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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 non - spore - forming gram - positive aerobic rod produces bull neck - sore throat with pseudomembranes - myocarditis - and sometimes respiratory obstructions?
Corynebacterium diphtheriae
Osteosarcoma
Repaglinide
Round and ovarian ligaments

2. Where is the lesion that produces these symptoms when a patient is asked to look to the left? - Right eye can't look left - left eye nystagmus - and convergence is intact
after abortion
Skeletal muscles
1. Tinea coli 2. Haustra 3. Epiploic appendages
Right medial longitudinal fasciculus

3. What is the major muscle used in the relaxed state of expiration?
Under resting conditions expiration is considered a passive process; therefore - no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
Herpesvirus
Varicocele
IgA - IgD - IgE - IgG - and IgM

4. What is found in the R group if the AA is acidic? Basic?
Humor
If a carboxyl group is the R group - it is acidic; if an amino group is the R group - it is said to be basic.
Chromosome 5 - 21
Viruses

5. What is the effect of LH on the production of adrenal androgens?
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
The larger the volume of distribution - the lower the plasma concentration of a drug.
Biotin - ATP - and CO2
Granulosa/thecal cell tumor of the ovary

6. What syndrome is described as bilateral lesions of the amygdala and the hippocampus resulting in placidity - anterograde amnesia - oral exploratory behavior - hypersexuality - and psychic blindness?
Spinal trigeminal nucleus
Kl
Pseudomembranous exudates
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)

7. What neuronal cell bodies are contained in the intermediate zone of the spinal cord? (T1- L2)
HPVs 16 and 18
On the superior body of the posterior wall of the uterus
Preganglionic sympathetic neurons
Coxsackie B

8. What is the name of the hypothesis you are trying to prove?
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
Rho (D) immune globulin (RhoGAM) - an anti - RhD IgG antibody - prevents generation of RhD- specific memory B cells in the mother.
Alternative hypothesis (What is left after the null has been defined)

9. It degenerates 4 to 5 days post fertilization - and implantation occurs __ days post fertilization!
HBcAb IgM - HBV- DNA - HBeAg - HBsAg
Cryptococcus
7
Epispadia

10. A Japanese man has weight loss - anorexia - early satiety - epigastric abdominal pain - and a palpable left supraclavicular lymph node. On endoscopy you find a large - irregular ulcer with elevated margins on the lesser curvature of the stomach. What
Gastric carcinoma
The systemic veins have the largest blood volume - and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.
Hydroxyproline (breakdown product of collagen)
Hepatitis E

11. What part of the inner ear contains the gravity receptors for changes in the position of the head?
Saccule and utricle
Melanoma - cancer of the stomach and bladder
CMV - Toxoplasma gondii - and Listeria
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)

12. What is the term for a large - immature RBC that is spherical - blue - and without a nucleus?
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
Reticulocyte

13. What are the pharmacologic effects seen sexually with x Neuroleptics?
Stage fright (discrete performance anxiety)
Serratia
Burr cells (echinocytes)
Erectile dysfunction

14. What is a plasma cell's life expectancy?
Alteplase
Amyloidosis
HBeAg
7 to 14 days

15. Name the macrophage based on its location: x Connective tissue macrophages
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
Histiocytes
Calcium oxalate
Inferior pancreaticoduodenal - middle colic - right colic - ileocolic - and 10 to 15 intestinal arteries

16. Name the associated chromosome - Cri - du - chat
Chromosome 15q
Chromosome 5p
Isolation of affect
60%

17. What is the term for the total percentage of correct answers selected on a screening test?
Fluconazole
Accuracy (think of it as all the trues - because they are the ones correctly identified)
Cytochrome b/c1
Macule (e.g. - a freckle)

18. Use of an outlet for emotions (stuff flows downhill).
X- linked recessive
Massive influx of calcium
Displacement
Glucuronidation

19. A 20-year - old woman goes to the ER with ptosis - diplopia - weakness in her jaw muscles when chewing - and muscle weakness with repeated use. What is your diagnosis?
Myasthenia gravis
Left eye anopsia (left nasal and temporal hemianopsia)
Frontal lobe
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)

20. What is the term for a schizophrenic episode lasting longer than 30 days with full return to former functioning capacity?
Nondominant temporal lobe
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
Vital capacity (VC)

21. If a patient cannot pay - can you refuse services?

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22. Which streptococcal species is characterized by being catalase negative - turning bile esculin agar black - producing a positive PYR test - and resulting in biliary and urinary tract infections?
env structural protein
D- Penicillamine
Enterococcus (Streptococcus faecalis)
Ulcerative colitis

23. What cells of the thyroid gland are stimulated in response to hypercalcemia?
>15 mm
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
Standardized rate
Hydroxyapatite

24. What organism causes Q fever?
Fat necrosis
Hydroxyproline (breakdown product of collagen)
Coxiella burnetii
Rochalimaea quintana (now called Bartonella quintana)

25. What is the name of the tremor that occurs during movements and is absent while the person is at rest?
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
Posterior compartment of the leg - tibial nerve
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e. - pill rolling) is seen in basal ganglia lesions.
Posterior interventricular artery

26. What is the term for edema that has LDH below 200 - protein level 2.5 - and a specific gravity below 1.020?
Zanamivir and oseltamivir
Transudative; exudative has the opposite values and has an elevated cellular content.
Triazolam
CO

27. What four CN carry preganglionic parasympathetic fibers?
Positive
1. ADP 2. PG 3. TXA2
CN III - VII - IX - and X
Complex 4

28. Is the coding or the template strand of DNA identical to mRNA (excluding the T/U difference)?
The coding strand is identical to mRNA - and the template strand is complementary and antiparallel.
Specificity (it deals with the healthy)
Bell pad
Nitroprusside

29. What encapsulated gram - negative - lactose - fermenting rod is associated with pneumonia in patients with alcoholism - diabetes - and chronic lung disease?
Crossover study
Myeloperoxidase
Klebsiella pneumoniae
Incidence rate

30. What tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum - helping monitor and modulate muscle movements?
Ungated channels
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
Streptokinase
Premature ejaculation

31. What HIV structural gene produces GP120 and GP41?
Axillary nerve and posterior humeral artery
env structural protein
DiGeorge syndrome
Encapsulated bacteria

32. Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle - delaying the closure of the pulmonic valve.
CN I
Microglial cells
Potter facies

33. Where is most of the body's Ca2+ stored?
High volume - watery solution; sympathetic stimulation results in thick - mucoid saliva.
RNA polymerase I
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
M- cells

34. What is the size of a positive PPD test for the following? (Reactive) x Healthy suburban male without any medical illnesses
Euchromatin - the dark stuff in the nucleus on an electron microscope image.
Echinococcus multilocularis
>15 mm
Diffuse proliferative GN

35. Name the primary vesicle the following structures are derived from (proencephalon - mesencephalon - or rhombencephalon) - Metencephalon
env structural protein
Both
Rhombencephalon
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states - do not proliferate.)

36. Has analgesic and antipyretic activities but lacks anti - inflammatory effects.
Acetaminophen
Heterochromatin - the light stuff in the nucleus on an electron microscope image.
The short arm of chromosome 6
Cryptococcus neoformans

37. What term is an index of the effort needed to expand the lungs (i.e. - overcomes recoil)?
Compliance; the more compliant a lung is - the easier it is to inflate.
Bisphosphonates
X- linked recessive
Caput medusa - internal hemorrhoids - esophageal varices - retroperitoneal varices - and splenomegaly

38. During a prolonged fast - why is the brain unable to use fatty acids?
Introjection (a sports fan is a good example)
Fatty acids cannot cross the blood - brain barrier; therefore - they cannot be used as an energy source.
Thermogenic
a -1 - 6 transferase

39. What is determined by the secondary structure of an AA?
The folding of an AA chain
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.
Microglia. All others are neuroectodermal derivatives.
Anterior tibial artery

40. What disorder - experienced more than half of the time for a 6- month period - is described as being fearful - worrisome - or impatient and having sleep disturbances - poor concentration - hyperactivity - and an overall sense of autonomic hyperactivi
Primary Hemochromatosis
Dimercaprol - D- penicillamine
IgA
Generalized anxiety disorder

41. What CNs are affected if there is a lesion in x The upper pons?
Follicular phase
hnRNA
Swan - neck deformities
CN V

42. Which of the following characteristics accurately describe fungi - bacteria - viruses - or parasites? - Eukaryotic cell - 15 to 25 microns - 80S ribosomes - no cell walls - replicates via cytokinesis with mitosis and meiosis
Small cell carcinoma (oat cell)
Sorbitol (resulting in cataracts)
Trichomonas vaginalis (treat with metronidazole)
Parasites

43. Which of the following
Entamoeba histolytica (treat with metronidazole)
CD40
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Progestins

44. Which thrombolytic agent - activated in the presence of fibrin - is manufactured by recombinant DNA process?
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
Neisseria gonorrhoeae and Chlamydia trachomatis
Alteplase
Liver (hepatocytes)

45. What AD syndrome involves 1000 or more edematous polyps - most commonly affects the colorectal area - and is associated with chromosome 5q21?
Somatomedins
Chemotaxis
Major
Familial polyposis coli

46. What area of the limbic system is responsible for attaching emotional significance to a stimulus?
Oxygen
Clofazimine
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero - order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than i
Amygdala; it helps imprint an emotional response in memory.

47. In a topographical arrangement of the cerebellar homunculus map - What area or lobe x Controls the axial and proximal musculature of the limbs?
The vermis
Hydroxyproline
Left anterior descending artery
Right - sided valves

48. Name the hypochromic microcytic anemia based on the following laboratory values - Decreased iron - percent saturation - and ferritin; increased TIBC
2% of population - 2 cm long - 2 feet from ileocecal valve - 2 years old - and 2% of carcinoid tumors
Iron deficiency anemia
Turner syndrome
Edward syndrome (trisomy 18)

49. The DSM- IV- TR is scored on the basis of five axes of diagnosis. In What axis would you place x Medical or physical ailments?
Axis III
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
Fibrous pericardium
urease positive

50. Which form of melanoma carries the best prognosis?
Lentigo maligna melanoma
Relative refractory period
Left abducens nucleus or right cerebral cortex
Y - W-135 - and C and A capsular polysaccharides