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USMLE Step 1 Prep 2

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. Ewing's sarcoma (malignant round cell tumor)
Soap bubble in femur or tibia on X- ray
Onion - skin periosteal reaction
Pupil accommodates but doesn't react
Circular grouping of dark tumor cells surrounding pale neurofibrils

2. Duchenne's muscular dystrophy
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Calf pseudohypertrophy
Podocyte fusion on EM
Red 'current jelly' sputum in alcoholic or diabetic patients

3. Scarlet fever - Kawasaki disease - TSS
Strawberry tongue
Necrotizing vasculitis (lungs) and necrotizing GN
portal hypertension (parasite)
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth

4. Goodpasture's syndome (glomerulonephritis and hemoptysis)
Thyroid - like appearance of kidney
AntiGBM antibodies
Honeycomb lung on X- ray
Pink complexion - dypnea - hyperventilation

5. Cori's disease (debranching enzyme deficiency - no glycogenolysis) or Von Gierke's
Narrowing of bowel lumen on barium radiograph
Ptosis - miosis - anhidrosis
brain cysts - seizures (parasite)
Infant with hypoglycemia - failure to thrive - and hepatomegaly

6. Huntington's
Enlarged. hard left supraclavicular node
Desquamated epithelium casts in sputum
Degeneration of dorsal column nerves
Chorea - dementia - caudate degeneration

7. Ferruginous bodies (asbestosis: risk of mesothelioma)
Intranuclear eosinophilic droplet - like bodies
No lactation postpartum - absent menstruation - cold intolerance
Antineutrophil cytoplasmic antibodies (ANCA)
Iron - containing nodules in alveolar septum

8. Blue bloater (chronic bronchitis)
Necrotizing vasculitis (lungs) and necrotizing GN
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Facial muscle spasm upon tapping
Hypoxemia - polycythemia - hypercapnia

9. Conn's (1* hyperaldosterone)
HTN - hypoK - metabolic alkalosis
Anticentromere antibodies
Antihistone antibodies
Recurrent colds - unusual eczema - high serum IgE

10. Fibrocystic change of the breast
Mammary gland (blue - domed) cyst
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
biliary tract disease - cholangiocarcinoma (parasite)
Large rash with bull's eye appearance

11. Osler's node (infective endocarditis)
Red urine in the morning - fragile RBCs
Indurated - ulcerated genital lesion
Painful - raised red lesions on palms and soles
Vascular birthmark (port - wine stain)

12. Interstitial fibrosis
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Adrenal hemorrhage - hypotension - DIC
Athlete with polycythemia
Honeycomb lung on X- ray

13. Paroxysmal nocturnal hemoglobinuria (C' mediated damage - lack of CD55/59)
Lucid interval after TBI
Eosinophilic cytoplasmic inclusion in nerve cell
Red urine in the morning - fragile RBCs
Worst headache of my life

14. Koilocytes (HPV) 'perrinuclear cytoplasmic clearing'
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Rash on palms and soles
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Pink complexion - dypnea - hyperventilation

15. Poststrep glomerulonephritis (IgG and C3b deposition)
Iron - containing nodules in alveolar septum
Monoclonal antibody spike
Sudden swollen/painful big toe joint - tophi
Lumpy- bumpy appearance of glomeruli on immunofluorescence

16. Janeway lesions (infective endocarditis)
Lytic (punched - out) bone lesions on X- ray
Painless erythematous lesions on palms and soles
Degeneration of dorsal column nerves
Pseudopalisading tumor cells on brain biopsy

17. Peyronie's disease
Fibrous plaques in soft tissue of penis
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Caf
Swollen - hard - painful finger joints

18. Senile plaques (Alzheimer's)
Triglyceride accumulation in liver cell vacuoles
Extracellular amyloid deposition in gray matter of brain
Bluish line on gingiva
Periosteum raised from bone - creating triangular area

19. Epiglossitis (H flu)
Polished - ivory- like appearance of bone at cartilage erosion
Blue sclera
Keratin pearls
Thumb sign on lateral X- ray

20. Subarachnoid hemorrhage
Bloody tap on LP
Weight loss - diarrhea - arthritis - fever - adenopathy
Chocolate cyst of ovary
Rib notching

21. Nonpainful = syphillis. Painful with exudate = chancroid
Increased a - fetoprotein in amniotic fluid / maternal serum
Urethritis - conjunctivitis - arthritis in a male
Indurated - ulcerated genital lesion
Bronchogenic apical lung tumor

22. Rouleax formation (high ESR - multiple myeloma)
Worst headache of my life
Stacks of RBCs
Chorea - dementia - caudate degeneration
Honeycomb lung on X- ray

23. Sjogren's syndrome
Sheets of medium - sized lymphoid cells (starry sky)
Increased a - fetoprotein in amniotic fluid / maternal serum
Hypercoagulability leading to thrombophlebitis
Dry eyes - dry mouth - arthritis

24. Iron deficiency anemia - lead poisoning - thalassemia (HbF sometimes present)
Strawberry tongue
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Bounding pulses - diastolic hear murmur - head bobbing
Hypochromic - microcytic anemia

25. Klebsiella pneumoniae

26. MS (Charcot's)
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Antimitochondrial antibodies
Anticentromere antibodies
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia

27. Cowdry type A bodies (HSV or CMV)
Stacks of RBCs
Swollen - hard - painful finger joints
Intranuclear eosinophilic droplet - like bodies
Resting tremor - rigidity - akinesia - postural instability

28. Cheyne - Stokes (central apnea from CHF or increased ICP)
Oscillating slow / fast breathing
Hypercoagulability leading to thrombophlebitis
Cellular crescents in Bowman's capsule
Cherry- red spot on macula

29. SLE nephropathy
Wire loop glomerular appearance on LM
Caf
Adrenal hemorrhage - hypotension - DIC
Pseudopalisading tumor cells on brain biopsy

30. Wegner's (c - ANCA) and Goodpasture's (anti - GBM). Wegner's can also have upper airway involvement
Necrotizing vasculitis (lungs) and necrotizing GN
Hypochromic - microcytic anemia
Dermatitis - dementia - diarrhea
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

31. Drug - induced SLE (hydralazine - isoniazid - phenytoin - procainamide)
Needle - shaped - negatively birefringent crystals
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Antihistone antibodies
Single palm crease

32. Pink puffer (emphysema)
Toe extension / fanning upon plantar scrape
WBCs that look smudged
Pink complexion - dypnea - hyperventilation
Bounding pulses - diastolic hear murmur - head bobbing

33. Chronic ESRD
Waxy casts with very low urine flow
Hypersegmented neutrophils
Polyuria - acidosis - growth failure - electrolyte imbalances
Toe extension / fanning upon plantar scrape

34. MEN 1 (Wermer's)
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Yellow CSF
Pancreatic - pituitary - parathyroid tumors
Nutmeg liver

35. Kartagener's syndrome (dynein)
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Cellular crescents in Bowman's capsule
RBC casts in urine
Severe jaundice in neonate

36. Myxedema
Keratin pearls
Cutaneous/dermal edema due to CT expansion
Increased uric acid levels
Enlarged cells with intranuclear inclusion bodies

37. Cancer at head of pancreas obstructing bile duct
Boot - shaped heart on X- ray
Painless jaundice
Swollen - hard - painful finger joints
Deep - labored breathing / hyperventilation

38. Gaucher's disease (glucocerebrosidase deficiency)
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Stippled vaginal epithelial cells
Streak ovaries - congenital heart disease - horseshoe kidney

39. Chagas disease (Trypanosoma cruzi)
liver cysts (parasite)
Slow progressive muscle weakness in boys
Hereditary nephritis - sensorineural hearing loss - cataracts
Cardiomegaly with apical atrophy

40. Tay- Sachs - Niemann - Pick - central retinal artery occlusion
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Honeycomb lung on X- ray
Cherry- red spot on macula

41. Guillain - Barre syndrome
Cardiomegaly with apical atrophy
Rapidly progressive leg weakness that ascend - following GI infection
Rib notching
WBCs that look smudged

42. Bibeck granules (histiocytosis X: eosinophilic granuloma)
Colonies of mucoid Pseudomonas in lungs
Antiplatelet antibodies
Recurrent colds - unusual eczema - high serum IgE
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

43. Orphan Annie nuclei - or 'disbursed chromatin' (papillary carcinoma of the thyroid)
Renal epithelial casts in urine
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Enlarged thyroid cells with ground - glass nuclei
Sheets of medium - sized lymphoid cells (starry sky)

44. Giant cell tumor of bone (generally benign)
Increased uric acid levels
Soap bubble in femur or tibia on X- ray
Necrotizing vasculitis (lungs) and necrotizing GN
Infant with hypoglycemia - failure to thrive - and hepatomegaly

45. Gout - Lesch - Nyhan syndrome - tumor lysis syndrome - loop and thiazide diuretics
Narrowing of bowel lumen on barium radiograph
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Increased uric acid levels
Vascular birthmark (port - wine stain)

46. Jarisch - Herxheimer reaction (lysis of spirochetes results in toxin release)
Increased a - fetoprotein in amniotic fluid / maternal serum
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Silver - staining spherical aggregation of tau proteins in neurons

47. Measles
Antimitochondrial antibodies
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots

48. Shwartzman reaction (follows second exposure to endotoxin)
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Sudden swollen/painful big toe joint - tophi
Lytic (punched - out) bone lesions on X- ray
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells

49. Erythropoietin injection
Slow progressive muscle weakness in boys
Back pain - fever - night sweats - weight loss
Athlete with polycythemia
Lucid interval after TBI

50. Fanconi's syndrome (proximal tubular reabsorption defect)
Hypoxemia - polycythemia - hypercapnia
Polyuria - acidosis - growth failure - electrolyte imbalances
Skin hyperpigmentation
Painful blue fingers / toes - hemolytic anemia