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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 oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis?
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
Metformin
If the ratio of the filtrate to plasma concentration of a substance is equal - the substance is freely filtered by the kidney.
Hydrostatic pressure of the glomerular capillaries (promotes filtration)

2. Name the cancer associated with the following tumor markers. (Some may have more than one answer.) x CA-19.9 and CEA
Primary follicle of the cortex
Ungated channels
Pancreatic cancer
Ischemia

3. Which chromosome is associated with MHC genes?
Histamine
Chromosome 6
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia

4. What are the two reasons for megaloblastic anemia with elevated MCV?
Potency
The alveolar PO2 and PCO2 levels
Escherichia coli
Vitamin B12 deficiency and folate deficiency

5. Waxy casts
Hypnopompic hallucinations occur during awakening - whereas hypnagogic hallucinations occur while one is falling asleep.
Ductus epididymis - Which is lined by pseudostratified epithelium with stereocilia.
Chronic end - stage renal disease
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.

6. Name the valve abnormality based on the following criteria: x Systolic murmur - increased preload and afterload - decreased aortic pulse pressure and coronary blood flow
Aortic stenosis
A patent processus vaginalis
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
Vitamin K deficiency has normal bleeding time and increased PT - and vitamin C deficiency has increased bleeding time and normal PT.

7. In which syndrome does a person present with intentionally produced physical ailments with the intent to assume the sick role?
Alzheimer's (dementia of Alzheimer's type - DAT). (Remember - Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
C5a
M
First M PITS for pharyngeal pouch derivatives

8. What is the term to describe the increase in organ size due to the increase in cell size and function?
Expressive aphasia
Hypertrophy
Secondary lysosome (think of the primary as inactive and secondary as active)
Case control studies cannot assess incidence or prevalence - but they can determine causal relationships.

9. From What embryonic structure are the following structures derived? - The sinus venarum - coronary sinus - and the oblique vein of the left atrium
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.
Glutamate dehydrogenase
Sinus venosus
Papillary carcinoma of the thyroid

10. Where is tropocollagen aggregated to form a collagen fibril?
HMP shunt
CN V
Outside the cell
Galactoside permease

11. What liver enzyme - for triglyceride synthesis - converts glycerol to glycerol -3- phosphate?
Glycerol kinase
Degenerates
Bitemporal heteronymous hemianopsia
Acute pyelonephritis

12. Are the following conditions associated with a negative or positive nitrogen balance? - Starvation
With arteriolar constriction both the flow and pressure downstream decrease.
Negative
HGPRT
Hemostasis

13. What paraphilia is defined as x Deriving sexual pleasure from being abused or in pain?
12 days after ovulation
Masochism
Staphylococcus aureus
Secondary lysosome (think of the primary as inactive and secondary as active)

14. Kayser - Fleischer rings
Wilson disease
Rhombencephalon
Aedes mosquito
Shortens

15. What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?
Pseudogout
Middle cerebral artery
Leukotriene B4 (LTB4)
Osteoporosis

16. What are the three main functions of surfactant?
HMG CoA reductase
>10 mm
1. Lowers surface tension - so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
Nimodipine

17. What is the first Ag seen in an individual with hepatitis?
IgM
14 L - 33% of body weight
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
HBsAg (incubation period)

18. Name the macrophage based on its location: x Connective tissue macrophages
Histiocytes
Dilator pupillae muscle
Factor XII for the intrinsic; factor VII for the extrinsic pathway
Hypertension

19. What is the name of the hypothesis you are trying to prove?
Histiocytosis X
Ganciclovir
MGB
Alternative hypothesis (What is left after the null has been defined)

20. What are the two broad - spectrum penicillins?
RBCs. That is why it is called red pulp.
Ampicillin and amoxicillin
Entamoeba histolytica (treat with metronidazole)
Rheumatoid arthritis and type 1 diabetes (with HLA- DR3)

21. Name the thalamic nucleus based on its input and output - Input from globus pallidus and substantia nigra; output to primary motor cortex
Postductal coarctation of the aorta (adult)
Gonorrhea
CN VI - VII - and VIII
Ventral anterior nucleus

22. What muscles make up the rotator cuff?
Helicase (requires ATP for energy)
Yes. (Remember - Jehovah's witnesses refuse blood transfusions.)
SITS
Anticentromere Abs

23. What intrauterine deficiency leads to failure to thrive - mental retardation - motor incoordination - and stunted growth?
Bronchogenic carcinoma
Chromosome 21
Iodine - resulting in congenital hypothyroidism
Autograft

24. 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
Lead - time bias (remember - patients don't live longer with the disease; they are diagnosed sooner.)
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
M 2
Dorsal prefrontal cortex

25. What somatoform disorder is described as x Having a F:M ratio of 20:1 - onset before age 30 - and having 4 pains (2 gastrointestinal - 1 sexual - 1 neurologic)?
Somatization disorder
Acetoacetate - acetone - and Beta- hydroxybutyrate
Succinylcholine
Aldehyde dehydrogenase

26. Name the thalamic nucleus based on its input and output - Input from globus pallidus and the cerebellum; output to the primary motor cortex
HMG CoA reductase
Temporal arteritis (giant cell arteritis)
Ventral lateral nucleus
Isotonic contraction

27. Irreversible ototoxicity is associated with which loop diuretic?
Autosomal recessive
Ethacrynic acid
Lithium
Concentration gradient

28. How does ventricular repolarization take place - base to apex or vice versa?
Chromosome 3p
Absolutely not! Answer any question you are asked.
Indirect or unconjugated
Repolarization is from base to apex and from epicardium to endocardium.

29. What are the pharmacologic effects seen sexually with x Neuroleptics?
In children - the fourth ventricle; in adults - the lateral ventricle or spinal cord
Erectile dysfunction
Formal operations (> 12 years)
Proton pump inhibitors

30. Describe the organism based on the following information: x Alpha - Hemolytic Streptococcus; lysed by bile; sensitive to Optochin
Risk factors for cervical cancer
Streptococcus pneumoniae
Transference. When it is from the physician to the patient it is called countertransference.
Pneumococcus (Streptococcus pneumoniae)

31. Name the three postganglionic sympathetic ganglia that receive input from thoracic splanchnics.

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32. What are the two ways that nitrogen can enter into the urea cycle?
Dysplasia
The energy of activation
Aspartate and carbomoyl PO4
Common peroneal nerve

33. What are defined by Ag - binding specificity?
Idiotypes
Sarcoplasmic reticulum
Burr cells (echinocytes)
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.

34. Name the thalamic nucleus based on its input and output - Input from the mammillary bodies via the mammillothalamic tract and the cingulated gyrus; output to the cingulated gyrus via the anterior limb of the internal capsule
Chloramphenicol
Serum 25- hydroxy- vitamin D (25- OH- D)
Amantadine
Anterior nuclear group (Papez circuit of the limbic system)

35. Which hepatitis B serology markers
Complex I
HBsAb IgG
Yellow fever (flavivirus)
Stratum corneum (keratinized)

36. What is the term for the number of individuals who have an attribute or disease at a particular point in time?
a - Blockers (- zosins)
Four
Superior
Prevalence rate

37. Are the following major or minor Jones criteria of rheumatic fever? - Erythema marginatum
HBcAb IgM
Confounding bias
Major
Isograft

38. What nerve is associated with the following functions? - Innervation of the flexor carpi ulnaris - flexor digiti profundus (pinky and ring fingers) - and the intrinsic muscles of the hand
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
Low molecular weight heparin (LMWH)
NREM sleep. Night terrors are dreams that we are unable to recall.
Ulnar nerve

39. The duodenal - jejunal flexure is suspended from the posterior abdominal wall by what?
Ligament of Treitz
Metastatic calcification
Genomic libraries are made from nuclear DNA - are fragmented - and contain all sequences found in the particular genome copied.
G-6- PD deficiency; pyruvate kinase deficiency is second.

40. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Ventral rami?
Both
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
Adenocarcinoma (30% to 35%)

41. What is the name for the most prominent spinous process?
Berger disease (IgA nephropathy)
Vertebra prominens (C7 in 70% of cases - C6 in 20% - T1 in 10%)
Graves disease
It is rare with normal grief; however - it is relatively common in depression

42. What papillae are responsible for sweet taste?
premature ejaculation
Circumvallate papillae
2.0 or greater
Permanent

43. What is the titratable acid form of H+ in the urine?
Ciliary ganglion producing a tonic pupil
Oblique fissure
H2PO4- (dihydrogen phosphate)
Actually - yes. You should encourage your patient to try other forms of medicine as long as they are not contraindicated with the patient's preexisting illness. You must be able to accept the health beliefs of your patients - even if you don't agree.

44. Where are the LMN cell bodies of the corticospinal tract?
Osteocyte
Helicobacter pylori - Which is also associated with an increased risk of gastric carcinoma
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.
Aromatase

45. What pancreatic islet cell secretes somatostatin?
Burkitt lymphoma
Plummer - Vinson syndrome
delta - Cells; somatostatin has an inhibitory effect on alpha - and Beta - islet cells.
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.

46. What is the only local anesthetic to produce vasoconstriction?
Glutamine and aspartate
Rubor (red) - dolor (pain) - calor (heat) - tumor (swelling); also sometimes there is loss of function
Cocaine
B lymphocyte

47. Has a sodium - conserving action in the distal colon.
Hypoxia
Dimorphic
Bunyavirus
Aldosterone

48. What is the most common form of inherited dwarfism?
Relative refractory period
Enterohepatic cycling
The secretory phase is progesterone - dependent and 14 days long - whereas the length of the proliferative phase varies
Achondroplasia

49. What enzyme is deficient in the following glycogen storage disease? - Hers' disease
Odds ratio. (Case control studies deal with prevalence.)
Transitional cell carcinoma
Hepatic glycogen phosphorylase
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.

50. What is the most common one? - Valve abnormality associated with rheumatic fever
Pelvic splanchnics (They all begin with P.)
Cystadenoma
Clostridium tetani
Mitral valve stenosis