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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. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Pons
CN III and IV
SITS
Cohort studies determine incidence and causality - not prevalence.
Rhombencephalon

2. What is the term for the degree to which a test measures what it is intended to measure?
REM latency; normally it is about 90 minutes.
Validity (remember - reliability is necessary but not the only thing needed for validity)
Neuroblastoma
Hydralazine - isoniazid - and procainamide (HIP)

3. What are the three most common sites for left - sided heart embolisms to metastasize?
Klinefelter syndrome
Brain - spleen - and kidney
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
1. Protest 2. Despair 3. Detachment

4. What enzyme of the TCA cycle catalyzes the production of the following: x GTP
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.
Succinylcholine
Haemophilus ducreyi
Succinyl CoA synthetase

5. Which aminoglycoside is used only topically because it is too toxic for systemic use?
Salmeterol
Neomycin
Down syndrome (it is slightly more common than fragile X syndrome.)
Carbidopa and benserazide

6. How many pairs of spinal nerves exit from the spinal cord?
31 pairs
Primary hypoparathyroidism
Duodenal ulcer
GERD

7. What urease - producing gram - negative curved rod is associated with PUD and chronic gastritis?
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero - order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than i
Helicobacter pylori - Which is also associated with an increased risk of gastric carcinoma
Wiskott - Aldrich syndrome
Salmeterol

8. What part of the heart forms x Anterior wall?
Copper
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
Ascending limb
Right ventricle

9. What is the most common cancer diagnosed in men? In women?
Clonidine
Spectinomycin
In men it is prostate cancer - and in women it is breast cancer.
CD21; it is a complement receptor for cleaved C3

10. What drug is an M1- specific antispasmodic?
Pirenzepine
2 to 4 hours
Salmeterol
Good Samaritan Law. (Physicians are not required to stop and help.)

11. Which sedative - hypnotic is contraindicated for patients taking warfarin?
Proencephalon diencephalon derivative
Extracellular
Chloral hydrate
Mast cells

12. What area of the small intestine is characterized by Peyer's patches?
Insulin
Kawasaki disease
Ileum
Increase in ECF osmolarity means a in decrease in ICF osmolarity - so cells shrink.

13. What happens to diastolic and systolic intervals with an increase in sympathetic activity?
Huntington's chorea; patients have chorea - athetoid movements - progressive dementia - and behavioral problems.
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
LDL
Staphylococcus aureus

14. Are used in the management of an acute asthmatic attack.
Fungiform papillae
Beta2- Adrenergic agents
Volvulus
CN XI - vertebral arteries

15. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)
The CD4 T cell; the APC is the first cell in the immune response.
The T- test (used when comparing two groups)
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.

16. Name the AD disease associated with chromosome 15 in which the patient has long extremities - lax joints - pigeon chest - and posterior mitral leaflet prolapse and is prone to developing dissecting aortic aneurysm.
Pyridoxine (B6) deficiency
Marfan syndrome
Lipoid nephrosis
CN I - II - III - VI - and XII Add 1 + 1 = 2 - 1 + 2 = 3 - 1 + 2 + 3 = 6 - 1 + 2 + 3 + 6 = 12

17. What enzyme of the purine salvage pathway is deficient in the following? - Lesch - Nyhan syndrome
Testicular feminization syndrome (Dude looks like a lady!)
HGPRT
Labile
Histidine

18. What pneumoconiosis is associated with exposure to the following occupations or materials? - Miners - metal grinders - and sandblasters

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19. What vitamin deficiency produces homocystinuria and methylmalonic aciduria?
Mesencephalon
Syphilitic
1 day prior to ovulation
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)

20. What is the most common opportunistic infection of the CNS in HIV?
Extinction
Toxoplasmosis
TXA2
Porcelain gallbladder

21. What disease is X- linked recessive - is associated with eczema thrombocytopenia and an increased chance of developing recurrent infections - involves a decrease in serum IgM and in the T cell - dependent paracortical areas of the lymph nodes - and m
Marfan syndrome
Maxillary division of CN V and glossopharyngeal nerves
Wiskott - Aldrich syndrome
HPV infection

22. Why is there a minimal change in BP during exercise if there is a large drop in TPR?
SSRIs
Because the large drop in TPR is accompanied by a large increase in cardiac output - resulting in a minimal change in BP.
Anticipation - associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.
Selegiline

23. What GnRH analog is used as a repository form of treatment in prostatic cancer?
Leuprolide
Ataxia - telangiectasia
Scleroderma
Leishmania donovani (kala azar is also known as visceral leishmaniasis)

24. With an increase in arterial systolic pressure - what happens to x Stroke volume?
Major
The AR form is malignant and AD is benign.
Increases
Pituitary adenoma

25. Name the RNA subtype based on the following: x Found only in the nucleus of eukaryotic cells and are precursors of mRNA
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.
hnRNA
GP IIb/IIIa - Which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
Third M PITS for pharyngeal pouch derivatives

26. What is the name of the B cell - rich area in the lymph node?
During stage 3 and 4 (remember - it is called deep sleep.)
Primary hypogonadism (postmenopausal women)
Primary follicle of the cortex
Lipoid nephrosis

27. At the D2A receptor have the capacity to induce pseudoparkinsonism.
Breast
Minor
Lumbar splanchnics
Dopamine antagonists

28. What is the most common one? - Cardiac anomaly in Turner syndrome
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
Embolic
1. Propranolol 2. Timolol 3. Carteolol
Coarctation of the aorta

29. Name the most common type or cause - Urethritis in a young - newly sexually active individual
Lateral pontine syndrome
Glanzmann syndrome
Positive
Staphylococcus saprophyticus

30. What embryonic structure forms the following adult structures? - Median umbilical ligament
Lung cancer
GH- producing adenoma
Necator americanus is treated with mebendazole and iron therapy.
Urachus

31. What branch off the vertebral artery supplies x The ventrolateral two - thirds of the cervical spinal cord and the ventrolateral part of the medulla?
Anti - HAV IgG Abs are associated with immunization or a prior infection. Anti - HAV IgM is associated with acute or recent infection.
Finasteride
Proud flesh
Anterior spinal artery

32. What is the only Ig that crosses the placenta?
Gastrin - releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)
Dissociative fugue. (Patients are unaware of memory loss.)
IgG
Prolactinoma

33. What is the pancreatic action of CCK?
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
Paramyxovirus
Shortens
CCK stimulates the pancreas to release amylase - lipase - and proteases for digestion.

34. What is the term for a substance secreted by a leukocyte in response to a stimulus?
Hypoglycemia for secretion and hyperglycemia for inhibition
Ligamentum arteriosum
IgG3
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.

35. What enzyme is inhibited by disulfiram?
Acetaldehyde dehydrogenase. When this enzyme is blocked - acetaldehyde builds up - and its presence in excess results in nausea and hypotension.
Uroporphyrinogen I synthetase
Postinfectious GN
Plasmodium falciparum

36. What four factors shift the Hgb - O2 dissociation curve to the right? What is the consequence of this shift?
The primitive streak grows caudal to rostral.
FSH and testosterone
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.
Left atrial myxoma

37. What two factors result in the apex of the lung being hypoperfused?
Bell pad
Adenosine deaminase
After the latent period
Decreased pulmonary arterial pressure (low perfusion) and less - distensible vessels (high resistance) result in decreased blood flow at the apex.

38. At What age do children begin to understand the irreversibility of death?
Down syndrome (trisomy 21)
Duchenne muscular dystrophy (Remember - Becker's is slower in progress - less severe - later in onset - and lacks cardiac involvement.)
Glucagon
At 8 to 9 years of age. Prior to this age they view death as a form of punishment.

39. Do the following structures pick up stain from hematoxylin or eosin? - Collagen
Boutonni
Calcium influx secondary to slow channel opening
Eosin
Sensory

40. What are the five branches of the median cord of the brachial plexus?
Azathioprine
Four Ms and a U 1. Median 2. Medial antebrachial 3. Medial pectoral 4. Medial brachial cutaneus 5. Ulnar
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.
Buerger disease (thromboangiitis obliterans)

41. What protein causes fibrinolysis?
Medial nuclear group (limbic system)
Membranous glomerulonephritis
Ordinal scale (e.g. - faster/slower - taller/shorter)
Plasmin

42. Why will turbulence first appear in the aorta in patients with anemia?
Because it is the largest vessel and has the highest velocity in systemic circulation
Type IV hypersensitivity (cell - mediated)
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Bronchioloalveolar carcinoma

43. What is the start codon - and What does it code for in eukaryotes? Prokaryotes?
Doxycycline
Iatrogenesis
Ulnar and radial arteries (ulnar is the main supplier)
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.

44. What are the two opsonizing factors?
Cryptococcus
Alcohol abuse
It is produced by the preload on the muscle prior to contraction.
The Fc region of IgG and C3b

45. What cell is under control of FSH and testosterone; secretes inhibin - MIF - and androgen - binding protein; and phagocytizes the excess cytoplasm of the spermatid?
Sertoli cell
Alcoholism
Malignancy
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.

46. Cowdry type A bodies
Acute toxic or viral nephrosis
Herpesvirus
Minor
Atelectasis

47. Which class of antiarrhythmics blocks sodium channels?
Type I (makes sense - since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
Vancomycin
GnRH
Class 1 (1A - 1B - and 1C)

48. What is the term for the rate measured for a subgroup of a population?
Carnitine acyltransferase I
Incidence rate
Specific rate (e.g. - men aged 55-60)
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.

49. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x Placental alkaline phosphatase
Progressive multifocal leukoencephalopathy
Seminoma
Clearance
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).

50. From What embryonic structure are the following structures derived? - The sinus venarum - coronary sinus - and the oblique vein of the left atrium
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.
Temporal arteritis (giant cell arteritis)
Trypanosoma cruzi
Sinus venosus