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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. Sezary syndrome (cutaneous T cell lymphoma)
Systolic ejection murmur (crescendo - decrescendo)
Painful - raised red lesions on palms and soles
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Rapidly progressive leg weakness that ascend - following GI infection

2. Echinococcus granulosus
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
liver cysts (parasite)
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
hemoptysis (parasite)

3. Cowdry type A bodies (HSV or CMV)
Intranuclear eosinophilic droplet - like bodies
Thumb sign on lateral X- ray
Depigmentation of neurons in substantia nigra
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration

4. Crigler - Najjar syndrome (congenital unconj hyper bilirubinemia)
Severe jaundice in neonate
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Cold intolerance
Chronic exercise intolerance with myalgia - fatigue - painful cramps

5. Pick bodies
Soap bubble in femur or tibia on X- ray
Yellow CSF
Silver - staining spherical aggregation of tau proteins in neurons
hematuria - bladder cancer (parasite)

6. Parkinson's
Pancreatic - pituitary - parathyroid tumors
Large lysosomal vesicles in phagocytes - immunodeficiency
No lactation postpartum - absent menstruation - cold intolerance
Depigmentation of neurons in substantia nigra

7. Gaucher's disease (glucocerebrosidase deficiency)
Toe extension / fanning upon plantar scrape
Hypoxemia - polycythemia - hypercapnia
brain cysts - seizures (parasite)
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm

8. Ancylostoma - Necator (hook worms)
microcytic anemia (parasite)
Unilateral facial drooping involving forehead
Enlarged. hard left supraclavicular node
Male child - recurrent infections - no mature B cells

9. Subarachnoid hemorrhage
HTN - hypoK - metabolic alkalosis
Painful - pale - cold fingers / toes
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Bloody tap on LP

10. Aortic regurg
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Bounding pulses - diastolic hear murmur - head bobbing
Sheets of medium - sized lymphoid cells (starry sky)
Bronchogenic apical lung tumor

11. 1. Bence Jones proteins (multiple myeloma - kappa or lambda light chains in urine) 2. Waldenstrom's macroglobulinemia (IgM)
liver cysts (parasite)
Thumb sign on lateral X- ray
Monoclonal globulin protein in blood/urine
Lumpy- bumpy appearance of glomeruli on immunofluorescence

12. Sjogren's syndrome
Extracellular amyloid deposition in gray matter of brain
Dry eyes - dry mouth - arthritis
Intranuclear eosinophilic droplet - like bodies
Narrowing of bowel lumen on barium radiograph

13. Diffuse systemic scleroderma
Anti - topoisomerase antibodies
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Cold intolerance
Red 'current jelly' sputum in alcoholic or diabetic patients

14. Measles
Extracellular amyloid deposition in gray matter of brain
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Bounding pulses - diastolic hear murmur - head bobbing

15. Megaloblastic anemia (B12 - folate deficiency)
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Pink complexion - dypnea - hyperventilation
Hypersegmented neutrophils
Hyperphagia - hypersexuality - hyperorality - hyperdocility

16. Osler's node (infective endocarditis)
Lucid interval after TBI
Back pain - fever - night sweats - weight loss
RBC casts in urine
Painful - raised red lesions on palms and soles

17. Ferruginous bodies (asbestosis: risk of mesothelioma)
Triglyceride accumulation in liver cell vacuoles
Worst headache of my life
Iron - containing nodules in alveolar septum
Toe extension / fanning upon plantar scrape

18. Paragonimus westermani
hemoptysis (parasite)
Needle - shaped - negatively birefringent crystals
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

19. Acute glomerulonephritis
Caf
Child uses arms to stand up from squat
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
RBC casts in urine

20. DVT - PE - DIC - Budd - Chiari (D dimer is fibrin breakdown products)
biliary tract disease - cholangiocarcinoma (parasite)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Hyperphagia - hypersexuality - hyperorality - hyperdocility
High level of D dimers

21. Paroxysmal nocturnal hemoglobinuria (C' mediated damage - lack of CD55/59)
Smooth - flat - moist white lesions on genitals
Red urine in the morning - fragile RBCs
Eosinophilic cytoplasmic inclusion in nerve cell
Monoclonal antibody spike

22. Strep pneumo
Necrotizing vasculitis (lungs) and necrotizing GN
RBC casts in urine
Indurated - ulcerated genital lesion
Rusty sputum

23. Tetralogy of Fallot - RVH
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Enlarged. hard left supraclavicular node
Boot - shaped heart on X- ray
Deep - labored breathing / hyperventilation

24. Ewing's sarcoma (malignant round cell tumor)
Painful blue fingers / toes - hemolytic anemia
Periosteum raised from bone - creating triangular area
Onion - skin periosteal reaction
Red - itchy - swollen rash of nipple/areola

25. Gout/podagra (hyperuricemia)
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Dilated cardiomyopathy - edema - polyneuropathy
Sudden swollen/painful big toe joint - tophi
Intranuclear eosinophilic droplet - like bodies

26. Infectious mono (HBV). IgM that agglutinates sheep RBCs
Heterophile antibodies
Brown tumor of bone
Mucin - filled cell with peripheral nucleus
Rash on palms and soles

27. Huntington's
Red urine in the morning - fragile RBCs
Heart nodules (inflammatory)
Worst headache of my life
Chorea - dementia - caudate degeneration

28. Slapped cheek - B19
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Child with fever develops red rash on face that spreads to body
Fibrous plaques in soft tissue of penis
Streak ovaries - congenital heart disease - horseshoe kidney

29. CLL (almost always B cell - affects the elderly)
WBCs that look smudged
Swollen - hard - painful finger joints
Enlarged. hard left supraclavicular node
perianal pruritis (parasite)

30. Dressler's (autoimmune post - MI)
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Chest pain - pericardial effusion/friction rub - persistent fever following MI
perianal pruritis (parasite)
brain cysts - seizures (parasite)

31. Drug - induced SLE (hydralazine - isoniazid - phenytoin - procainamide)
Unilateral facial drooping involving forehead
Child with fever develops red rash on face that spreads to body
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Antihistone antibodies

32. SLE nephropathy
Thumb sign on lateral X- ray
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Wire loop glomerular appearance on LM

33. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Extracellular amyloid deposition in gray matter of brain
Green -yellow rings around peripheral iris
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Resting tremor - rigidity - akinesia - postural instability

34. Howell - Jolly bodies (due to splenectomy or nonfunctional spleen)
Basophilic nuclear remnants in RBCs
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Lucid interval after TBI
Iron - containing nodules in alveolar septum

35. Parkinson's
Degeneration of dorsal column nerves
Resting tremor - rigidity - akinesia - postural instability
Depigmentation of neurons in substantia nigra
AntiGBM antibodies

36. Internuclear ophthalmoplegia (MS or stroke)
Azurophilic granular needles in leukemic blasts
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Conjugate lateral gaze palsy - horizontal diplopia
Waxy casts with very low urine flow

37. Erythropoietin injection
Athlete with polycythemia
Eosinophilic cytoplasmic inclusion in liver cell
Iron - containing nodules in alveolar septum
Eosinophilic cytoplasmic inclusion in nerve cell

38. Call - Exner bodies (granulosa - theca cell tumor of the ovary)
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Disarrayed granulosa cells in eosinophilic fluid
Strawberry tongue
Conjugate lateral gaze palsy - horizontal diplopia

39. Simian crease (Down's)
Vomiting blood following esophagogastric lacerations
Podocyte fusion on EM
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Single palm crease

40. Rouleax formation (high ESR - multiple myeloma)
Basophilic stipplling of RBCs
Green -yellow rings around peripheral iris
Weight loss - diarrhea - arthritis - fever - adenopathy
Stacks of RBCs

41. Shwartzman reaction (follows second exposure to endotoxin)
Caf
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Heterophile antibodies
Rapidly progressive leg weakness that ascend - following GI infection

42. Osteogenesis imperfecta
Heterophile antibodies
Painful blue fingers / toes - hemolytic anemia
Blue sclera
Recurrent colds - unusual eczema - high serum IgE

43. Auer rods (AML - esp promyelocytic type)
Monoclonal antibody spike
WBC casts in urine
hemoptysis (parasite)
Azurophilic granular needles in leukemic blasts

44. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Painful - pale - cold fingers / toes
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Basophilic stipplling of RBCs
Vomiting blood following esophagogastric lacerations

45. Trousseau's sign (adenocarcinoma of pancreas or lung)
Hypercoagulability leading to thrombophlebitis
Bronchogenic apical lung tumor
Renal epithelial casts in urine
Anti - IgG antibodies

46. Taenia solium (cysticercosis)
Cold intolerance
brain cysts - seizures (parasite)
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Weight loss - diarrhea - arthritis - fever - adenopathy

47. Giant cell tumor of bone (generally benign)
Caf
Soap bubble in femur or tibia on X- ray
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)

48. Jarisch - Herxheimer reaction (lysis of spirochetes results in toxin release)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Nutmeg liver
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Painless erythematous lesions on palms and soles

49. Enterobius
Keratin pearls
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
perianal pruritis (parasite)

50. McArdle's (muscle phosphorylase deficiency)
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Urethritis - conjunctivitis - arthritis in a male
Conjugate lateral gaze palsy - horizontal diplopia
Chronic exercise intolerance with myalgia - fatigue - painful cramps