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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. Shwartzman reaction (follows second exposure to endotoxin)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Hypoxemia - polycythemia - hypercapnia
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells

2. Chronic bacterial pyelo
Enlarged thyroid cells with ground - glass nuclei
Depigmentation of neurons in substantia nigra
Child with fever develops red rash on face that spreads to body
Thyroid - like appearance of kidney

3. Howell - Jolly bodies (due to splenectomy or nonfunctional spleen)
Basophilic nuclear remnants in RBCs
Soap bubble in femur or tibia on X- ray
Heterophile antibodies
Thumb sign on lateral X- ray

4. Alport's syndrome (type IV collagen)
Mucin - filled cell with peripheral nucleus
Chorea - dementia - caudate degeneration
Green -yellow rings around peripheral iris
Hereditary nephritis - sensorineural hearing loss - cataracts

5. Erb - Duchenne palsy
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Severe RLQ pain with rebound tenderness
Depigmentation of neurons in substantia nigra

6. Tetralogy of Fallot - RVH
Boot - shaped heart on X- ray
hematuria - bladder cancer (parasite)
Antidesmoglein (epithelial) antibodies
Monoclonal antibody spike

7. B symptoms or TB
Red 'current jelly' sputum in alcoholic or diabetic patients
Fever - night sweats - weight loss
Weight loss - diarrhea - arthritis - fever - adenopathy
Yellow CSF

8. DVT - PE - DIC - Budd - Chiari (D dimer is fibrin breakdown products)
Renal epithelial casts in urine
High level of D dimers
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Systolic ejection murmur (crescendo - decrescendo)

9. Pemphigus vulgaris (blistering)
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Antidesmoglein (epithelial) antibodies
Mucin - filled cell with peripheral nucleus
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

10. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Systolic ejection murmur (crescendo - decrescendo)
Vomiting blood following esophagogastric lacerations
Necrotizing vasculitis (lungs) and necrotizing GN
Antihistone antibodies

11. Aschoff bodies = focal myocardial inflammation with giant cells (rheumatic fever)
biliary tract disease - cholangiocarcinoma (parasite)
Heart nodules (inflammatory)
Red 'current jelly' sputum in alcoholic or diabetic patients
Cold intolerance

12. PDA
Continuous machinery heart murmur
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
High level of D dimers

13. Endometriosis (usually bilateral)
Painful blue fingers / toes - hemolytic anemia
Antimitochondrial antibodies
Painless erythematous lesions on palms and soles
Chocolate cyst of ovary

14. Goodpasture's syndome (glomerulonephritis and hemoptysis)
Conjugate lateral gaze palsy - horizontal diplopia
Male child - recurrent infections - no mature B cells
Hypercoagulability leading to thrombophlebitis
AntiGBM antibodies

15. Vasculitis (c - ANCA = Wegener's - p - ANCA = microscopic polyangiitis or Churg - Strauss syndrome)
Antineutrophil cytoplasmic antibodies (ANCA)
Red 'current jelly' sputum in alcoholic or diabetic patients
Monoclonal antibody spike
Yellow CSF

16. Sheehan's syndrome
No lactation postpartum - absent menstruation - cold intolerance
perianal pruritis (parasite)
Keratin pearls
Fat - female - fertile - forty

17. Paget's
Oscillating slow / fast breathing
Mammary gland (blue - domed) cyst
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Adrenal hemorrhage - hypotension - DIC

18. Marfan's (fibrillin defect)
Polyuria - acidosis - growth failure - electrolyte imbalances
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Painful - pale - cold fingers / toes

19. Actinomyces israelii
Jaundice - RUQ pain - fever
Branching gram + rods with sulfur granules
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Enlarged thyroid cells with ground - glass nuclei

20. Squamous cell carcinoma
Fever - night sweats - weight loss
Keratin pearls
Anti - topoisomerase antibodies
Ptosis - miosis - anhidrosis

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

22. Ancylostoma - Necator (hook worms)
Bloody tap on LP
microcytic anemia (parasite)
Male child - recurrent infections - no mature B cells
Vomiting blood following esophagogastric lacerations

23. Blue bloater (chronic bronchitis)
Anticentromere antibodies
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Hypoxemia - polycythemia - hypercapnia
Chocolate cyst of ovary

24. Rouleax formation (high ESR - multiple myeloma)
Stacks of RBCs
B12 deficiency (parasite)
Red 'current jelly' sputum in alcoholic or diabetic patients
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance

25. Cold agglutinin disease (autoimmune from Mp or mono - from IgM)
Toe extension / fanning upon plantar scrape
Antihistone antibodies
Painful blue fingers / toes - hemolytic anemia
Dry eyes - dry mouth - arthritis

26. Guillain - Barre syndrome
Resting tremor - rigidity - akinesia - postural instability
Glomerulus - like structure surrounding vessel in germ cells
Hypersegmented neutrophils
Rapidly progressive leg weakness that ascend - following GI infection

27. Membranoproliferative glomerulonephritis
Tram - track on LM
Painful blue fingers / toes - hemolytic anemia
Anti - IgG antibodies
Small - irregular red spots on buccal mucosa with blue - white centers

28. Koplick spots (measles)
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Narrowing of bowel lumen on barium radiograph
Small - irregular red spots on buccal mucosa with blue - white centers
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells

29. Pellagra (B3 / niacin deficiency)
Pupil accommodates but doesn't react
Tram - track on LM
Triglyceride accumulation in liver cell vacuoles
Dermatitis - dementia - diarrhea

30. Chediak - Higashi disease (congenital failure of phagolysosome formation)
Large lysosomal vesicles in phagocytes - immunodeficiency
Enlarged thyroid cells with ground - glass nuclei
Basophilic nuclear remnants in RBCs
Continuous machinery heart murmur

31. Turner syndrome (X0 - short stature - webbed neck - lymphedema)
Heterophile antibodies
Streak ovaries - congenital heart disease - horseshoe kidney
Nutmeg liver
Necrotizing vasculitis (lungs) and necrotizing GN

32. Rapidly progressive crescentic glomerulonephritis

33. Lead poisoning or sideroblastic anemia
Basophilic stipplling of RBCs
Recurrent colds - unusual eczema - high serum IgE
Polished - ivory- like appearance of bone at cartilage erosion
Dry eyes - dry mouth - arthritis

34. Gout/podagra (hyperuricemia)
Cutaneous/dermal edema due to CT expansion
Caf
Resting tremor - rigidity - akinesia - postural instability
Sudden swollen/painful big toe joint - tophi

35. Paroxysmal nocturnal hemoglobinuria (C' mediated damage - lack of CD55/59)
Red urine in the morning - fragile RBCs
Periosteum raised from bone - creating triangular area
Current jelly stool
Back pain - fever - night sweats - weight loss

36. Bronchial asthma (Charcot - Leyden crystals: eosinophilic granules)
Pupil accommodates but doesn't react
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Protein aggregates in neurons from hyperphosphorylation of tau protein
hemoptysis (parasite)

37. SLE (type III hypersensitivity)
microcytic anemia (parasite)
No lactation postpartum - absent menstruation - cold intolerance
Antinuclear antibodies
Blue sclera

38. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Glomerulus - like structure surrounding vessel in germ cells
Nutmeg liver
Green -yellow rings around peripheral iris
Pseudopalisading tumor cells on brain biopsy

39. Auer rods (AML - esp promyelocytic type)
Worst headache of my life
Azurophilic granular needles in leukemic blasts
Lytic (punched - out) bone lesions on X- ray
Nutmeg liver

40. Von Hippel - Lindau diease
Antihistone antibodies
Splinter hemorrhages in fingernails
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Heart nodules (inflammatory)

41. Duchenne's muscular dystrophy
Silver - staining spherical aggregation of tau proteins in neurons
Calf pseudohypertrophy
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Dilated cardiomyopathy - edema - polyneuropathy

42. Signet ring (gastric carcinoma)
Sudden swollen/painful big toe joint - tophi
Resting tremor - rigidity - akinesia - postural instability
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Mucin - filled cell with peripheral nucleus

43. Enterobius
Athlete with polycythemia
perianal pruritis (parasite)
Increased uric acid levels
Painful blue fingers / toes - hemolytic anemia

44. Celiac (diarrhea - distention - weight loss)
Protein aggregates in neurons from hyperphosphorylation of tau protein
Waxy casts with very low urine flow
Elastic skin - hypermobility of joints
Anti - transglutaminase/antigliadin/anti - endomysial antibodies

45. Peutz - Jeghers syndrome
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Gout - MR - self - mutilating behavior in a boy
Enlarged cells with intranuclear inclusion bodies
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands

46. Measles
Facial muscle spasm upon tapping
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Intranuclear eosinophilic droplet - like bodies
Single palm crease

47. Paget's disease of the breast
portal hypertension (parasite)
Red - itchy - swollen rash of nipple/areola
High level of D dimers
Deep - labored breathing / hyperventilation

48. Drug - induced SLE (hydralazine - isoniazid - phenytoin - procainamide)
Fibrous plaques in soft tissue of penis
Swollen - hard - painful finger joints
Antihistone antibodies
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth

49. Job's syndrome
Recurrent colds - unusual eczema - high serum IgE
Large lysosomal vesicles in phagocytes - immunodeficiency
Nodular hyaline deposits in glomeruli
Lumpy- bumpy appearance of glomeruli on immunofluorescence

50. Pick bodies
Silver - staining spherical aggregation of tau proteins in neurons
Severe jaundice in neonate
Dry eyes - dry mouth - arthritis
Brown tumor of bone