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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. Chediak - Higashi disease (congenital failure of phagolysosome formation)
Pancreatic - pituitary - parathyroid tumors
Stippled vaginal epithelial cells
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Large lysosomal vesicles in phagocytes - immunodeficiency

2. NF (1 = optic glimoas and pheo - 2 = acoustic Schwannomas)
Caf
Basophilic nuclear remnants in RBCs
Recurrent colds - unusual eczema - high serum IgE
Antineutrophil cytoplasmic antibodies (ANCA)

3. Schiller - Duval bodies (yolk sac tumor)
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Extracellular amyloid deposition in gray matter of brain
Green -yellow rings around peripheral iris
Glomerulus - like structure surrounding vessel in germ cells

4. Lead poisoning or sideroblastic anemia
Basophilic stipplling of RBCs
Chorea - dementia - caudate degeneration
Cellular crescents in Bowman's capsule
hematuria - bladder cancer (parasite)

5. Wegner's (c - ANCA) and Goodpasture's (anti - GBM). Wegner's can also have upper airway involvement
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Necrotizing vasculitis (lungs) and necrotizing GN
Basophilic stipplling of RBCs

6. Kussmaul breathing - DKA
Deep - labored breathing / hyperventilation
Rapidly progressive leg weakness that ascend - following GI infection
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Splinter hemorrhages in fingernails

7. Strep pneumo
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Rusty sputum
Cellular crescents in Bowman's capsule

8. Condylomata lata (2* syphilis)
HTN - hypoK - metabolic alkalosis
Lytic (punched - out) bone lesions on X- ray
Child with fever develops red rash on face that spreads to body
Smooth - flat - moist white lesions on genitals

9. Coarctation of the aorta
Honeycomb lung on X- ray
Caf
Rib notching
Skin hyperpigmentation

10. String sign (Crohn's)
Narrowing of bowel lumen on barium radiograph
Thumb sign on lateral X- ray
Cardiomegaly with apical atrophy
Single palm crease

11. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Antinuclear antibodies
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Vomiting blood following esophagogastric lacerations
Pupil accommodates but doesn't react

12. Epiglossitis (H flu)
Single palm crease
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Thumb sign on lateral X- ray

13. Babinski (UMN lesion)
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Toe extension / fanning upon plantar scrape
Enlarged cells with intranuclear inclusion bodies
Circular grouping of dark tumor cells surrounding pale neurofibrils

14. Diphyllobothrium latum
B12 deficiency (parasite)
Green -yellow rings around peripheral iris
Indurated - ulcerated genital lesion
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)

15. Waterhouse - Friderichsen syndrome (meningococcemia)
Achilles tendon xanthoma
Adrenal hemorrhage - hypotension - DIC
Strawberry tongue
Resting tremor - rigidity - akinesia - postural instability

16. Choriocarcinoma - hydatidiform mole
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
hCG elevated
B12 deficiency (parasite)
Palpable purpura - joint pain - abdominal pain in a child

17. Multiple myeloma
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Lytic (punched - out) bone lesions on X- ray
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Bluish line on gingiva

18. Fanconi's syndrome (proximal tubular reabsorption defect)
Pupil accommodates but doesn't react
Antiplatelet antibodies
Polyuria - acidosis - growth failure - electrolyte imbalances
Pink complexion - dypnea - hyperventilation

19. Interstitial fibrosis
Red 'current jelly' sputum in alcoholic or diabetic patients
Resting tremor - rigidity - akinesia - postural instability
Honeycomb lung on X- ray
Hyperphagia - hypersexuality - hyperorality - hyperdocility

20. Guillain - Barre syndrome
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Degeneration of dorsal column nerves
Rapidly progressive leg weakness that ascend - following GI infection
Lytic (punched - out) bone lesions on X- ray

21. Blue bloater (chronic bronchitis)
Intranuclear eosinophilic droplet - like bodies
Current jelly stool
Vascular birthmark (port - wine stain)
Hypoxemia - polycythemia - hypercapnia

22. Goodpasture's syndome (glomerulonephritis and hemoptysis)
perianal pruritis (parasite)
AntiGBM antibodies
Painful - pale - cold fingers / toes
hematuria - bladder cancer (parasite)

23. Becker's muscular dystrophy
Retinal hemorrhages with pale centers
Rhomboid crystals - positively birefringent
Slow progressive muscle weakness in boys
Caf

24. Paroxysmal nocturnal hemoglobinuria (C' mediated damage - lack of CD55/59)
Painless erythematous lesions on palms and soles
Large lysosomal vesicles in phagocytes - immunodeficiency
Dry eyes - dry mouth - arthritis
Red urine in the morning - fragile RBCs

25. Chvostek's sign (hypocalcemia)
Jaundice - RUQ pain - fever
Rapidly progressive leg weakness that ascend - following GI infection
Hypoxemia - polycythemia - hypercapnia
Facial muscle spasm upon tapping

26. CF
Iron - containing nodules in alveolar septum
Colonies of mucoid Pseudomonas in lungs
Hypersegmented neutrophils
Child with fever develops red rash on face that spreads to body

27. Huntington's
Chorea - dementia - caudate degeneration
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Waxy casts with very low urine flow

28. Peutz - Jeghers syndrome
Thumb sign on lateral X- ray
Onion - skin periosteal reaction
Hypoxemia - polycythemia - hypercapnia
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands

29. CLL (almost always B cell - affects the elderly)
WBCs that look smudged
Child with fever develops red rash on face that spreads to body
Vascular birthmark (port - wine stain)
Antiplatelet antibodies

30. Scleroderma (CREST)
Renal epithelial casts in urine
Skin hyperpigmentation
Monoclonal antibody spike
Anticentromere antibodies

31. Peyronie's disease
Cherry- red spot on macula
Fibrous plaques in soft tissue of penis
Weight loss - diarrhea - arthritis - fever - adenopathy
Antiplatelet antibodies

32. Wet beriberi (B1 / thiamine deficiency)
Slow progressive muscle weakness in boys
Bilateral hilar adenopathy - uveitis
Adrenal hemorrhage - hypotension - DIC
Dilated cardiomyopathy - edema - polyneuropathy

33. Horner's syndrome (usually with Pancoast tumor in apex of lung)
Colonies of mucoid Pseudomonas in lungs
Ptosis - miosis - anhidrosis
Antimitochondrial antibodies
Antihistone antibodies

34. Clonorchis sinensis
Podocyte fusion on EM
Facial muscle spasm upon tapping
Vascular birthmark (port - wine stain)
biliary tract disease - cholangiocarcinoma (parasite)

35. Membranous glomerulonephritis (may progress to nephrotic)
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Spikes on basement membrane - dome - like endothelial deposits
Indurated - ulcerated genital lesion
Chorea - dementia - caudate degeneration

36. Sheehan's syndrome
Painful - pale - cold fingers / toes
No lactation postpartum - absent menstruation - cold intolerance
Weight loss - diarrhea - arthritis - fever - adenopathy
Jaundice - RUQ pain - fever

37. Shwartzman reaction (follows second exposure to endotoxin)
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Protein aggregates in neurons from hyperphosphorylation of tau protein

38. Budd - Chiari syndrome
Colonies of mucoid Pseudomonas in lungs
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Stippled vaginal epithelial cells
Honeycomb lung on X- ray

39. Infectious mono (HBV). IgM that agglutinates sheep RBCs
Silver - staining spherical aggregation of tau proteins in neurons
Heterophile antibodies
Degeneration of dorsal column nerves
Palpable purpura - joint pain - abdominal pain in a child

40. Koilocytes (HPV) 'perrinuclear cytoplasmic clearing'
Thyroid - like appearance of kidney
Lytic (punched - out) bone lesions on X- ray
Cellular crescents in Bowman's capsule
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

41. Mallory bodies (alcoholic liver disease)
Eosinophilic cytoplasmic inclusion in liver cell
Small - irregular red spots on buccal mucosa with blue - white centers
Gout - MR - self - mutilating behavior in a boy
liver cysts (parasite)

42. Lesch - Nyhan syndrome (HGPRT deficiency - X- linked recessive)
Athlete with polycythemia
Painless erythematous lesions on palms and soles
Gout - MR - self - mutilating behavior in a boy
hCG elevated

43. Tabes dorsalis - lose proprioception (3* syphilis)
Degeneration of dorsal column nerves
High level of D dimers
Swollen - hard - painful finger joints
Toe extension / fanning upon plantar scrape

44. Osler's node (infective endocarditis)
Rib notching
Increased uric acid levels
Child with fever develops red rash on face that spreads to body
Painful - raised red lesions on palms and soles

45. Tetralogy of Fallot - RVH
Recurrent colds - unusual eczema - high serum IgE
Boot - shaped heart on X- ray
Fibrous plaques in soft tissue of penis
Antinuclear antibodies

46. Bacterial endocarditis
Painful blue fingers / toes - hemolytic anemia
Colonies of mucoid Pseudomonas in lungs
Splinter hemorrhages in fingernails
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots

47. Eburnation (OA resulting in bony sclerosis)
Recurrent colds - unusual eczema - high serum IgE
Severe jaundice in neonate
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Polished - ivory- like appearance of bone at cartilage erosion

48. Councilman body (toxic or viral hepatitis - often yellow fever)
Honeycomb lung on X- ray
Caf
Cardiomegaly with apical atrophy
Eosinophilic globule in liver

49. Job's syndrome
Colonies of mucoid Pseudomonas in lungs
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Recurrent colds - unusual eczema - high serum IgE
Hereditary nephritis - sensorineural hearing loss - cataracts

50. Tay- Sachs - Niemann - Pick - central retinal artery occlusion
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Smooth - flat - moist white lesions on genitals
Lucid interval after TBI
Cherry- red spot on macula