Sunday, 21 August 2016

USMLE Step 1 - Mock Exam-1

title

Test-1
Total questions 20
Time allowed 30 min


Question 1 A 47 years old man comes to the hospital with complaints of dizziness.
His Blood pressure is 140/100 mm of Hg.
He is a well controlled diabetic.
His ECG is shown below.
What is diagnosis in this case?





Question 2 A 46 years old male had diarrrhea and fever for a period of one weak.
His stool culture showed the growth of Salmonella.
Now the patient have developed pain in left knee joint.
On examination the joint is swollen.
The culture of the joint aspirate did not show any growth.
The symtomatic treatment was effective.
The most likely cause of his joint disease is?




Question 3 Pannus is found in which disease?



Question 4 Parasympathetic muscarinic receptors are blocked by?



Question 5 A 53 year old woman was found to be having raised blood pressure for the last six months.
Her recent reading was 160/110 and she was prescribed Prazocin.
Her blood pressure became 120/80.
What was the mechanism involved?



Question 6 A 45 years old man was having problem in the planter flexion of his feet.
The power was weak and the reflexes were normal.
The gastrocnemius and soleus were investigated for muscular vs neuropathic disease.
The muscle biopsy showed the following picture.
The findings are suggestive of which disease?




Question 7 A 60 years old patient with a known history of Myocardial infarction became gradually
increasing breathless over a period of one month.
Pulse=90/min regular. Blood pressure 110/70.
On auscultation an abnormal heart sound was detected.
The ejection fraction was low on echocardiography.
Which phase of the cardiac cycle that abnormal heart sound is associated?




Question 8 A 25 years old female was having fever and weight loss for a period of six months.
Her blood picture showed the leukemic picture.
A bone marrow transplantation was decided.
The leukocyte count was normal after transplantation.
The chromosomal analysis of her blood cells showed 46 XY chromosomes.
What is the most probable cuause of this finding?




Question 9 A 20 year old patient was investigated for a genetic disease.
There is gain-of-function mutation in the FGF receptor 3 (FGFR3).
The elder brother and sister are also affected by the same disease.
Which of the following findings will be obvious in this patient?




Question 10 A 10 year old male is suffering from fever and headache.
Neck rigidity is present on examination.
He feels irritated when being in light.
Lumber puncture reveals an aseptic type of picture.
A single stranded RNA virus is isolated.
Which one of the following is the most likely cause?



Question 11 What is the most common type of hemangioma?



Question 12 Which is the major criteria for Rheumatic fever?



Question 13 A 25 years old female develops breast cancer.
Her elder sister had a bone sarcoma.
Her mother had leukemia.
Her brother had repeated headaches and was found to be having a glioblastoma.
She is worried if she might have another tumour at sometime in her life.
Which one of the following is most likely to affect this patient?



Question 14 A medical student becomes interested in genetic cloning.
He has to do Polymerase chain reaction during various investigations.
Almost all Polymerase reactions invlove a heat stable DNA polymerase
which is an enzyme originally derived from the bacterium Thermus aquaticus.
What does this enzyme do?




Question 15 A 27 years old female was suffering from palpitations.
On echocardiography she was suffering from mitral regurgitation.
An artificial valve was placed.
She needs life long costeffective anticoagulation.
Which of the following agents is recommended in her case?




Question 16 A 56 years old man suffered from hemiplegia for the last two weeks and then died suddenly.
On autopsy his kidney on cut section revealed a pale wedge shaped area
with its base at the cortex and apex at the medulla.
A small portion of the subcortical area was unaffected.
What is the most probable diagnosis in this patient?



Question 17 A 45 years old woman who received a blood transfusion and developed Hepatitis C Infection.
Her liver fuction deteriorated.
Her ALT was 400U/L, AST=800 U/L and a Total bilirubin= 5.3mg/Dl.
Liver size was reduced on Ultrasound.
A liver tranplant was planned.
Six months after the transplant her sclera became yellow again.
Her ALT= 2ooU/L, AST=400U/L and a total bilirubin=4.2mg/Dl.
Which of the following is the most probable cause of her problem?



Question 18 A 35 years old female had complaints of indigestion of food, pain abdomen and weight loss.
Serum amylase was raised.
Her CT scan reveals a pancreatic tumor.
Her serum calcium was raised and she had surgery in the neck to treat the cause.
Now she is having problem on seeing the things that are on the either side of her body.
Which of the following is the most probable cause of her vision problem?



Question 19 A 30 years old female is in the proccess of invitro fertilization.
She has normal menstrual history.
The gynecologist is worried whether she has normal ova formed or not.
The DNA of the ova will have a special pattern in its nucleus.
Which phase arrangement of the DNA material is normal for in vitro fertilization?





Question 20 A 10 year old boy was having cellulitis of the hand with blister formation.
Culture of the fluid from the blister revealed the growth of Staphylococcus aureus.
He has been having frequent infections with Stretpcoccus, E coli and candida since his early childhood.
The doctor has ordered the nitroblue tetrazolium reduction test.
Which of the following is the most probable cause of his illness?




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