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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. Which a - blocking agent is used to treat refractory hypertension and baldness?
Ergosterol
Mast cells
Minoxidil (orally and topically - respectively!)
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma

2. What is the precursor of all sphingolipids?
Ceramide
Demeclocycline
total body water
Hashimoto thyroiditis

3. Where is most of the body's Ca2+ stored?
Chief cells
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
McArdle's syndrome

4. What inhibitor of microtubule synthesis is the drug of choice for whipworm and pinworm?
Adipose tissue
Mebendazole
Week four - and they remain dormant there until puberty.
Permanent

5. What enzyme of the TCA cycle catalyzes the production of the following: x GTP
After the eclipse period
Succinyl CoA synthetase
Melanoma
With arteriolar constriction both the flow and pressure downstream decrease.

6. What is the most common one? - Pituitary tumor
common variable hypogammaglobinemia
Chromophobe adenoma
ASA (salicylate)
Myelofibrosis with myeloid metaplasia

7. What are the three glycogenic organs?
Hemophilia A
Thrombocytopenia - eczema - and immunodeficiency is the triad of this X- linked recessive disorder.
Pancreatic insufficiency
Liver - kidney - and GI epithelium

8. What type of Ag do B cells recognize?
Free - unprocessed Ag
Hypercortisolism (Cushing syndrome)
Haemophilus influenzae type B
Leuprolide

9. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Pons
LTB4
Rhombencephalon
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
d - Tubocurarine

10. What is the triad of Wiskott - Aldrich syndrome?
Accessory nucleus
Alendronate
Thrombocytopenia - eczema - and immunodeficiency is the triad of this X- linked recessive disorder.
Utricle and saccule

11. What two HIV regulatory genes down - regulate MHC class I expression in the host?
LTB4
nef and tat genes
Proto - oncogenes
Ulnar nerve

12. What nerve lesion presents with ape or simian hand as its sign?
Median nerve lesion
Large intestine. Water is passively removed from the lumen.
The greater the cell diameter - the greater the conduction velocity.
Hot pink with PAS and grey to black with silver stain

13. What personality disorder affects 75% of the prison population?
50% - with 50% of them having the child
Bronchogenic carcinoma
C5a
Antisocial personality

14. Name the stages of sleep with these EEG patterns: x Sleep spindles - K- complexes
Desipramine
Thymidylate synthetase
None; they are the storage sites for ADH and oxytocin.
Stage 2

15. Based on the following information - is the renal transplantation rejection acute - chronic - or hyperacute? - Months to years after transplantation; gradual onset of HTN - oliguria - and azotemia; seen as intimal fibrosis of the blood vessels and in
Klebsiella pneumoniae
Glucose -6- phosphatase
Chronic rejection
Hemochromatosis

16. What is the term for tissue - based basophils?
Isograft
Mast cells
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
Expiratory reserve volume (ERV)

17. What is the most common one? - Sites for abdominal aorta aneurysm
Between the renal arteries and at the bifurcation of the abdominal aorta
Paramesonephric ducts
Onset of bleeding
common variable hypogammaglobinemia

18. The ___________ of the urinary bladder and the urethra are embryologic hindgut derivatives.
Thrush
Lisch nodules
epithelial lining
Renal failure

19. What disorder of aldosterone secretion is characterized by x Decreased total body sodium - ECF volume - plasma volume - BP - and pH; increased potassium - renin - and AT II activity; no edema?

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20. Name the most common cause - Chronic pancreatitis
Alcohol abuse
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
Turcot syndrome
Liver - kidney - and GI epithelium

21. Which streptococcal species is associated with dental caries and infective endocarditis in patients with poor oral hygiene?
Lead
Primary erectile disorder
Potency
Streptococcus viridans

22. What vitamin deficiency can result in high - output cardiac failure?
Fo/F1 complex
Outside the cell
Recall bias. These problems arise in retrospective studies.
Thiamine

23. What lower extremity nerve is described by the following motor loss? - Loss of flexion of the knees and toes - plantarflexion - and weakened inversion
Staphylococcus aureus
Tibial nerve
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
The short arm of chromosome 6

24. How many carbons do androgens have?
Prolyl and lysyl hydroxylases
CD15 and CD30
Androgens are 19- carbon steroids.
Motilin

25. 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 - decrease; body: increase
Krukenberg tumor
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)
Huntington disease
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)

26. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
Wilson disease. (Remember - patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
Thyroarytenoid muscles
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
The T- test (used when comparing two groups)

27. What are the CAGE questions?
Ventricular contraction Atrial - Contraction - Venous
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Persistent truncus arteriosus

28. What is the anatomic positioning of the right and left gastric nerve plexus of the esophagus as they pass through the diaphragm?
Mitral insufficiency
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
von Hippel - Lindau syndrome

29. What capsular serotype is associated with Escherichia coli - induced meningitis?
K1 capsule
Vancomycin
90% of benign myxomas arise within the left atrium near the fossa ovalis.
Osteoma

30. What is the size of a positive PPD test for the following? (Reactive) x IV drug abuser
Hypotonia (rag doll appearance)
Zollinger - Ellison syndrome
>10 mm
Right and left pulmonary arteries and the ductus arteriosus

31. Would a G- C or an A- T rich dsDNA sequence have a higher melting point? Why?
Negative
G- C rich sequences - because they have 3 hydrogen bonds - where A- T has 2 hydrogen bonds - resulting in higher melting points.
Diastole. During systole the left ventricle contracts - resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Ligament of Treitz

32. What disease with familial mental retardation produces large - everted ears and macro - orchidism?
Osmosis; water will diffuse from higher to lower water concentrations.
Fragile X syndrome
Escherichia coli
The carotid sinus reflex

33. What viruses are associated with cervical carcinoma?
Escherichia coli
Cleft palate
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
HPVs 16 and 18

34. What percentage of nephrons is cortical?
Wiskott - Aldrich syndrome
Seven - eighths of nephrons are cortical - with the remainder juxtamedullary.
Peau d'orange
Cystic fibrosis

35. What is the term for black pigmentation of the colon associated with laxative abuse?
Sadism
Melanosis coli
NADPH and molecular O 2
T cells - B cells - and macrophages

36. What three muscles constitute the pes anserinus?
In the PNS - myelin is produced by Schwann cells - in the CNS by oligodendrocytes.
1. Sartorius 2. Gracilis 3. Semitendinous
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases
A gene (a rather simple definition but accurate)

37. Increases the risk of developing squamous cell carcinoma of the penis.
HPV infection
Eosin
Tryptophan
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis

38. Name the area of the cerebral cortex affected by the description of the effects - symptoms - and results of the lesion - Apathy - poor grooming - poor ability to think abstractly - decreased drive - poor attention span (Hint: if the lesion is in the
Dorsal prefrontal cortex
Pseudohyphae
Lung recoil - being a force to collapse the lung - increases as the lung enlarges during inspiration.
HBeAg

39. What is the most common one? - Malignant tumor in the bone of teenagers
Osteosarcoma
Treacher Collins syndrome
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.
Hematogenous

40. What type of pleura is adherent to the surface of the organ?
Purulent exudates
Emphysema
apo A-1
Visceral pleura

41. What happens to prevalence as duration increases?
RNA polymerase II
Heart rate determines the diastolic interval - and contractility determines the systolic interval.
Adult polycystic kidney disease
Prevalence increases. (Incidence does not change.)

42. What signals are used to direct an enzyme to a lysosome?
Agranulocytosis; approximately 2% develop this side effect.
Glucocorticoids and amphetamines
Phosphorylation of mannose residues
Breast and lung cancer - respectively.

43. Name at least three bacteria that use capsules to prevent immediate destruction from the host's defense system.
Streptococcus pneumoniae - Klebsiella pneumoniae - Haemophilus influenzae - Pseudomonas aeruginosa - and Neisseria meningitidis; also Cryptococcus neoformans - a fungus
Klinefelter syndrome
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Osteogenesis imperfecta

44. Which organism causes trench mouth?
The resistance will decrease one - sixteenth of the original resistance.
Hexosaminidase A
Fusobacterium
Aldosterone

45. Preeclampsia in the first trimester - hCG levels above 100 - 00 mIU/mL - and an enlarged bleeding uterus are clinical signs of what?
Hydatidiform mole
Phase 3
Undoing
Boutonni

46. What is the DOC for trigeminal neuralgia?
Ligament teres
Kl
Trimethoprim/sulfamethoxazole (TMP- SMX)
Carbamazepine

47. Name the most common type or cause - Noniatrogenic hypothyroidism in the United States
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.
CN VII and VIII
Ethyl alcohol
Hashimoto thyroiditis

48. What subtype of IgG does not activate complement cascade?
Jejunum (upper)
IgG4
Osteoblasts (Remember - they modulate the function of osteoclasts.)
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.

49. Name the antidote - Organophosphates
Postinfectious GN
Atrophy. Disuse can also be due to immobilization - ischemia - aging - and a host of other causes.
Trichomonas vaginalis (treat with metronidazole)
Atropine - 2- PAM (pralidoxime)

50. Name the ventricular muscle membrane channel: x Always open
Graves disease
Ungated potassium channel
CN V1 - the occulomotor division of the trigeminal nerve - is the sensory component of the corneal reflex.
Sarcoidosis