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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. Call - Exner bodies (granulosa - theca cell tumor of the ovary)
Conjugate lateral gaze palsy - horizontal diplopia
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Disarrayed granulosa cells in eosinophilic fluid
Anti - IgG antibodies

2. Infectious mono (HBV). IgM that agglutinates sheep RBCs
Wire loop glomerular appearance on LM
Antineutrophil cytoplasmic antibodies (ANCA)
Heterophile antibodies
Resting tremor - rigidity - akinesia - postural instability

3. Rouleax formation (high ESR - multiple myeloma)
Pupil accommodates but doesn't react
Athlete with polycythemia
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Stacks of RBCs

4. Multiple myeloma
Onion - skin periosteal reaction
Polyuria - acidosis - growth failure - electrolyte imbalances
hemoptysis (parasite)
Lytic (punched - out) bone lesions on X- ray

5. Giant cell tumor of bone (generally benign)
Palpable purpura - joint pain - abdominal pain in a child
Colonies of mucoid Pseudomonas in lungs
Soap bubble in femur or tibia on X- ray
Urethritis - conjunctivitis - arthritis in a male

6. Babinski (UMN lesion)
Toe extension / fanning upon plantar scrape
Honeycomb lung on X- ray
Glomerulus - like structure surrounding vessel in germ cells
Cellular crescents in Bowman's capsule

7. Neurofibrillary tangles (Alzheimer's and CJD)
Vomiting blood following esophagogastric lacerations
Protein aggregates in neurons from hyperphosphorylation of tau protein
Painful - raised red lesions on palms and soles
Silver - staining spherical aggregation of tau proteins in neurons

8. Clonorchis sinensis
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
biliary tract disease - cholangiocarcinoma (parasite)
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)

9. Hemangioma (benign - associated with Sturge - Weber syndrome - in which case it's V1 distribution)
Vascular birthmark (port - wine stain)
Low serum ceruloplasmin
Elastic skin - hypermobility of joints
Severe jaundice in neonate

10. Klebsiella pneumoniae

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11. Bronchial asthma (Charcot - Leyden crystals: eosinophilic granules)
Enlarged. hard left supraclavicular node
WBCs that look smudged
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Unilateral facial drooping involving forehead

12. Bruton's disease (X- linked agammaglobulinemia)
Wire loop glomerular appearance on LM
Splinter hemorrhages in fingernails
Male child - recurrent infections - no mature B cells
Hair - on - end (crewcut) appearance on X- ray

13. Pellagra (B3 / niacin deficiency)
Fibrous plaques in soft tissue of penis
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Dermatitis - dementia - diarrhea
Urethritis - conjunctivitis - arthritis in a male

14. 1* biliary cirrhosis (female - cholestasis - portal HTN)
Strawberry tongue
Antimitochondrial antibodies
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Severe jaundice in neonate

15. Scarlet fever - Kawasaki disease - TSS
Enlarged cells with intranuclear inclusion bodies
hemoptysis (parasite)
Painless jaundice
Strawberry tongue

16. Vasculitis (c - ANCA = Wegener's - p - ANCA = microscopic polyangiitis or Churg - Strauss syndrome)
Wire loop glomerular appearance on LM
Antineutrophil cytoplasmic antibodies (ANCA)
biliary tract disease - cholangiocarcinoma (parasite)
Eosinophilic globule in liver

17. Fatty liver disease (alcoholic or metabolic syndrome)
Unilateral facial drooping involving forehead
Triglyceride accumulation in liver cell vacuoles
Glomerulus - like structure surrounding vessel in germ cells
Periosteum raised from bone - creating triangular area

18. RA (systemic inflammation - joint pannus - boutonniere deformity) - IgM anti IgG
Calf pseudohypertrophy
Slow progressive muscle weakness in boys
Anti - IgG antibodies
Mucosal bleeding and prolonged bleeding time

19. Howell - Jolly bodies (due to splenectomy or nonfunctional spleen)
Elastic skin - hypermobility of joints
Bilateral hilar adenopathy - uveitis
Basophilic nuclear remnants in RBCs
Green -yellow rings around peripheral iris

20. Membranoproliferative glomerulonephritis
Tram - track on LM
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Dermatitis - dementia - diarrhea
liver cysts (parasite)

21. Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
Antidesmoglein (epithelial) antibodies
Tram - track on LM
Hypochromic - microcytic anemia
Mucosal bleeding and prolonged bleeding time

22. Choriocarcinoma - hydatidiform mole
hCG elevated
Vascular birthmark (port - wine stain)
Single palm crease
Onion - skin periosteal reaction

23. Dressler's (autoimmune post - MI)
Resting tremor - rigidity - akinesia - postural instability
Glomerulus - like structure surrounding vessel in germ cells
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Heterophile antibodies

24. Tabes dorsalis - lose proprioception (3* syphilis)
Degeneration of dorsal column nerves
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Athlete with polycythemia
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

25. Subarachnoid hemorrhage
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Bloody tap on LP
Iron - containing nodules in alveolar septum
Onion - skin periosteal reaction

26. Chronic bacterial pyelo
Thyroid - like appearance of kidney
Dilated cardiomyopathy - edema - polyneuropathy
Rash on palms and soles
Painful - raised red lesions on palms and soles

27. Cold agglutinin disease (autoimmune from Mp or mono - from IgM)
Waxy casts with very low urine flow
Monoclonal antibody spike
Rapidly progressive leg weakness that ascend - following GI infection
Painful blue fingers / toes - hemolytic anemia

28. Rabies virus - negri bodies (Lyssavirus)
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Monoclonal globulin protein in blood/urine
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth

29. Paget's
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Low serum ceruloplasmin
Dermatitis - dementia - diarrhea
Rib notching

30. CLL (almost always B cell - affects the elderly)
WBCs that look smudged
Honeycomb lung on X- ray
Caf
Thyroid (medullary) and parathyroid tumors - pheochromocytoma

31. Marfan's (fibrillin defect)
Cardiomegaly with apical atrophy
Anticentromere antibodies
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Anti - transglutaminase/antigliadin/anti - endomysial antibodies

32. Wilson's disease (hepatolenticular degeneration)
Low serum ceruloplasmin
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Onion - skin periosteal reaction
Wire loop glomerular appearance on LM

33. SLE (type III hypersensitivity)
Narrowing of bowel lumen on barium radiograph
Pupil accommodates but doesn't react
biliary tract disease - cholangiocarcinoma (parasite)
Antinuclear antibodies

34. Parkinson's
Severe jaundice in neonate
Depigmentation of neurons in substantia nigra
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Vomiting blood following esophagogastric lacerations

35. Scurvy (vit C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Mammary gland (blue - domed) cyst
Conjugate lateral gaze palsy - horizontal diplopia

36. Schistosoma haematobium
Ptosis - miosis - anhidrosis
Increased a - fetoprotein in amniotic fluid / maternal serum
Anti - topoisomerase antibodies
hematuria - bladder cancer (parasite)

37. Gaucher's disease (glucocerebrosidase deficiency)
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Small - irregular red spots on buccal mucosa with blue - white centers
Iron - containing nodules in alveolar septum
AntiGBM antibodies

38. Ankylosing spondylitis (chronic inflammatory arthritis - HLA B27)
Streak ovaries - congenital heart disease - horseshoe kidney
Bamboo spine on X- ray
Skin hyperpigmentation
Sheets of medium - sized lymphoid cells (starry sky)

39. Kluver - Bucy syndrome (bilateral amygdala)
Increased uric acid levels
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Deep - labored breathing / hyperventilation

40. Kussmaul breathing - DKA
Large rash with bull's eye appearance
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Deep - labored breathing / hyperventilation
Waxy casts with very low urine flow

41. Sheehan's syndrome
No lactation postpartum - absent menstruation - cold intolerance
Waxy casts with very low urine flow
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)

42. Conn's (1* hyperaldosterone)
Resting tremor - rigidity - akinesia - postural instability
Enlarged cells with intranuclear inclusion bodies
HTN - hypoK - metabolic alkalosis
Back pain - fever - night sweats - weight loss

43. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Antimitochondrial antibodies
Jaundice - RUQ pain - fever
Green -yellow rings around peripheral iris

44. DVT - PE - DIC - Budd - Chiari (D dimer is fibrin breakdown products)
Hypercoagulability leading to thrombophlebitis
High level of D dimers
Iron - containing nodules in alveolar septum
Continuous machinery heart murmur

45. Osler's node (infective endocarditis)
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Smooth - flat - moist white lesions on genitals
Painful - raised red lesions on palms and soles
portal hypertension (parasite)

46. Signet ring (gastric carcinoma)
Skin hyperpigmentation
Mucin - filled cell with peripheral nucleus
Polyuria - acidosis - growth failure - electrolyte imbalances
perianal pruritis (parasite)

47. 2* syphilis - Rocky Mountain spotted fever - coxsackie A
Dry eyes - dry mouth - arthritis
Rash on palms and soles
Pancreatic - pituitary - parathyroid tumors
Pseudopalisading tumor cells on brain biopsy

48. Alport's syndrome (type IV collagen)
Hereditary nephritis - sensorineural hearing loss - cataracts
Podocyte fusion on EM
Silver - staining spherical aggregation of tau proteins in neurons
Stacks of RBCs

49. Ferruginous bodies (asbestosis: risk of mesothelioma)
Renal epithelial casts in urine
Heterophile antibodies
Iron - containing nodules in alveolar septum
Pupil accommodates but doesn't react

50. MS (Charcot's)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Tram - track on LM
Brown tumor of bone
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia