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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. Ankylosing spondylitis (chronic inflammatory arthritis - HLA B27)
Bamboo spine on X- ray
Red - itchy - swollen rash of nipple/areola
Low serum ceruloplasmin
Chorea - dementia - caudate degeneration

2. Koplick spots (measles)
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Small - irregular red spots on buccal mucosa with blue - white centers
Keratin pearls
Continuous machinery heart murmur

3. Alport's syndrome (type IV collagen)
Achilles tendon xanthoma
Renal epithelial casts in urine
Hereditary nephritis - sensorineural hearing loss - cataracts
Stippled vaginal epithelial cells

4. Choriocarcinoma - hydatidiform mole
Depigmentation of neurons in substantia nigra
Back pain - fever - night sweats - weight loss
Antineutrophil cytoplasmic antibodies (ANCA)
hCG elevated

5. Scarlet fever - Kawasaki disease - TSS
Strawberry tongue
Enlarged. hard left supraclavicular node
Pink complexion - dypnea - hyperventilation
Child with fever develops red rash on face that spreads to body

6. Homer Wright rosettes (adrenal neuroblastoma - medulloblastoma - Ewing's sarcoma)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Bloody tap on LP
Needle - shaped - negatively birefringent crystals
Elastic skin - hypermobility of joints

7. McCune - Albright syndome (G protein problem)
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Caf
Unilateral facial drooping involving forehead
Fever - night sweats - weight loss

8. Hypothyroidism
Cold intolerance
Sheets of medium - sized lymphoid cells (starry sky)
Systolic ejection murmur (crescendo - decrescendo)
Triglyceride accumulation in liver cell vacuoles

9. Burkitt's lymphoma (t(8:14) c - myc - EBV)
Sheets of medium - sized lymphoid cells (starry sky)
Sudden swollen/painful big toe joint - tophi
Iron - containing nodules in alveolar septum
Pink complexion - dypnea - hyperventilation

10. Chvostek's sign (hypocalcemia)
Sheets of medium - sized lymphoid cells (starry sky)
Mammary gland (blue - domed) cyst
Facial muscle spasm upon tapping
Cutaneous/dermal edema due to CT expansion

11. Budd - Chiari syndrome
Slow progressive muscle weakness in boys
Anticentromere antibodies
Pupil accommodates but doesn't react
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)

12. Familial hypercholesterolemia
Small - irregular red spots on buccal mucosa with blue - white centers
Vascular birthmark (port - wine stain)
Iron - containing nodules in alveolar septum
Achilles tendon xanthoma

13. Kluver - Bucy syndrome (bilateral amygdala)
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Enlarged. hard left supraclavicular node
B12 deficiency (parasite)
Rhomboid crystals - positively birefringent

14. Lewy body (Parkinson's)
Disarrayed granulosa cells in eosinophilic fluid
Heart nodules (inflammatory)
Stippled vaginal epithelial cells
Eosinophilic cytoplasmic inclusion in nerve cell

15. Pellagra (B3 / niacin deficiency)
High level of D dimers
Dermatitis - dementia - diarrhea
Caf
Hypersegmented neutrophils

16. Reinke crystals (Leydig cell tumor)
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Cold intolerance
Rash on palms and soles
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells

17. Rabies virus - negri bodies (Lyssavirus)
Rusty sputum
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Stacks of RBCs
Pink complexion - dypnea - hyperventilation

18. Cori's disease (debranching enzyme deficiency - no glycogenolysis) or Von Gierke's
Toe extension / fanning upon plantar scrape
Hypochromic - microcytic anemia
Thyroid - like appearance of kidney
Infant with hypoglycemia - failure to thrive - and hepatomegaly

19. Parkinson's
Male child - recurrent infections - no mature B cells
Basophilic stipplling of RBCs
Resting tremor - rigidity - akinesia - postural instability
Chorea - dementia - caudate degeneration

20. Tabes dorsalis - lose proprioception (3* syphilis)
Hair - on - end (crewcut) appearance on X- ray
Indurated - ulcerated genital lesion
Mammary gland (blue - domed) cyst
Degeneration of dorsal column nerves

21. Bell's palsy (LMN CN VII)
Monoclonal antibody spike
Rash on palms and soles
Silver - staining spherical aggregation of tau proteins in neurons
Unilateral facial drooping involving forehead

22. Ehler - Danlos (type III collagen)
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Elastic skin - hypermobility of joints
Bamboo spine on X- ray
Splinter hemorrhages in fingernails

23. Squamous cell carcinoma
Needle - shaped - negatively birefringent crystals
Fibrous plaques in soft tissue of penis
Keratin pearls
Enlarged cells with intranuclear inclusion bodies

24. Waterhouse - Friderichsen syndrome (meningococcemia)
Adrenal hemorrhage - hypotension - DIC
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Hereditary nephritis - sensorineural hearing loss - cataracts
Eosinophilic globule in liver

25. Chagas disease (Trypanosoma cruzi)
Cardiomegaly with apical atrophy
Current jelly stool
Mucosal bleeding and prolonged bleeding time
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands

26. Pott's (TB to the vertebrae)
Weight loss - diarrhea - arthritis - fever - adenopathy
Lucid interval after TBI
Back pain - fever - night sweats - weight loss
RBC casts in urine

27. Rouleax formation (high ESR - multiple myeloma)
Mucosal bleeding and prolonged bleeding time
Basophilic stipplling of RBCs
Stacks of RBCs
HTN - hypoK - metabolic alkalosis

28. Peutz - Jeghers syndrome
Basophilic stipplling of RBCs
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Worst headache of my life

29. SLE (type III hypersensitivity)
Stacks of RBCs
Antinuclear antibodies
Triglyceride accumulation in liver cell vacuoles
Antihistone antibodies

30. Rapidly progressive crescentic glomerulonephritis

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31. Fibrocystic change of the breast
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Anticentromere antibodies
Mammary gland (blue - domed) cyst
Fever - chills - headache - myalgia following antibiotic treatment for syphillis

32. Kartagener's syndrome (dynein)
Hereditary nephritis - sensorineural hearing loss - cataracts
Desquamated epithelium casts in sputum
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Tram - track on LM

33. Addison's
Skin hyperpigmentation
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Onion - skin periosteal reaction
Large rash with bull's eye appearance

34. Pick bodies
Recurrent colds - unusual eczema - high serum IgE
RBC casts in urine
Silver - staining spherical aggregation of tau proteins in neurons
Periosteum raised from bone - creating triangular area

35. VIrchow's node (abdominal met)
Enlarged. hard left supraclavicular node
Dark purple skin / mouth nodules
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells

36. Multiple myeloma
Stippled vaginal epithelial cells
Anticentromere antibodies
Renal epithelial casts in urine
Lytic (punched - out) bone lesions on X- ray

37. Ferruginous bodies (asbestosis: risk of mesothelioma)
Achilles tendon xanthoma
Increased uric acid levels
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Iron - containing nodules in alveolar septum

38. Job's syndrome
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Large rash with bull's eye appearance
Child with fever develops red rash on face that spreads to body
Recurrent colds - unusual eczema - high serum IgE

39. Acute glomerulonephritis
Painful - pale - cold fingers / toes
RBC casts in urine
Caf
Continuous machinery heart murmur

40. Henoch - Schonlein purpura (IgA vasculitis)
Palpable purpura - joint pain - abdominal pain in a child
Renal epithelial casts in urine
Onion - skin periosteal reaction
Child with fever develops red rash on face that spreads to body

41. Curschmann's spirals (bronchial asthma - can result in whorled mucous plugs)
Increased a - fetoprotein in amniotic fluid / maternal serum
Desquamated epithelium casts in sputum
Bloody tap on LP
Intranuclear eosinophilic droplet - like bodies

42. Kussmaul breathing - DKA
Lytic (punched - out) bone lesions on X- ray
Glomerulus - like structure surrounding vessel in germ cells
Red - itchy - swollen rash of nipple/areola
Deep - labored breathing / hyperventilation

43. Pink puffer (emphysema)
Cold intolerance
Fever - night sweats - weight loss
Pink complexion - dypnea - hyperventilation
Glomerulus - like structure surrounding vessel in germ cells

44. Schistosoma haematobium
Increased uric acid levels
Severe RLQ pain with rebound tenderness
hematuria - bladder cancer (parasite)
Bamboo spine on X- ray

45. Condylomata lata (2* syphilis)
Hypochromic - microcytic anemia
Smooth - flat - moist white lesions on genitals
Male child - recurrent infections - no mature B cells
High level of D dimers

46. Tay- Sachs - Niemann - Pick - central retinal artery occlusion
Cherry- red spot on macula
liver cysts (parasite)
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
WBCs that look smudged

47. Peyronie's disease
Fibrous plaques in soft tissue of penis
Anticentromere antibodies
Red urine in the morning - fragile RBCs
hCG elevated

48. McBurney's sign
Rusty sputum
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Severe RLQ pain with rebound tenderness
Systolic ejection murmur (crescendo - decrescendo)

49. 1. Multiple myeloma (M protein - IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (aging) 3. Waldenstrom's macroglobulinemia (IgM) 4. Primary amyloidosis
Cold intolerance
Degeneration of dorsal column nerves
Monoclonal antibody spike
Small - irregular red spots on buccal mucosa with blue - white centers

50. Chronic ESRD
Periosteum raised from bone - creating triangular area
Waxy casts with very low urine flow
Red 'current jelly' sputum in alcoholic or diabetic patients
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells