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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. Orphan Annie nuclei - or 'disbursed chromatin' (papillary carcinoma of the thyroid)
Enlarged thyroid cells with ground - glass nuclei
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Painful - pale - cold fingers / toes
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells

2. Kussmaul breathing - DKA
Large rash with bull's eye appearance
Streak ovaries - congenital heart disease - horseshoe kidney
Deep - labored breathing / hyperventilation
Waxy casts with very low urine flow

3. Scurvy (vit C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
Continuous machinery heart murmur
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Wire loop glomerular appearance on LM
Lumpy- bumpy appearance of glomeruli on immunofluorescence

4. Signet ring (gastric carcinoma)
Mucin - filled cell with peripheral nucleus
Rash on palms and soles
Eosinophilic globule in liver
Eosinophilic cytoplasmic inclusion in nerve cell

5. Diffuse systemic scleroderma
Depigmentation of neurons in substantia nigra
Azurophilic granular needles in leukemic blasts
Anti - topoisomerase antibodies
Lucid interval after TBI

6. Choriocarcinoma - hydatidiform mole
hCG elevated
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
HTN - hypoK - metabolic alkalosis
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration

7. Slapped cheek - B19
Gout - MR - self - mutilating behavior in a boy
Podocyte fusion on EM
Brown tumor of bone
Child with fever develops red rash on face that spreads to body

8. PDA
Green -yellow rings around peripheral iris
Cardiomegaly with apical atrophy
Monoclonal antibody spike
Continuous machinery heart murmur

9. Koplick spots (measles)
Small - irregular red spots on buccal mucosa with blue - white centers
Weight loss - diarrhea - arthritis - fever - adenopathy
Recurrent colds - unusual eczema - high serum IgE
Strawberry tongue

10. Tabes dorsalis - lose proprioception (3* syphilis)
Dermatitis - dementia - diarrhea
Degeneration of dorsal column nerves
Chorea - dementia - caudate degeneration
Hexagonal - double - pointed - needle - like crystals in bronchial secretions

11. Taenia solium (cysticercosis)
brain cysts - seizures (parasite)
Wire loop glomerular appearance on LM
Colonies of mucoid Pseudomonas in lungs
WBC casts in urine

12. Reinke crystals (Leydig cell tumor)
Calf pseudohypertrophy
Sheets of medium - sized lymphoid cells (starry sky)
Rash on palms and soles
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells

13. Horner's syndrome (usually with Pancoast tumor in apex of lung)
Small - irregular red spots on buccal mucosa with blue - white centers
Monoclonal globulin protein in blood/urine
Ptosis - miosis - anhidrosis
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration

14. Wegner's (c - ANCA) and Goodpasture's (anti - GBM). Wegner's can also have upper airway involvement
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Current jelly stool
Necrotizing vasculitis (lungs) and necrotizing GN
Chest pain - pericardial effusion/friction rub - persistent fever following MI

15. Aortic regurg
Anticentromere antibodies
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
High level of D dimers
Bounding pulses - diastolic hear murmur - head bobbing

16. Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
Painful blue fingers / toes - hemolytic anemia
Mucosal bleeding and prolonged bleeding time
Caf
Urethritis - conjunctivitis - arthritis in a male

17. Vasculitis (c - ANCA = Wegener's - p - ANCA = microscopic polyangiitis or Churg - Strauss syndrome)
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Antineutrophil cytoplasmic antibodies (ANCA)
Intranuclear eosinophilic droplet - like bodies

18. Bell's palsy (LMN CN VII)
Unilateral facial drooping involving forehead
Renal epithelial casts in urine
Lytic (punched - out) bone lesions on X- ray
Hypochromic - microcytic anemia

19. Duchenne's muscular dystrophy
Cellular crescents in Bowman's capsule
Hypoxemia - polycythemia - hypercapnia
Calf pseudohypertrophy
Red - itchy - swollen rash of nipple/areola

20. Measles
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Skin hyperpigmentation
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Sudden swollen/painful big toe joint - tophi

21. Kimmelstiel - Wilson nodules (diabetic)
Nodular hyaline deposits in glomeruli
Heart nodules (inflammatory)
hemoptysis (parasite)
Recurrent colds - unusual eczema - high serum IgE

22. Goodpasture's syndome (glomerulonephritis and hemoptysis)
Chronic exercise intolerance with myalgia - fatigue - painful cramps
AntiGBM antibodies
hCG elevated
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)

23. Enterobius
Hypochromic - microcytic anemia
perianal pruritis (parasite)
Depigmentation of neurons in substantia nigra
Triglyceride accumulation in liver cell vacuoles

24. Owl's eye appearance of CMV - Cowdry A bodies
Enlarged cells with intranuclear inclusion bodies
Spikes on basement membrane - dome - like endothelial deposits
Gout - MR - self - mutilating behavior in a boy
Child uses arms to stand up from squat

25. Paragonimus westermani
perianal pruritis (parasite)
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Antiplatelet antibodies
hemoptysis (parasite)

26. Gout
Needle - shaped - negatively birefringent crystals
Hypochromic - microcytic anemia
Hypoxemia - polycythemia - hypercapnia
Rash on palms and soles

27. Pick bodies
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Polished - ivory- like appearance of bone at cartilage erosion
Thyroid - like appearance of kidney
Silver - staining spherical aggregation of tau proteins in neurons

28. Senile plaques (Alzheimer's)
Rib notching
Antihistone antibodies
Extracellular amyloid deposition in gray matter of brain
Painful blue fingers / toes - hemolytic anemia

29. Burton's line - lead poisoning
Swollen - hard - painful finger joints
Bluish line on gingiva
Painful blue fingers / toes - hemolytic anemia
Ptosis - miosis - anhidrosis

30. Coarctation of the aorta
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Pseudopalisading tumor cells on brain biopsy
Rib notching
Podocyte fusion on EM

31. Raynaud's syndrome (vasospasm)
Antimitochondrial antibodies
Painful - pale - cold fingers / toes
Calf pseudohypertrophy
Monoclonal globulin protein in blood/urine

32. Chronic passive congestion of the liver due to right heart failure
Splinter hemorrhages in fingernails
Nutmeg liver
Hypoxemia - polycythemia - hypercapnia
Worst headache of my life

33. Pancoast tumor (can cause Horner's)
Splinter hemorrhages in fingernails
Bronchogenic apical lung tumor
hCG elevated
Lumpy- bumpy appearance of glomeruli on immunofluorescence

34. Epiglossitis (H flu)
Anti - topoisomerase antibodies
Fibrous plaques in soft tissue of penis
Chorea - dementia - caudate degeneration
Thumb sign on lateral X- ray

35. Cold agglutinin disease (autoimmune from Mp or mono - from IgM)
Basophilic stipplling of RBCs
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Painful blue fingers / toes - hemolytic anemia

36. Kaposi's sarcoma
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Dark purple skin / mouth nodules
Monoclonal antibody spike
Red - itchy - swollen rash of nipple/areola

37. Babinski (UMN lesion)
Toe extension / fanning upon plantar scrape
Splinter hemorrhages in fingernails
WBCs that look smudged
Boot - shaped heart on X- ray

38. Niemann - Pick disease (genetic sphingomyelinase deficiency)
Child with fever develops red rash on face that spreads to body
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Protein aggregates in neurons from hyperphosphorylation of tau protein
Eosinophilic cytoplasmic inclusion in liver cell

39. Membranous glomerulonephritis (may progress to nephrotic)
WBC casts in urine
Needle - shaped - negatively birefringent crystals
Spikes on basement membrane - dome - like endothelial deposits
Disarrayed granulosa cells in eosinophilic fluid

40. Fanconi's anemia (esp AML)
Nutmeg liver
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Necrotizing vasculitis (lungs) and necrotizing GN
Rusty sputum

41. Gaucher's disease (glucocerebrosidase deficiency)
Dog or cat bite resulting in infection
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Rusty sputum
Periosteum raised from bone - creating triangular area

42. Scleroderma (CREST)
Anticentromere antibodies
Nodular hyaline deposits in glomeruli
Cherry- red spot on macula
Cellular crescents in Bowman's capsule

43. Ancylostoma - Necator (hook worms)
Fat - female - fertile - forty
Bluish line on gingiva
Lumpy- bumpy appearance of glomeruli on immunofluorescence
microcytic anemia (parasite)

44. CF
Rib notching
Colonies of mucoid Pseudomonas in lungs
Bluish line on gingiva
Hypoxemia - polycythemia - hypercapnia

45. McCune - Albright syndome (G protein problem)
Urethritis - conjunctivitis - arthritis in a male
Caf
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect

46. Lesch - Nyhan syndrome (HGPRT deficiency - X- linked recessive)
Oscillating slow / fast breathing
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
WBC casts in urine
Gout - MR - self - mutilating behavior in a boy

47. Endometriosis (usually bilateral)
Chocolate cyst of ovary
WBC casts in urine
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Mammary gland (blue - domed) cyst

48. Strep pneumo
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Child uses arms to stand up from squat
Rusty sputum
Fibrous plaques in soft tissue of penis

49. Charcot's triad (ascending cholangitis)
Depigmentation of neurons in substantia nigra
Jaundice - RUQ pain - fever
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Painful - raised red lesions on palms and soles

50. Chvostek's sign (hypocalcemia)
Back pain - fever - night sweats - weight loss
Jaundice - RUQ pain - fever
Gout - MR - self - mutilating behavior in a boy
Facial muscle spasm upon tapping