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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 II hypersensitivity disorder is defined as x Autoantibodies directed against ACh receptors?
Dihydrofolate reductase
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
Graves disease
Myasthenia gravis

2. Name the type of regeneration (i.e. - labile - stable - or permanent) based on the following examples - Pancreas
Invasive ductal carcinoma
Stable
For the USMLE Step 1 the answer is no - but if the information would do more harm than good - withhold. This is very rare but it does occur.
Serocystadenoma

3. What organelle is responsible for ribosomal RNA synthesis?
CN III and IV
Chromosome 5q21
Adenosine deaminase
Nucleolus. Ribosomal assembly also takes place in the nucleolus.

4. What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
HMG CoA synthase
Hormone - sensitive lipase
Bile pigments and bile salts
The T- test (used when comparing two groups)

5. Is T3 or T4 responsible for the negative feedback loop on to the hypothalamus and anterior pituitary gland?
T4 - as long as T4 levels remain constant - TSH will be minimally effected by T3.
ALA dehydrogenase and ferrochelatase
PTH
Decreasing potassium conductance - which results in increased excitability

6. What is the term for a direct connection between the intestine and the external environment through the umbilicus because the vitelline duct persists?
Atrial contraction Atrial - Contraction - Venous
Neutropenia - splenomegaly - and rheumatoid arthritis
Vitelline fistula
Alveolar dead space

7. What nerve is associated with the following functions? - Flex the wrist and digits - pronate the wrist and the LOAF (Lumbricales - Opponens pollicis - Abductor pollicis brevis - Flexor pollicis brevis) muscles of the hand
Clostridium perfringens
Muscle spindles
Pneumococcus
Median nerve

8. What fungus causes endocarditis in IV drug users?
Candida albicans
If the polyuria begins before the collecting ducts - the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts - the patient is dehydrated with normal electrolytes.
pK (think of it as where half is base and half is acid)
Spasms of the uterus - bladder - and the biliary tree occur with all of the opioids except meperidine.

9. Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it?
Lateral compartment of the leg - superficial peroneal nerve
The greater the cell diameter - the greater the conduction velocity.
Chromosome 19
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia

10. What happens to extracellular volume with a net gain in body fluid?
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Serratus anterior
Ribonucleotide reductase

11. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Personality and mental disorders?
Axis II
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Adenocarcinoma
Bulla

12. What antiviral agent is used in the treatment of drug - induced Parkinson's disease?
Amantadine
Aorta - azygos vein - and thoracic duct Remember: 1 at T8 - 2 at T10 - and 3 at T12
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
The right gonadal vein drains into the inferior vena cava directly - and the left gonadal vein drains into the left renal vein.

13. What are the four capsular polysaccharides used in the Neisseria meningitides vaccine?
HHV 8
Y - W-135 - and C and A capsular polysaccharides
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
Acebutolol and Pindolol

14. What is the label given to an individual whose IQ is x Below 69
Coxiella burnetii
Stratum corneum (keratinized)
Mentally disabled
Breathing high - pressure nitrogen over a long time and sudden decompression result in the bends.

15. Is not found in smooth muscle - liver - and the kidneys.
Median nerve
A right CN V lesion results in weakened muscles of mastication - and the jaw deviates to the right.
Paneth cells
Catechol - O- methyl transferase (COMT)

16. Name the six vitamin K- dependent coagulation factors.
Factors II - VII - IX - and X and proteins C and S.
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
Thymidylate synthase
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells

17. Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade?
Glucose and galactose
Resorb CSF into the blood
Valence
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade

18. What form of renal tubular reabsorption is characterized by low back leaks - high affinity of a substance - and easy saturation? It is surmised that the entire filtered load is reabsorbed until the carriers are saturated - and then the rest is excret
At least 30% blast in the bone marrow
Cytochrome b/c1
Senile plaques - neurofibrillary tangles - and granulovascular changes in neurons
A transport maximum (Tm) system

19. What are the two most common viral infections in HIV?
CMV retinitis and HSV-2
Homogentisic oxidase
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
Dendritic cells - macrophages - and thymic epithelial cells

20. How does myelination affect conduction velocity of an action potential?
The greater the myelination - the greater the conduction velocity.
Chromosome 15q
Transposons
C5- C8 deficiency

21. What is the term for the load on a muscle in the relaxed state?
Klebsiella pneumoniae
Duct cells secrete HCO3- - electrolytes - and water. The acini secrete the enzymes necessary for carbohydrate - nucleic acid - protein cleavage - and emulsification of fats.
Phallic stage (4-6 years)
Preload. It is the load on a muscle Prior to contraction.

22. What limb of the internal capsule is not supplied by the middle cerebral artery?
Pneumothorax
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
Hemiballismus

23. In what stage of sleep is GH secreted?
Stages 3 and 4 (NREM)
Compliance (think of it as distensibility)
VLDL
Endometriosis

24. Which sedative - hypnotic is contraindicated for patients taking warfarin?
Superior and posterior
Chloral hydrate
Affinity
Yellow fever (flavivirus)

25. Which drug is used to treat respiratory depression associated with an overdose of opioids?
Naloxone or naltrexone
Lesser curvature of the antrum of the stomach
Ependymoma
Purine nucleoside phosphorylase

26. What three vitamin deficiencies are associated with homocystinemia?
Gardnerella vaginalis
Palindrome
Cefuroxime and cefaclor
Folate - vitamin B12 - and vitamin B6

27. What presynaptic receptor does NE use to terminate further neurotransmitter release?
Middle
alpha2- Receptors
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)
Sideroblastic anemia

28. What hormone causes milk letdown?
Small to medium - sized cerebral vessels
Hyperplasia
Kl
Oxytocin

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?
Friedreich ataxia
2 acetyl CoA per glucose - producing 12 ATPs per acetyl CoA - resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
Arginine
Anterior compartment of the leg - deep peroneal nerve

30. Name the most common type or cause - Restrictive cardiomyopathy
A Ghon focus is a TB tubercle - whereas a Ghon complex is a focus with hilar lymph node involvement.
Amyloidosis
There would be two Fab and Fc regions.
Action potential

31. What enzyme requires molybdenum as a cofactor?
Xanthine oxidase
Isocitrate dehydrogenase - a - ketoglutarate dehydrogenase - and malate dehydrogenase
Duodenal ulcer
Masochism

32. Name the associated chromosome - Tay- Sachs disease
A loss of afferent activity indicates a decrease in BP - and an increase in afferent activity indicates an increase in BP.
Chromosome 15q
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
Clostridium botulinum

33. What are the two leading causes of cancer - related death in women?
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)
Breast and lung cancer - respectively.
ELISA test
Giardia lamblia (treat with metronidazole)

34. Name these narcissistic defense mechanisms: x Person takes his or her own feelings - beliefs - wishes - and so on and thinks they are someone else's. (e.g. - a cheating man thinks his wife is unfaithful)
Two - way ANOVA. It allows the test to check several variables at the same time.
Rationalization
Fibrocystic change of the breast
Projection

35. What is the start codon - and What does it code for in eukaryotes? Prokaryotes?
Sjogren's syndrome - active hepatitis - systemic lupus erythematosus (with HLA- DR2) and type 1 diabetes (with HLA- DR4)
Rapid efflux of potassium
The one start codon - AUG - in eukaryotes codes for methionine and in prokaryotes formylmethionine.
Neonatal respiratory distress syndrome (NRDS)

36. What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
The parasympathetic nervous system
Cardiac output
The fasciculus gracilis (Graceful) - which lies closest to the midline of the spinal cord.
Operant conditioning (reinforcement is after a response)

37. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Asbestos
Alcohol and its related problems cost the country approximately $100 billion a year.
Bunyavirus
Transudative; exudative has the opposite values and has an elevated cellular content.
Mesothelioma and bronchogenic carcinoma

38. What are the primary neurotransmitters at the following sites? - Postganglionic sympathetic neurons
NE
The energy of activation (Ea)
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
The optic disk is the blind spot.

39. What complex of the ETC contains Cu2+?
ALA dehydrogenase and ferrochelatase
Complex 4
Because RPF is markedly decreased - while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Depression

40. Name the type of mutation: x The deletion or addition of a base
HPV serotypes 1 and 4
Multiple sclerosis
Frameshift
Psammoma bodies

41. Regarding the Lac operon - for What do the following genes code? - A gene
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.
Secondary spermatocyte
Second M PITS for pharyngeal pouch derivatives
Thiogalactoside transacetylase

42. What is the leading cause of preventable premature death and illness in the United States?
The respiratory system
Single - strand DNA binding protein
Middle
Smoking

43. What enzyme catalyzes the rate - limiting step in glycogenolysis?
Glycogen phosphorylase
Removal of the ileum
Probenecid
Pyelonephritis

44. What disorder is due to a deficiency in the enzyme glucocerebrosidase?
Chi - square (when you are in doubt and have nominal data - use chi - square)
Axis I
Ceramide
Gaucher disease

45. What nematode is known as whipworms? What is the treatment?
T3
Osteoblasts (Remember - they modulate the function of osteoclasts.)
Trichuris trichiura is treated with albendazole.
Thiogalactoside transacetylase

46. What is the drug of choice for filariasis and onchocerciasis?
IDL
Diethylcarbamazine
CN X (Remember - the vagus nerve supplies the parasympathetic information from the tip of the pharynx to the end of the midgut and all between.)
Fibrocystic change of the breast

47. What receptors are the best markers for NK cells?
CD16 and CD56
Cardiac muscle
Guanethidine and bretylium
Molybdenum (Mb)

48. Name the stages of sleep with these EEG patterns: x Disappearance of alpha waves - appearance of theta waves
Klinefelter syndrome
Stage 1
Fusobacterium
L4 to S3 (L2 to L4 - thigh; L4 to S3 - leg)

49. Name the cancer associated with the following chemical agents. (Some may have more than one answer.) x Polycyclic aromatic hydrocarbons
Bronchogenic carcinoma
absorption
Factor XII for the intrinsic; factor VII for the extrinsic pathway
AML- M3

50. Name the Hgb - O2 binding site based on the following information: x Remains attached under most physiologic conditions
The vaccine contains 23 capsular polysaccharides.
Site 1
First - pass metabolism and acid lability
No. It is abnormal only if it interferes with normal sexual or occupational function.