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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 result occurs because of the negative alveolar pressure generated during inspiration?
Acetyl CoA (pyruvate to acetyl CoA)
Lumbar splanchnics
Right atrium
Air flows into the respiratory system.

2. What is the treatment for nephrogenic diabetes insipidus induced by lithium?
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
Farnesyl pyrophosphate (FPP)
Amiloride
excites the neuron

3. What phobia is described as the fear of open spaces?
Agoraphobia. It also means having a sense of humiliation or hopelessness.
Inhibin - m
Urachus
Triazolam

4. What endocrine abnormality is characterized by the following changes in PTH - Ca2+ - and inorganic phosphate (Pi)? - PTH increased - Ca2+ increased - Pi decreased
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
Primary hyperparathyroidism
1. Sweat glands 2. Arterioles 3. Veins
Anterior hypothalamic zone; lesions here result in hyperthermia.

5. What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? - Osmolarity
Pantothenic acid
Postinfectious GN
Voyeurism
300 mOsm/L

6. What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency - glucocorticoid deficiency - and an excess of adrenal androgens?
21-Beta- Hydroxylase deficiency leads to hypotension - hyponatremia - and virilization.
Borrelia recurrentis
Short - chain fatty acids
Cryptococcus

7. What muscle or muscles are innervated by the following nerves? - Long thoracic nerve
Plasmodium malariae; the others are tertian.
Serratus anterior
<2
Fc portion of IgG - C3b - and mannose - binding proteins

8. What is the signal to open the voltage - gated transmembrane sodium channels?
Trazodone
None. Denaturation of dsDNA breaks hydrogen bonds - not covalent bonds.
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Achalasia

9. What pancreatic islet cell secretes somatostatin?
ydroxyproline
Acetyl CoA - FADH2 - and NADH
Second M PITS for pharyngeal pouch derivatives
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.

10. What is the largest organ in the body?
Integument (skin and its derivatives)
Conduction aphasia
Yolk sac tumor
First pharyngeal groove; all others degenerate.

11. What is the most common one? - Brain tumor
Metastatic
Corynebacterium diphtheriae
8 weeks (response to a face)
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid

12. Name the MCC - Aspiration pneumonia in an alcoholic
Pneumothorax
Klebsiella pneumoniae
Pons
Water - soluble hormones are considered fast - acting hormones.

13. What drug causes a sixfold increase in schizophrenia - can impair motor activity - and can cause lung problems?
Tay- Sachs disease
Marijuana
Proencephalon diencephalon derivative
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.

14. What disorder of aldosterone secretion is characterized by x Increased total body sodium - ECF volume - plasma volume - BP - and pH; decreased potassium - renin and AT II activity; no edema?
Hepatic glycogen phosphorylase
Viruses
1. Posterior auricular vein 2. Posterior division of the retromandibular vein
Primary hyperaldosteronism (Conn syndrome)

15. To What is the diffusion rate indirectly proportional?
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
Being single
RNA polymerase III
Superior

16. Is not found in smooth muscle - liver - and the kidneys.
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
Large intestine. Water is passively removed from the lumen.
Catechol - O- methyl transferase (COMT)
Voyeurism

17. What pituitary hormone is inhibited during sleep?
Being a white male
TSH. 5- HT and prolactin increase during sleep - and dopamine levels decrease during sleep.
Nystagmus is named by the fast component - Which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Yes - as long the illness does not threaten limb or life. If illness is critical or an emergency - treat the child.

18. A schizophrenic patient who is taking haloperidol is brought to your ER with muscle rigidity - a temperature of 104
M12 strains
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR - Appearance - Pulse - Grimace - Activity - Respiration
Neuroleptic malignant syndrome is a potentially life - threatening condition Which is treated with symptomatic support - bromocriptine - and dantrolene.

19. Is Dubin - Johnson or Rotor syndrome associated with black pigmentation of the liver?
Intraductal papilloma
Nodular melanoma
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Both are AR with conjugated hyperbilirubinemia - but Dubin - Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.

20. What bacterium is a gram - negative - oxidase - positive aerobic rod that produces a grapelike odor and pyocyanin pigmentation?
Hepatitis C
NO!! Remember - only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Pseudomonas aeruginosa
PR interval

21. Name the compartment of the mediastinum associated with the following thoracic structures: Left common carotid artery
Thyroid gland
Spermatogonia (type B)
Histoplasma capsulatum
Superior

22. Name the associated chromosome - Albinism
Recall bias. These problems arise in retrospective studies.
Intermediate part of the hemispheres
Chromosome 11p
Denial

23. What is the second cell involved in the immune response?
Histidine - because of the imidazole ring found in the R group - is basic.
The CD4 T cell; the APC is the first cell in the immune response.
Subarachnoid hematoma
Confounding bias

24. What is the triad of Reiter syndrome?

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25. Where in the GI tract does the reabsorption of bile salts take place?
Bile salts are actively reabsorbed in the distal ileum.
ydroxyproline
REM and stage 4 sleep; they decrease.
Arnold - Chiari malformation type 2

26. What do the following values indicate? - ED50
Effective dose for 50% of drug takers (median effective dose)
Pyridoxine (B6) deficiency
Skin - liver - and kidneys
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)

27. What DNA viral disease is associated with aplastic crisis in patients with sickle cell anemia?
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream - and the -35 promoter site is self - explanatory.
Parvovirus B-19
1. Propranolol 2. Timolol 3. Carteolol
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get

28. All of the hormones in the hypothalamus and anterior pituitary gland are...
G1 phase (gap 1)
Water soluble
Succinylcholine and halothane (Treatment is with dantrolene.)
Thiamine

29. Indicates the patient has active pulmonary disease.
Hypochondriasis (they will begin with 'I think I have...')
A positive PPD skin test
Nigrostriatal pathways (basal ganglia)
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.

30. What is the name of the major chemotactic agent released from x Bacteria?
Dihydropteroate synthetase
F- Met - Peptides
Myasthenia gravis
Al - Anon

31. Name the pattern of genetic transmission characterized thus: both M and F are affected; M may transmit to M; each generation has at least one affected parent; and one mutant allele may produce the disease.
Valproic acid
Autosomal dominant
ACL
Hepatitis D

32. What is the most common one? - Pancreatic islet cell tumor
Insulinoma
Oxytocin
Methylation of bacterial DNA
Lesch - Nyhan syndrome

33. How many acetyl CoAs per glucose enter into the TCA cycle?
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
Transposons
Constrictor pupillae and ciliary muscles
They innervate LMNs.

34. What cell is under control of FSH and testosterone; secretes inhibin - MIF - and androgen - binding protein; and phagocytizes the excess cytoplasm of the spermatid?
Edinger - Westphal nucleus (via CN III)
Fructose -1 - 6- bisphosphatase
Hydatidiform mole
Sertoli cell

35. Name the compartment of the lower extremity and the nerve based on its movements - Plantar flex the foot and evert the foot
Lateral compartment of the leg - superficial peroneal nerve
Venous pressure above the heart is subatmospheric - so a puncture there has the potential to introduce air into the system.
1. Maltose 2. Maltotetrose 3. a - Limit dextrans (a -1 - 6 binding)
Bacterial meningitis

36. At what stage of cognitive development (according to Piaget) do children x Lack law of conservation and be egocentric?
Staphylococcus aureus
Galactitol
Variable ratio If it is based on time - it is an interval - and if it is based on the number of responses - it is a ratio.
Preoperational (2-6 years)

37. What operant conditioning therapy or modification is described as x Providing the person with information regarding his or her internal responses to stimuli with methods of controlling them?
Biofeedback
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Succinylcholine
Sheehan syndrome

38. What is the most common one? - Form of arthritis
Osteoarthritis
5' deiodinase
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
Dimorphic

39. What connects the lateral ventricles to the third ventricle?
Aspiration pneumonia
Gabapentin
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
Foramen of Monro

40. Name the area of the cerebral cortex with the function described: x Skill - based memory - verbal recall - balance - refined voluntary movements
Tibial nerve
Cerebellum
Prostate and lung cancer - respectively
Vanillylmandelic acid (VMA)

41. Name the antidote - Nitrates
Methylene blue
It both begins and ends at T4 (sternal angle [of Louis]).
Paranoid schizophrenia
The sensory component is through the superior laryngeal nerve - and the motor limb is via the recurrent laryngeal nerve.

42. Name the most common type or cause - Restrictive cardiomyopathy
Alzheimer disease
Amyloidosis
Transmembrane potential (an absolute number)
Inferior Oblique (CN III) (LR6 SO4)3

43. What is the most common disease or infection reported to the CDC?
Listeria monocytogenes
Melanin
Chlamydia; gonorrhea is second (Remember - it is mandatory to report STDs to the CDC.)
Dilator pupillae muscle

44. What two forms of insulin - if mixed together - precipitate zinc?
The carotid sinus is a pressure - sensitive (low) receptor - while the carotid body is an oxygen - sensitive (low) receptor. (Remember 'Sinus Pressure').
Rapid cycling bipolar disorder
Lente insulin and either NPH or protamine zinc insulin (PZI)
Crigler - Najjar syndrome

45. What is the anatomic positioning of the right and left gastric nerve plexus of the esophagus as they pass through the diaphragm?
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
Pseudomonas aeruginosa
hCG
Edward syndrome (trisomy 18)

46. What enzyme is needed to activate the following reactions? - Procarboxypeptidase to carboxypeptidase
Trypsin
In the first and second bronchi
Phase 0
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.

47. What condition results in a strawberry gallbladder?
Papillary carcinoma of the ovary
Cholesterolosis
Ventricular fibrillation (V fib)
Narcissistic

48. What is the main mechanism for exchange of nutrients and gases across a capillary membrane?
Mean
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Simple diffusion; it does not use protein - mediated transport
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.

49. What are the three effects of insulin on protein metabolism?
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
Adult T- cell leukemia
Positive sense RNA means it can serve as mRNA and therefore has 5'-3' polarity

50. Describe the organism based on the following information: x Beta - hemolytic Streptococcus sensitive to bacitracin
Streptococcus pyogenes
Fitz - Hugh - Curtis syndrome
TXA2
Adult T- cell leukemia