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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 erythema do you see in x Rheumatic fever?
Erythema marginatum
Bone deposition increases with increased Ca2+ or PO 4- concentrations - whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
Correlation. No - correlation does not imply causation.
Zona fasciculata and zona reticularis

2. Name the lung measurement based on the following descriptions: x The amount of air that enters or leaves the lung system in a single breath
Metaphase II
Areas 18 and 19
Tidal volume (VT)
Glomerular capillary pressure (increased glomerular capillary pressure - increased GFR and vice versa)

3. What type of hepatitis has the highest mortality rate among pregnant women?
Osteocyte
Hepatitis E
Brucella and Listeria (has tumbling motility)
Fibrocystic change of the breast

4. What percent of sexual abuse cases are committed by family members?
Proencephalon diencephalon derivative
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.
McArdle's syndrome
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)

5. What syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use?
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Glycine/arginine
Eaton - Lambert syndrome

6. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Small prokaryotic cells; no histones; 70S ribosomes; no sterols in cell membrane; peptidoglycans in cell wall; replicate by binary fission
Tinea favosa (favus)
Bacteria
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.

7. What fungus is characterized by India ink staining of the CSF that produces colorless cells with a halo on a black background?
Lead poisoning
Klinefelter syndrome
Cryptococcus neoformans
Metastatic carcinomas

8. Which gram - positive bacteria infection of infancy is associated with ingestion of honey?
Hypersegmented neutrophils
Proencephalon diencephalon derivative
Clostridium botulinum
Histrionic

9. Name the stages of sleep with these EEG patterns: x Disappearance of alpha waves - appearance of theta waves
Stage 1
naked viruses
Medial collateral ligament
Lac repressor protein

10. Name the structure that enters or exits the following foramina: x Stylomastoid foramen
Lysine and arginine
Diazoxide
Ordinal scale (e.g. - faster/slower - taller/shorter)
CN VII

11. Which gram - negative diplococcus ferments maltose?
Phase III. It is considered the definitive test.
Meningococcus (Gonococcus does not)
C5a
Labioscrotal swelling

12. What is the term for the difference between systolic and diastolic pressures?
Physostigmine
Rheumatoid arthritis
Toxic dose for 50% of drug takers (median toxic dose)
Pulse pressure

13. What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway?
ASA
Progressive multifocal leukoencephalopathy
Carbamoyl phosphate synthetase I
Swan - neck deformities

14. What is the term for an inhibitory interneuron?
Creutzfeldt - Jakob disease
Herpes virus
Renshaw neuron
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus

15. Do agents used in the treatment of Parkinson's disease that decrease ACh function have little effect on reducing tremors and rigidity?
Cilia
CN V
Infant Doe. Generally - parents cannot forego lifesaving treatment - but this case states that there are exceptions to the rule.
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.

16. How are drugs that are excreted via the biliary system resorbed by the GI tract?
IgA nephropathy
Enterohepatic cycling
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
Id

17. What type of damage to the kidneys is caused by drinking ethylene glycol (antifreeze)?
Nephrotoxic oxylate stones
Melanoma
Brain abscess
Left ventricle and tip of right ventricle

18. What cell type is found in the peripheral white pulp of the spleen?
Mesangial macrophages
Low average
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.
N- formyl - methionine LTB4 C5a IL-8

19. A urethral swab of a patient shows gram - negative diplococci in PMNs; what organism do you diagnose?
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Churg - Strauss syndrome
Progressive multifocal leukoencephalopathy
Neisseria gonorrhoeae

20. What vitamin deficiency causes a glove - and - stocking neuropathy seen in alcoholics?
7
Previous suicide attempt
Staphylococcus aureus
Pyridoxine (B6) deficiency

21. What is the DOC for the following protozoal infections? - Trichomoniasis
Metronidazole
Intermediate part of the hemispheres
Hot pink with PAS and grey to black with silver stain
There would be a Fab' region; thus - it would still be able to participate in precipitation and agglutination.

22. From What embryonic structure are the following structures derived? - The right and left ventricles
Primitive ventricle
Peutz - Jeghers syndrome
The muscle's ATPase activity
Muscle glycogen phosphorylase

23. Name the hepatitis virus based on the following information - Enveloped RNA flavivirus
Hepatitis C
IgM
Oncotic pressure increases because of the removal of water.
Contralateral muscle weakness when above the decussation - whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.

24. What vitamin deficiency is evidenced by poor wound healing - loose teeth - bleeding gums - petechiae - and ecchymosis?
Superior and middle
a - Blockers (- zosins)
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
Ankylosing spondylitis

25. What is the most common fungal infection in HIV?
Functional residual capacity (FRC)
Parafollicular C cells
Candida
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa

26. What test is done to diagnose CGD?
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
Proencephalon
Periaortic lymph nodes
Fetal alcohol syndrome

27. What is the most potent stimulus for glucagon secretion? Inhibition?
Hypoglycemia for secretion and hyperglycemia for inhibition
Fibroadenoma
absorption
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.

28. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Liver
Theca cell
Stable
Wernicke's encephalopathy
Direct; in males less than 50 years old indirect hernias are the most common type.

29. A 70-year - old man complains of urinary urgency - nocturia - hesitancy - postvoid dribbling - urinary retention - and a PSA result of 6.5 ng/mL. What is your diagnosis?
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result) - these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease - when obstructive symptoms begin to occur.
Seminoma
Zafirlukast
Posterior

30. Name the hypochromic microcytic anemia based on the following laboratory values - Decreased iron - percent saturation - and ferritin; increased TIBC
Papule
3- Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
Hematoxylin
Iron deficiency anemia

31. How many covalent bonds per purine - pyrimidine base pairing are broken during denaturation of dsDNA?
FSH and testosterone
Serocystadenoma
Polycystic kidney disease of childhood
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.

32. Why is the cell's resting membrane potential negative?
Trypanosoma cruzi
Autosomal dominant
Ordinal scale (e.g. - faster/slower - taller/shorter)
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.

33. On a graphical representation of filtration - reabsorption - and excretion - When does glucose first appear in the urine?
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
Lethal dose for 50% of drug takers (median lethal dose)
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.

34. Schiller - Duval bodies
Introjection (a sports fan is a good example)
Yolk sac tumor
Keloid
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)

35. What is the most common opportunistic infection of the CNS in HIV?
Trichomonas vaginalis (treat with metronidazole)
Steroid synthesis - drug detoxification - triglyceride resynthesis - and Ca2+handling
Decreases
Toxoplasmosis

36. What happens to free hormone levels when the liver decreases production and release of binding proteins?
G-6- PD deficiency
ACh; think about the ANS.
Lung and bronchus cancer
Free hormone levels remain constant - and the bound hormone level changes with a decrease in binding hormones.

37. Which sodium channel blocker is used to treat lithium - induced diabetes insipidus?
Thymic epithelial cells - dendritic cells - and macrophages
Amiloride
Inhibin - m
Ethyl alcohol

38. Name the antidote - Heparin
Venlafaxine. (It also has a mild dopaminergic effect.)
The tsetse fly
Protamine sulfate
Iron deficiency anemia

39. How many ATPs per glucose are generated from glycolysis in RBCs?
2 ATPs - because RBCs use only anaerobic metabolism.
The rate of Beta- oxidation
Intussusception
Naloxone or naltrexone

40. What Brodmann area is associated with x Wernicke's area?
Hypersegmented neutrophils
Giant cell tumor of the bone
Area 22 and occasionally 39 and 40
GLUT 4

41. What class of pharmaceuticals are inactive until they are metabolized to their active products?
Carbidopa and benserazide
Hapten; if it is coupled with a carrier - it may become immunogenic.
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.
Prodrugs

42. Name the MCC - Pneumonia in a neutropenic burn patient
Pseudomonas sp.
CML
Salmonella
Type III hypersensitivity reaction

43. What is the DOC for esophageal candidiasis?
Coronary circulation
Diphyllobothrium latum
Subarachnoid hematoma
Fluconazole

44. What hormone - produced by the syncytiotrophoblast - stimulates the production of progesterone by the corpus luteum?
Haemophilus influenzae type B
IgE
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
hCG

45. What three Beta- blockers are used in the treatment of glaucoma?
Unconjugated (indirect)
TAT (Thematic apperception test)
Membranous glomerulonephritis
1. Propranolol 2. Timolol 3. Carteolol

46. What Freudian psyche component is described as x The urges - sex aggression - and 'primitive' processes?
Middle
Secretin stimulates the pancreas to secrete a HCO3-- rich solution to neutralize the acidity of the chyme entering the duodenum.
Osteogenesis imperfecta
Id (pleasure principle)

47. What type of mortality rate is defined as the number of deaths x From a specific cause per all deaths?
Dihydrofolate reductase
Proportionate mortality rate
Skeletal muscle
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.

48. Which aminoglycoside is used only topically because it is too toxic for systemic use?
Motilin
C5a
Neomycin
Tetralogy of Fallot

49. Which one of the cerebellar peduncles is mainly responsible for outgoing (efferent) information?
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.
Chromosome 15
Insulin
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.

50. What is the most common one? - Renal cell cancer type
Rathke's pouch; they can result in compression of the optic chiasm.
Cohort studies determine incidence and causality - not prevalence.
Clear cell
Mercury