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Test your basic knowledge |
USMLE Step 1 Prep 2
Start Test
Study First
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. Diffuse systemic scleroderma
Anti - topoisomerase antibodies
Disarrayed granulosa cells in eosinophilic fluid
Heart nodules (inflammatory)
Basophilic stipplling of RBCs
2. Paget's disease of the breast
Red - itchy - swollen rash of nipple/areola
Pupil accommodates but doesn't react
WBCs that look smudged
No lactation postpartum - absent menstruation - cold intolerance
3. 1. Bence Jones proteins (multiple myeloma - kappa or lambda light chains in urine) 2. Waldenstrom's macroglobulinemia (IgM)
Enlarged thyroid cells with ground - glass nuclei
Waxy casts with very low urine flow
Monoclonal globulin protein in blood/urine
Pseudopalisading tumor cells on brain biopsy
4. Interstitial fibrosis
Honeycomb lung on X- ray
Monoclonal globulin protein in blood/urine
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Colonies of mucoid Pseudomonas in lungs
5. Pott's (TB to the vertebrae)
Brown tumor of bone
Soap bubble in femur or tibia on X- ray
Back pain - fever - night sweats - weight loss
Bluish line on gingiva
6. Tetralogy of Fallot - RVH
Spikes on basement membrane - dome - like endothelial deposits
biliary tract disease - cholangiocarcinoma (parasite)
Boot - shaped heart on X- ray
Rib notching
7. Gower's sign (Duchenne's)
Low serum ceruloplasmin
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Painful - pale - cold fingers / toes
Child uses arms to stand up from squat
8. Kussmaul breathing - DKA
Deep - labored breathing / hyperventilation
Sheets of medium - sized lymphoid cells (starry sky)
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Antiplatelet antibodies
9. Hemangioma (benign - associated with Sturge - Weber syndrome - in which case it's V1 distribution)
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Vascular birthmark (port - wine stain)
Rapidly progressive leg weakness that ascend - following GI infection
Enlarged cells with intranuclear inclusion bodies
10. Simian crease (Down's)
Single palm crease
Retinal hemorrhages with pale centers
Cherry- red spot on macula
Branching gram + rods with sulfur granules
11. Fanconi's syndrome (proximal tubular reabsorption defect)
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Streak ovaries - congenital heart disease - horseshoe kidney
Conjugate lateral gaze palsy - horizontal diplopia
Polyuria - acidosis - growth failure - electrolyte imbalances
12. Sheehan's syndrome
Vomiting blood following esophagogastric lacerations
No lactation postpartum - absent menstruation - cold intolerance
Large rash with bull's eye appearance
Palpable purpura - joint pain - abdominal pain in a child
13. Drug - induced SLE (hydralazine - isoniazid - phenytoin - procainamide)
Antihistone antibodies
Rash on palms and soles
Renal epithelial casts in urine
Hypochromic - microcytic anemia
14. Bell's palsy (LMN CN VII)
Pupil accommodates but doesn't react
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Unilateral facial drooping involving forehead
15. Blue bloater (chronic bronchitis)
Small - irregular red spots on buccal mucosa with blue - white centers
Bounding pulses - diastolic hear murmur - head bobbing
Lucid interval after TBI
Hypoxemia - polycythemia - hypercapnia
16. Neurofibrillary tangles (Alzheimer's and CJD)
perianal pruritis (parasite)
Onion - skin periosteal reaction
Thrombi made of white/red layers
Protein aggregates in neurons from hyperphosphorylation of tau protein
17. Strep pneumo
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Rusty sputum
Podocyte fusion on EM
Monoclonal antibody spike
18. Parkinson's
Urethritis - conjunctivitis - arthritis in a male
Basophilic nuclear remnants in RBCs
perianal pruritis (parasite)
Depigmentation of neurons in substantia nigra
19. Megaloblastic anemia (B12 - folate deficiency)
Heterophile antibodies
Hypersegmented neutrophils
B12 deficiency (parasite)
Severe jaundice in neonate
20. Curschmann's spirals (bronchial asthma - can result in whorled mucous plugs)
Desquamated epithelium casts in sputum
Cold intolerance
Sheets of medium - sized lymphoid cells (starry sky)
No lactation postpartum - absent menstruation - cold intolerance
21. Chronic bacterial pyelo
Dermatitis - dementia - diarrhea
Cellular crescents in Bowman's capsule
Thyroid - like appearance of kidney
Antiplatelet antibodies
22. Tabes dorsalis - lose proprioception (3* syphilis)
Branching gram + rods with sulfur granules
Skin hyperpigmentation
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Degeneration of dorsal column nerves
23. Whipple's disease (Tropheryma whippelii)
Weight loss - diarrhea - arthritis - fever - adenopathy
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Necrotizing vasculitis (lungs) and necrotizing GN
hCG elevated
24. Infectious mono (HBV). IgM that agglutinates sheep RBCs
Heterophile antibodies
Azurophilic granular needles in leukemic blasts
Soap bubble in femur or tibia on X- ray
Vomiting blood following esophagogastric lacerations
25. Addison's
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Fever - night sweats - weight loss
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Skin hyperpigmentation
26. Osler's node (infective endocarditis)
Hypoxemia - polycythemia - hypercapnia
Dog or cat bite resulting in infection
Single palm crease
Painful - raised red lesions on palms and soles
27. Membranous glomerulonephritis (may progress to nephrotic)
Necrotizing vasculitis (lungs) and necrotizing GN
Boot - shaped heart on X- ray
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Spikes on basement membrane - dome - like endothelial deposits
28. CF
Hypersegmented neutrophils
Colonies of mucoid Pseudomonas in lungs
microcytic anemia (parasite)
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
29. 1. Multiple myeloma (M protein - IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (aging) 3. Waldenstrom's macroglobulinemia (IgM) 4. Primary amyloidosis
Pseudopalisading tumor cells on brain biopsy
Low serum ceruloplasmin
Monoclonal antibody spike
Toe extension / fanning upon plantar scrape
30. Roth's spots (bacterial endocarditis)
Antineutrophil cytoplasmic antibodies (ANCA)
Onion - skin periosteal reaction
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Retinal hemorrhages with pale centers
31. Actinomyces israelii
Branching gram + rods with sulfur granules
Retinal hemorrhages with pale centers
Polished - ivory- like appearance of bone at cartilage erosion
No lactation postpartum - absent menstruation - cold intolerance
32. Chvostek's sign (hypocalcemia)
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Narrowing of bowel lumen on barium radiograph
Bloody tap on LP
Facial muscle spasm upon tapping
33. Celiac (diarrhea - distention - weight loss)
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
High level of D dimers
Resting tremor - rigidity - akinesia - postural instability
Back pain - fever - night sweats - weight loss
34. Gallstones
Fat - female - fertile - forty
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Wire loop glomerular appearance on LM
Swollen - hard - painful finger joints
35. Duchenne's muscular dystrophy
Calf pseudohypertrophy
portal hypertension (parasite)
Increased a - fetoprotein in amniotic fluid / maternal serum
Toe extension / fanning upon plantar scrape
36. Becker's muscular dystrophy
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Degeneration of dorsal column nerves
Slow progressive muscle weakness in boys
Lytic (punched - out) bone lesions on X- ray
37. Peyronie's disease
Fibrous plaques in soft tissue of penis
Rapidly progressive leg weakness that ascend - following GI infection
Vomiting blood following esophagogastric lacerations
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
38. Henoch - Schonlein purpura (IgA vasculitis)
Podocyte fusion on EM
Palpable purpura - joint pain - abdominal pain in a child
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
39. Ferruginous bodies (asbestosis: risk of mesothelioma)
B12 deficiency (parasite)
Iron - containing nodules in alveolar septum
Male child - recurrent infections - no mature B cells
Anti - IgG antibodies
40. Chagas disease (Trypanosoma cruzi)
Cardiomegaly with apical atrophy
Honeycomb lung on X- ray
Degeneration of dorsal column nerves
Weight loss - diarrhea - arthritis - fever - adenopathy
41. Fibrocystic change of the breast
portal hypertension (parasite)
WBCs that look smudged
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Mammary gland (blue - domed) cyst
42. Horner's syndrome (usually with Pancoast tumor in apex of lung)
Ptosis - miosis - anhidrosis
Hereditary nephritis - sensorineural hearing loss - cataracts
Anti - IgG antibodies
Bronchogenic apical lung tumor
43. Goodpasture's syndome (glomerulonephritis and hemoptysis)
Rhomboid crystals - positively birefringent
AntiGBM antibodies
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Dilated cardiomyopathy - edema - polyneuropathy
44. Lead poisoning or sideroblastic anemia
Green -yellow rings around peripheral iris
Dry eyes - dry mouth - arthritis
Thumb sign on lateral X- ray
Basophilic stipplling of RBCs
45. MS (Charcot's)
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Palpable purpura - joint pain - abdominal pain in a child
Low serum ceruloplasmin
Smooth - flat - moist white lesions on genitals
46. GBM (cells may be called 'serpentine')
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Pseudopalisading tumor cells on brain biopsy
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Hypercoagulability leading to thrombophlebitis
47. Call - Exner bodies (granulosa - theca cell tumor of the ovary)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Antimitochondrial antibodies
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Disarrayed granulosa cells in eosinophilic fluid
48. Trousseau's sign (adenocarcinoma of pancreas or lung)
Chocolate cyst of ovary
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Hypercoagulability leading to thrombophlebitis
Bloody tap on LP
49. 'b - thalassemia - sickle cell anemia (extramedullary hematopoiesis). ''Hair on end'' means marrow expansion (skull)
Current jelly stool
Heart nodules (inflammatory)
Hair - on - end (crewcut) appearance on X- ray
Enlarged. hard left supraclavicular node
50. Acute toxic/viral nephrosis
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Palpable purpura - joint pain - abdominal pain in a child
Renal epithelial casts in urine
Strawberry tongue