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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. Codman's triangle on X- ray (osteosarcoma - Ewing's - pyogenic osteomyelitis)
Painless jaundice
Periosteum raised from bone - creating triangular area
Depigmentation of neurons in substantia nigra
Hypoxemia - polycythemia - hypercapnia

2. Poststrep glomerulonephritis (IgG and C3b deposition)
Fever - night sweats - weight loss
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Swollen - hard - painful finger joints
Calf pseudohypertrophy

3. Membranoproliferative glomerulonephritis
Fever - night sweats - weight loss
Tram - track on LM
Thumb sign on lateral X- ray
Hyperphagia - hypersexuality - hyperorality - hyperdocility

4. Gout
Pink complexion - dypnea - hyperventilation
Needle - shaped - negatively birefringent crystals
Smooth - flat - moist white lesions on genitals
Vasculitis from exposure to endotoxin casuing glomerular thrombosis

5. Reed - Sternberg cells (Hodgkin's lymphoma)

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6. Marfan's (fibrillin defect)
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Desquamated epithelium casts in sputum
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Conjugate lateral gaze palsy - horizontal diplopia

7. Squamous cell carcinoma
Anti - IgG antibodies
Keratin pearls
Fever - night sweats - weight loss
Heterophile antibodies

8. Rabies virus - negri bodies (Lyssavirus)
Pancreatic - pituitary - parathyroid tumors
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Enlarged cells with intranuclear inclusion bodies
Onion - skin periosteal reaction

9. Cold agglutinin disease (autoimmune from Mp or mono - from IgM)
Polished - ivory- like appearance of bone at cartilage erosion
Painful blue fingers / toes - hemolytic anemia
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Single palm crease

10. Bruton's disease (X- linked agammaglobulinemia)
Male child - recurrent infections - no mature B cells
Protein aggregates in neurons from hyperphosphorylation of tau protein
Enlarged thyroid cells with ground - glass nuclei
Silver - staining spherical aggregation of tau proteins in neurons

11. Wilson's disease (hepatolenticular degeneration)
Low serum ceruloplasmin
Bounding pulses - diastolic hear murmur - head bobbing
Intranuclear eosinophilic droplet - like bodies
Enlarged thyroid cells with ground - glass nuclei

12. Acute toxic/viral nephrosis
Renal epithelial casts in urine
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Toe extension / fanning upon plantar scrape
Pupil accommodates but doesn't react

13. 1. Multiple myeloma (M protein - IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (aging) 3. Waldenstrom's macroglobulinemia (IgM) 4. Primary amyloidosis
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Urethritis - conjunctivitis - arthritis in a male
Colonies of mucoid Pseudomonas in lungs
Monoclonal antibody spike

14. Anencephaly - spina bifida (neural tube defects) - gastrocesis - omphalmocele
perianal pruritis (parasite)
Caf
Increased a - fetoprotein in amniotic fluid / maternal serum
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm

15. Pasteurella multocida (local cellulitis)
Dog or cat bite resulting in infection
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Periosteum raised from bone - creating triangular area
Painless erythematous lesions on palms and soles

16. Job's syndrome
Disarrayed granulosa cells in eosinophilic fluid
Ptosis - miosis - anhidrosis
Dark purple skin / mouth nodules
Recurrent colds - unusual eczema - high serum IgE

17. Lewy body (Parkinson's)
Eosinophilic cytoplasmic inclusion in nerve cell
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Severe RLQ pain with rebound tenderness

18. Schistosoma haematobium
hematuria - bladder cancer (parasite)
Wire loop glomerular appearance on LM
hCG elevated
Mucin - filled cell with peripheral nucleus

19. Huntington's
Chorea - dementia - caudate degeneration
Conjugate lateral gaze palsy - horizontal diplopia
Antineutrophil cytoplasmic antibodies (ANCA)
Toe extension / fanning upon plantar scrape

20. Argyll Robertson pupil (neurosyphilis)

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21. Janeway lesions (infective endocarditis)
Red - itchy - swollen rash of nipple/areola
Painless erythematous lesions on palms and soles
Hair - on - end (crewcut) appearance on X- ray
Heart nodules (inflammatory)

22. Chagas disease (Trypanosoma cruzi)
Cardiomegaly with apical atrophy
Bronchogenic apical lung tumor
Silver - staining spherical aggregation of tau proteins in neurons
Short stature - increased incidence of tumors / leukemia - aplastic anemia

23. Chediak - Higashi disease (congenital failure of phagolysosome formation)
liver cysts (parasite)
Stacks of RBCs
Large lysosomal vesicles in phagocytes - immunodeficiency
Strawberry tongue

24. Pick bodies
Back pain - fever - night sweats - weight loss
Silver - staining spherical aggregation of tau proteins in neurons
Brown tumor of bone
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints

25. Enterobius
Cellular crescents in Bowman's capsule
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
perianal pruritis (parasite)
Toe extension / fanning upon plantar scrape

26. Myxedema
Cutaneous/dermal edema due to CT expansion
Blue sclera
Bamboo spine on X- ray
HTN - hypoK - metabolic alkalosis

27. Parkinson's
Fat - female - fertile - forty
Resting tremor - rigidity - akinesia - postural instability
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Continuous machinery heart murmur

28. Measles
Back pain - fever - night sweats - weight loss
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
microcytic anemia (parasite)
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots

29. Diphyllobothrium latum
Increased a - fetoprotein in amniotic fluid / maternal serum
Pink complexion - dypnea - hyperventilation
B12 deficiency (parasite)
Toe extension / fanning upon plantar scrape

30. Fanconi's syndrome (proximal tubular reabsorption defect)
Polyuria - acidosis - growth failure - electrolyte imbalances
brain cysts - seizures (parasite)
Boot - shaped heart on X- ray
Hyperphagia - hypersexuality - hyperorality - hyperdocility

31. Pott's (TB to the vertebrae)
Bluish line on gingiva
Rash on palms and soles
Back pain - fever - night sweats - weight loss
Hair - on - end (crewcut) appearance on X- ray

32. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Facial muscle spasm upon tapping
Vomiting blood following esophagogastric lacerations
Monoclonal antibody spike
Slow progressive muscle weakness in boys

33. Peutz - Jeghers syndrome
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Depigmentation of neurons in substantia nigra
hCG elevated

34. MEN 1 (Wermer's)
Bilateral hilar adenopathy - uveitis
biliary tract disease - cholangiocarcinoma (parasite)
Pseudopalisading tumor cells on brain biopsy
Pancreatic - pituitary - parathyroid tumors

35. Fanconi's anemia (esp AML)
Antinuclear antibodies
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Urethritis - conjunctivitis - arthritis in a male
Mucosal bleeding and prolonged bleeding time

36. Acute pyelo
WBC casts in urine
Child uses arms to stand up from squat
hCG elevated
Low serum ceruloplasmin

37. Tabes dorsalis - lose proprioception (3* syphilis)
Sudden swollen/painful big toe joint - tophi
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Painful blue fingers / toes - hemolytic anemia
Degeneration of dorsal column nerves

38. Schistosoma mansoni
Caf
Silver - staining spherical aggregation of tau proteins in neurons
portal hypertension (parasite)
Cardiomegaly with apical atrophy

39. Erb - Duchenne palsy
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Recurrent colds - unusual eczema - high serum IgE
Low serum ceruloplasmin
Onion - skin periosteal reaction

40. Cori's disease (debranching enzyme deficiency - no glycogenolysis) or Von Gierke's
Bounding pulses - diastolic hear murmur - head bobbing
Sheets of medium - sized lymphoid cells (starry sky)
Lucid interval after TBI
Infant with hypoglycemia - failure to thrive - and hepatomegaly

41. Ghon complex (1* TB)
Bloody tap on LP
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Pseudopalisading tumor cells on brain biopsy
Adrenal hemorrhage - hypotension - DIC

42. SLE nephropathy
Worst headache of my life
Wire loop glomerular appearance on LM
Cardiomegaly with apical atrophy
Bilateral hilar adenopathy - uveitis

43. Ehler - Danlos (type III collagen)
Antineutrophil cytoplasmic antibodies (ANCA)
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
microcytic anemia (parasite)
Elastic skin - hypermobility of joints

44. Parkinson's
WBC casts in urine
liver cysts (parasite)
hemoptysis (parasite)
Depigmentation of neurons in substantia nigra

45. 2* syphilis - Rocky Mountain spotted fever - coxsackie A
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Painful - raised red lesions on palms and soles
Rash on palms and soles
Soap bubble in femur or tibia on X- ray

46. 'b - thalassemia - sickle cell anemia (extramedullary hematopoiesis). ''Hair on end'' means marrow expansion (skull)
Recurrent colds - unusual eczema - high serum IgE
HTN - hypoK - metabolic alkalosis
Cherry- red spot on macula
Hair - on - end (crewcut) appearance on X- ray

47. CF
Eosinophilic globule in liver
Green -yellow rings around peripheral iris
Colonies of mucoid Pseudomonas in lungs
Swollen - hard - painful finger joints

48. OA (osteophytes on PIP (Bouchard) and DIP (Heberden)
Pink complexion - dypnea - hyperventilation
Swollen - hard - painful finger joints
Pupil accommodates but doesn't react
Bamboo spine on X- ray

49. Intussesseption
Current jelly stool
Systolic ejection murmur (crescendo - decrescendo)
Red 'current jelly' sputum in alcoholic or diabetic patients
Cardiomegaly with apical atrophy

50. Fatty liver disease (alcoholic or metabolic syndrome)
Triglyceride accumulation in liver cell vacuoles
Hair - on - end (crewcut) appearance on X- ray
Necrotizing vasculitis (lungs) and necrotizing GN
Worst headache of my life