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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. Conn's (1* hyperaldosterone)
Rusty sputum
Elastic skin - hypermobility of joints
Anticentromere antibodies
HTN - hypoK - metabolic alkalosis

2. CF
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Hypochromic - microcytic anemia
Colonies of mucoid Pseudomonas in lungs
Enlarged cells with intranuclear inclusion bodies

3. Chagas disease (Trypanosoma cruzi)
perianal pruritis (parasite)
Azurophilic granular needles in leukemic blasts
Cardiomegaly with apical atrophy
Silver - staining spherical aggregation of tau proteins in neurons

4. SLE (type III hypersensitivity)
Painful - pale - cold fingers / toes
Cellular crescents in Bowman's capsule
Antinuclear antibodies
B12 deficiency (parasite)

5. Rabies virus - negri bodies (Lyssavirus)
Narrowing of bowel lumen on barium radiograph
Anticentromere antibodies
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Hair - on - end (crewcut) appearance on X- ray

6. Rouleax formation (high ESR - multiple myeloma)
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Stacks of RBCs
Antinuclear antibodies
Yellow CSF

7. Parkinson's
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
hCG elevated
Bluish line on gingiva
Resting tremor - rigidity - akinesia - postural instability

8. Actinomyces israelii
Branching gram + rods with sulfur granules
Resting tremor - rigidity - akinesia - postural instability
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Eosinophilic globule in liver

9. Cowdry type A bodies (HSV or CMV)
Increased uric acid levels
Rhomboid crystals - positively birefringent
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Intranuclear eosinophilic droplet - like bodies

10. Lead poisoning or sideroblastic anemia
Basophilic stipplling of RBCs
Dark purple skin / mouth nodules
Nutmeg liver
Bounding pulses - diastolic hear murmur - head bobbing

11. Bronchial asthma (Charcot - Leyden crystals: eosinophilic granules)
Painful - raised red lesions on palms and soles
Fat - female - fertile - forty
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Antihistone antibodies

12. Cancer at head of pancreas obstructing bile duct
Painless jaundice
Enlarged thyroid cells with ground - glass nuclei
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Brown tumor of bone

13. Job's syndrome
Large lysosomal vesicles in phagocytes - immunodeficiency
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Recurrent colds - unusual eczema - high serum IgE
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

14. Erythema chronicum migrans from Ixodes tick bite (Lyme)

15. Ancylostoma - Necator (hook worms)
microcytic anemia (parasite)
Current jelly stool
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Swollen gums - mucous bleeding - poor wound healing - spots on skin

16. Becker's muscular dystrophy
Fat - female - fertile - forty
Splinter hemorrhages in fingernails
Slow progressive muscle weakness in boys
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)

17. Gaucher's disease (glucocerebrosidase deficiency)
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Tram - track on LM
Honeycomb lung on X- ray
Pupil accommodates but doesn't react

18. Cold agglutinin disease (autoimmune from Mp or mono - from IgM)
Vomiting blood following esophagogastric lacerations
Eosinophilic cytoplasmic inclusion in nerve cell
Hypercoagulability leading to thrombophlebitis
Painful blue fingers / toes - hemolytic anemia

19. Reiter's syndrome (reactive arthritis associated with HLA B27)
Urethritis - conjunctivitis - arthritis in a male
Yellow CSF
Cold intolerance
Pink complexion - dypnea - hyperventilation

20. Aschoff bodies = focal myocardial inflammation with giant cells (rheumatic fever)
Thyroid - like appearance of kidney
Bilateral hilar adenopathy - uveitis
Rash on palms and soles
Heart nodules (inflammatory)

21. Cheyne - Stokes (central apnea from CHF or increased ICP)
Streak ovaries - congenital heart disease - horseshoe kidney
Cellular crescents in Bowman's capsule
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Oscillating slow / fast breathing

22. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Vomiting blood following esophagogastric lacerations
Splinter hemorrhages in fingernails
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Oscillating slow / fast breathing

23. Fatty liver disease (alcoholic or metabolic syndrome)
WBC casts in urine
Hypoxemia - polycythemia - hypercapnia
Eosinophilic cytoplasmic inclusion in liver cell
Triglyceride accumulation in liver cell vacuoles

24. MS (Charcot's)
Eosinophilic cytoplasmic inclusion in nerve cell
Needle - shaped - negatively birefringent crystals
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells

25. Bruton's disease (X- linked agammaglobulinemia)
No lactation postpartum - absent menstruation - cold intolerance
Intranuclear eosinophilic droplet - like bodies
Male child - recurrent infections - no mature B cells
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

26. Subarachnoid hemorrhage
Streak ovaries - congenital heart disease - horseshoe kidney
Elastic skin - hypermobility of joints
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Bloody tap on LP

27. Peyronie's disease
Spikes on basement membrane - dome - like endothelial deposits
Fibrous plaques in soft tissue of penis
Branching gram + rods with sulfur granules
Vascular birthmark (port - wine stain)

28. Iron deficiency anemia - lead poisoning - thalassemia (HbF sometimes present)
Conjugate lateral gaze palsy - horizontal diplopia
Hypochromic - microcytic anemia
Bilateral hilar adenopathy - uveitis
Hair - on - end (crewcut) appearance on X- ray

29. Goodpasture's syndome (glomerulonephritis and hemoptysis)
Hypersegmented neutrophils
Painful blue fingers / toes - hemolytic anemia
AntiGBM antibodies
Severe jaundice in neonate

30. Raynaud's syndrome (vasospasm)
Painful - pale - cold fingers / toes
Colonies of mucoid Pseudomonas in lungs
Nutmeg liver
Bilateral hilar adenopathy - uveitis

31. Interstitial fibrosis
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Honeycomb lung on X- ray
Deep - labored breathing / hyperventilation
Colonies of mucoid Pseudomonas in lungs

32. Nonpainful = syphillis. Painful with exudate = chancroid
hematuria - bladder cancer (parasite)
Tram - track on LM
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Indurated - ulcerated genital lesion

33. B symptoms or TB
Anti - IgG antibodies
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Fever - night sweats - weight loss
Cardiomegaly with apical atrophy

34. Gout - Lesch - Nyhan syndrome - tumor lysis syndrome - loop and thiazide diuretics
Podocyte fusion on EM
Severe jaundice in neonate
Hypoxemia - polycythemia - hypercapnia
Increased uric acid levels

35. USMLE Step 1 (or subarachnoid hemorrhage)
Boot - shaped heart on X- ray
Necrotizing vasculitis (lungs) and necrotizing GN
Worst headache of my life
Large lysosomal vesicles in phagocytes - immunodeficiency

36. Jarisch - Herxheimer reaction (lysis of spirochetes results in toxin release)
Anti - topoisomerase antibodies
portal hypertension (parasite)
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Athlete with polycythemia

37. Kartagener's syndrome (dynein)
Elastic skin - hypermobility of joints
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Pink complexion - dypnea - hyperventilation
Stippled vaginal epithelial cells

38. Scleroderma (CREST)
Large lysosomal vesicles in phagocytes - immunodeficiency
Anticentromere antibodies
Dilated cardiomyopathy - edema - polyneuropathy
Calf pseudohypertrophy

39. Schistosoma haematobium
Eosinophilic cytoplasmic inclusion in nerve cell
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
hematuria - bladder cancer (parasite)
Anticentromere antibodies

40. Lesch - Nyhan syndrome (HGPRT deficiency - X- linked recessive)
Thyroid - like appearance of kidney
Antinuclear antibodies
Gout - MR - self - mutilating behavior in a boy
Cutaneous/dermal edema due to CT expansion

41. Lines of Zahn (arterial thrombus - layers of platelets/RBCs)
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Athlete with polycythemia
Thrombi made of white/red layers
Small - irregular red spots on buccal mucosa with blue - white centers

42. Paroxysmal nocturnal hemoglobinuria (C' mediated damage - lack of CD55/59)
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
WBC casts in urine
Red urine in the morning - fragile RBCs
Spikes on basement membrane - dome - like endothelial deposits

43. Gower's sign (Duchenne's)
Antinuclear antibodies
Child uses arms to stand up from squat
Conjugate lateral gaze palsy - horizontal diplopia
Situs inversus - chronic sinusitis - bronchiectasis - infertility

44. Aortic regurg
Severe RLQ pain with rebound tenderness
Bounding pulses - diastolic hear murmur - head bobbing
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Conjugate lateral gaze palsy - horizontal diplopia

45. Aortic valve stenosis
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Systolic ejection murmur (crescendo - decrescendo)
biliary tract disease - cholangiocarcinoma (parasite)
Severe RLQ pain with rebound tenderness

46. Hemangioma (benign - associated with Sturge - Weber syndrome - in which case it's V1 distribution)
Antiplatelet antibodies
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Vascular birthmark (port - wine stain)
Silver - staining spherical aggregation of tau proteins in neurons

47. Clue cells (Gardenella vaginalis)
Stippled vaginal epithelial cells
Protein aggregates in neurons from hyperphosphorylation of tau protein
Conjugate lateral gaze palsy - horizontal diplopia
WBCs that look smudged

48. 1. Multiple myeloma (M protein - IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (aging) 3. Waldenstrom's macroglobulinemia (IgM) 4. Primary amyloidosis
Nutmeg liver
Antidesmoglein (epithelial) antibodies
Monoclonal antibody spike
Hair - on - end (crewcut) appearance on X- ray

49. NF (1 = optic glimoas and pheo - 2 = acoustic Schwannomas)
Caf
Hypercoagulability leading to thrombophlebitis
Iron - containing nodules in alveolar septum
Thumb sign on lateral X- ray

50. Chronic ESRD
Mammary gland (blue - domed) cyst
Increased a - fetoprotein in amniotic fluid / maternal serum
Painless erythematous lesions on palms and soles
Waxy casts with very low urine flow