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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. In What area of the GI tract are water - soluble vitamins absorbed?
Enkephalins
Cyproheptadine
No - it is used in chronic treatment of gout to decrease the uric acid pools in the body.
Duodenum

2. What is the only pharyngeal muscle not innervated by CN X?
Indirect pathway (Tourette syndrome for example)
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
Competitive antagonist
Vitamin A

3. Describe What type of fluid is either gained or lost with the following changes in body hydration for the ECF volume - ICF volume - and body osmolarity - respectively: x ECF - decrease; ICF - decrease; body: increase
apo A-1
Odds ratio. (Case control studies deal with prevalence.)
Loss of hypotonic fluid (alcohol - diabetes insipidus - dehydration)
Are live attenuated vaccines available in the United States

4. What enzyme catalyzes the rate - limiting step in fatty acid oxidation?
HBsAg as its envelope
CD16 and CD56
Carnitine acyltransferase - I
Hydrolysis

5. What protective covering adheres to the spinal cord and CNS tissue?
Tolcapone and entacapone
Liquefaction necrosis
Pia mater
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.

6. More Ag is needed to produce a ____________ than a first immune response.
secondary immune response
Hydatidiform mole
Primary hypoaldosteronism (Addison's disease)
Succinyl CoA

7. Which trophoblast layer of the placenta remains until the end of pregnancy?
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
Radial Immuno Diffusion (RID) for Ig levels.
Left atrium

8. What large - diameter vessel has the smallest cross - sectional area in systemic circulation?
Lesch - Nyhan syndrome
The aorta
Hypercortisolism (Cushing syndrome)
Hepatitis D

9. What is the term to describe the increase in organ size due to the increase in cell size and function?
Lateral collateral ligament
excites the neuron
Hypertrophy
Vagus nerve

10. What is the amount in liters and percent body weight for the following compartments? - Interstitial fluid
9.3 L - 15% of body weight
Midazolam
Carnitine acyltransferase - I
In men it is prostate cancer - and in women it is breast cancer.

11. What are the three characteristics of ADHD?
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
CO
1. Short attention span 2. Impulsivity 3. Hyperactivity
Vitamin B12 deficiency and folate deficiency

12. Where is the action potential generated on a neuron?
Axon hillock
Inhaled anesthetics with low lipid solubility have low potency (directly related) - so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
Thymus - independent Ags
Conn syndrome (primary hyperaldosteronism)

13. What is the term to describe a man who has x The ability to have an erection sometimes and other times not?
Aminoacyl - tRNA synthetase - which uses 2 ATPs for this reaction.
1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity
Selective erectile disorder
Water

14. Name the most common cause - Chronic pancreatitis
IgE
Alcohol abuse
Class IV
Meningomyelocele All except occulta cause elevated - fetoprotein levels.

15. In What type of circuit is the total resistance always less than that of the individual resistors?
Hurler syndrome and Hunter syndrome - respectively
Parallel circuit
Marrow failure - cancer - and leukemia
Staphylococcus aureus (but they are more prone to salmonella infections)

16. What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
Negative
Hemolytic uremic syndrome
Physostigmine
Alzheimer disease

17. Name the associated chromosome - Albinism
Gaucher disease
Fovea
Chromosome 11p
Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUpS DAKRI is the mnemonic - everything else is covered with peritoneum

18. What is the second leading cause of death in the United States?
>5 mm
Clonidine
4 years old
Cancer

19. What is the name of the T cell - rich area of the lymph node?
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8 - 2 at T10 - and 3 at T12
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3- L4 - with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspino
Flumazenil
Paracortex

20. What enzyme of pyrimidine synthesis is inhibited by the following? - Methotrexate
Dihydrofolate reductase
Copper
Tyramine
Ischemic

21. What staphylococcal species is positive for Beta - hemolysis and coagulase?
HBc Ab
Succinyl CoA
Urogenital sinus
Staphylococcus aureus

22. What paraphilia is defined as x Having a recurrent desire to expose the genitals to strangers?
Concrete operations (6-12 years)
Exhibitionism
Heart disease
MGN

23. How many pairs of spinal nerves are associated with x Cervical vertebrae?
Bcl -2
GH - especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.

24. What area of the brain is responsible for emotion - feeding - mating - attention - and memory?
IL-4
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
The limbic system
Small cell carcinoma (oat cell)

25. Neurofibrillary tangles
The optic disk is the blind spot.
Thoracic and sacral
Alzheimer disease
Transudative; exudative has the opposite values and has an elevated cellular content.

26. How are resistance and length related regarding flow?
Resistance and vessel length are proportionally related. The greater the length of the vessel - the greater the resistance is on the vessel.
reflexes
Adipose tissue
The increased H+ moves intracellularly and is buffered by K+ leaving the cells - resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis - even though the serum

27. What is the DOC for severe infections with Sporothrix - Mucor - Histoplasma - Cryptococcus - Candida - and Aspergillus?
Picornaviridae
Glutamine and aspartate
env structural protein
Amphotericin B

28. In Parkinson's disease - What area of the basal ganglia has a decreased amount of dopamine?
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
C1 esterase inhibitor (C1INH)
Glucosyl cerebroside
Substantia nigra

29. What disease is produced by a deficiency in the enzyme tyrosinase?
There are 10 bronchopulmonary segments on the right and 8 on the left.
ELISA test
Beta- Endorphin
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.

30. Which cestode in raw or rare beef containing cysticerci results in intestinal tapeworms?
Taenia saginata
Wernicke's encephalopathy
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern - my senior resident asked me this question more times than I would like to remember.)
Brucella and Listeria (has tumbling motility)

31. What are the three glycogenic organs?
Pulmonary alveolar macrophages
Prevalence increases. (Remember - prevalence can decrease in only two ways - recovery and death.)
Liver - kidney - and GI epithelium
The primitive streak grows caudal to rostral.

32. What are the five AAs that are both ketogenic and glucogenic?
Leucine and lysine
Creutzfeldt - Jakob's disease. Patients first develop vague somatic complaints and anxiety - rapidly followed by dysarthria - myoclonus - ataxia - and choreoathetosis.
Isoleucine - threonine - tryptophan - tyrosine - and phenylalanine
Neuroblastoma

33. What form of nephritic syndrome is associated with celiac sprue and Henoch - Sch
Physiologic antagonism
No change in length
G1 phase (gap 1)
IgA nephropathy

34. What are the primary neurotransmitters at the following sites? - Chromaffin cells of the adrenal medulla
Medial umbilical ligaments
1. Large sample size 2. Large effect size 3. Type I error is greater
The short arm of chromosome 6
Epinephrine

35. Insulin - induced hypoglycemia is the most reliable (by far not the safest) test For what hormone deficiency?
Negative
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
Hereditary spherocytosis
GH deficiency

36. Prolactin levels can serve as a rough indicator of...
overall dopamine activity
All
Very superior (<2.5% of the population)
Primary intention

37. What test - by using specific Abs to different receptors - allows for rapid analysis of cell types in a blood sample?
7
Molybdenum (Mb)
Isolation of affect
Flow cytometric analysis

38. What is the first epidermal layer without organelles and nuclei
RU 486
Iron deficiency anemia
Stratum lucidum
Frotteurism

39. Name the MCC of death - In SLE
Renal failure
Beta2- integrins
Asparagine
3 ATPs by oxidative phosphorylation

40. In the elderly - what happens to total sleep time - percentage of REM sleep - and percentage of NREM sleep?
Basal cell carcinoma
Total and NREM sleep decrease considerably as we age - but REM sleep remains relatively constant (20%) up to age 80 - then begins to decline.
Gout
Pulmonary infections

41. What causes the lysis of RBCs by oxidizing agents in a G-6- PD deficiency?
Ipratropium
The lack of glutathione peroxidase activity results in a decrease in NADPH production - leaving glutathione in the reduced state.
Hydralazine
Hypertrophic scar

42. What lipoprotein is formed if an IDL particle acquires cholesterol from a HDL particle?
Lysosomal a -1 - 4- glucosidase
LDL
Dendritic cells - macrophages - and thymic epithelial cells
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.

43. Name the hormone
Epinephrine
tRNA
Anterior nuclear group (Papez circuit of the limbic system)
Limbic system

44. What is the rate - limiting step of the following? - Cholesterol synthesis
Breast cancer
Cocaine
HMG CoA reductase
Hepatitis B

45. What is the most common one? - Viral cause of myocarditis
Staphylococcus aureus
EF-1 and GTP
Coxsackie B
The number of cross - bridges cycling during contraction: the greater the number - the greater the force of contraction.

46. During What embryonic week do somites begin to form?
Gastric ulcer
Third week
No - but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
Left colic - superior rectal - and sigmoidal arteries

47. Which diuretic is used as an adrenal steroid antagonist?
Hepatitis E
The myotatic reflex is responsible for the tension present in all resting muscle.
Spironolactone
Chemotaxis

48. What type of correlation is defined as x Two variables that go together in the same direction?
Positive correlation
Neonatal respiratory distress syndrome (NRDS)
Conus arteriosus of the right ventricle and right and left auricles
Superior and anterior

49. What type of personality test is the Rorschach inkblot test - objective or projective?
Projective test. Most tests with a wide range of possibilities for the answers are projective.
Duodenal ulcers (4 times as common as gastric)
Isoniazid treatment
apo B-48

50. What is the name of the program that deals with codependency and enabling behaviors for family members of alcohol abusers?
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember - it may be negative in the first week of the illness - so retest if you have a high index of suspicion.)
As sample size increases - the lower the chance of error.
PGE2
Al - Anon