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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. McArdle's (muscle phosphorylase deficiency)
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Cold intolerance
WBC casts in urine
Chronic exercise intolerance with myalgia - fatigue - painful cramps

2. Kluver - Bucy syndrome (bilateral amygdala)
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Bilateral hilar adenopathy - uveitis
Degeneration of dorsal column nerves
Hyperphagia - hypersexuality - hyperorality - hyperdocility

3. Niemann - Pick disease (genetic sphingomyelinase deficiency)
Green -yellow rings around peripheral iris
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
hematuria - bladder cancer (parasite)
Fever - night sweats - weight loss

4. Schistosoma haematobium
WBCs that look smudged
No lactation postpartum - absent menstruation - cold intolerance
Antiplatelet antibodies
hematuria - bladder cancer (parasite)

5. Whipple's disease (Tropheryma whippelii)
Bronchogenic apical lung tumor
Weight loss - diarrhea - arthritis - fever - adenopathy
perianal pruritis (parasite)
hemoptysis (parasite)

6. Crigler - Najjar syndrome (congenital unconj hyper bilirubinemia)
Vascular birthmark (port - wine stain)
Severe jaundice in neonate
Dilated cardiomyopathy - edema - polyneuropathy
Red - itchy - swollen rash of nipple/areola

7. Megaloblastic anemia (B12 - folate deficiency)
Glomerulus - like structure surrounding vessel in germ cells
Hypersegmented neutrophils
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

8. Blue bloater (chronic bronchitis)
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Hypoxemia - polycythemia - hypercapnia
Worst headache of my life
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints

9. String sign (Crohn's)
Needle - shaped - negatively birefringent crystals
Narrowing of bowel lumen on barium radiograph
Green -yellow rings around peripheral iris
Male child - recurrent infections - no mature B cells

10. Scleroderma (CREST)
HTN - hypoK - metabolic alkalosis
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Painless jaundice
Anticentromere antibodies

11. Multiple myeloma
Red - itchy - swollen rash of nipple/areola
Lytic (punched - out) bone lesions on X- ray
Cellular crescents in Bowman's capsule
Bounding pulses - diastolic hear murmur - head bobbing

12. Endometriosis (usually bilateral)
Waxy casts with very low urine flow
Current jelly stool
Chocolate cyst of ovary
Cutaneous/dermal edema due to CT expansion

13. Paragonimus westermani
Necrotizing vasculitis (lungs) and necrotizing GN
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Hypoxemia - polycythemia - hypercapnia
hemoptysis (parasite)

14. Iron deficiency anemia - lead poisoning - thalassemia (HbF sometimes present)
Hypochromic - microcytic anemia
Monoclonal globulin protein in blood/urine
Podocyte fusion on EM
Red urine in the morning - fragile RBCs

15. Curschmann's spirals (bronchial asthma - can result in whorled mucous plugs)
Desquamated epithelium casts in sputum
Dry eyes - dry mouth - arthritis
Caf
Dog or cat bite resulting in infection

16. Hemangioma (benign - associated with Sturge - Weber syndrome - in which case it's V1 distribution)
Vascular birthmark (port - wine stain)
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Red urine in the morning - fragile RBCs
Gout - MR - self - mutilating behavior in a boy

17. Reinke crystals (Leydig cell tumor)
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Spikes on basement membrane - dome - like endothelial deposits
Facial muscle spasm upon tapping
Rapidly progressive leg weakness that ascend - following GI infection

18. Hypothyroidism
Cold intolerance
Eosinophilic cytoplasmic inclusion in liver cell
Current jelly stool
Back pain - fever - night sweats - weight loss

19. Rouleax formation (high ESR - multiple myeloma)
Stacks of RBCs
Large lysosomal vesicles in phagocytes - immunodeficiency
Nodular hyaline deposits in glomeruli
Dilated cardiomyopathy - edema - polyneuropathy

20. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Green -yellow rings around peripheral iris
Hair - on - end (crewcut) appearance on X- ray
Desquamated epithelium casts in sputum
Tram - track on LM

21. Actinomyces israelii
Toe extension / fanning upon plantar scrape
Child uses arms to stand up from squat
Branching gram + rods with sulfur granules
Azurophilic granular needles in leukemic blasts

22. Ewing's sarcoma (malignant round cell tumor)
Onion - skin periosteal reaction
Painless jaundice
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Gout - MR - self - mutilating behavior in a boy

23. Osler's node (infective endocarditis)
Painful - raised red lesions on palms and soles
Facial muscle spasm upon tapping
WBC casts in urine
Vascular birthmark (port - wine stain)

24. Diphyllobothrium latum
Red 'current jelly' sputum in alcoholic or diabetic patients
B12 deficiency (parasite)
hemoptysis (parasite)
Branching gram + rods with sulfur granules

25. Chagas disease (Trypanosoma cruzi)
HTN - hypoK - metabolic alkalosis
Pancreatic - pituitary - parathyroid tumors
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Cardiomegaly with apical atrophy

26. MS (Charcot's)
Bounding pulses - diastolic hear murmur - head bobbing
Silver - staining spherical aggregation of tau proteins in neurons
WBC casts in urine
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia

27. Wet beriberi (B1 / thiamine deficiency)
Large lysosomal vesicles in phagocytes - immunodeficiency
Dilated cardiomyopathy - edema - polyneuropathy
AntiGBM antibodies
Chest pain - pericardial effusion/friction rub - persistent fever following MI

28. Cori's disease (debranching enzyme deficiency - no glycogenolysis) or Von Gierke's
Periosteum raised from bone - creating triangular area
Cold intolerance
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Streak ovaries - congenital heart disease - horseshoe kidney

29. Enterobius
Small - irregular red spots on buccal mucosa with blue - white centers
Splinter hemorrhages in fingernails
perianal pruritis (parasite)
Smooth - flat - moist white lesions on genitals

30. Intussesseption
Current jelly stool
Chorea - dementia - caudate degeneration
Bloody tap on LP
perianal pruritis (parasite)

31. Bronchial asthma (Charcot - Leyden crystals: eosinophilic granules)
Smooth - flat - moist white lesions on genitals
Pink complexion - dypnea - hyperventilation
Silver - staining spherical aggregation of tau proteins in neurons
Hexagonal - double - pointed - needle - like crystals in bronchial secretions

32. Condylomata lata (2* syphilis)
Smooth - flat - moist white lesions on genitals
Bilateral hilar adenopathy - uveitis
Low serum ceruloplasmin
Eosinophilic globule in liver

33. Acute pyelo
Protein aggregates in neurons from hyperphosphorylation of tau protein
Recurrent colds - unusual eczema - high serum IgE
Adrenal hemorrhage - hypotension - DIC
WBC casts in urine

34. Kussmaul breathing - DKA
Dry eyes - dry mouth - arthritis
Deep - labored breathing / hyperventilation
Caf
Skin hyperpigmentation

35. Councilman body (toxic or viral hepatitis - often yellow fever)
Stippled vaginal epithelial cells
Sheets of medium - sized lymphoid cells (starry sky)
Eosinophilic globule in liver
Pseudopalisading tumor cells on brain biopsy

36. Anencephaly - spina bifida (neural tube defects) - gastrocesis - omphalmocele
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Increased a - fetoprotein in amniotic fluid / maternal serum
Unilateral facial drooping involving forehead
Dilated cardiomyopathy - edema - polyneuropathy

37. Conn's (1* hyperaldosterone)
HTN - hypoK - metabolic alkalosis
Vascular birthmark (port - wine stain)
Urethritis - conjunctivitis - arthritis in a male
Vasculitis from exposure to endotoxin casuing glomerular thrombosis

38. RA (systemic inflammation - joint pannus - boutonniere deformity) - IgM anti IgG
Antihistone antibodies
Anti - IgG antibodies
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
High level of D dimers

39. Taenia solium (cysticercosis)
Yellow CSF
Chorea - dementia - caudate degeneration
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
brain cysts - seizures (parasite)

40. 1. Multiple myeloma (M protein - IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (aging) 3. Waldenstrom's macroglobulinemia (IgM) 4. Primary amyloidosis
HTN - hypoK - metabolic alkalosis
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Monoclonal antibody spike
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

41. Wilson's disease (hepatolenticular degeneration)
Mucosal bleeding and prolonged bleeding time
Low serum ceruloplasmin
Bounding pulses - diastolic hear murmur - head bobbing
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration

42. Henoch - Schonlein purpura (IgA vasculitis)
Weight loss - diarrhea - arthritis - fever - adenopathy
Palpable purpura - joint pain - abdominal pain in a child
Branching gram + rods with sulfur granules
Thyroid - like appearance of kidney

43. Aortic regurg
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Onion - skin periosteal reaction
Bounding pulses - diastolic hear murmur - head bobbing
Extracellular amyloid deposition in gray matter of brain

44. Vasculitis (c - ANCA = Wegener's - p - ANCA = microscopic polyangiitis or Churg - Strauss syndrome)
Narrowing of bowel lumen on barium radiograph
Antineutrophil cytoplasmic antibodies (ANCA)
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
B12 deficiency (parasite)

45. Wegner's (c - ANCA) and Goodpasture's (anti - GBM). Wegner's can also have upper airway involvement
Fibrous plaques in soft tissue of penis
Necrotizing vasculitis (lungs) and necrotizing GN
Boot - shaped heart on X- ray
Fat - female - fertile - forty

46. Raynaud's syndrome (vasospasm)
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
hematuria - bladder cancer (parasite)
Painful - pale - cold fingers / toes

47. McCune - Albright syndome (G protein problem)
Pancreatic - pituitary - parathyroid tumors
RBC casts in urine
Caf
Jaundice - RUQ pain - fever

48. Gout/podagra (hyperuricemia)
Small - irregular red spots on buccal mucosa with blue - white centers
Calf pseudohypertrophy
Sudden swollen/painful big toe joint - tophi
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma

49. Lines of Zahn (arterial thrombus - layers of platelets/RBCs)
Cardiomegaly with apical atrophy
Thrombi made of white/red layers
Intranuclear eosinophilic droplet - like bodies
Facial muscle spasm upon tapping

50. Auer rods (AML - esp promyelocytic type)
Azurophilic granular needles in leukemic blasts
Chorea - dementia - caudate degeneration
Waxy casts with very low urine flow
Increased uric acid levels