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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. Gallstones
Enlarged. hard left supraclavicular node
Achilles tendon xanthoma
Antidesmoglein (epithelial) antibodies
Fat - female - fertile - forty

2. Dressler's (autoimmune post - MI)
Antineutrophil cytoplasmic antibodies (ANCA)
Glomerulus - like structure surrounding vessel in germ cells
Achilles tendon xanthoma
Chest pain - pericardial effusion/friction rub - persistent fever following MI

3. Iron deficiency anemia - lead poisoning - thalassemia (HbF sometimes present)
Bamboo spine on X- ray
Hypochromic - microcytic anemia
Spikes on basement membrane - dome - like endothelial deposits
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia

4. Poststrep glomerulonephritis (IgG and C3b deposition)
Monoclonal globulin protein in blood/urine
Triglyceride accumulation in liver cell vacuoles
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Painless erythematous lesions on palms and soles

5. Senile plaques (Alzheimer's)
Extracellular amyloid deposition in gray matter of brain
Calf pseudohypertrophy
Painful blue fingers / toes - hemolytic anemia
Heart nodules (inflammatory)

6. Aschoff bodies = focal myocardial inflammation with giant cells (rheumatic fever)
Increased a - fetoprotein in amniotic fluid / maternal serum
Worst headache of my life
Heart nodules (inflammatory)
Degeneration of dorsal column nerves

7. McArdle's (muscle phosphorylase deficiency)
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Mucosal bleeding and prolonged bleeding time
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Pancreatic - pituitary - parathyroid tumors

8. Gout/podagra (hyperuricemia)
Sudden swollen/painful big toe joint - tophi
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Sheets of medium - sized lymphoid cells (starry sky)

9. Fatty liver disease (alcoholic or metabolic syndrome)
Vomiting blood following esophagogastric lacerations
Retinal hemorrhages with pale centers
Triglyceride accumulation in liver cell vacuoles
Bronchogenic apical lung tumor

10. Erb - Duchenne palsy
Smooth - flat - moist white lesions on genitals
Indurated - ulcerated genital lesion
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Thyroid (medullary) and parathyroid tumors - pheochromocytoma

11. Owl's eye appearance of CMV - Cowdry A bodies
Bounding pulses - diastolic hear murmur - head bobbing
AntiGBM antibodies
Enlarged cells with intranuclear inclusion bodies
Cherry- red spot on macula

12. Kluver - Bucy syndrome (bilateral amygdala)
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Podocyte fusion on EM
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Child with fever develops red rash on face that spreads to body

13. Neurofibrillary tangles (Alzheimer's and CJD)
Small - irregular red spots on buccal mucosa with blue - white centers
Antidesmoglein (epithelial) antibodies
Enlarged thyroid cells with ground - glass nuclei
Protein aggregates in neurons from hyperphosphorylation of tau protein

14. Pompe's disease (lysosomal glucosidase deficiency)
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Nodular hyaline deposits in glomeruli
Heart nodules (inflammatory)
B12 deficiency (parasite)

15. Peutz - Jeghers syndrome
Smooth - flat - moist white lesions on genitals
Dermatitis - dementia - diarrhea
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands

16. Anencephaly - spina bifida (neural tube defects) - gastrocesis - omphalmocele
Increased a - fetoprotein in amniotic fluid / maternal serum
Enlarged thyroid cells with ground - glass nuclei
Pink complexion - dypnea - hyperventilation
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)

17. Acute glomerulonephritis
Conjugate lateral gaze palsy - horizontal diplopia
RBC casts in urine
Low serum ceruloplasmin
Adrenal hemorrhage - hypotension - DIC

18. Clonorchis sinensis
Increased a - fetoprotein in amniotic fluid / maternal serum
WBCs that look smudged
biliary tract disease - cholangiocarcinoma (parasite)
Indurated - ulcerated genital lesion

19. Howell - Jolly bodies (due to splenectomy or nonfunctional spleen)
Basophilic nuclear remnants in RBCs
Keratin pearls
Toe extension / fanning upon plantar scrape
Onion - skin periosteal reaction

20. Chvostek's sign (hypocalcemia)
High level of D dimers
Facial muscle spasm upon tapping
Degeneration of dorsal column nerves
Fever - chills - headache - myalgia following antibiotic treatment for syphillis

21. Kaposi's sarcoma
Antinuclear antibodies
Dark purple skin / mouth nodules
Disarrayed granulosa cells in eosinophilic fluid
Fat - female - fertile - forty

22. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Narrowing of bowel lumen on barium radiograph
Antineutrophil cytoplasmic antibodies (ANCA)
B12 deficiency (parasite)
Vomiting blood following esophagogastric lacerations

23. Celiac (diarrhea - distention - weight loss)
Necrotizing vasculitis (lungs) and necrotizing GN
Podocyte fusion on EM
Cardiomegaly with apical atrophy
Anti - transglutaminase/antigliadin/anti - endomysial antibodies

24. Charcot's triad (ascending cholangitis)
Red urine in the morning - fragile RBCs
Azurophilic granular needles in leukemic blasts
Jaundice - RUQ pain - fever
Thyroid (medullary) and parathyroid tumors - pheochromocytoma

25. Henoch - Schonlein purpura (IgA vasculitis)
Antidesmoglein (epithelial) antibodies
B12 deficiency (parasite)
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Palpable purpura - joint pain - abdominal pain in a child

26. NF (1 = optic glimoas and pheo - 2 = acoustic Schwannomas)
hCG elevated
Caf
Rapidly progressive leg weakness that ascend - following GI infection
Male child - recurrent infections - no mature B cells

27. Infectious mono (HBV). IgM that agglutinates sheep RBCs
Current jelly stool
Hereditary nephritis - sensorineural hearing loss - cataracts
Heterophile antibodies
Athlete with polycythemia

28. Minimal change disease (child - nephrotic)
Toe extension / fanning upon plantar scrape
Low serum ceruloplasmin
Deep - labored breathing / hyperventilation
Podocyte fusion on EM

29. Shwartzman reaction (follows second exposure to endotoxin)
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Vasculitis from exposure to endotoxin casuing glomerular thrombosis

30. Tabes dorsalis - lose proprioception (3* syphilis)
Yellow CSF
Degeneration of dorsal column nerves
Recurrent colds - unusual eczema - high serum IgE
Hypercoagulability leading to thrombophlebitis

31. Bibeck granules (histiocytosis X: eosinophilic granuloma)
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Mucin - filled cell with peripheral nucleus
Vasculitis from exposure to endotoxin casuing glomerular thrombosis

32. Wet beriberi (B1 / thiamine deficiency)
Pseudopalisading tumor cells on brain biopsy
Weight loss - diarrhea - arthritis - fever - adenopathy
Dilated cardiomyopathy - edema - polyneuropathy
Bounding pulses - diastolic hear murmur - head bobbing

33. Ancylostoma - Necator (hook worms)
microcytic anemia (parasite)
Severe jaundice in neonate
Keratin pearls
Jaundice - RUQ pain - fever

34. Chronic ESRD
Protein aggregates in neurons from hyperphosphorylation of tau protein
Caf
Waxy casts with very low urine flow
Monoclonal globulin protein in blood/urine

35. Kussmaul breathing - DKA
Polyuria - acidosis - growth failure - electrolyte imbalances
Sheets of medium - sized lymphoid cells (starry sky)
Deep - labored breathing / hyperventilation
Weight loss - diarrhea - arthritis - fever - adenopathy

36. Acute toxic/viral nephrosis
Renal epithelial casts in urine
Palpable purpura - joint pain - abdominal pain in a child
Gout - MR - self - mutilating behavior in a boy
Anti - IgG antibodies

37. Scleroderma (CREST)
Nutmeg liver
Anticentromere antibodies
Hypercoagulability leading to thrombophlebitis
Swollen gums - mucous bleeding - poor wound healing - spots on skin

38. USMLE Step 1 (or subarachnoid hemorrhage)
Periosteum raised from bone - creating triangular area
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Worst headache of my life
Tram - track on LM

39. Intussesseption
Bilateral hilar adenopathy - uveitis
Oscillating slow / fast breathing
Monoclonal globulin protein in blood/urine
Current jelly stool

40. Actinomyces israelii
Rib notching
Branching gram + rods with sulfur granules
Hypochromic - microcytic anemia
Hyperphagia - hypersexuality - hyperorality - hyperdocility

41. Hemangioma (benign - associated with Sturge - Weber syndrome - in which case it's V1 distribution)
Desquamated epithelium casts in sputum
Vascular birthmark (port - wine stain)
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Skin hyperpigmentation

42. Gout
Skin hyperpigmentation
Severe RLQ pain with rebound tenderness
Needle - shaped - negatively birefringent crystals
WBCs that look smudged

43. Osteogenesis imperfecta
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Blue sclera
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Antineutrophil cytoplasmic antibodies (ANCA)

44. Burton's line - lead poisoning
Dermatitis - dementia - diarrhea
Indurated - ulcerated genital lesion
Bluish line on gingiva
Polyuria - acidosis - growth failure - electrolyte imbalances

45. Squamous cell carcinoma
Worst headache of my life
Keratin pearls
Green -yellow rings around peripheral iris
Cherry- red spot on macula

46. Pasteurella multocida (local cellulitis)
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Dog or cat bite resulting in infection
Stippled vaginal epithelial cells
Pupil accommodates but doesn't react

47. Trousseau's sign (adenocarcinoma of pancreas or lung)
Fibrous plaques in soft tissue of penis
Ptosis - miosis - anhidrosis
Hypercoagulability leading to thrombophlebitis
Bluish line on gingiva

48. Janeway lesions (infective endocarditis)
Periosteum raised from bone - creating triangular area
liver cysts (parasite)
Streak ovaries - congenital heart disease - horseshoe kidney
Painless erythematous lesions on palms and soles

49. Lines of Zahn (arterial thrombus - layers of platelets/RBCs)
Thrombi made of white/red layers
Fibrous plaques in soft tissue of penis
Desquamated epithelium casts in sputum
Intranuclear eosinophilic droplet - like bodies

50. GBM (cells may be called 'serpentine')
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Azurophilic granular needles in leukemic blasts
Dog or cat bite resulting in infection
Pseudopalisading tumor cells on brain biopsy