COMPLETE USMLE STEP 1 EXAM PREP
TEST QUESTIONS WITH ANSWERS
UPDATED STUDENT EDITION
MCC of Vaginal Candidiasis - CORRECT ANSWER>>>>1. Abx use= reduces lactobacilli pop
2. High estrogen levels- preg
3. System corticosteroid therapy
4. Uncontrolled DM
5. Immunosuppression, including HIV
Drug causes of SIADH - CORRECT ANSWER>>>>-Carbamazepine
-
Cyclophosphamide
-
SSRI
MC Ankle Sprain due to inversion of plantar-flexed foot - CORRECT ANSWER>>>>-Ant
Talofibular Lig dmg
-ecchymosis at the ant-lat aspect of the ankle
Upper Brachial Plexus Injury - CORRECT ANSWER>>>>-
Musculocutaneous and
Suprascapular N.
1|Page
,- dystocia mc in neonates; severe trauma mc in
adults
- should adduction, elbow extension, and forearm
pronation
Patent foramen ovale - CORRECT ANSWER>>>>-failure of septum primum and
septum
secundum to fuse after
birth
-can lead to paradoxical
emboli
Ventricular Septal Defect - CORRECT ANSWER>>>>-MC occurs in membranous septum
-Acyanotic at birth bc of L to R shunt
Coronary Blood Flow Peak - CORRECT ANSWER>>>>-at Early Diastole
-coronary perfusion driven by diastolic pressure
-tachycardia will decrease coronary perfusion
Right Dom Heart - CORRECT ANSWER>>>>majority of
people
-PDA comes off
RCA
-SA and AV nodes supplied by
RCA
Left Dom Heart - CORRECT ANSWER>>>>-PDA comes off of
LCX
- SA and AV node supplied by
LCX
Increased Pulse Pressure - CORRECT ANSWER>>>>hyperthyroidism, aortic regurgitation,
aortic stiffening (isolated systolic hypertension in elderly), obstructive sleep apnea ( sympathetic
tone), exercise (transient)
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,Decreased Pulse Pressure - CORRECT ANSWER>>>>aortic stenosis, cardiogenic shock,
cardiac tamponade, advanced heart failure (HF)
Causes of Spontaneous Depol causing Tachyarrhythmias - CORRECT
ANSWER>>>>Hypokalemia, Hypermagnesemia, or prolonged QT interval
= all cause spontaneous depol of ventricles in phase 3 or 4 and it will cause an extra AP in heart
Direct alpha 1 agonist mediated effects - CORRECT ANSWER>>>>- vasc smooth muscle
contraction= increased afterload and venous return= increased DBP + SBP causes reflexive
increase in vagal tone= dec HR and slowed AV conduction
-
mydriasis
- increased internal urethral sphincter tone and prostate contraction
Direct alpha 2 agonist mediated effects - CORRECT ANSWER>>>>- CNS med decrease in BP
- decreased intraocular pressure
- decreased lipolysis
- decreased presyn NE release
- increased platelet aggregation
Heterophile ab NEGATIVE Mono-like syndromes - CORRECT ANSWER>>>>*CMV
HHV-6
HIV
Toxoplasmosis
Wernicke's Aphasia - CORRECT ANSWER>>>>-word salad: well-articulated, nonsensical
speech paired with lack of lang comprehension
-aud association cortex: post part of sup temporal gyrus
- supplied by MCA
3|Page
, Congenital Deficiency of Propionyl CoA Carboxylase - CORRECT ANSWER>>>>-prevents
conversion of propionyl CoA to methylmalonyl CoA
-propionyl CoA derived from= val, ile, met, thr, odd # FA, cholesterol side chains
-Propionic Acidemia: poor feeding, vomiting, hypotonia, lethargy, dehydration, anion gap
acidosis
Down Synd Comorbidities - CORRECT ANSWER>>>>Neuro: MR, early onset Alzheimer's
Cardio: complete AV septal defect, VSD, ASD
GI: duodenal atresia, hirschprung disease
Endo: hypothyroid, DM1, obesity
Heme: ALL (> 5 yo) and AML (<5 yo)
Rheumatology: atlantoaxial stability
MCC of Hypoglycemia in EtOH-ics - CORRECT ANSWER>>>>Thiamine def= suppression of
GNG (pyruvate DH) and TCA cyle (alpha-KG DH)
MCC of Hypoglycemia in advanced renal insuff - CORRECT
ANSWER>>>>impaired
clearance of insulin
Avoid Nitrates in Hypertrophic Cardiomyopathy bc... - CORRECT
ANSWER>>>>Nitrates
decrease preload, which will increase the LV outflow tract... BUT since the ventricle
is
abnormally shaped, there is an outflow
obstruction
Mets through BM - CORRECT ANSWER>>>>Clonal proliferation of cells can invade/
metastasize*
1. malignant cells to lose their cell-to-cell adhesion molecules (cadherins)
4|Page
TEST QUESTIONS WITH ANSWERS
UPDATED STUDENT EDITION
MCC of Vaginal Candidiasis - CORRECT ANSWER>>>>1. Abx use= reduces lactobacilli pop
2. High estrogen levels- preg
3. System corticosteroid therapy
4. Uncontrolled DM
5. Immunosuppression, including HIV
Drug causes of SIADH - CORRECT ANSWER>>>>-Carbamazepine
-
Cyclophosphamide
-
SSRI
MC Ankle Sprain due to inversion of plantar-flexed foot - CORRECT ANSWER>>>>-Ant
Talofibular Lig dmg
-ecchymosis at the ant-lat aspect of the ankle
Upper Brachial Plexus Injury - CORRECT ANSWER>>>>-
Musculocutaneous and
Suprascapular N.
1|Page
,- dystocia mc in neonates; severe trauma mc in
adults
- should adduction, elbow extension, and forearm
pronation
Patent foramen ovale - CORRECT ANSWER>>>>-failure of septum primum and
septum
secundum to fuse after
birth
-can lead to paradoxical
emboli
Ventricular Septal Defect - CORRECT ANSWER>>>>-MC occurs in membranous septum
-Acyanotic at birth bc of L to R shunt
Coronary Blood Flow Peak - CORRECT ANSWER>>>>-at Early Diastole
-coronary perfusion driven by diastolic pressure
-tachycardia will decrease coronary perfusion
Right Dom Heart - CORRECT ANSWER>>>>majority of
people
-PDA comes off
RCA
-SA and AV nodes supplied by
RCA
Left Dom Heart - CORRECT ANSWER>>>>-PDA comes off of
LCX
- SA and AV node supplied by
LCX
Increased Pulse Pressure - CORRECT ANSWER>>>>hyperthyroidism, aortic regurgitation,
aortic stiffening (isolated systolic hypertension in elderly), obstructive sleep apnea ( sympathetic
tone), exercise (transient)
2|Page
,Decreased Pulse Pressure - CORRECT ANSWER>>>>aortic stenosis, cardiogenic shock,
cardiac tamponade, advanced heart failure (HF)
Causes of Spontaneous Depol causing Tachyarrhythmias - CORRECT
ANSWER>>>>Hypokalemia, Hypermagnesemia, or prolonged QT interval
= all cause spontaneous depol of ventricles in phase 3 or 4 and it will cause an extra AP in heart
Direct alpha 1 agonist mediated effects - CORRECT ANSWER>>>>- vasc smooth muscle
contraction= increased afterload and venous return= increased DBP + SBP causes reflexive
increase in vagal tone= dec HR and slowed AV conduction
-
mydriasis
- increased internal urethral sphincter tone and prostate contraction
Direct alpha 2 agonist mediated effects - CORRECT ANSWER>>>>- CNS med decrease in BP
- decreased intraocular pressure
- decreased lipolysis
- decreased presyn NE release
- increased platelet aggregation
Heterophile ab NEGATIVE Mono-like syndromes - CORRECT ANSWER>>>>*CMV
HHV-6
HIV
Toxoplasmosis
Wernicke's Aphasia - CORRECT ANSWER>>>>-word salad: well-articulated, nonsensical
speech paired with lack of lang comprehension
-aud association cortex: post part of sup temporal gyrus
- supplied by MCA
3|Page
, Congenital Deficiency of Propionyl CoA Carboxylase - CORRECT ANSWER>>>>-prevents
conversion of propionyl CoA to methylmalonyl CoA
-propionyl CoA derived from= val, ile, met, thr, odd # FA, cholesterol side chains
-Propionic Acidemia: poor feeding, vomiting, hypotonia, lethargy, dehydration, anion gap
acidosis
Down Synd Comorbidities - CORRECT ANSWER>>>>Neuro: MR, early onset Alzheimer's
Cardio: complete AV septal defect, VSD, ASD
GI: duodenal atresia, hirschprung disease
Endo: hypothyroid, DM1, obesity
Heme: ALL (> 5 yo) and AML (<5 yo)
Rheumatology: atlantoaxial stability
MCC of Hypoglycemia in EtOH-ics - CORRECT ANSWER>>>>Thiamine def= suppression of
GNG (pyruvate DH) and TCA cyle (alpha-KG DH)
MCC of Hypoglycemia in advanced renal insuff - CORRECT
ANSWER>>>>impaired
clearance of insulin
Avoid Nitrates in Hypertrophic Cardiomyopathy bc... - CORRECT
ANSWER>>>>Nitrates
decrease preload, which will increase the LV outflow tract... BUT since the ventricle
is
abnormally shaped, there is an outflow
obstruction
Mets through BM - CORRECT ANSWER>>>>Clonal proliferation of cells can invade/
metastasize*
1. malignant cells to lose their cell-to-cell adhesion molecules (cadherins)
4|Page
