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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. Acute toxic/viral nephrosis
Renal epithelial casts in urine
Tram - track on LM
Pseudopalisading tumor cells on brain biopsy
Swollen - hard - painful finger joints

2. MS (Charcot's)
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Boot - shaped heart on X- ray
No lactation postpartum - absent menstruation - cold intolerance
Pink complexion - dypnea - hyperventilation

3. Owl's eye appearance of CMV - Cowdry A bodies
Enlarged cells with intranuclear inclusion bodies
Dog or cat bite resulting in infection
Antinuclear antibodies
Pancreatic - pituitary - parathyroid tumors

4. Interstitial fibrosis
Heterophile antibodies
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
AntiGBM antibodies
Honeycomb lung on X- ray

5. Eburnation (OA resulting in bony sclerosis)
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Glomerulus - like structure surrounding vessel in germ cells
Polished - ivory- like appearance of bone at cartilage erosion
Silver - staining spherical aggregation of tau proteins in neurons

6. Fibrocystic change of the breast
hCG elevated
Mammary gland (blue - domed) cyst
Large lysosomal vesicles in phagocytes - immunodeficiency
Lytic (punched - out) bone lesions on X- ray

7. Parkinson's
Mammary gland (blue - domed) cyst
Stacks of RBCs
Onion - skin periosteal reaction
Resting tremor - rigidity - akinesia - postural instability

8. Babinski (UMN lesion)
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Toe extension / fanning upon plantar scrape
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)

9. RA (systemic inflammation - joint pannus - boutonniere deformity) - IgM anti IgG
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Mucin - filled cell with peripheral nucleus
Anti - IgG antibodies
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells

10. Auer rods (AML - esp promyelocytic type)
High level of D dimers
Azurophilic granular needles in leukemic blasts
Yellow CSF
Antidesmoglein (epithelial) antibodies

11. Becker's muscular dystrophy
Weight loss - diarrhea - arthritis - fever - adenopathy
Slow progressive muscle weakness in boys
portal hypertension (parasite)
hCG elevated

12. Lead poisoning or sideroblastic anemia
Nutmeg liver
Anti - topoisomerase antibodies
Basophilic stipplling of RBCs
Painful - pale - cold fingers / toes

13. Niemann - Pick disease (genetic sphingomyelinase deficiency)
Smooth - flat - moist white lesions on genitals
Increased a - fetoprotein in amniotic fluid / maternal serum
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Cold intolerance

14. Councilman body (toxic or viral hepatitis - often yellow fever)
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Soap bubble in femur or tibia on X- ray
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Eosinophilic globule in liver

15. OA (osteophytes on PIP (Bouchard) and DIP (Heberden)
Bounding pulses - diastolic hear murmur - head bobbing
Pink complexion - dypnea - hyperventilation
Weight loss - diarrhea - arthritis - fever - adenopathy
Swollen - hard - painful finger joints

16. B symptoms or TB
Renal epithelial casts in urine
Vascular birthmark (port - wine stain)
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Fever - night sweats - weight loss

17. Aortic regurg
Renal epithelial casts in urine
Bounding pulses - diastolic hear murmur - head bobbing
Anticentromere antibodies
Sheets of medium - sized lymphoid cells (starry sky)

18. Pemphigus vulgaris (blistering)
Swollen - hard - painful finger joints
Eosinophilic cytoplasmic inclusion in nerve cell
Antidesmoglein (epithelial) antibodies
Bilateral hilar adenopathy - uveitis

19. Pancoast tumor (can cause Horner's)
Bronchogenic apical lung tumor
Degeneration of dorsal column nerves
Thyroid - like appearance of kidney
Fat - female - fertile - forty

20. Trousseau's sign (adenocarcinoma of pancreas or lung)
HTN - hypoK - metabolic alkalosis
Needle - shaped - negatively birefringent crystals
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Hypercoagulability leading to thrombophlebitis

21. Conn's (1* hyperaldosterone)
Pink complexion - dypnea - hyperventilation
HTN - hypoK - metabolic alkalosis
Systolic ejection murmur (crescendo - decrescendo)
Heterophile antibodies

22. Fanconi's anemia (esp AML)
Palpable purpura - joint pain - abdominal pain in a child
Sudden swollen/painful big toe joint - tophi
microcytic anemia (parasite)
Short stature - increased incidence of tumors / leukemia - aplastic anemia

23. Koplick spots (measles)
Small - irregular red spots on buccal mucosa with blue - white centers
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Azurophilic granular needles in leukemic blasts
Anticentromere antibodies

24. Choriocarcinoma - hydatidiform mole
Unilateral facial drooping involving forehead
Dilated cardiomyopathy - edema - polyneuropathy
hCG elevated
Short stature - increased incidence of tumors / leukemia - aplastic anemia

25. Rouleax formation (high ESR - multiple myeloma)
Bluish line on gingiva
Triglyceride accumulation in liver cell vacuoles
Ptosis - miosis - anhidrosis
Stacks of RBCs

26. MEN 1 (Wermer's)
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
B12 deficiency (parasite)
Pancreatic - pituitary - parathyroid tumors
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia

27. Actinomyces israelii
Thyroid - like appearance of kidney
Smooth - flat - moist white lesions on genitals
Branching gram + rods with sulfur granules
Large lysosomal vesicles in phagocytes - immunodeficiency

28. SLE nephropathy
portal hypertension (parasite)
Wire loop glomerular appearance on LM
Anti - topoisomerase antibodies
Toe extension / fanning upon plantar scrape

29. Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to hyperparathyroidism or osteitis fibrosa cystica
Urethritis - conjunctivitis - arthritis in a male
Stippled vaginal epithelial cells
Brown tumor of bone
Dilated cardiomyopathy - edema - polyneuropathy

30. Paragonimus westermani
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Bloody tap on LP
Branching gram + rods with sulfur granules
hemoptysis (parasite)

31. Ferruginous bodies (asbestosis: risk of mesothelioma)
Thrombi made of white/red layers
Iron - containing nodules in alveolar septum
Pseudopalisading tumor cells on brain biopsy
Chorea - dementia - caudate degeneration

32. Parkinson's
Red 'current jelly' sputum in alcoholic or diabetic patients
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Nodular hyaline deposits in glomeruli
Depigmentation of neurons in substantia nigra

33. Tetralogy of Fallot - RVH
Boot - shaped heart on X- ray
Antimitochondrial antibodies
Ptosis - miosis - anhidrosis
Calf pseudohypertrophy

34. Ancylostoma - Necator (hook worms)
Chorea - dementia - caudate degeneration
Fever - night sweats - weight loss
microcytic anemia (parasite)
Antiplatelet antibodies

35. Kussmaul breathing - DKA
Deep - labored breathing / hyperventilation
Pink complexion - dypnea - hyperventilation
Streak ovaries - congenital heart disease - horseshoe kidney
Glomerulus - like structure surrounding vessel in germ cells

36. Sezary syndrome (cutaneous T cell lymphoma)
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Thyroid - like appearance of kidney
HTN - hypoK - metabolic alkalosis
Colonies of mucoid Pseudomonas in lungs

37. Anencephaly - spina bifida (neural tube defects) - gastrocesis - omphalmocele
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Increased a - fetoprotein in amniotic fluid / maternal serum
Sheets of medium - sized lymphoid cells (starry sky)
Systolic ejection murmur (crescendo - decrescendo)

38. Megaloblastic anemia (B12 - folate deficiency)
Dermatitis - dementia - diarrhea
Hypersegmented neutrophils
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Cutaneous/dermal edema due to CT expansion

39. McBurney's sign
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Severe RLQ pain with rebound tenderness
Vasculitis from exposure to endotoxin casuing glomerular thrombosis

40. Giant cell tumor of bone (generally benign)
Soap bubble in femur or tibia on X- ray
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Weight loss - diarrhea - arthritis - fever - adenopathy
Cardiomegaly with apical atrophy

41. Gout
Needle - shaped - negatively birefringent crystals
Red urine in the morning - fragile RBCs
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance

42. DVT - PE - DIC - Budd - Chiari (D dimer is fibrin breakdown products)
No lactation postpartum - absent menstruation - cold intolerance
Dilated cardiomyopathy - edema - polyneuropathy
HTN - hypoK - metabolic alkalosis
High level of D dimers

43. Reinke crystals (Leydig cell tumor)
Onion - skin periosteal reaction
Waxy casts with very low urine flow
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Hexagonal - double - pointed - needle - like crystals in bronchial secretions

44. Bronchial asthma (Charcot - Leyden crystals: eosinophilic granules)
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
portal hypertension (parasite)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Cardiomegaly with apical atrophy

45. Sarcoid
Anti - topoisomerase antibodies
Bilateral hilar adenopathy - uveitis
WBC casts in urine
Pupil accommodates but doesn't react

46. Job's syndrome
RBC casts in urine
liver cysts (parasite)
Heart nodules (inflammatory)
Recurrent colds - unusual eczema - high serum IgE

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

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48. Gardner's syndrome
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Polished - ivory- like appearance of bone at cartilage erosion
Dry eyes - dry mouth - arthritis
Strawberry tongue

49. 2* syphilis - Rocky Mountain spotted fever - coxsackie A
Disarrayed granulosa cells in eosinophilic fluid
Rash on palms and soles
Painful - raised red lesions on palms and soles
Low serum ceruloplasmin

50. Tabes dorsalis - lose proprioception (3* syphilis)
Extracellular amyloid deposition in gray matter of brain
Degeneration of dorsal column nerves
Chorea - dementia - caudate degeneration
Dilated cardiomyopathy - edema - polyneuropathy