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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. Whipple's disease (Tropheryma whippelii)
Chorea - dementia - caudate degeneration
Anti - IgG antibodies
Weight loss - diarrhea - arthritis - fever - adenopathy
Painful blue fingers / toes - hemolytic anemia

2. Janeway lesions (infective endocarditis)
microcytic anemia (parasite)
Lucid interval after TBI
Thyroid - like appearance of kidney
Painless erythematous lesions on palms and soles

3. Pellagra (B3 / niacin deficiency)
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Dermatitis - dementia - diarrhea
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Infant with hypoglycemia - failure to thrive - and hepatomegaly

4. Edward's syndrome (Trisomy 18)
Extracellular amyloid deposition in gray matter of brain
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Painful - pale - cold fingers / toes
Red 'current jelly' sputum in alcoholic or diabetic patients

5. Mallory bodies (alcoholic liver disease)
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Oscillating slow / fast breathing
Eosinophilic cytoplasmic inclusion in liver cell
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands

6. Paget's disease of the breast
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Retinal hemorrhages with pale centers
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Red - itchy - swollen rash of nipple/areola

7. Kussmaul breathing - DKA
Needle - shaped - negatively birefringent crystals
Waxy casts with very low urine flow
Deep - labored breathing / hyperventilation
Back pain - fever - night sweats - weight loss

8. SLE (type III hypersensitivity)
Single palm crease
Low serum ceruloplasmin
hematuria - bladder cancer (parasite)
Antinuclear antibodies

9. Fanconi's syndrome (proximal tubular reabsorption defect)
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Chorea - dementia - caudate degeneration
Azurophilic granular needles in leukemic blasts
Polyuria - acidosis - growth failure - electrolyte imbalances

10. Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to hyperparathyroidism or osteitis fibrosa cystica
Rash on palms and soles
Chest pain - pericardial effusion/friction rub - persistent fever following MI
biliary tract disease - cholangiocarcinoma (parasite)
Brown tumor of bone

11. Ghon complex (1* TB)
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Current jelly stool
Hypochromic - microcytic anemia
Colonies of mucoid Pseudomonas in lungs

12. RA (systemic inflammation - joint pannus - boutonniere deformity) - IgM anti IgG
Antihistone antibodies
Slow progressive muscle weakness in boys
Resting tremor - rigidity - akinesia - postural instability
Anti - IgG antibodies

13. Chronic bacterial pyelo
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Thyroid - like appearance of kidney
Stacks of RBCs
Antimitochondrial antibodies

14. Goodpasture's syndome (glomerulonephritis and hemoptysis)
Cold intolerance
Protein aggregates in neurons from hyperphosphorylation of tau protein
AntiGBM antibodies
Current jelly stool

15. Peutz - Jeghers syndrome
Narrowing of bowel lumen on barium radiograph
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Monoclonal antibody spike

16. Giant cell tumor of bone (generally benign)
Recurrent colds - unusual eczema - high serum IgE
Antidesmoglein (epithelial) antibodies
Intranuclear eosinophilic droplet - like bodies
Soap bubble in femur or tibia on X- ray

17. Becker's muscular dystrophy
Green -yellow rings around peripheral iris
Slow progressive muscle weakness in boys
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Basophilic nuclear remnants in RBCs

18. Epidural hematoma (middle meningeal artery)
Oscillating slow / fast breathing
Renal epithelial casts in urine
Vascular birthmark (port - wine stain)
Lucid interval after TBI

19. Erythropoietin injection
Athlete with polycythemia
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Painless erythematous lesions on palms and soles
Pancreatic - pituitary - parathyroid tumors

20. Von Hippel - Lindau diease
RBC casts in urine
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Hereditary nephritis - sensorineural hearing loss - cataracts
Honeycomb lung on X- ray

21. Diffuse systemic scleroderma
hCG elevated
Anti - topoisomerase antibodies
Disarrayed granulosa cells in eosinophilic fluid
Male child - recurrent infections - no mature B cells

22. Osler's node (infective endocarditis)
Rusty sputum
Extracellular amyloid deposition in gray matter of brain
Painful - raised red lesions on palms and soles
Green -yellow rings around peripheral iris

23. Bruton's disease (X- linked agammaglobulinemia)
Cutaneous/dermal edema due to CT expansion
Necrotizing vasculitis (lungs) and necrotizing GN
WBCs that look smudged
Male child - recurrent infections - no mature B cells

24. Scarlet fever - Kawasaki disease - TSS
Strawberry tongue
Anti - topoisomerase antibodies
biliary tract disease - cholangiocarcinoma (parasite)
Short stature - increased incidence of tumors / leukemia - aplastic anemia

25. Coarctation of the aorta
Rib notching
RBC casts in urine
Dermatitis - dementia - diarrhea
Painless jaundice

26. Kluver - Bucy syndrome (bilateral amygdala)
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Depigmentation of neurons in substantia nigra
Sheets of medium - sized lymphoid cells (starry sky)

27. SLE nephropathy
Fibrous plaques in soft tissue of penis
Ptosis - miosis - anhidrosis
Red 'current jelly' sputum in alcoholic or diabetic patients
Wire loop glomerular appearance on LM

28. Lewy body (Parkinson's)
Enlarged. hard left supraclavicular node
Extracellular amyloid deposition in gray matter of brain
Oscillating slow / fast breathing
Eosinophilic cytoplasmic inclusion in nerve cell

29. Reiter's syndrome (reactive arthritis associated with HLA B27)
Antineutrophil cytoplasmic antibodies (ANCA)
Iron - containing nodules in alveolar septum
Urethritis - conjunctivitis - arthritis in a male
Hypercoagulability leading to thrombophlebitis

30. CLL (almost always B cell - affects the elderly)
Antinuclear antibodies
WBCs that look smudged
Facial muscle spasm upon tapping
Rusty sputum

31. Sezary syndrome (cutaneous T cell lymphoma)
Deep - labored breathing / hyperventilation
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Pseudopalisading tumor cells on brain biopsy

32. Addison's
Dark purple skin / mouth nodules
Enlarged thyroid cells with ground - glass nuclei
Skin hyperpigmentation
Increased uric acid levels

33. Tabes dorsalis - lose proprioception (3* syphilis)
Degeneration of dorsal column nerves
Stacks of RBCs
Sudden swollen/painful big toe joint - tophi
Pupil accommodates but doesn't react

34. Megaloblastic anemia (B12 - folate deficiency)
Basophilic nuclear remnants in RBCs
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Antimitochondrial antibodies
Hypersegmented neutrophils

35. Chronic passive congestion of the liver due to right heart failure
Gout - MR - self - mutilating behavior in a boy
Nutmeg liver
Eosinophilic globule in liver
Deep - labored breathing / hyperventilation

36. Gower's sign (Duchenne's)
Antimitochondrial antibodies
Child uses arms to stand up from squat
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Elastic skin - hypermobility of joints

37. Chvostek's sign (hypocalcemia)
Pink complexion - dypnea - hyperventilation
WBC casts in urine
Narrowing of bowel lumen on barium radiograph
Facial muscle spasm upon tapping

38. Gout/podagra (hyperuricemia)
Sudden swollen/painful big toe joint - tophi
Colonies of mucoid Pseudomonas in lungs
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Conjugate lateral gaze palsy - horizontal diplopia

39. VIrchow's node (abdominal met)
Antiplatelet antibodies
Waxy casts with very low urine flow
Keratin pearls
Enlarged. hard left supraclavicular node

40. Turner syndrome (X0 - short stature - webbed neck - lymphedema)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Splinter hemorrhages in fingernails
Streak ovaries - congenital heart disease - horseshoe kidney
Desquamated epithelium casts in sputum

41. Condylomata lata (2* syphilis)
Smooth - flat - moist white lesions on genitals
Lucid interval after TBI
Eosinophilic globule in liver
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm

42. Ankylosing spondylitis (chronic inflammatory arthritis - HLA B27)
Intranuclear eosinophilic droplet - like bodies
Conjugate lateral gaze palsy - horizontal diplopia
Bamboo spine on X- ray
Tram - track on LM

43. Pott's (TB to the vertebrae)
Enlarged thyroid cells with ground - glass nuclei
High level of D dimers
Back pain - fever - night sweats - weight loss
Dry eyes - dry mouth - arthritis

44. Huntington's
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Unilateral facial drooping involving forehead
Chorea - dementia - caudate degeneration
Iron - containing nodules in alveolar septum

45. Crigler - Najjar syndrome (congenital unconj hyper bilirubinemia)
Calf pseudohypertrophy
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Nodular hyaline deposits in glomeruli
Severe jaundice in neonate

46. Subarachnoid hemorrhage
Retinal hemorrhages with pale centers
Increased a - fetoprotein in amniotic fluid / maternal serum
Bloody tap on LP
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma

47. Lead poisoning or sideroblastic anemia
Red urine in the morning - fragile RBCs
Basophilic stipplling of RBCs
Achilles tendon xanthoma
microcytic anemia (parasite)

48. Internuclear ophthalmoplegia (MS or stroke)
Thrombi made of white/red layers
Conjugate lateral gaze palsy - horizontal diplopia
Bluish line on gingiva
Strawberry tongue

49. Endometriosis (usually bilateral)
Mucosal bleeding and prolonged bleeding time
Anticentromere antibodies
Antinuclear antibodies
Chocolate cyst of ovary

50. Drug - induced SLE (hydralazine - isoniazid - phenytoin - procainamide)
Bilateral hilar adenopathy - uveitis
Chorea - dementia - caudate degeneration
Antihistone antibodies
Mammary gland (blue - domed) cyst