Test your basic knowledge |

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. RA (systemic inflammation - joint pannus - boutonniere deformity) - IgM anti IgG
Rapidly progressive leg weakness that ascend - following GI infection
Wire loop glomerular appearance on LM
Intranuclear eosinophilic droplet - like bodies
Anti - IgG antibodies

2. Chvostek's sign (hypocalcemia)
Pseudopalisading tumor cells on brain biopsy
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Facial muscle spasm upon tapping

3. Iron deficiency anemia - lead poisoning - thalassemia (HbF sometimes present)
Desquamated epithelium casts in sputum
Mucosal bleeding and prolonged bleeding time
Elastic skin - hypermobility of joints
Hypochromic - microcytic anemia

4. McArdle's (muscle phosphorylase deficiency)
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Rusty sputum
Ptosis - miosis - anhidrosis
Oscillating slow / fast breathing

5. Roth's spots (bacterial endocarditis)
Continuous machinery heart murmur
Periosteum raised from bone - creating triangular area
Hair - on - end (crewcut) appearance on X- ray
Retinal hemorrhages with pale centers

6. Turner syndrome (X0 - short stature - webbed neck - lymphedema)
Red 'current jelly' sputum in alcoholic or diabetic patients
Pancreatic - pituitary - parathyroid tumors
Streak ovaries - congenital heart disease - horseshoe kidney
Honeycomb lung on X- ray

7. Ehler - Danlos (type III collagen)
Resting tremor - rigidity - akinesia - postural instability
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Elastic skin - hypermobility of joints
Onion - skin periosteal reaction

8. Argyll Robertson pupil (neurosyphilis)

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

9. Familial hypercholesterolemia
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Achilles tendon xanthoma
Enlarged cells with intranuclear inclusion bodies
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells

10. Bacterial endocarditis
Bloody tap on LP
Splinter hemorrhages in fingernails
biliary tract disease - cholangiocarcinoma (parasite)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

11. Gout/podagra (hyperuricemia)
Cellular crescents in Bowman's capsule
Bluish line on gingiva
AntiGBM antibodies
Sudden swollen/painful big toe joint - tophi

12. Lead poisoning or sideroblastic anemia
Renal epithelial casts in urine
Lucid interval after TBI
Podocyte fusion on EM
Basophilic stipplling of RBCs

13. Jarisch - Herxheimer reaction (lysis of spirochetes results in toxin release)
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Palpable purpura - joint pain - abdominal pain in a child
Back pain - fever - night sweats - weight loss

14. Chronic passive congestion of the liver due to right heart failure
Branching gram + rods with sulfur granules
brain cysts - seizures (parasite)
Nutmeg liver
Glomerulus - like structure surrounding vessel in germ cells

15. Becker's muscular dystrophy
Thumb sign on lateral X- ray
Depigmentation of neurons in substantia nigra
Slow progressive muscle weakness in boys
Mucin - filled cell with peripheral nucleus

16. Lines of Zahn (arterial thrombus - layers of platelets/RBCs)
Caf
Thrombi made of white/red layers
Enlarged. hard left supraclavicular node
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth

17. CF
Lumpy- bumpy appearance of glomeruli on immunofluorescence
HTN - hypoK - metabolic alkalosis
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Colonies of mucoid Pseudomonas in lungs

18. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Male child - recurrent infections - no mature B cells
Thumb sign on lateral X- ray
Green -yellow rings around peripheral iris
Retinal hemorrhages with pale centers

19. Erb - Duchenne palsy
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Antihistone antibodies
Toe extension / fanning upon plantar scrape
Systolic ejection murmur (crescendo - decrescendo)

20. Gardner's syndrome
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
HTN - hypoK - metabolic alkalosis
Bluish line on gingiva
Thrombi made of white/red layers

21. Tay- Sachs - Niemann - Pick - central retinal artery occlusion
Cherry- red spot on macula
Bilateral hilar adenopathy - uveitis
Polyuria - acidosis - growth failure - electrolyte imbalances
Hypersegmented neutrophils

22. Duchenne's muscular dystrophy
Large rash with bull's eye appearance
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Calf pseudohypertrophy
Enlarged cells with intranuclear inclusion bodies

23. Burton's line - lead poisoning
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Bluish line on gingiva
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Boot - shaped heart on X- ray

24. Bronchial asthma (Charcot - Leyden crystals: eosinophilic granules)
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Yellow CSF
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
perianal pruritis (parasite)

25. Codman's triangle on X- ray (osteosarcoma - Ewing's - pyogenic osteomyelitis)
hematuria - bladder cancer (parasite)
Periosteum raised from bone - creating triangular area
Colonies of mucoid Pseudomonas in lungs
perianal pruritis (parasite)

26. Scurvy (vit C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
Silver - staining spherical aggregation of tau proteins in neurons
Renal epithelial casts in urine
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Back pain - fever - night sweats - weight loss

27. Curschmann's spirals (bronchial asthma - can result in whorled mucous plugs)
Large lysosomal vesicles in phagocytes - immunodeficiency
Anticentromere antibodies
Desquamated epithelium casts in sputum
Iron - containing nodules in alveolar septum

28. Cancer at head of pancreas obstructing bile duct
Painless jaundice
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Blue sclera
Wire loop glomerular appearance on LM

29. Reinke crystals (Leydig cell tumor)
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Nodular hyaline deposits in glomeruli
Vascular birthmark (port - wine stain)
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells

30. Cold agglutinin disease (autoimmune from Mp or mono - from IgM)
Enlarged cells with intranuclear inclusion bodies
Dark purple skin / mouth nodules
Painful blue fingers / toes - hemolytic anemia
Hexagonal - double - pointed - needle - like crystals in bronchial secretions

31. MEN 1 (Wermer's)
Pancreatic - pituitary - parathyroid tumors
Intranuclear eosinophilic droplet - like bodies
Dermatitis - dementia - diarrhea
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect

32. Dressler's (autoimmune post - MI)
Resting tremor - rigidity - akinesia - postural instability
Chest pain - pericardial effusion/friction rub - persistent fever following MI
B12 deficiency (parasite)
Painful blue fingers / toes - hemolytic anemia

33. Giant cell tumor of bone (generally benign)
Large rash with bull's eye appearance
Soap bubble in femur or tibia on X- ray
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Bilateral hilar adenopathy - uveitis

34. Homer Wright rosettes (adrenal neuroblastoma - medulloblastoma - Ewing's sarcoma)
Antineutrophil cytoplasmic antibodies (ANCA)
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Periosteum raised from bone - creating triangular area

35. Infectious mono (HBV). IgM that agglutinates sheep RBCs
Waxy casts with very low urine flow
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Heterophile antibodies
Vomiting blood following esophagogastric lacerations

36. Conn's (1* hyperaldosterone)
HTN - hypoK - metabolic alkalosis
Painful - raised red lesions on palms and soles
Protein aggregates in neurons from hyperphosphorylation of tau protein
AntiGBM antibodies

37. Fanconi's anemia (esp AML)
Yellow CSF
Antidesmoglein (epithelial) antibodies
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Unilateral facial drooping involving forehead

38. Minimal change disease (child - nephrotic)
Green -yellow rings around peripheral iris
Antiplatelet antibodies
Protein aggregates in neurons from hyperphosphorylation of tau protein
Podocyte fusion on EM

39. Rabies virus - negri bodies (Lyssavirus)
Sheets of medium - sized lymphoid cells (starry sky)
Urethritis - conjunctivitis - arthritis in a male
Fibrous plaques in soft tissue of penis
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

40. Paragonimus westermani
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Lytic (punched - out) bone lesions on X- ray
Red - itchy - swollen rash of nipple/areola
hemoptysis (parasite)

41. Councilman body (toxic or viral hepatitis - often yellow fever)
Azurophilic granular needles in leukemic blasts
Eosinophilic globule in liver
Low serum ceruloplasmin
Stacks of RBCs

42. Reed - Sternberg cells (Hodgkin's lymphoma)

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

43. Gallstones
Fat - female - fertile - forty
Tram - track on LM
Cherry- red spot on macula
Recurrent colds - unusual eczema - high serum IgE

44. Diphyllobothrium latum
B12 deficiency (parasite)
Unilateral facial drooping involving forehead
microcytic anemia (parasite)
High level of D dimers

45. Von Hippel - Lindau diease
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Dermatitis - dementia - diarrhea
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Periosteum raised from bone - creating triangular area

46. Paroxysmal nocturnal hemoglobinuria (C' mediated damage - lack of CD55/59)
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Red urine in the morning - fragile RBCs
Thumb sign on lateral X- ray
Mammary gland (blue - domed) cyst

47. Pink puffer (emphysema)
Painful blue fingers / toes - hemolytic anemia
Increased a - fetoprotein in amniotic fluid / maternal serum
Pink complexion - dypnea - hyperventilation
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia

48. 'b - thalassemia - sickle cell anemia (extramedullary hematopoiesis). ''Hair on end'' means marrow expansion (skull)
Basophilic stipplling of RBCs
Caf
Hypochromic - microcytic anemia
Hair - on - end (crewcut) appearance on X- ray

49. 1. Bence Jones proteins (multiple myeloma - kappa or lambda light chains in urine) 2. Waldenstrom's macroglobulinemia (IgM)
Chorea - dementia - caudate degeneration
Monoclonal globulin protein in blood/urine
portal hypertension (parasite)
hCG elevated

50. Huntington's
Yellow CSF
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Chorea - dementia - caudate degeneration
Antidesmoglein (epithelial) antibodies