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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 large - diameter vessel has the smallest cross - sectional area in systemic circulation?
The aorta
Expiratory reserve volume (ERV)
Idiotypes
Confounding bias

2. What lymphoma is characterized by CD19 - CD20 - CD5; CD23- negative; and chromosome 11;14 translocations?
Thymine
Mantle cell lymphoma
Paramyxovirus
GnRH

3. Are the following major or minor Jones criteria of rheumatic fever? - Migratory polyarthritis
IF-2 of the 30S subunit
Vesicular stomatitis virus
Major
Burkitt lymphoma

4. Name the hypochromic microcytic anemia based on the following laboratory values - Normal iron - TIBC - percent saturation - and ferritin
Thalassemia minor
Ulnar nerve
Stratified squamous nonkeratinized epithelium - which has cilia that beat toward the oropharynx.
Proencephalon

5. What are the three branches of the lateral cord of the brachial plexus?
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
Eosinophils
Increased leukocyte alkaline phosphatase (LAP)

6. What muscle or muscles are innervated by the following nerves? - Thoracodorsal nerve
Masochism
First - pass metabolism and acid lability
Increased CO2 - H+ - temperature - and 2 - 3- BPG levels all shift the curve to the right - thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.
Latissimus dorsi

7. In prokaryotes - What is the name of the RNA sequence that ribosomes bind to so translation can occur?
At the end of the PCT 25% of the original volume is left
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells - virus - infected cells
Shine - Dalgarno sequence
Breast cancer

8. What virus causes small pink benign wartlike tumors and is associated with HIV- positive patients?
Middle cerebral artery
Ciliary ganglion
Erythema nodosum
Molluscum contagiosum

9. What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
Macule (e.g. - a freckle)
HBc Ab
Adrenarche
Papule

10. What hormone controls relaxation of the lower esophageal sphincter during swallowing?
Primitive atrium
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Neuroblastoma
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.

11. What is the drug of choice for filariasis and onchocerciasis?
Diethylcarbamazine
There would be two Fab and Fc regions.
Hepatitis D
Varicocele

12. With What thoracic vertebra or vertebrae does rib 7 articulate?
Dissociative fugue. (Patients are unaware of memory loss.)
Ptosis (eyelid drooping) - miosis (pupillary constriction) - and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1- to T4 are obstructed.
Streptokinase
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.

13. What scale assesses a rank order classification but does not tell the difference between the two groups?
Gap junctions
Cross - sectional studies determine prevalence - not incidence or cause and effect.
Ordinal scale (e.g. - faster/slower - taller/shorter)
Leptospira

14. What protein allows Mycoplasma to attach to the respiratory epithelium?
Musculophrenic and superior epigastric arteries
HMG CoA synthase
P1 protein
GP IIb and IIIa receptors

15. Based on the onset of the symptoms - how are bacterial conjunctivitis from Neisseria and Chlamydia differentiated?
Graves disease
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days - whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.
REM latency; normally it is about 90 minutes.
Hot pink with PAS and grey to black with silver stain

16. Is ACh associated with bronchoconstriction or bronchodilation?
Upper outer quadrant (left more than right)
BPH
Bronchoconstriction is associated with parasympathetic stimulation (ACh) - and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
Rods

17. Name the most common type or cause - Infantile bacterial diarrhea
Stranger anxiety
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
90% as HCO3- - 5% as carbamino compounds - and 5% as dissolved CO2
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)

18. What adrenal enzyme deficiency results in hypertension - hypernatremia - increased ECF volume - and decreased adrenal androgen production?
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
Parainfluenza virus
Confidence interval. It is a way of admitting estimation for the population.
17- alpha - Hydroxylase deficiency

19. What does Candida albicans do that distinguishes it from other fungi?
It forms a germinal tube at 37
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
Saltatory conduction

20. What wave is the cause of the following venous pulse deflections? - The rise in right atrial pressure secondary to blood filling and terminating when the tricuspid valves opens
Parainfluenza virus
Lower lobe
Aromatase
V wave

21. What test is used to detect anti - RBC Abs seen in hemolytic anemia?
Proportionate mortality rate
Phase 1
Astrocytoma
Coombs test

22. What cells of the retina see in black and white and are used for night vision?
Superego
Proportionate mortality rate
Spinal trigeminal nucleus
Rods

23. Which penicillin can cause interstitial nephritis?
Temporal arteritis
IgE
Methicillin
Median nerve

24. What are the five hormones produced by Sertoli cells?
Early collecting duct
Microglia. All others are neuroectodermal derivatives.
Pseudomembranous colitis
1. Inhibin 2. Estradiol (E2) 3. Androgen - binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antim

25. What is the only diuretic that works on the blood side of the nephron?
Adenocarcinoma (because of Barrett esophagus)
Gardnerella vaginalis
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Spironolactone (binds to aldosterone receptors)

26. Name the valve abnormality based on the following criteria: x Systolic murmur - increased preload and afterload - decreased aortic pulse pressure and coronary blood flow
Class IV
Verbigeration
Aortic stenosis
The pulmonary vein - which carries oxygenated blood from the lung to the left atrium.

27. From What aortic arch are the following structures derived?
Calcium oxalate
They are in the grey matter of the CNS.
Degenerates
Huntington disease

28. What are the vitamin K- dependent coagulation factors?
Factors II - VII - IX - X - and proteins C and S
100% - with about 20% remaining positive after 1 year
Hemophilia A
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.

29. Charcot - Leyden crystals
Secondary hypercortisolism (pituitary)
Alcoholism
HTLV-1
Bronchial asthma (eosinophil membranes)

30. At what stage of sleep is GH output elevated?
Stage 4
Klinefelter syndrome
Pedophilia
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.

31. Caf
Neurofibromatosis
The left is a branch of the aortic arch - while the right is a branch of the brachiocephalic trunk.
Hydatidiform mole
Shigella

32. What hormones - secreted in proportion to the size of the placenta - are an index of fetal well - being?
Mast cells
Nodular sclerosis
Pedophilia
hCS and serum estriol - which are produced by the fetal liver and placenta - respectively - are used as estimates of fetal well - being.

33. What happens to prevalence as incidence increases?
Separation anxiety
Prevalence increases.
Yes
False - positive rate

34. What is the term for the same results achieved again on testing a subject a second or third time?
NH4+(ammonium)
Mitochondria
Test - retest reliability
The Halsted - Reitan battery. It consists of finger oscillation - speech sound perception - rhythm - tactual - and category testing.

35. How many NADPHs are used per addition of acetyl CoA into a fatty acid chain?
2 NADPHs per acetyl CoA
Negative
Loss of isotonic fluid (diarrhea - vomiting - hemorrhage)
Filtered and secreted: Cx > Cin (i.e. - PAH). Filtered and reabsorbed: Cx < Cin (i.e. - glucose) - where Cx = clearance of a substance and Cin = clearance of inulin.

36. Name the associated chromosome - Edward syndrome
Chromosome 18
B lymphocyte
HMG- CoA reductase
Hydrophobic (water - insoluble) end faces the aqueous environment and the hydrophilic (water - soluble) end faces the interior of the cell.

37. What are the two absolute requirements for the cytochrome P450 enzyme system?
Complex I
Respiratory depression
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
NADPH and molecular O 2

38. How many high - energy bonds are used to activate an AA?
Ischemic
S phase
Eosin
2 ATPs - via the amino acyl tRNA synthase enzyme

39. Name the Plasmodium species based on the following information: No persistent liver stage or relapse; blood smear shows multiple ring forms and crescent - shaped gametes; irregular febrile pattern; associated with cerebral malaria
Type 2
Scavenger receptor (SR- B1)
H 2
Plasmodium falciparum

40. What is the term for hyphae with constrictions at each septum that are commonly seen in Candida albicans?
Pseudohyphae
Eaton - Lambert syndrome
Internal abdominal oblique
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)

41. What percentage of children born to HIV- positive mothers will test positive for HIV at birth?
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.
The fast component is directed toward the affected side of a cerebellar lesion.
100% - with about 20% remaining positive after 1 year
Lente insulin and either NPH or protamine zinc insulin (PZI)

42. What parasympathetic nucleus is found on the floor of the fourth ventricle and supplies preganglionic fibers innervating the terminal ganglias of the thorax - foregut - and midgut?
Phase 4
Measles (rubeola)
Dorsal motor nucleus of CN X
Mast cells

43. What classical conditioning therapy or modification is described as x Pairing noxious stimuli to an inappropriate behavior?
Aversive conditioning
Cytochrome a/a3
IL-8 (IL-1 and TNF- gamma also)
Microglia

44. What are the two exceptions to the rule 'all cocci are gram positive'?
Crohn disease
Both Neisseria and Moraxella are gram - negative cocci.
QRS complex
Being a female physician increases the risk of suicide nearly four times the general population.

45. What is the term for the number of individuals who have an attribute or disease at a particular point in time?
V wave
Stage 2
1. Glycine 2. Aspartate 3. Glutamine
Prevalence rate

46. Name the cancer associated with the following oncogenes. (Some may have more than one answer) x hst -1 - int -2 - erb -2 - and erb -3
Seminoma
Ribonucleotide reductase
Breast cancer
Phase 1

47. Name the macrophages by location: x CNS
The venae recta maintain the gradient via countercurrent flow.
Proportionate mortality rate
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
Microglial cells

48. What prokaryotic positioning enzyme in translation is blocked by the following? - Erythromycin
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)
EF- G of the 50S subunit
Projective drawing. The artistic form is irrelevant - but the size - placement - erasures - and distortions are relevant.
Intussusception

49. What level of mental retardation is characterized by x Needing a highly structured environment with constant supervision?
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.
Profound (I.Q. range < 20)
Pseudomonas aeruginosa
Metronidazole

50. If a lesion occurs before the onset of puberty and arrests sexual development - What area of the hypothalamus is affected?
Hapten; if it is coupled with a carrier - it may become immunogenic.
Type II hypersensitivity reaction
Scleroderma
Preoptic area of the hypothalamus; if the lesion occurs after puberty - amenorrhea or impotence will be seen.