USMLE Step 1 Qs (2)

50 Questions | Total Attempts: 83

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USMLE Step 1 Qs (2)

Questions from various sources for practicing


Questions and Answers
  • 1. 
    The structures labeled in the figure with an asterisk produce which of the following substances?
    • A. 

      Acid

    • B. 

      Mucus and HCO3–

    • C. 

      Pepsinogen

    • D. 

      Lysozyme

    • E. 

      Enterokinase

  • 2. 
    In hemolytic jaundice, the structure labeled with the arrow in the accompanying photomicrograph will contain which of the following?
    • A. 

      Elevated urobilinogen levels

    • B. 

      Elevated bilirubin levels

    • C. 

      Decreased urobilinogen levels

    • D. 

      Decreased bilirubin levels

    • E. 

      Elevated numbers of lymphocytes undergoing diapedesis

  • 3. 
    A 42-year-old woman (5 ft, 3in., 170 lb) complains of sudden onset of severe pain in the right upper abdomen "under the ribs" accompanied by sweating, nausea, and a feeling of imminent collapse. The pain lasts for about two hours and then persists as a dull ache. When seen several hours later, she has normal bowel sounds, is tender throughout the abdomen, especially in the right upper quadrant, and is faintly icteric. She has noticed her urine is darker than usual but has not passed stool recently. She recalls occasional episodes of "indigestion" referred to the right upper abdomen and radiating to the shoulder. This has occurred especially after eating fried foods or after eating a meal following a long period of fasting. She has no fever but is anxious and tachycardic. The tests available are a blood count and blood chemistry including liver enzymes, alkaline phosphatase, and bilirubin. She has a WBC of 10,000. Her cellular hepatic enzymes are: AST/SGOT = 52 (2-33) and ALT/SGPT = 70 (4 to 44), alkaline phosphatase = 300 (17 to 91), bilirubin = 6.3 (0.2 to 1.0). Which of the following is the most likely diagnosis?
    • A. 

      Hepatitis A

    • B. 

      Hepatitis B

    • C. 

      Carcinoma of the head of the pancreas

    • D. 

      Gallstone obstructing common bile duct

    • E. 

      Biliary cirrhosis

  • 4. 
    A pheochromocytoma is a common tumor of the adrenal medulla. In the presence of this tumor, which of the following symptoms would most likely be observed?
    • A. 

      Hypotension

    • B. 

      Hypoglycemia

    • C. 

      Hirsutism

    • D. 

      Decreased metabolic rate

    • E. 

      Paroxysms

  • 5. 
    During the physical examination of a newborn child, it was observed that the genitalia were female, but masculinized. The genotype was determined to be 46,XX. Which of the following is the most likely cause of this condition?
    • A. 

      Androgen insensitivity

    • B. 

      Decreased blood ACTH levels

    • C. 

      Atrophy of the zona reticularis

    • D. 

      A defect in the cortisol pathway

    • E. 

      Hypersecretion of vasopressin

  • 6. 
    A pituitary adenoma is likely to result in which of the following clinical conditions?
    • A. 

      Cushing's syndrome

    • B. 

      Deficiency in T3 and T4

    • C. 

      Diabetes insipidus

    • D. 

      Osteoporosis

    • E. 

      Stunted growth or dwarfism

  • 7. 
    A tumor in the specific region denoted by the asterisks will most likely cause which of the following clinical conditions?
    • A. 

      Diabetes

    • B. 

      Hypoglycemia

    • C. 

      Elevated blood pressure

    • D. 

      Decreased blood pressure

    • E. 

      Increased bone resorption

  • 8. 
    Which of the following is the function of the organ shown in the photomicrograph below?
    • A. 

      Passage of urine and sperm in the male

    • B. 

      Passage of urine in the female

    • C. 

      Passage of urine from the bladder to the urethrae in males and females

    • D. 

      Passage of sperm from the epididymis to the urethra

    • E. 

      Storage of sperm and absorption of fluid

  • 9. 
    Which of the following organs is shown in the figure below?
    • A. 

      Female urethra

    • B. 

      Male urethra

    • C. 

      Oviduct

    • D. 

      Ureter

    • E. 

      Seminal vesicle

  • 10. 
    The organ shown in this photomicrograph is responsible for production of which of the following substances?
    • A. 

      Spermine and fibrolysin

    • B. 

      T3 and T4

    • C. 

      Proteins that coagulate semen

    • D. 

      Acid phosphatase

    • E. 

      Milk

  • 11. 
    The organ pictured in the photomicrograph performs which of the following functions?
    • A. 

      The site of spermiogenesis

    • B. 

      Production of fructose and prostaglandins

    • C. 

      Phagocytosis of sperm and residual bodies

    • D. 

      The site of implantation

    • E. 

      The site of milk production

  • 12. 
    . The urologist may describe the reattachment of a severed vas deferens (vasovasostomy) as successful, more than 90% of the time. However, it is unsuccessful from the patients' point of view since a much lower percentage of these men can father a child. The difference in success rate is due to which of the following facts?
    • A. 

      Spermatogonia are exposed to humoral factors

    • B. 

      Genetic recombination in haploid sperm creates novel antigens

    • C. 

      Cryptorchid testes are often incapable of producing fertile sperm

    • D. 

      Vasectomy prevents phagocytosis of sperm by macrophages

    • E. 

      Sperm coated with autoimmune antibodies are unable to fertilize an egg.

  • 13. 
    Which of the following are characteristic of the secretory phase of the menstrual cycle?
    • A. 

      It precedes ovulation

    • B. 

      It depends on progesterone secretion by the corpus luteum

    • C. 

      It coincides with the development of ovarian follicles

    • D. 

      It coincides with a rapid drop in estrogen levels

    • E. 

      It produces ischemia and necrosis of the stratum functionale

  • 14. 
    • A. 

      She will begin menstruating in a few days

    • B. 

      She will ovulate within a few days

    • C. 

      Her serum progesterone levels are very low

    • D. 

      There are detectable levels of hCG in her serum and urine

    • E. 

      She is undergoing menopause

  • 15. 
    In the accompanying transmission electron micrograph from the renal corpuscle, which of the following are the structures labeled with arrows?
    • A. 

      Podocyte foot processes

    • B. 

      Endothelial cell fenestrations

    • C. 

      Pedicels

    • D. 

      Filtration slits

    • E. 

      The lamina rara of the basement membrane

  • 16. 
    Renal changes in the kidney in a patient with diabetes mellitus of 30 years duration may result in which of the following?
    • A. 

      Decreased permeability to plasma proteins

    • B. 

      Enhanced selectivity of the filtration barrier

    • C. 

      Hyperalbuminemia

    • D. 

      A generalized increase in osmotic pressure

    • E. 

      Compensatory secretion of aldosterone

  • 17. 
    Which of the following is involved in glomerular filtration
    • A. 

      Facilitated diffusion of large anionic proteins

    • B. 

      Maintenance of a charge barrier

    • C. 

      A physical barrier consisting of type II collagen

    • D. 

      Filtration slits between adjacent endothelial cells

    • E. 

      A positive charge in the basement membrane due to the presence of heparan sulfate

  • 18. 
    Visual transduction involves which of the following?
    • A. 

      Inactivation of phosphodiesterase

    • B. 

      Increase in cGMP levels

    • C. 

      Conversion of all-trans-retinal to 11-cis retinal

    • D. 

      Closing of a Na+ channel

    • E. 

      Depolarization of the rod cell membrane

  • 19. 
    An elderly gentleman is delivered to the hospital in a febrile and septic condition. The only remarkable recent history was an episode of choking on swallowing a rough object during a meal a few days previously. The choking resolved, but there was some hematemesis the following day that also resolved. The examiner notes edematous pharyngeal tissue and assumes an esophageal laceration with infection within the retrovisceral space. The examining physician suspects that the infection
    • A. 

      Tracks superiorly and inferiorly within the carotid sheath

    • B. 

      Extends anteriorly to the trachea

    • C. 

      Extends into the posterior mediastinum

    • D. 

      Will not extend below the manubrium

  • 20. 
    A carcinoma in the medial portion of the lower lip is most likely to first metastasize via which of the following lymph nodes?
    • A. 

      Submandibular lynph nodes

    • B. 

      Parotid lymph nodes

    • C. 

      Superficial cervical lymph nodes

    • D. 

      Submental lymph nodes

    • E. 

      Buccal lymph nodes

  • 21. 
    The arachnoid villi allow cerebrospinal fluid to pass between which of the following two spaces?
    • A. 

      Choroid plexus and subdural space

    • B. 

      Subarachnoid space and subdural space

    • C. 

      Subarachnoid space and superior sagittal sinus

    • D. 

      Subdural space and cavernous sinus

    • E. 

      Superior sagittal sinus and jugular vein

  • 22. 
    An elderly man, persuaded to have his eyes examined after a series of minor automobile accidents, was found to have a pituitary adenoma that was producing visual field defects. A pituitary adenoma that expands superiorly and compresses the central portion of the optic chiasm will result in which of the following?
    • A. 

      Total blindness

    • B. 

      Losses of left and right inferior fields of vision

    • C. 

      Losses of left and right nasal fields of vision

    • D. 

      Losses of left and right temporal fields of vision

  • 23. 
    Which of the following statements concerning the lacrimal apparatus is correct?
    • A. 

      The lacrimal gland lies in the medial portion of the orbit

    • B. 

      Lacrimal fluid is secreted at the puncta in the medial edges of both upper and lower lids

    • C. 

      The nasolacrimal duct has a blind-ending lacrimal sac at its upper portion

    • D. 

      The nasolacrimal duct ends in the middle meatus of the nose

  • 24. 
    Tic douloureux (trigeminal neuralgia) is characterized by sharp pain over the distribution of the trigeminal nerve. This syndrome involves neurons that have their cell bodies in which of the following?
    • A. 

      Geniculate ganglion

    • B. 

      Otic ganglion

    • C. 

      Pterygopalatine ganglion

    • D. 

      Submandibular ganglion

    • E. 

      Trigeminal ganglion

  • 25. 
    • A. 

      Buccinator

    • B. 

      Lateral pterygoid

    • C. 

      Medial pterygoid

    • D. 

      Masseter

    • E. 

      Temporalis