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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. Chronic passive congestion of the liver due to right heart failure
Dry eyes - dry mouth - arthritis
Nutmeg liver
Hypochromic - microcytic anemia
Dilated cardiomyopathy - edema - polyneuropathy

2. Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to hyperparathyroidism or osteitis fibrosa cystica
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Swollen - hard - painful finger joints
Eosinophilic cytoplasmic inclusion in liver cell
Brown tumor of bone

3. Eburnation (OA resulting in bony sclerosis)
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Azurophilic granular needles in leukemic blasts
Polished - ivory- like appearance of bone at cartilage erosion

4. Multiple myeloma
Lytic (punched - out) bone lesions on X- ray
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
perianal pruritis (parasite)
Splinter hemorrhages in fingernails

5. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Slow progressive muscle weakness in boys
Vomiting blood following esophagogastric lacerations
Bounding pulses - diastolic hear murmur - head bobbing
liver cysts (parasite)

6. Guillain - Barre syndrome
Rapidly progressive leg weakness that ascend - following GI infection
Skin hyperpigmentation
Bluish line on gingiva
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)

7. Intussesseption
Bamboo spine on X- ray
Severe jaundice in neonate
Current jelly stool
Glomerulus - like structure surrounding vessel in germ cells

8. Membranoproliferative glomerulonephritis
HTN - hypoK - metabolic alkalosis
Needle - shaped - negatively birefringent crystals
Tram - track on LM
Rusty sputum

9. Horner's syndrome (usually with Pancoast tumor in apex of lung)
Ptosis - miosis - anhidrosis
Bilateral hilar adenopathy - uveitis
Back pain - fever - night sweats - weight loss
Mammary gland (blue - domed) cyst

10. Sheehan's syndrome
Back pain - fever - night sweats - weight loss
No lactation postpartum - absent menstruation - cold intolerance
Strawberry tongue
Vomiting blood following esophagogastric lacerations

11. Minimal change disease (child - nephrotic)
Unilateral facial drooping involving forehead
Podocyte fusion on EM
Bamboo spine on X- ray
Caf

12. DVT - PE - DIC - Budd - Chiari (D dimer is fibrin breakdown products)
Green -yellow rings around peripheral iris
High level of D dimers
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Renal epithelial casts in urine

13. Lewy body (Parkinson's)
Resting tremor - rigidity - akinesia - postural instability
Boot - shaped heart on X- ray
Antidesmoglein (epithelial) antibodies
Eosinophilic cytoplasmic inclusion in nerve cell

14. Orphan Annie nuclei - or 'disbursed chromatin' (papillary carcinoma of the thyroid)
Enlarged thyroid cells with ground - glass nuclei
B12 deficiency (parasite)
Pupil accommodates but doesn't react
Polished - ivory- like appearance of bone at cartilage erosion

15. Job's syndrome
Brown tumor of bone
Soap bubble in femur or tibia on X- ray
Recurrent colds - unusual eczema - high serum IgE
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age

16. Infectious mono (HBV). IgM that agglutinates sheep RBCs
Heterophile antibodies
Low serum ceruloplasmin
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Palpable purpura - joint pain - abdominal pain in a child

17. Cold agglutinin disease (autoimmune from Mp or mono - from IgM)
Painful blue fingers / toes - hemolytic anemia
Narrowing of bowel lumen on barium radiograph
Anticentromere antibodies
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect

18. Edward's syndrome (Trisomy 18)
Cold intolerance
Monoclonal globulin protein in blood/urine
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
brain cysts - seizures (parasite)

19. Tay- Sachs - Niemann - Pick - central retinal artery occlusion
Calf pseudohypertrophy
Antinuclear antibodies
Cherry- red spot on macula
Stippled vaginal epithelial cells

20. Poststrep glomerulonephritis (IgG and C3b deposition)
Pancreatic - pituitary - parathyroid tumors
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Rash on palms and soles

21. Kluver - Bucy syndrome (bilateral amygdala)
hCG elevated
Hypoxemia - polycythemia - hypercapnia
Narrowing of bowel lumen on barium radiograph
Hyperphagia - hypersexuality - hyperorality - hyperdocility

22. Pott's (TB to the vertebrae)
Back pain - fever - night sweats - weight loss
Oscillating slow / fast breathing
Cellular crescents in Bowman's capsule
Bounding pulses - diastolic hear murmur - head bobbing

23. Epiglossitis (H flu)
Heart nodules (inflammatory)
Adrenal hemorrhage - hypotension - DIC
Continuous machinery heart murmur
Thumb sign on lateral X- ray

24. Reinke crystals (Leydig cell tumor)
Eosinophilic cytoplasmic inclusion in liver cell
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Eosinophilic cytoplasmic inclusion in nerve cell
Enlarged thyroid cells with ground - glass nuclei

25. Raynaud's syndrome (vasospasm)
Painful - pale - cold fingers / toes
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

26. Auer rods (AML - esp promyelocytic type)
Disarrayed granulosa cells in eosinophilic fluid
Thumb sign on lateral X- ray
Azurophilic granular needles in leukemic blasts
Honeycomb lung on X- ray

27. Celiac (diarrhea - distention - weight loss)
Extracellular amyloid deposition in gray matter of brain
Cutaneous/dermal edema due to CT expansion
Child with fever develops red rash on face that spreads to body
Anti - transglutaminase/antigliadin/anti - endomysial antibodies

28. Henoch - Schonlein purpura (IgA vasculitis)
Renal epithelial casts in urine
Palpable purpura - joint pain - abdominal pain in a child
Degeneration of dorsal column nerves
Antineutrophil cytoplasmic antibodies (ANCA)

29. Pompe's disease (lysosomal glucosidase deficiency)
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Rusty sputum
Disarrayed granulosa cells in eosinophilic fluid
Anticentromere antibodies

30. Schistosoma haematobium
hematuria - bladder cancer (parasite)
Keratin pearls
Red urine in the morning - fragile RBCs
Nutmeg liver

31. Reiter's syndrome (reactive arthritis associated with HLA B27)
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Dark purple skin / mouth nodules
Urethritis - conjunctivitis - arthritis in a male
Podocyte fusion on EM

32. Wilson's disease (hepatolenticular degeneration)
Depigmentation of neurons in substantia nigra
Vomiting blood following esophagogastric lacerations
Low serum ceruloplasmin
Cold intolerance

33. Anencephaly - spina bifida (neural tube defects) - gastrocesis - omphalmocele
Eosinophilic cytoplasmic inclusion in liver cell
Stippled vaginal epithelial cells
Stacks of RBCs
Increased a - fetoprotein in amniotic fluid / maternal serum

34. Epidural hematoma (middle meningeal artery)
Glomerulus - like structure surrounding vessel in germ cells
Single palm crease
Painful - raised red lesions on palms and soles
Lucid interval after TBI

35. Membranous glomerulonephritis (may progress to nephrotic)
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Spikes on basement membrane - dome - like endothelial deposits
Oscillating slow / fast breathing
Hypochromic - microcytic anemia

36. Tabes dorsalis - lose proprioception (3* syphilis)
Degeneration of dorsal column nerves
Urethritis - conjunctivitis - arthritis in a male
Weight loss - diarrhea - arthritis - fever - adenopathy
Heart nodules (inflammatory)

37. Marfan's (fibrillin defect)
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Ptosis - miosis - anhidrosis
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints

38. Whipple's disease (Tropheryma whippelii)
Rhomboid crystals - positively birefringent
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Weight loss - diarrhea - arthritis - fever - adenopathy
Severe jaundice in neonate

39. Megaloblastic anemia (B12 - folate deficiency)
Tram - track on LM
Hypersegmented neutrophils
Lucid interval after TBI
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints

40. Condylomata lata (2* syphilis)
Increased a - fetoprotein in amniotic fluid / maternal serum
Antidesmoglein (epithelial) antibodies
Smooth - flat - moist white lesions on genitals
Rapidly progressive leg weakness that ascend - following GI infection

41. Ankylosing spondylitis (chronic inflammatory arthritis - HLA B27)
Bamboo spine on X- ray
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Severe RLQ pain with rebound tenderness
Tram - track on LM

42. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Red - itchy - swollen rash of nipple/areola
Continuous machinery heart murmur
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Green -yellow rings around peripheral iris

43. Scarlet fever - Kawasaki disease - TSS
perianal pruritis (parasite)
Strawberry tongue
Child with fever develops red rash on face that spreads to body
liver cysts (parasite)

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

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45. Paget's disease of the breast
Brown tumor of bone
Current jelly stool
Red - itchy - swollen rash of nipple/areola
Enlarged thyroid cells with ground - glass nuclei

46. Conn's (1* hyperaldosterone)
Back pain - fever - night sweats - weight loss
Intranuclear eosinophilic droplet - like bodies
HTN - hypoK - metabolic alkalosis
Oscillating slow / fast breathing

47. MEN 2A (Sipple)
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Severe RLQ pain with rebound tenderness
Pancreatic - pituitary - parathyroid tumors
Protein aggregates in neurons from hyperphosphorylation of tau protein

48. Acute pyelo
WBC casts in urine
Bilateral hilar adenopathy - uveitis
Antihistone antibodies
Pancreatic - pituitary - parathyroid tumors

49. Internuclear ophthalmoplegia (MS or stroke)
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Elastic skin - hypermobility of joints
Rhomboid crystals - positively birefringent
Conjugate lateral gaze palsy - horizontal diplopia

50. Nonpainful = syphillis. Painful with exudate = chancroid
Red - itchy - swollen rash of nipple/areola
Basophilic stipplling of RBCs
Anti - topoisomerase antibodies
Indurated - ulcerated genital lesion