USMLE Step 1 EXAM QUESTIONS
WITH CORRECT ANSWERS || ALL
HEALTH PRINCPLES COVERED ||
THERAPY || CLINICAL MEDICINE ||
100% PASS
\.Heterophile ab NEGATIVE Mono-like syndromes - Answer-*CMV
HHV-6
HIV
Toxoplasmosis
\.Wernicke's Aphasia - 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
\.Congenital Deficiency of Propionyl CoA Carboxylase - 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 - 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 - Answer-Thiamine def= suppression of GNG (pyruvate DH)
and TCA cyle (alpha-KG DH)
\.MCC of Hypoglycemia in advanced renal insuff - Answer-impaired clearance of insulin
\.Avoid Nitrates in Hypertrophic Cardiomyopathy bc... - 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 - Answer-Clonal proliferation of cells can invade/ metastasize*
1. malignant cells to lose their cell-to-cell adhesion molecules (cadherins)
2. cell receptors to attach to laminin (a glycoprotein) in the basement membrane and to release
metalloproteinases (e.g., collagenases, stromelysins, gelatinases) to degrade the basement
membrane and other enzymes to degrade the interstitial connective tissue- tissue inhibitors of
metalloproteinases neutralize these tumor-produced enzymes and limit the degree of invasion
3. cell receptors to attach to bronectin and other proteins in the extracellular matrix (ECM) and
to break it down
4. malignant cells to produce cytokines that stimulate locomotion, so that they can move
through basement membranes and the intracellular and extracellular matrices
\.Bicuspid Aortic Valve - Answer-Commonly presents in young, asymptomatic patient with soft
systolic ejection at right 2nd ICS
-can cause aortic regurg
,\.MCC of Vaginal Candidiasis - 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 - Answer--Carbamazepine
-Cyclophosphamide
-SSRI
\.MC Ankle Sprain due to inversion of plantar-flexed foot - Answer--Ant Talofibular Lig dmg
-ecchymosis at the ant-lat aspect of the ankle
\.Upper Brachial Plexus Injury - Answer-- Musculocutaneous and Suprascapular N.
- dystocia mc in neonates; severe trauma mc in adults
- should adduction, elbow extension, and forearm pronation
\.Patent foramen ovale - Answer--failure of septum primum and septum secundum to fuse after
birth
-can lead to paradoxical emboli
\.Ventricular Septal Defect - Answer--MC occurs in membranous septum
-Acyanotic at birth bc of L to R shunt
\.Coronary Blood Flow Peak - Answer--at Early Diastole
-coronary perfusion driven by diastolic pressure
, -tachycardia will decrease coronary perfusion
\.Right Dom Heart - Answer-majority of people
-PDA comes off RCA
-SA and AV nodes supplied by RCA
\.Left Dom Heart - Answer--PDA comes off of LCX
- SA and AV node supplied by LCX
\.Increased Pulse Pressure - Answer-hyperthyroidism, aortic regurgitation, aortic stiffening
(isolated systolic hypertension in elderly), obstructive sleep apnea ( sympathetic tone), exercise
(transient)
\.Decreased Pulse Pressure - Answer-aortic stenosis, cardiogenic shock, cardiac tamponade,
advanced heart failure (HF)
\.Causes of Spontaneous Depol causing Tachyarrhythmias - 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 - 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 - Answer-- CNS med decrease in BP
- decreased intraocular pressure
WITH CORRECT ANSWERS || ALL
HEALTH PRINCPLES COVERED ||
THERAPY || CLINICAL MEDICINE ||
100% PASS
\.Heterophile ab NEGATIVE Mono-like syndromes - Answer-*CMV
HHV-6
HIV
Toxoplasmosis
\.Wernicke's Aphasia - 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
\.Congenital Deficiency of Propionyl CoA Carboxylase - 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 - 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 - Answer-Thiamine def= suppression of GNG (pyruvate DH)
and TCA cyle (alpha-KG DH)
\.MCC of Hypoglycemia in advanced renal insuff - Answer-impaired clearance of insulin
\.Avoid Nitrates in Hypertrophic Cardiomyopathy bc... - 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 - Answer-Clonal proliferation of cells can invade/ metastasize*
1. malignant cells to lose their cell-to-cell adhesion molecules (cadherins)
2. cell receptors to attach to laminin (a glycoprotein) in the basement membrane and to release
metalloproteinases (e.g., collagenases, stromelysins, gelatinases) to degrade the basement
membrane and other enzymes to degrade the interstitial connective tissue- tissue inhibitors of
metalloproteinases neutralize these tumor-produced enzymes and limit the degree of invasion
3. cell receptors to attach to bronectin and other proteins in the extracellular matrix (ECM) and
to break it down
4. malignant cells to produce cytokines that stimulate locomotion, so that they can move
through basement membranes and the intracellular and extracellular matrices
\.Bicuspid Aortic Valve - Answer-Commonly presents in young, asymptomatic patient with soft
systolic ejection at right 2nd ICS
-can cause aortic regurg
,\.MCC of Vaginal Candidiasis - 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 - Answer--Carbamazepine
-Cyclophosphamide
-SSRI
\.MC Ankle Sprain due to inversion of plantar-flexed foot - Answer--Ant Talofibular Lig dmg
-ecchymosis at the ant-lat aspect of the ankle
\.Upper Brachial Plexus Injury - Answer-- Musculocutaneous and Suprascapular N.
- dystocia mc in neonates; severe trauma mc in adults
- should adduction, elbow extension, and forearm pronation
\.Patent foramen ovale - Answer--failure of septum primum and septum secundum to fuse after
birth
-can lead to paradoxical emboli
\.Ventricular Septal Defect - Answer--MC occurs in membranous septum
-Acyanotic at birth bc of L to R shunt
\.Coronary Blood Flow Peak - Answer--at Early Diastole
-coronary perfusion driven by diastolic pressure
, -tachycardia will decrease coronary perfusion
\.Right Dom Heart - Answer-majority of people
-PDA comes off RCA
-SA and AV nodes supplied by RCA
\.Left Dom Heart - Answer--PDA comes off of LCX
- SA and AV node supplied by LCX
\.Increased Pulse Pressure - Answer-hyperthyroidism, aortic regurgitation, aortic stiffening
(isolated systolic hypertension in elderly), obstructive sleep apnea ( sympathetic tone), exercise
(transient)
\.Decreased Pulse Pressure - Answer-aortic stenosis, cardiogenic shock, cardiac tamponade,
advanced heart failure (HF)
\.Causes of Spontaneous Depol causing Tachyarrhythmias - 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 - 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 - Answer-- CNS med decrease in BP
- decreased intraocular pressure
