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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 is the signal to open the voltage - gated transmembrane sodium channels?
Rhabdovirus
Imipenem and meropenem
Membrane depolarization is the stimulus to open these channels - which are closed in resting conditions.
Tetracyclines

2. What happens to the following during skeletal muscle contraction? - Sarcomere
Shortens
DNA polymerase - d
Splitting
Criterion - referenced tests. You need a certain number correct to pass (e.g. - the USMLE).

3. What is the term for formation of a stable fibrin - platelet plug to stop bleeding?
Hemostasis
Vesicle (e.g. - poison ivy)
Initiate and manage gross skeletal muscle movement control
Adenosine (it is an excellent agent to use in emergencies because its half - life is 30 seconds)

4. What is the first sign of megaloblastic anemia on a peripheral blood smear?
LC4 - LD4 - and LE 4
Hypersegmented neutrophils
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
HMG CoA synthase

5. Which major cell type is found in the red pulp of the spleen?
Testicular lymphoma
RBCs. That is why it is called red pulp.
Medullary carcinoma of the thyroid
Posterior chamber

6. Name the antidote - Lead
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used - cutting the rate from 20% to 10%.
GH- producing adenoma
Respiratory acidosis (summary: high CO2 - high H+ - slightly high HCO3-)
Penicillamine - EDTA (calcium disodium edetate) - or dimercaprol

7. What statistical method do you use when analyzing x Case control studies?
Odds ratio. (Case control studies deal with prevalence.)
No - you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.
T4; because of the greater affinity for the binding protein - T4 has a significantly (nearly fifty times) longer half - life than T3.
It increases Ca2+ excretion from the kidney and increases bone mineralization.

8. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Dorsal rami?
The Purkinje cell
Glucosyl cerebroside
Clostridium perfrigens
Both

9. What muscle laterally rotates the femur to unlock the knee?
Middle meningeal artery
Snails
Popliteus
The affinity of the drug for its receptor

10. What Staphylococcus aureus protein inhibits phagocytosis?
Protein A
Coagulative necrosis
False - positive rate
Copper

11. Name the phase of the eukaryotic cell cycle: x Period of DNA replication (preparing for mitosis)
Round and ovarian ligaments
They prevent mast cell degranulation.
S phase
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes

12. What is the term for any region of the respiratory system that is incapable of gas exchange?
Dihydrofolate reductase
Rathke's pouch; they can result in compression of the optic chiasm.
Arcuate line
Anatomical dead space - which ends at the level of the terminal bronchioles.

13. What Freudian psyche component is described as x The urges - sex aggression - and 'primitive' processes?
Middle
IgA
Alanine and glutamine
Id (pleasure principle)

14. What are the four components of the basement membrane?
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
Bladder cancer
Fibrinoid necrosis
Plasmodium falciparum

15. What purine base is contained in inosine monophosphate?
Range
T9
Treacher Collins syndrome
Hypoxanthine (remember - IMP is a precursor for AMP and GMP)

16. Which of the colliculi help direct the movement of both eyes in a gaze?
Minimal change disease
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
p -53
Axis I

17. What neuroendocrine tumor produces excess serotonin; is associated with diarrhea - flushing - bronchospasms - wheezing; and is diagnosed by findings of elevated urinary 5- HIAA levels?
Ephedrine
Carcinoid tumor
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
Plasmodium malariae; the others are tertian.

18. How do elevated blood glucose levels decrease GH secretion? (Hint: what inhibitory hypothalamic hormone is stimulated by IGF-1?)
IGF-1
GLUT 2
Somatotrophins are stimulated by IGF-1 - and they inhibit GH secretion. GHRH stimulates GH secretion.
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. a - Ketoglutarate dehydrogenase

19. What type of lysosome is formed when lysosome fuses with a substrate for breakdown?
Humerus with ulna (major) and radius (minor)
Secondary lysosome (think of the primary as inactive and secondary as active)
No - unsaturated fatty acids have double bonds.
Melanoma - cancer of the stomach and bladder

20. What potentially fatal disease occurs in children who are given aspirin during a viral illness?
Functional residual capacity (FRC)
Reye syndrome
Agents that decrease ACh function reduce tremors and rigidity - not bradykinesias.
Blastomyces dermatitidis

21. What cell type of the body or fundus of the stomach secretes IF?
Parietal cells (Remember - they secrete HCl - too.)
Mitochondria - linked disorders are always inherited from the mother.
Catechol - O- methyl transferase (COMT)
Chlortetracycline

22. Name the structure that enters or exits the following foramina: x Internal auditory meatus
2 ATPs by oxidative phosphorylation
Altruism
Tylosis
CN VII and VIII

23. Preeclampsia in the first trimester - hCG levels above 100 - 00 mIU/mL - and an enlarged bleeding uterus are clinical signs of what?
Corticosteroid
Glucose -6- phosphatase
Osteocyte
Hydatidiform mole

24. What happens to the tonicity of the urine with increased ADH secretion?
Eaton - Lambert syndrome
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased Beta-1- sympathetic stimulation of the JG cells
Large segment deletions
The urine becomes hypertonic because of water reabsorption in the collecting duct.

25. Name the cluster B personality disorder: x Criminal behavior; lacking friends - reckless - and unable to conform to social norms
Absolutely not. Diabetics who are given a Beta- blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Antisocial
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Medullary carcinoma of the thyroid

26. At high doses aspirin has ________ properties.
Pseudomonas aeruginosa
Tolcapone and entacapone
Uricosuric
Subarachnoid hematoma

27. In what condition do you see dimpling on the kidney's surface?
Pyelonephritis
DM - hypercholesterolemia - smoking - and HTN are major risk factors. Being male - obesity - sedentary lifestyle - homocysteine elevation - oral contraceptive pills - and genetics are minor risk factors for atherosclerosis.
Inferior Oblique (CN III) (LR6 SO4)3
C- peptide levels

28. From what pharyngeal groove is the external auditory meatus derived?
First pharyngeal groove; all others degenerate.
Decreases Remember - the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. -------------------------------------------------------------------------------
Ferrochelatase
Carbonic anhydrase

29. What is the most abused drug across all age groups?
PCT
HBsAg (incubation period)
Alcohol. Nearly 10% of adults have a problem with alcohol.
Fibrinoid necrosis

30. What epidermal layer's function is to release lipids to act as a sealant?
Autosomal recessive
Leukemias and lymphomas
Stratum granulosum
Left homonymous hemianopsia

31. Name the type of graft described by these transplants: x From one site to another on the same person
Autograft
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions - and only cells with bound Ag undergo clonal expansion
Crohn disease
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)

32. What are the primary neurotransmitters at the following sites? - Chromaffin cells of the adrenal medulla
Molybdenum (Mb)
Epinephrine
Chromosome 19
Nasal polyps - rhinitis - and aspirin hypersensitivity

33. How many carbons do androgens have?
Mantle cell lymphoma
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
Aversive conditioning
Androgens are 19- carbon steroids.

34. Why is there a minimal change in BP during exercise if there is a large drop in TPR?
Because the large drop in TPR is accompanied by a large increase in cardiac output - resulting in a minimal change in BP.
Paget disease of the breast
Id (pleasure principle)
Actinomyces israelii

35. What water - soluble - vitamin deficiency is associated with cheilosis and magenta tongue?
The optic disk is the blind spot.
Flurazepam
Riboflavin (B2)
Avidity. There is a positive correlation between valence numbers and avidity.

36. What B cell disorder is characterized by pre - B cells in the bone marrow - no circulating B cells in plasma - normal cell - mediated immunity - low Igs - and appearance by 6 months of age?
Urophilia
Hydroxyapatite
Homocysteine methyl transferase
Bruton X- linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.

37. What two Ags must be positive for a patient to have chronic active hepatitis?
Skeletal muscles
X- linked recessive
HBsAg and HBeAg
Enkephalins

38. What embryonic structure forms the adult female structures? - Labia minora
Mast cells
Urogenital folds
Hypochondriasis (they will begin with 'I think I have...')
Truncus arteriosus

39. Serious psychiatric illness is more common _______ than childbirth.
Diffuse proliferative GN
Hemophilia A
after abortion
Accessory nucleus

40. Are contraindicated in patients with SCID.
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti - Ab
Intussusception
The left is a branch of the aortic arch - while the right is a branch of the brachiocephalic trunk.
Live vaccines

41. What nerve and artery could be affected in a humeral neck fracture?
Axillary nerve and posterior humeral artery
CHF - cirrhosis - and nephrosis
Adenocarcinoma (because of Barrett esophagus)
In men it is prostate cancer - and in women it is breast cancer.

42. What is absorbed in the gallbladder to concentrate bile?
Avidity. There is a positive correlation between valence numbers and avidity.
Water
Range
Phosphofructokinase -1 and costs 1 ATP

43. What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting - fissuring - and oozing?
Stibogluconate
Jejunum (upper)
Transcortical aphasia
Paget disease of the breast

44. What type of fiber or fibers are carried in (answer motor - sensory - or both) x Dorsal root ganglion?
Adenovirus
Sensory
False - positive rate
Ribonucleotide reductase

45. What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?
Boutonni
TCA cycle.
Hydatidiform mole
Testicular feminization syndrome (Dude looks like a lady!)

46. What type of DNA library is made from the mRNA from a tissue expressing a particular gene?
Plasmodium vivax
Ventricular contraction Atrial - Contraction - Venous
cDNA libraries are derived from mRNA - are continuous - and contain no introns or regulatory elements.
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

47. What is a sign of a Sertoli cell tumor in a man?
High - frequency sound waves
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III) - B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.
Excess estradiol in the blood
Adenovirus

48. What part of the ANS is affected in the biofeedback model of operant conditioning?
CD4+ T cells (helper)
The biofeedback model is based on the parasympathetic nervous system.
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
2 - 4- Dinitrophenol

49. What is the term for production of a DNA copy from an RNA molecule?
The alveoli at the apex are almost completely inflated prior to inflation - and although they are large - they receive low levels of alveolar ventilation.
Reverse transcription
Collecting ducts - which make them readily permeable to water reabsorption.
Chromophobe adenoma

50. Do the following structures pick up stain from hematoxylin or eosin? - Fibrin
Eosin
refractory sexual periods
Affinity decreases; they are inversely proportional.
Case fatality rate

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USMLE Step 1 Prep

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