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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. Clonorchis sinensis
biliary tract disease - cholangiocarcinoma (parasite)
Iron - containing nodules in alveolar septum
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Rusty sputum

2. Pellagra (B3 / niacin deficiency)
Dermatitis - dementia - diarrhea
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Honeycomb lung on X- ray
Elastic skin - hypermobility of joints

3. Gout - Lesch - Nyhan syndrome - tumor lysis syndrome - loop and thiazide diuretics
Increased uric acid levels
Polyuria - acidosis - growth failure - electrolyte imbalances
Deep - labored breathing / hyperventilation
Resting tremor - rigidity - akinesia - postural instability

4. Jarisch - Herxheimer reaction (lysis of spirochetes results in toxin release)
Mucin - filled cell with peripheral nucleus
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Branching gram + rods with sulfur granules
Cardiomegaly with apical atrophy

5. Duchenne's muscular dystrophy
Soap bubble in femur or tibia on X- ray
Calf pseudohypertrophy
Nodular hyaline deposits in glomeruli
B12 deficiency (parasite)

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

7. Turner syndrome (X0 - short stature - webbed neck - lymphedema)
Bilateral hilar adenopathy - uveitis
Streak ovaries - congenital heart disease - horseshoe kidney
Podocyte fusion on EM
hCG elevated

8. Bronchial asthma (Charcot - Leyden crystals: eosinophilic granules)
Rash on palms and soles
Recurrent colds - unusual eczema - high serum IgE
Achilles tendon xanthoma
Hexagonal - double - pointed - needle - like crystals in bronchial secretions

9. Job's syndrome
Recurrent colds - unusual eczema - high serum IgE
Splinter hemorrhages in fingernails
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Achilles tendon xanthoma

10. Acute glomerulonephritis
Cellular crescents in Bowman's capsule
RBC casts in urine
Cherry- red spot on macula
Hypoxemia - polycythemia - hypercapnia

11. Conn's (1* hyperaldosterone)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Facial muscle spasm upon tapping
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
HTN - hypoK - metabolic alkalosis

12. Janeway lesions (infective endocarditis)
Bluish line on gingiva
Skin hyperpigmentation
Cellular crescents in Bowman's capsule
Painless erythematous lesions on palms and soles

13. String sign (Crohn's)
Antinuclear antibodies
Large lysosomal vesicles in phagocytes - immunodeficiency
Narrowing of bowel lumen on barium radiograph
Back pain - fever - night sweats - weight loss

14. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Nodular hyaline deposits in glomeruli
Vomiting blood following esophagogastric lacerations
hematuria - bladder cancer (parasite)
Silver - staining spherical aggregation of tau proteins in neurons

15. Aortic valve stenosis
Systolic ejection murmur (crescendo - decrescendo)
Anti - topoisomerase antibodies
Monoclonal antibody spike
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance

16. Ankylosing spondylitis (chronic inflammatory arthritis - HLA B27)
Protein aggregates in neurons from hyperphosphorylation of tau protein
Fibrous plaques in soft tissue of penis
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Bamboo spine on X- ray

17. Scurvy (vit C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
Soap bubble in femur or tibia on X- ray
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Antidesmoglein (epithelial) antibodies

18. Koplick spots (measles)
Antinuclear antibodies
Small - irregular red spots on buccal mucosa with blue - white centers
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Mammary gland (blue - domed) cyst

19. Xanthochromia (subarachnoid hemorrhage)
Large rash with bull's eye appearance
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Severe jaundice in neonate
Yellow CSF

20. Henoch - Schonlein purpura (IgA vasculitis)
RBC casts in urine
Depigmentation of neurons in substantia nigra
Palpable purpura - joint pain - abdominal pain in a child
Podocyte fusion on EM

21. Roth's spots (bacterial endocarditis)
Cold intolerance
Streak ovaries - congenital heart disease - horseshoe kidney
Caf
Retinal hemorrhages with pale centers

22. Paget's disease of the breast
Red - itchy - swollen rash of nipple/areola
Intranuclear eosinophilic droplet - like bodies
Disarrayed granulosa cells in eosinophilic fluid
Antihistone antibodies

23. Ancylostoma - Necator (hook worms)
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Bilateral hilar adenopathy - uveitis
microcytic anemia (parasite)
Jaundice - RUQ pain - fever

24. Schistosoma haematobium
hematuria - bladder cancer (parasite)
hCG elevated
Athlete with polycythemia
Splinter hemorrhages in fingernails

25. Shwartzman reaction (follows second exposure to endotoxin)
Heterophile antibodies
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
brain cysts - seizures (parasite)
Pupil accommodates but doesn't react

26. Clue cells (Gardenella vaginalis)
Nutmeg liver
Stippled vaginal epithelial cells
Anti - topoisomerase antibodies
Deep - labored breathing / hyperventilation

27. Senile plaques (Alzheimer's)
Strawberry tongue
Eosinophilic globule in liver
Extracellular amyloid deposition in gray matter of brain
microcytic anemia (parasite)

28. Sezary syndrome (cutaneous T cell lymphoma)
Skin hyperpigmentation
Soap bubble in femur or tibia on X- ray
Anti - IgG antibodies
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells

29. Chvostek's sign (hypocalcemia)
Protein aggregates in neurons from hyperphosphorylation of tau protein
Triglyceride accumulation in liver cell vacuoles
Facial muscle spasm upon tapping
Periosteum raised from bone - creating triangular area

30. Peyronie's disease
Caf
Fibrous plaques in soft tissue of penis
Thyroid - like appearance of kidney
Swollen gums - mucous bleeding - poor wound healing - spots on skin

31. Parkinson's
Resting tremor - rigidity - akinesia - postural instability
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
RBC casts in urine

32. Myxedema
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Small - irregular red spots on buccal mucosa with blue - white centers
Cutaneous/dermal edema due to CT expansion
Bounding pulses - diastolic hear murmur - head bobbing

33. 'b - thalassemia - sickle cell anemia (extramedullary hematopoiesis). ''Hair on end'' means marrow expansion (skull)
Silver - staining spherical aggregation of tau proteins in neurons
B12 deficiency (parasite)
Hair - on - end (crewcut) appearance on X- ray
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

34. Ewing's sarcoma (malignant round cell tumor)
Toe extension / fanning upon plantar scrape
Onion - skin periosteal reaction
Thumb sign on lateral X- ray
RBC casts in urine

35. Schistosoma mansoni
portal hypertension (parasite)
Gout - MR - self - mutilating behavior in a boy
Monoclonal antibody spike
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells

36. B symptoms or TB
Fever - night sweats - weight loss
Bluish line on gingiva
Back pain - fever - night sweats - weight loss
Child with fever develops red rash on face that spreads to body

37. Intussesseption
Increased a - fetoprotein in amniotic fluid / maternal serum
Desquamated epithelium casts in sputum
Current jelly stool
Swollen gums - mucous bleeding - poor wound healing - spots on skin

38. Waterhouse - Friderichsen syndrome (meningococcemia)
Painless erythematous lesions on palms and soles
Adrenal hemorrhage - hypotension - DIC
Polyuria - acidosis - growth failure - electrolyte imbalances
Athlete with polycythemia

39. Tay- Sachs - Niemann - Pick - central retinal artery occlusion
Conjugate lateral gaze palsy - horizontal diplopia
Dark purple skin / mouth nodules
Cherry- red spot on macula
Red - itchy - swollen rash of nipple/areola

40. Lesch - Nyhan syndrome (HGPRT deficiency - X- linked recessive)
Gout - MR - self - mutilating behavior in a boy
Spikes on basement membrane - dome - like endothelial deposits
Blue sclera
Cherry- red spot on macula

41. 2* syphilis - Rocky Mountain spotted fever - coxsackie A
Large rash with bull's eye appearance
Rash on palms and soles
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia

42. Kaposi's sarcoma
Dark purple skin / mouth nodules
RBC casts in urine
Urethritis - conjunctivitis - arthritis in a male
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia

43. Homer Wright rosettes (adrenal neuroblastoma - medulloblastoma - Ewing's sarcoma)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Facial muscle spasm upon tapping
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Circular grouping of dark tumor cells surrounding pale neurofibrils

44. Councilman body (toxic or viral hepatitis - often yellow fever)
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Bilateral hilar adenopathy - uveitis
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Eosinophilic globule in liver

45. Taenia solium (cysticercosis)
Rapidly progressive leg weakness that ascend - following GI infection
Honeycomb lung on X- ray
brain cysts - seizures (parasite)
Ptosis - miosis - anhidrosis

46. Enterobius
hemoptysis (parasite)
perianal pruritis (parasite)
Situs inversus - chronic sinusitis - bronchiectasis - infertility
High level of D dimers

47. Fanconi's anemia (esp AML)
Dry eyes - dry mouth - arthritis
Onion - skin periosteal reaction
perianal pruritis (parasite)
Short stature - increased incidence of tumors / leukemia - aplastic anemia

48. Wegner's (c - ANCA) and Goodpasture's (anti - GBM). Wegner's can also have upper airway involvement
Blue sclera
Caf
Dark purple skin / mouth nodules
Necrotizing vasculitis (lungs) and necrotizing GN

49. Erythropoietin injection
Large rash with bull's eye appearance
Athlete with polycythemia
Current jelly stool
Pink complexion - dypnea - hyperventilation

50. Interstitial fibrosis
Vascular birthmark (port - wine stain)
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Hair - on - end (crewcut) appearance on X- ray
Honeycomb lung on X- ray