
X- linked dominant
EBV

39. What pancreatic islet cell tumor is associated with MEN I syndrome?
Transudative; exudative has the opposite values and has an elevated cellular content.
Gastrinoma
It forms a germinal tube at 37
Thrombus

40. What happens to the following during skeletal muscle contraction? - H zone
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
Superior
Chi - square.
Shortens

41. What hormone is necessary for normal GH secretion?
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
Chromosome 5p
Adenine and guanine
Edward syndrome (trisomy 18)

42. What small gram - negative facultative intracellular rod is transmitted to human host by Dermacentor tick bite?
Francisella tularensis
SITS
Poliomyelitis; it is a bilateral LMN lesion.
Absolutely not! Answer any question you are asked.

43. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Myelencephalon
CN I
Rhombencephalon
Right brachiocephalic artery
1. Covalent bonding between the hapten and carrier 2. B- cell exposure to hapten twice 3. T- cell exposure to carrier twice

44. The blood stored in the systemic veins and the pulmonary circuit are considered part of the...
Pick's disease
Superior
Squamous cell carcinoma
Cardiac output

45. What bacterium is diagnosed using the Dieterle silver stain?
Accessory nucleus
Crigler - Najjar syndrome
CN VII - IX - and X; taste and general sensation for the tongue is sent to the solitary nucleus.
Legionella

46. What phase of the cell cycle are the following antineoplastic agents specific for? - Cisplatin
Yes
G0 phase
Osteopetrosis (Albers - Sch
Hypotonic - because NaCl is reabsorbed in the salivary ducts

47. What is the term for the round intracytoplasmic eosinophilic inclusions containing ?- synuclein found in the dopaminergic neurons of the substantia nigra?
Hematoxylin
Herpes virus I and II
Lewy bodies
Acarbose

48. What herpes virus is associated with Kaposi sarcoma?
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Type IV collagen
Prostatic carcinoma
HHV 8

49. What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway?
Hematogenous
ASA
Chromosome 13
Malignancy

50. Are the following major or minor Jones criteria of rheumatic fever? - Fever
Intercellular adhesion molecule (ICAM) 1
Beta2- Adrenergic agents
Minor
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.