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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 MCC - Pneumonia in adults
Glucose
Gastrinoma
First - order elimination
Streptococcus pneumoniae

2. What type of test asks a patient to draw a scene - attempting to find out the individual's unconscious perceptions in his or her life?
Vancomycin
REM
Arginine
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.

3. What is the bioactive form of thyroid hormone?
Inulin
Negative
Depolarization (i.e. - Na+ influx)
T3

4. Initiates rhythmic contractions associated with labor.
Left atrium and tip of the right atrium
Listeria monocytogenes
Oxytocin
Chromosome 18

5. What medication is used to help alcoholics avoid relapse by decreasing glutamate receptor activity?
Western blot
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
Glutamate
Breast

6. What is the term for the negative resting membrane potential becoming more negative?
Hyperpolarization (i.e. - K+ influx)
Dilation of afferent arteriole
Multiple myeloma
MstII; changing codon 6 (from A to T) destroys the restriction site.

7. What enzyme is deficient in the following glycogen storage disease? - Hers' disease
Hepatic glycogen phosphorylase
The blood withdrawn is the unconditioned stimulus - inducing the unconditioned response (fainting). The needle is part of the blood - drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in th
Follicular phase is estrogen - dependent with increased FSH levels - while the luteal phase is progesterone - dependent.
Clostridium perfringens

8. What are the three Beta - lactamase inhibitors?
Caseous necrosis
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
Isovolumetric contraction
IgA

9. Which organism releases endotoxins prior to cell death?
In the dorsal horn of the spinal cord on the primary afferent neurons
Neisseria meningitidis
Short - chain fatty acids
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material

10. What thyroid abnormality has the following? - TRH increased - TSH decreased - T4 decreased
antiemetic
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first - not worry about legal responsibility.
False - positive rate

11. What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
Hemiballismus
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
Hapten; if it is coupled with a carrier - it may become immunogenic.
Thoracic splanchnic fibers

12. What is the most common one? - Form of arthritis
Osteoarthritis
Clozapine
Erythema marginatum
Fibrinoid necrosis

13. What are the three polymorphonuclear leukocytes? Be specific.
Neutrophils - eosinophils - and basophils
Sublimation
Omega -3 fatty acids
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.

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: increase; ICF: no change; body: no change
Posterior
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Gain of isotonic fluid (isotonic saline)
Increase enzyme concentrations

15. What neuroleptic agent causes retinal deposits - hypotension - and torsades de pointes?
Roth spots
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)
Osteoblasts (Remember - they modulate the function of osteoclasts.)
Thioridazine

16. Name the type of exudate - given the following examples - Meningococcal infection
Purulent exudates
Vesicle (e.g. - poison ivy)
Y - W-135 - and C and A capsular polysaccharides
Megaloblasts

17. What portion of the intervertebral disk is a remnant of the notochord?
Renshaw neuron
Parasympathetic stimulation - via the vagus nerve - results in bronchoconstriction - whereas sympathetic stimulation results in bronchodilation.
Nucleus pulposus
Emphysematous bleb

18. What protein prevents ssDNA from reannealing during DNA replication?
Single - strand DNA binding protein
Rectum
Resistance decreases as resistors are added in parallel.
M:F 4:1 committing - but M:F ratio of attempts is 1:3 (males commit more but females try it more)

19. What operant conditioning therapy or modification is described as x Having a stimulus take over the control of the behavior (unintentionally)?
Stimulus control
HHV-8
Terbinafine
Ventricular contraction Atrial - Contraction - Venous

20. Ophthalmic artery is a branch of What artery?
Metaplasia (usually to a more protective cell type)
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol
Internal carotid artery

21. What color do fungi stain with PAS? Silver stain?
Breast
Hot pink with PAS and grey to black with silver stain
Disulfiram
Rhinovirus

22. Renal epithelial casts in the urine
Acute toxic or viral nephrosis
Serous exudates
Metaplasia (usually to a more protective cell type)
PICA

23. What water - associated organism is a weakly stained gram - negative rod that requires cysteine and iron for growth?
They prevent mast cell degranulation.
One day after the LH surge and 2 days after the estrogen peak.
Legionella (think air conditioners)
Primase

24. What gene stimulates apoptosis when DNA repair is unable to be done?
p -53
CN IX - X - and XII
Simple diffusion; it does not use protein - mediated transport
Trichuris trichiura is treated with albendazole.

25. Is ACh associated with bronchoconstriction or bronchodilation?
Beta- Blockers
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
Disseminated intravascular coagulation (DIC)
Projection

26. Starry sky appearance of macrophages is pathognomonic of what lymphoma?
CSF
Staphylococcus
Burkitt lymphoma
Lithium

27. What area of the brain acts as the center for ipsilateral horizontal gaze?
Giant cell bone tumor (osteoclastoma)
PPRF
Echinococcus multilocularis
GLUT 4

28. Name the ocular lesion; be specific - Left Meyer's loop lesion of the optic radiations.
Left homonymous hemianopsia
The venae recta maintain the gradient via countercurrent flow.
Roth spots - and they are seen in bacterial endocarditis.
Estrone

29. What AR CNS disorder presents early in childhood with gait ataxia - loss of deep tendon reflexes - impaired vibratory sensation - hand clumsiness - and loss of position sense?
Frotteurism
Friedreich ataxia
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Week four - and they remain dormant there until puberty.

30. Is the coding or the template strand of DNA identical to mRNA (excluding the T/U difference)?
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Microsporum
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors

31. What would be the result if an Ab were cleaved with papain?
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
Ciliary ganglion
Choriocarcinomas and trophoblastic tumors
There would be two Fab and Fc regions.

32. Which cerebral herniation results in compression of the anterior cerebral artery?
Cingulate gyrus herniation (subfalcine)
Corticosteroid
Right brachiocephalic artery
Bridging veins draining into the sagittal sinus

33. What enzyme is needed to activate the following reactions? - Trypsinogen to trypsin
Enterokinase
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major
Increased REM sleep - decreased REM latency - and decreased stage 4 sleep - leading to early morning awakening
Rhabdovirus

34. Name the most common type or cause - Nephrotic syndrome in children
Leukemias and lymphomas
Supraoptic nuclei; lesions here result in diabetes insipidus.
Lipoid nephrosis
Beryllium

35. What AD syndrome produces hamartomatous polyps in the small intestine and pigmentation of the lips and oral mucosa?
LTC4 - LTD4 - and LTE4
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
HBeAb
Peutz - Jeghers syndrome

36. What are the primary neurotransmitters at the following sites? - Brainstem cells
Serotonin
Alzheimer disease
Pertussis toxin
Mitosis

37. What urinary metabolite is elevated in pheochromocytoma?
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
premature ejaculation
Lateral part of the hemispheres
Vanillylmandelic acid (VMA)

38. What drug is being given to HIV- positive mothers during labor and to the children after birth to decrease the risk of mother - to - child HIV transmission?
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.
Translation
5HT1D
QRS complex

39. What is the function of the basal ganglia?
Initiate and manage gross skeletal muscle movement control
Spermatogonia (type B)
Variola (smallpox)
Jejunum (upper)

40. How many ATPs per glucose are generated from glycolysis in RBCs?
2 ATPs by oxidative phosphorylation
Paneth cells
2 ATPs - because RBCs use only anaerobic metabolism.
Reiter syndrome

41. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Weeks to months after transplantation; abrupt onset of oliguria and azotemia; seen as neutrophilic vasculitis and interstitial lymphocytes
Occulta All except occulta cause elevated - fetoprotein levels.
Series circuit
Skeletal muscle
Acute rejection

42. What is the only organ in the body supplied by preganglionic sympathetic fibers?
Quinolones
Adrenal medulla
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.
Hematoxylin

43. What is the term for headaches - inability to concentrate - sleep disturbances; avoidance of associated stimuli; reliving events as dreams or flashbacks following a psychologically stressful event beyond the normal range of expectation?
Middle meningeal artery
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
Pyelonephritis
Chief cells

44. What are the top three causes of infant mortality?
premature ejaculation
First pharyngeal groove; all others degenerate.
Birth defects - low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS) - and SIDS
epithelial lining

45. Regarding the viral growth curve - is the internal virus present before or after the eclipse period?
Permanent
After the eclipse period
Crohn disease
The dentate nucleus

46. What is the MCC of the following meningitides? - In renal transplant patients
12 days after ovulation
C5a
Listeria monocytogenes
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.

47. What bactericidal agents are resistant to Beta- lactamases and are used to treat in - hospital life - threatening infections?
Imipenem and meropenem
Rho-immunoglobin
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
Inhibin - m

48. What three drugs are associated with SLE- like syndrome in slow acetylators?
Hydralazine - isoniazid - and procainamide (HIP)
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Ciliary ganglion
Herpes virus

49. What are the pharmacologic effects seen sexually with x a1- Blockers?
Staphylococcus
Celecoxib
Impaired ejaculation
LTC4 and LTD4

50. At the apex of the lung - What is the baseline intrapleural pressure - and what force does it exert on the alveoli?
P = .05; P < .05 rejects the null hypothesis
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.
Superior and posterior
Hydroxyapatite