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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 antidote - Iron
Deferoxamine - penicillamine
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
Radial nerve
Nitrofurantoin

2. What is the most common one? - Solid tumor in the body
Acting out
Nephroblastoma
Purine nucleoside phosphorylase
Middle cerebral artery

3. Is a marker for increased bone formation.
Spironolactone
Alveolar macrophages (dust cells)
Urachus
An elevated serum osteocalcin level

4. What type of cell is surrounded by mineralized bone?
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
Osteocyte
Resistance decreases as resistors are added in parallel.
Osteoblasts - which in turn stimulate osteoclasts to break down bone - releasing Ca2+ into the interstitium. (Remember - blasts make - clasts take.)

5. Which gram - negative diplococcus grows on chocolate agar? Thayer - Martin medium?
Fat necrosis
During stage 3 and 4 (remember - it is called deep sleep.)
Long - term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
Meningococcus grows on chocolate agar - and Gonococcus grows on Thayer - Martin medium.

6. What event signifies the first day of the menstrual cycle?
G-6- PD deficiency
Taenia solium
Onset of bleeding
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.

7. What level of mental retardation is characterized by x Being self - supportive with minimal guidance and able to be gainfully employed (includes 85% of the mentally retarded)?
Lisch nodules
Acetyl CoA (pyruvate to acetyl CoA)
Mild (50-70)
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)

8. What are the pharmacologic effects seen sexually with x a1- Blockers?
Tinea favosa (favus)
Impaired ejaculation
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
Small cell cancer of the lung

9. What pyrimidine base is found x Only in DNA?
NAVEL: Femoral Nerve - Artery - Vein - Empty space - and Lymphatics/Lacunar ligament
Positive reinforcement
Ultraviolet B (UVB) sunlight
Thymine

10. Which three organisms cause heterophilic negative mononucleosis?
MEN I (or Wermer syndrome)
CMV - Toxoplasma gondii - and Listeria
Vancomycin
Pneumococcus (Streptococcus pneumoniae)

11. Are hydrolysis - oxidation - and reduction phase I or II biotransformations?
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
Magnesium
Phase I
Ungated potassium channel

12. Name the compartment of the mediastinum associated with the following thoracic structures: Vagus nerve
Posterior
Pyridoxine (B6)
Monosodium urate crystals
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency

13. What linkage of complex CHOs does pancreatic amylase hydrolyze? What three complexes are formed?
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim
A positive AV difference indicates that a substance is extracted by the organ - and a negative difference indicates that it is produced by the organ.
Marrow failure - cancer - and leukemia
Amylase hydrolyzes alpha -1 - 4- glucoside linkages - forming alpha - limit dextrins - maltotriose - and maltose.

14. What is the term for excessive production of collagen that flattens out and does not extend beyond the site of the injury?
Frotteurism
Urogenital sinus
Hypertrophic scar
Nystagmus and ataxia

15. What CNs arise from x The midbrain?
CN III and IV
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
Parvovirus B-19

16. In the alveoli - what cell type is x for gas exchange?
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Type I pneumocytes
Alcohol abuse
Fluconazole

17. What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?
Vitamin E
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
The resistance increases 16- fold.
Mitral stenosis

18. What are the first signs of overdose from phenobarbitals?
LVEDV and LVEDP (left ventricular end - diastolic volume and end - diastolic pressure - respectively)
Stanford - Binet Scale - developed in 1905 - is useful in the very bright - the impaired - and children less than 6 years old.
Vitamin E
Nystagmus and ataxia

19. What picornavirus is associated with hand - foot - and - mouth disease?
Small cell cancer of the lung
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
Ipsilateral loss at and below the level of the lesion
Coxsackie A

20. What has proved to be the best way to extinguish enuresis?
They are inversely proportional to each other; as pulse pressure increases - compliance decreases.
Plasma concentration and excretion rate
Bell pad
Creutzfeldt - Jakob disease

21. What hormone has the following effects: chondrogenic in the epiphyseal end plates of bones; increases AA transport for protein synthesis; increases hydroxyproline (collagen); and increases chondroitin sulfate synthesis?
Metabolic alkalosis (summary: high pH - low H+ and high HCO3-)
Neuroblastoma
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
MI

22. What statistical test compares the means of groups generated by two nominal variables by using an interval variable?
Two - way ANOVA. It allows the test to check several variables at the same time.
Fibrocystic change of the breast
Skeletal muscle
Goodpasture disease

23. What nerves provide sensory innervation above the vocal cords? Below the vocal cords?
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
Free - unprocessed Ag
Lipid - soluble hormones are considered slow - acting hormones.
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.

24. What virus lies dormant in the x Trigeminal ganglia?
Staphylococcus aureus
Streptococcus agalactiae
Herpes I
Hepatocellular carcinoma

25. Name the correct artery - The left recurrent laryngeal nerve passes around it.
CD4+ T cells (helper)
Arch of the aorta
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
Renal cell carcinoma

26. Are the following conditions associated with a negative or positive nitrogen balance? - Infection
Chromosome 15 - 17
Escherichia coli
Both Neisseria and Moraxella are gram - negative cocci.
Negative

27. Name the DNA virus x Linear dsDNA; nuclear envelope; icosahedral; replicates in the nucleus
Stage 1
Positive
Adenocarcinoma (30% to 35%)
Herpes virus

28. What abdominal muscle contributes to the anterior layer of the rectus sheath - forms the inguinal ligament - and in men gives rise to the external spermatic fascia of the spermatic cord?
Conus arteriosus of the right ventricle and right and left auricles
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
External abdominal oblique
CMV; remember - EBV is associated with heterophile - positive mononucleosis.

29. Name the type of necrosis - Histologically resembles fibrin
Osteocyte
Phallus
Achalasia
Fibrinoid necrosis

30. What Ig is the major protective factor in colostrum?
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major
IgA
Chromosome 5 - 21

31. What family do the following viruses belong to? - RSV
1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
Hematoxylin
Paramyxovirus

32. Are the following major or minor Jones criteria of rheumatic fever? - Sydenham chorea
Galactose and glucose
Streptococcus agalactiae and Escherichia coli
Transcription (C comes before L in the alphabet - and transCription comes before transLation)
Major

33. Regarding the viral growth curve - is the external virus present before or after the latent period?
7
After the latent period
Valproic acid
'Lady between two Majors': latissimus dorsi - pectoralis major - and teres major

34. What are the two best indices of left ventricular preload?
Emphysema
Urogenital folds
LVEDV and LVEDP (left ventricular end - diastolic volume and end - diastolic pressure - respectively)
The central vein of the liver lobule

35. What enzyme does HIV use to integrate the proviral dsDNA into the host?
The Purkinje cell
Right brachiocephalic artery
Cryptococcus neoformans
Integrase

36. What type of membrane is characterized as being permeable to water only?
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
Complex I
Membrane depolarization is the stimulus to open these slow channels - and if they are prevented from opening - it will slow down the repolarization phase.

37. What is the most common one? - Benign ovarian tumor
Operant conditioning (reinforcement is after a response)
Cystadenoma
Diethylcarbamazine
1 day prior to ovulation

38. What is the most common one? - Viral cause of myocarditis
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Volume of distribution is decreased when a large percentage of drug is protein bound.
Coxsackie B
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.

39. What is the most common one? - Form of muscular dystrophy
Duchenne muscular dystrophy
Vagus nerve
Muscle glycogen phosphorylase
Procainamide

40. Unconsciously forgetting(forgetting that you forgot something!)
The otic ganglion. (These fibers are carried in CN IX. Remember it like this: the - oti - is in both otic ganglion and parotid gland.)
Repression
Kl
Left colic - superior rectal - and sigmoidal arteries

41. Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium?
Adult T- cell leukemia
Carbamazepine
Upper outer quadrant (left more than right)
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.

42. Name the antidote - Carbon monoxide (CO)
Small to medium - sized cerebral vessels
The stomach
Oxygen
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).

43. You would not prescribe __________ for a patient with gout who is an overexcretor of uric acid.
1. a - Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl - coenzyme A -
7
Probenecid
Phase II

44. What are the five branches of the superior mesenteric artery?
Proencephalon diencephalon derivative
Hypotonic - because NaCl is reabsorbed in the salivary ducts
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries
Insulin

45. A schizophrenic patient who is taking haloperidol is brought to your ER with muscle rigidity - a temperature of 104
Crude mortality rate
Catechol - O- methyl transferase (COMT)
Duchenne muscular dystrophy (Remember - Becker's is slower in progress - less severe - later in onset - and lacks cardiac involvement.)
Neuroleptic malignant syndrome is a potentially life - threatening condition Which is treated with symptomatic support - bromocriptine - and dantrolene.

46. What three carcinomas are associated with EBV?

47. What type of spore is defined as an asexual budding daughter yeast cell?
Metastatic carcinomas
Blastoconidia
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
Yes

48. Name the structure that enters or exits the following foramina: x Optic canal
CN II and ophthalmic artery
Staphylococcus aureus
The left gastric - splenic - and common hepatic arteries
Nasopharynx

49. What disease is associated with the HLA- DR2 and HLA- DR3 alleles
Constipation and miosis
Macule (e.g. - a freckle)
Systemic lupus erythematosus
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)

50. What disease involves microcephaly - mental retardation - cleft lip or palate - and dextrocardia?
Prophase of meiosis I (between 12th and 22nd week in utero)
Patau syndrome (trisomy 13)
Capillaries
Staphylococcus saprophyticus