Test your basic knowledge |

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. Parkinson's
High level of D dimers
Painful - raised red lesions on palms and soles
Depigmentation of neurons in substantia nigra
Hereditary nephritis - sensorineural hearing loss - cataracts

2. Actinomyces israelii
Hair - on - end (crewcut) appearance on X- ray
Branching gram + rods with sulfur granules
Desquamated epithelium casts in sputum
B12 deficiency (parasite)

3. Osteogenesis imperfecta
Monoclonal globulin protein in blood/urine
Anti - IgG antibodies
Periosteum raised from bone - creating triangular area
Blue sclera

4. Hemangioma (benign - associated with Sturge - Weber syndrome - in which case it's V1 distribution)
Bilateral hilar adenopathy - uveitis
Vascular birthmark (port - wine stain)
Back pain - fever - night sweats - weight loss
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells

5. Choriocarcinoma - hydatidiform mole
Depigmentation of neurons in substantia nigra
Needle - shaped - negatively birefringent crystals
Lucid interval after TBI
hCG elevated

6. Pink puffer (emphysema)
Elastic skin - hypermobility of joints
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Keratin pearls
Pink complexion - dypnea - hyperventilation

7. Edward's syndrome (Trisomy 18)
Single palm crease
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Gout - MR - self - mutilating behavior in a boy
Painful - pale - cold fingers / toes

8. Enterobius
perianal pruritis (parasite)
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Chocolate cyst of ovary
Antimitochondrial antibodies

9. Intussesseption
Brown tumor of bone
Anti - IgG antibodies
Current jelly stool
Continuous machinery heart murmur

10. DVT - PE - DIC - Budd - Chiari (D dimer is fibrin breakdown products)
High level of D dimers
Oscillating slow / fast breathing
Rhomboid crystals - positively birefringent
Back pain - fever - night sweats - weight loss

11. Nonpainful = syphillis. Painful with exudate = chancroid
Indurated - ulcerated genital lesion
Cellular crescents in Bowman's capsule
Strawberry tongue
Soap bubble in femur or tibia on X- ray

12. Clue cells (Gardenella vaginalis)
Dog or cat bite resulting in infection
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Urethritis - conjunctivitis - arthritis in a male
Stippled vaginal epithelial cells

13. Whipple's disease (Tropheryma whippelii)
Weight loss - diarrhea - arthritis - fever - adenopathy
Cherry- red spot on macula
Skin hyperpigmentation
Worst headache of my life

14. Budd - Chiari syndrome
Systolic ejection murmur (crescendo - decrescendo)
Hereditary nephritis - sensorineural hearing loss - cataracts
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Cherry- red spot on macula

15. Kluver - Bucy syndrome (bilateral amygdala)
Hyperphagia - hypersexuality - hyperorality - hyperdocility
biliary tract disease - cholangiocarcinoma (parasite)
Systolic ejection murmur (crescendo - decrescendo)
Enlarged cells with intranuclear inclusion bodies

16. Lead poisoning or sideroblastic anemia
perianal pruritis (parasite)
Dilated cardiomyopathy - edema - polyneuropathy
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Basophilic stipplling of RBCs

17. Cowdry type A bodies (HSV or CMV)
Intranuclear eosinophilic droplet - like bodies
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Worst headache of my life
Skin hyperpigmentation

18. Curschmann's spirals (bronchial asthma - can result in whorled mucous plugs)
Degeneration of dorsal column nerves
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Desquamated epithelium casts in sputum
Calf pseudohypertrophy

19. Epiglossitis (H flu)
Unilateral facial drooping involving forehead
Thumb sign on lateral X- ray
Hypochromic - microcytic anemia
Dry eyes - dry mouth - arthritis

20. Reinke crystals (Leydig cell tumor)
Boot - shaped heart on X- ray
Hair - on - end (crewcut) appearance on X- ray
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Cutaneous/dermal edema due to CT expansion

21. Raynaud's syndrome (vasospasm)
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Painful - pale - cold fingers / toes
Extracellular amyloid deposition in gray matter of brain
Urethritis - conjunctivitis - arthritis in a male

22. Homer Wright rosettes (adrenal neuroblastoma - medulloblastoma - Ewing's sarcoma)
brain cysts - seizures (parasite)
RBC casts in urine
Cherry- red spot on macula
Circular grouping of dark tumor cells surrounding pale neurofibrils

23. Scarlet fever - Kawasaki disease - TSS
Single palm crease
Strawberry tongue
B12 deficiency (parasite)
Basophilic nuclear remnants in RBCs

24. Erb - Duchenne palsy
Basophilic nuclear remnants in RBCs
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Needle - shaped - negatively birefringent crystals
Small - irregular red spots on buccal mucosa with blue - white centers

25. Taenia solium (cysticercosis)
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
brain cysts - seizures (parasite)
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Enlarged thyroid cells with ground - glass nuclei

26. Pancoast tumor (can cause Horner's)
Blue sclera
Bronchogenic apical lung tumor
Antineutrophil cytoplasmic antibodies (ANCA)
Honeycomb lung on X- ray

27. Multiple myeloma
Lytic (punched - out) bone lesions on X- ray
Thrombi made of white/red layers
Weight loss - diarrhea - arthritis - fever - adenopathy
Increased uric acid levels

28. Diffuse systemic scleroderma
Podocyte fusion on EM
Eosinophilic cytoplasmic inclusion in nerve cell
Anti - topoisomerase antibodies
Pupil accommodates but doesn't react

29. Rouleax formation (high ESR - multiple myeloma)
Protein aggregates in neurons from hyperphosphorylation of tau protein
Stacks of RBCs
Calf pseudohypertrophy
Painful - pale - cold fingers / toes

30. Horner's syndrome (usually with Pancoast tumor in apex of lung)
Deep - labored breathing / hyperventilation
Red 'current jelly' sputum in alcoholic or diabetic patients
Ptosis - miosis - anhidrosis
Lytic (punched - out) bone lesions on X- ray

31. Ankylosing spondylitis (chronic inflammatory arthritis - HLA B27)
Pseudopalisading tumor cells on brain biopsy
Painless jaundice
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Bamboo spine on X- ray

32. Anencephaly - spina bifida (neural tube defects) - gastrocesis - omphalmocele
Streak ovaries - congenital heart disease - horseshoe kidney
Increased a - fetoprotein in amniotic fluid / maternal serum
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Silver - staining spherical aggregation of tau proteins in neurons

33. Von Hippel - Lindau diease
Unilateral facial drooping involving forehead
Glomerulus - like structure surrounding vessel in germ cells
Dry eyes - dry mouth - arthritis
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma

34. Lines of Zahn (arterial thrombus - layers of platelets/RBCs)
Antineutrophil cytoplasmic antibodies (ANCA)
Thrombi made of white/red layers
Small - irregular red spots on buccal mucosa with blue - white centers
Degeneration of dorsal column nerves

35. Megaloblastic anemia (B12 - folate deficiency)
Hypersegmented neutrophils
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Branching gram + rods with sulfur granules
Tram - track on LM

36. Paget's
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Painful blue fingers / toes - hemolytic anemia
Elastic skin - hypermobility of joints

37. Aortic regurg
Disarrayed granulosa cells in eosinophilic fluid
Bounding pulses - diastolic hear murmur - head bobbing
microcytic anemia (parasite)
Fibrous plaques in soft tissue of penis

38. Goodpasture's syndome (glomerulonephritis and hemoptysis)
Recurrent colds - unusual eczema - high serum IgE
AntiGBM antibodies
Degeneration of dorsal column nerves
Sudden swollen/painful big toe joint - tophi

39. Chronic ESRD
Caf
Pupil accommodates but doesn't react
Narrowing of bowel lumen on barium radiograph
Waxy casts with very low urine flow

40. Chronic passive congestion of the liver due to right heart failure
Narrowing of bowel lumen on barium radiograph
Protein aggregates in neurons from hyperphosphorylation of tau protein
Nutmeg liver
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth

41. 2* syphilis - Rocky Mountain spotted fever - coxsackie A
Large rash with bull's eye appearance
Toe extension / fanning upon plantar scrape
Rash on palms and soles
WBC casts in urine

42. Minimal change disease (child - nephrotic)
Swollen - hard - painful finger joints
Pancreatic - pituitary - parathyroid tumors
Podocyte fusion on EM
Nutmeg liver

43. Wegner's (c - ANCA) and Goodpasture's (anti - GBM). Wegner's can also have upper airway involvement
Eosinophilic globule in liver
Necrotizing vasculitis (lungs) and necrotizing GN
Disarrayed granulosa cells in eosinophilic fluid
Heart nodules (inflammatory)

44. Bell's palsy (LMN CN VII)
Unilateral facial drooping involving forehead
Soap bubble in femur or tibia on X- ray
Red 'current jelly' sputum in alcoholic or diabetic patients
B12 deficiency (parasite)

45. Tay- Sachs - Niemann - Pick - central retinal artery occlusion
Swollen - hard - painful finger joints
Basophilic nuclear remnants in RBCs
Cherry- red spot on macula
Vascular birthmark (port - wine stain)

46. Blue bloater (chronic bronchitis)
Hypoxemia - polycythemia - hypercapnia
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
portal hypertension (parasite)
Rib notching

47. Condylomata lata (2* syphilis)
Smooth - flat - moist white lesions on genitals
Toe extension / fanning upon plantar scrape
Hypersegmented neutrophils
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)

48. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Green -yellow rings around peripheral iris
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Honeycomb lung on X- ray
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands

49. Turner syndrome (X0 - short stature - webbed neck - lymphedema)
Streak ovaries - congenital heart disease - horseshoe kidney
Azurophilic granular needles in leukemic blasts
Red urine in the morning - fragile RBCs
Triglyceride accumulation in liver cell vacuoles

50. McCune - Albright syndome (G protein problem)
Caf
Anticentromere antibodies
Basophilic nuclear remnants in RBCs
Continuous machinery heart murmur