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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. Gout - Lesch - Nyhan syndrome - tumor lysis syndrome - loop and thiazide diuretics
Weight loss - diarrhea - arthritis - fever - adenopathy
Increased uric acid levels
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Rusty sputum

2. McCune - Albright syndome (G protein problem)
Caf
Narrowing of bowel lumen on barium radiograph
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Male child - recurrent infections - no mature B cells

3. Echinococcus granulosus
liver cysts (parasite)
Chorea - dementia - caudate degeneration
Vascular birthmark (port - wine stain)
Strawberry tongue

4. Ehler - Danlos (type III collagen)
Achilles tendon xanthoma
Ptosis - miosis - anhidrosis
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Elastic skin - hypermobility of joints

5. Reiter's syndrome (reactive arthritis associated with HLA B27)
Red urine in the morning - fragile RBCs
RBC casts in urine
Urethritis - conjunctivitis - arthritis in a male
Ptosis - miosis - anhidrosis

6. 2* syphilis - Rocky Mountain spotted fever - coxsackie A
Antiplatelet antibodies
Rash on palms and soles
Red - itchy - swollen rash of nipple/areola
Polished - ivory- like appearance of bone at cartilage erosion

7. Kimmelstiel - Wilson nodules (diabetic)
Enlarged thyroid cells with ground - glass nuclei
Nodular hyaline deposits in glomeruli
Hypercoagulability leading to thrombophlebitis
Strawberry tongue

8. Huntington's
Chorea - dementia - caudate degeneration
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Bilateral hilar adenopathy - uveitis
Podocyte fusion on EM

9. Pink puffer (emphysema)
Onion - skin periosteal reaction
Dry eyes - dry mouth - arthritis
Waxy casts with very low urine flow
Pink complexion - dypnea - hyperventilation

10. Choriocarcinoma - hydatidiform mole
No lactation postpartum - absent menstruation - cold intolerance
Polished - ivory- like appearance of bone at cartilage erosion
Chest pain - pericardial effusion/friction rub - persistent fever following MI
hCG elevated

11. Cold agglutinin disease (autoimmune from Mp or mono - from IgM)
Smooth - flat - moist white lesions on genitals
Thrombi made of white/red layers
Painful blue fingers / toes - hemolytic anemia
Thyroid (medullary) and parathyroid tumors - pheochromocytoma

12. Bacterial endocarditis
Nutmeg liver
No lactation postpartum - absent menstruation - cold intolerance
Splinter hemorrhages in fingernails
Hypochromic - microcytic anemia

13. Schistosoma haematobium
Adrenal hemorrhage - hypotension - DIC
hematuria - bladder cancer (parasite)
Narrowing of bowel lumen on barium radiograph
Antimitochondrial antibodies

14. Bibeck granules (histiocytosis X: eosinophilic granuloma)
Stacks of RBCs
Lytic (punched - out) bone lesions on X- ray
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Red - itchy - swollen rash of nipple/areola

15. Strep pneumo
Rusty sputum
Boot - shaped heart on X- ray
Branching gram + rods with sulfur granules
Bronchogenic apical lung tumor

16. Charcot's triad (ascending cholangitis)
Dermatitis - dementia - diarrhea
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Jaundice - RUQ pain - fever
Facial muscle spasm upon tapping

17. Chediak - Higashi disease (congenital failure of phagolysosome formation)
Nutmeg liver
Large lysosomal vesicles in phagocytes - immunodeficiency
Brown tumor of bone
Bluish line on gingiva

18. Pick bodies
Silver - staining spherical aggregation of tau proteins in neurons
Lytic (punched - out) bone lesions on X- ray
Vomiting blood following esophagogastric lacerations
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma

19. Roth's spots (bacterial endocarditis)
Branching gram + rods with sulfur granules
Antinuclear antibodies
Retinal hemorrhages with pale centers
Soap bubble in femur or tibia on X- ray

20. 1* biliary cirrhosis (female - cholestasis - portal HTN)
Antimitochondrial antibodies
Mucosal bleeding and prolonged bleeding time
No lactation postpartum - absent menstruation - cold intolerance
Deep - labored breathing / hyperventilation

21. Bell's palsy (LMN CN VII)
High level of D dimers
Unilateral facial drooping involving forehead
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Dog or cat bite resulting in infection

22. Bruton's disease (X- linked agammaglobulinemia)
HTN - hypoK - metabolic alkalosis
Male child - recurrent infections - no mature B cells
Athlete with polycythemia
Smooth - flat - moist white lesions on genitals

23. Chagas disease (Trypanosoma cruzi)
Anti - IgG antibodies
Back pain - fever - night sweats - weight loss
Cardiomegaly with apical atrophy
microcytic anemia (parasite)

24. Infectious mono (HBV). IgM that agglutinates sheep RBCs
Heterophile antibodies
Indurated - ulcerated genital lesion
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Caf

25. Anencephaly - spina bifida (neural tube defects) - gastrocesis - omphalmocele
Red 'current jelly' sputum in alcoholic or diabetic patients
Increased a - fetoprotein in amniotic fluid / maternal serum
Rusty sputum
Antihistone antibodies

26. Subarachnoid hemorrhage
Bloody tap on LP
Adrenal hemorrhage - hypotension - DIC
Disarrayed granulosa cells in eosinophilic fluid
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)

27. Cancer at head of pancreas obstructing bile duct
RBC casts in urine
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Painless jaundice
Heart nodules (inflammatory)

28. Addison's
Skin hyperpigmentation
Stacks of RBCs
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints

29. Minimal change disease (child - nephrotic)
Lytic (punched - out) bone lesions on X- ray
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Cold intolerance
Podocyte fusion on EM

30. Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Worst headache of my life
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Mucosal bleeding and prolonged bleeding time

31. 'b - thalassemia - sickle cell anemia (extramedullary hematopoiesis). ''Hair on end'' means marrow expansion (skull)
Splinter hemorrhages in fingernails
Red urine in the morning - fragile RBCs
Dermatitis - dementia - diarrhea
Hair - on - end (crewcut) appearance on X- ray

32. Peyronie's disease
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Low serum ceruloplasmin
Fibrous plaques in soft tissue of penis
Severe jaundice in neonate

33. Councilman body (toxic or viral hepatitis - often yellow fever)
RBC casts in urine
Eosinophilic globule in liver
Anticentromere antibodies
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells

34. Pellagra (B3 / niacin deficiency)
Renal epithelial casts in urine
Dermatitis - dementia - diarrhea
Silver - staining spherical aggregation of tau proteins in neurons
hemoptysis (parasite)

35. Clonorchis sinensis
Mucosal bleeding and prolonged bleeding time
Renal epithelial casts in urine
Situs inversus - chronic sinusitis - bronchiectasis - infertility
biliary tract disease - cholangiocarcinoma (parasite)

36. Chronic bacterial pyelo
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Triglyceride accumulation in liver cell vacuoles
Thyroid - like appearance of kidney
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

37. Peutz - Jeghers syndrome
Child uses arms to stand up from squat
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Thumb sign on lateral X- ray
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints

38. Von Hippel - Lindau diease
Antiplatelet antibodies
Unilateral facial drooping involving forehead
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age

39. Acute glomerulonephritis
Protein aggregates in neurons from hyperphosphorylation of tau protein
Athlete with polycythemia
RBC casts in urine
WBCs that look smudged

40. Actinomyces israelii
AntiGBM antibodies
Depigmentation of neurons in substantia nigra
Tram - track on LM
Branching gram + rods with sulfur granules

41. Raynaud's syndrome (vasospasm)
Achilles tendon xanthoma
Painful - pale - cold fingers / toes
Stacks of RBCs
WBC casts in urine

42. OA (osteophytes on PIP (Bouchard) and DIP (Heberden)
Polyuria - acidosis - growth failure - electrolyte imbalances
Mammary gland (blue - domed) cyst
Enlarged thyroid cells with ground - glass nuclei
Swollen - hard - painful finger joints

43. Kartagener's syndrome (dynein)
HTN - hypoK - metabolic alkalosis
Chocolate cyst of ovary
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Depigmentation of neurons in substantia nigra

44. Horner's syndrome (usually with Pancoast tumor in apex of lung)
Azurophilic granular needles in leukemic blasts
Back pain - fever - night sweats - weight loss
Ptosis - miosis - anhidrosis
Degeneration of dorsal column nerves

45. Erb - Duchenne palsy
Antihistone antibodies
Antidesmoglein (epithelial) antibodies
Narrowing of bowel lumen on barium radiograph
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age

46. Pompe's disease (lysosomal glucosidase deficiency)
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Cardiomegaly with apical atrophy
High level of D dimers

47. MEN 1 (Wermer's)
Large lysosomal vesicles in phagocytes - immunodeficiency
Pancreatic - pituitary - parathyroid tumors
Recurrent colds - unusual eczema - high serum IgE
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma

48. SLE (type III hypersensitivity)
Antinuclear antibodies
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Antimitochondrial antibodies
Increased uric acid levels

49. DVT - PE - DIC - Budd - Chiari (D dimer is fibrin breakdown products)
High level of D dimers
Iron - containing nodules in alveolar septum
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Toe extension / fanning upon plantar scrape

50. Erythema chronicum migrans from Ixodes tick bite (Lyme)