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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. There is an inverse relationship between fat content and...
total body water
Curling ulcers (think curling iron = burn)
Phosphorylation of mannose residues
Previous suicide attempt

2. Is cigarette smoking associated with transitional cell carcinoma of the bladder?
Constrictor pupillae and ciliary muscles
d - Tubocurarine
Klebsiella pneumoniae
Yes. It is also a cause of cancers of the lung - esophagus - ureter - and kidney - just to Name a few.

3. Why are eukaryotes unable to perform transcription and translation at the same time like prokaryotes?
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Tinea favosa (favus)
T wave
About 80% of stage 4 sleep is recovered - approximately half of REM is recovered - and only one - third of total sleep is ever made up.

4. What hormone disorder is characterized by the following abnormalities in sex steroids? - LH? - and FSH?? - Sex steroids - LH - FSH ?
Omphalocele and gastroschisis
d - ALA synthase
Spleen
GnRH constant infusion

5. What type of bias is it when the sample population is not a true representative of the population?
Right - sided
Increase in urinary excretion of HCO3- - shifting the reaction to the right and increasing H+
Selection bias
Thrombus

6. What virus lies dormant in the x Trigeminal ganglia?
Herpes I
There is a difference; it takes about 7 to 8 half - lives to reach mathematical steady state and 4 to 5 half - lives to reach clinical steady state.
Major basic protein
Reticulocyte

7. What is the term for precipitation of calcium phosphate in dying or necrotic tissue?
Dystrophic calcification
Arginine
Medial midbrain (Weber's) syndrome
Are live attenuated vaccines available in the United States

8. Is suicidal ideation a component of normal grief?
It is rare with normal grief; however - it is relatively common in depression
The Purkinje cell
Transient ischemic attack
Pertussis toxin

9. From What embryonic structure are the following structures derived? - The right and left atria
Lente insulin and either NPH or protamine zinc insulin (PZI)
Primitive atrium
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer - Which is commonly unilateral - single nodule - no variation with pregnancy.
Melanosis coli

10. What small - to medium - sized vasculitis is seen in a 35-year - old man who is a heavy smoker presenting with claudication symptoms in the upper and lower extremities?
Buerger disease (thromboangiitis obliterans)
1. Concentration (greater concentration gradient - greater diffusion rate) 2. Surface area (greater surface area - greater diffusion rate) 3. Solubility (greater solubility - greater diffusion rate) 4. Membrane thickness (thicker the membrane - slowe
O2
Metastatic

11. What term is defined as a patient unconsciously placing his or her thoughts and feelings on the physician in a caregiver or parent role?
IgG
Transference. When it is from the physician to the patient it is called countertransference.
Major
G-6- PD

12. What vascular injury may result from a supracondylar fracture of the femur?
The popliteal artery - the deepest structure in the popliteal fossa - risks injury in a supracondylar fracture of the femur.
IL-7 (A 7 upside down is an L; L is for Lymphoid)
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
Voltage - gated potassium channels

13. Hereditary angioneurotic edema (AD) produces local edema in organs (e.g. - GI - skin - respiratory tract). What enzyme deficiency causes increased capillary permeability due to a release of vasoactive peptides?
C1 esterase inhibitor (C1INH)
Histiocytes
CLL (B- cell origin)
CMV; remember - EBV is associated with heterophile - positive mononucleosis.

14. What enzyme is used to remove the hairpin loop during production of cDNA from mRNA?
Homeodomain proteins
S1 nuclease
An internal elastic lamina
ACE inhibitors (the - pril agents)

15. Where is the lesion that produces these symptoms when a patient is asked to look to the left? - Left eye can't look to the left
RBCs
Left abducens nerve
Cilia
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.

16. Is there a shift in p50 values with anemia? Polycythemia?
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
Follicular phase
RSV
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.

17. What form of antimicrobial therapy is best for an immunocompromised patient?
Stable
Syringomyelia
Bactericidal
White rami are preganglionic fibers - whereas grey rami are postganglionic fibers.

18. Inhibition of peripheral COMT - allowing increased CNS availability of L- dopa - is accomplished by What two agents?
White muscle; short term too
Lithium
DiGeorge's syndrome
Tolcapone and entacapone

19. What muscle or muscles are innervated by the following nerves? - Suprascapular nerve
Buffers (remember that buffers are best when they are used in a pH range near its pK)
Goodpasture disease
Supraspinatus and infraspinatus
Mycoplasma pneumoniae

20. What two sugars can be used to produce cerebrosides?
Anticentromere Abs
Glucose and galactose
Sacrococcygeal teratoma
Taenia saginata

21. What are the three exceptions to the rule of codominant gene expression?
Lateral pontine syndrome
Axis I
Guanethidine and bretylium
Barr bodies in females - T- cell receptor loci - and immunoglobulin light and heavy chain loci

22. What agent - in combination with a MAOI inhibitor - can cause hypertensive crisis?
Astrocytoma
Microglia
Tyramine
Lateral rectus (CN VI) (LR6 SO4)3

23. What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN - hypokalemia - and low rennin levels?
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
Arch of the aorta
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see - can't wee - can't kick with your knee
Conn syndrome (primary hyperaldosteronism)

24. Name the compartment of the lower extremity and the nerve based on its movements - Flex the hip and extend the knee
A- T are linked by 2 hydrogen bonds - C- G by 3 hydrogen bonds.
Gilbert's syndrome
Agoraphobia. It also means having a sense of humiliation or hopelessness.
Anterior compartment of the thigh - femoral nerve

25. What is the major hormone produced in the following areas of the adrenal cortex? - Zona glomerulosa
6 years old
The primitive streak grows caudal to rostral.
Fixed ratio (rewards set behaviors)
Aldosterone Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.

26. What CN nucleus receives auditory information from both ears via the cochlear nuclei?
Humor
HHV-8
Naloxone or naltrexone
Superior olivary nucleus

27. What aphasia produces a nonfluent pattern of speech with the abilty to understand written and spoken language seen in lesions in the dominant hemisphere?
Candida
IgG
Cystic fibrosis
Expressive aphasia

28. What are the three left - to - right shunts?
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.
Gastrinoma
HPVs 16 and 18
1. VSD 2. ASD 3. PDA

29. What type of questions should you begin with when a patient seeks your medical opinion?
T lymphocyte
Streptococcus agalactiae
It is best to begin with open - ended questions - allowing patients to describe in their own words What troubles them. You can then move to closed - ended questions when narrowing the diagnosis.
Cancer of the lung - stomach - colon - and breast

30. What syndrome is associated with the following brainstem lesions? - AICA or superior cerebellar artery occlusion - resulting in ipsilateral limb ataxia - ipsilateral facial pain and temperature loss - contralateral loss of pain and temperature to the
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.
Lateral pontine syndrome
Staphylococcus aureus
Pyrantel pamoate

31. Via what cell surface receptor does HDL cholesterol from the periphery enter hepatoceles?
Cyanocobalamin (B12)
Blood
Scavenger receptor (SR- B1)
50%. The uncles and older siblings are the most likely perpetrators - although stepfathers also have a high rate.

32. What form of bilirubin can cross the blood - brain barrier?
Unconjugated free bilirubin
C5a
Craniopharyngioma
O2 affinity increases with a decrease in the p50 - making O2 more difficult to remove from the Hgb molecule.

33. Early menses - late menopause - history of breast cancer - obesity - and multiparity.
Risk factors for breast cancer
Flumazenil
Folate deficiency (very common in the elderly)
The splenic vein

34. Name the eukaryotic RNA polymerase based on the following: x Synthesizes tRNA - snRNA - and the 5S rRNA
RNA polymerase III
Alteplase
Depression
Cytokine. If a cytokine affects another class of leukocytes - it is called an interleukin.

35. What enzyme is blocked by 5- FU?
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
Knee
Decrease (5- HT and dopamine levels do the same)
Thymidylate synthetase

36. What enzyme is deficient in the following glycogen storage disease? - Pompe's disease
Thyroid gland
Lysosomal a -1 - 4- glucosidase
CN I
Aminoglycosides

37. What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?
Planning and fine - tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember - the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
Excision endonuclease - which removes thiamine dimers from DNA
Right vagus innervates the SA node and the left vagus innervates the AV node
42 L - 67% of body weight

38. What two Beta- blockers decrease serum lipids?
Klinefelter syndrome
Acebutolol and Pindolol
alpha2- Receptors
Dorsal motor nucleus of CN X

39. Name the type of necrosis - Due to lipase activity and has a chalky white appearance
GP120
pI (isoelectric point)
Fat necrosis
Pasteurella - Brucella - Legionella - and Francisella (all of the - ellas)

40. What metal poisoning produces microcytic anemia with basophilic stippling?
Phallic stage (4-6 years)
Fourth M PITS for pharyngeal pouch derivatives
Down syndrome (trisomy 21)
Lead poisoning

41. What cells of the thyroid gland secrete calcitonin?
gag gene
Parafollicular C cells
Estrogens are 18- carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
Suprachiasmatic nucleus

42. 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
The zygote divides mitotically; only germ cells divide meiotically.
IDL
One - way ANOVA
Wiskott - Aldrich syndrome

43. Pseudorosettes
Thyroid hormones are necessary for conversion of carotene to vitamin A.
PGI 2
Howell - Jolly bodies
Ewing sarcoma

44. What vessel can be found atop the scalene anterior?
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.
Subclavian vein
Legionella
Autoimmune hemolytic anemia

45. Name the most common type or cause - Diarrhea in children
Cyproheptadine
premature ejaculation
Cholesterol biosynthesis
Rotavirus

46. What organ of the body has the smallest AV oxygen difference?
Type IV collagen
Physostigmine
A positive PPD skin test
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.

47. What facultative intracellular fungus is associated with hepatosplenomegaly?
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases
Hemophilia A
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
Aedes (the same for yellow fever)

48. What law was adopted to shield physicians from liability when helping at the scene of an accident?
Flea - bitten kidney (can also be seen in pyelonephritis)
Good Samaritan Law. (Physicians are not required to stop and help.)
Antisocial
Bitemporal heteronymous hemianopsia

49. Up to How many hours post ejaculation do sperm retain their ability to fertilize the ovum?
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
Demeclocycline
Cortisol Remember - from the outer cortex to the inner layer - Salt - Sugar - Sex. The adrenal cortex gets sweeter as you go deeper.
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+ - K+ - and Cl -.

50. What Ab is an indication of low transmissibility for hepatitis?
Hairy cell leukemia
Hirschsprung disease
Legionella
HBeAb