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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. Megaloblastic anemia (B12 - folate deficiency)
Oscillating slow / fast breathing
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Hypersegmented neutrophils
Swollen gums - mucous bleeding - poor wound healing - spots on skin

2. Lesch - Nyhan syndrome (HGPRT deficiency - X- linked recessive)
Green -yellow rings around peripheral iris
Thumb sign on lateral X- ray
Large rash with bull's eye appearance
Gout - MR - self - mutilating behavior in a boy

3. Celiac (diarrhea - distention - weight loss)
Soap bubble in femur or tibia on X- ray
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Nodular hyaline deposits in glomeruli
Hypercoagulability leading to thrombophlebitis

4. Giant cell tumor of bone (generally benign)
Soap bubble in femur or tibia on X- ray
Heterophile antibodies
Antiplatelet antibodies
Continuous machinery heart murmur

5. Paroxysmal nocturnal hemoglobinuria (C' mediated damage - lack of CD55/59)
hemoptysis (parasite)
Achilles tendon xanthoma
Red urine in the morning - fragile RBCs
Calf pseudohypertrophy

6. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Vomiting blood following esophagogastric lacerations
Hair - on - end (crewcut) appearance on X- ray
hemoptysis (parasite)
Keratin pearls

7. Schistosoma haematobium
Pancreatic - pituitary - parathyroid tumors
Antineutrophil cytoplasmic antibodies (ANCA)
hematuria - bladder cancer (parasite)
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma

8. MS (Charcot's)
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Thrombi made of white/red layers
Swollen - hard - painful finger joints
Red - itchy - swollen rash of nipple/areola

9. Gout - Lesch - Nyhan syndrome - tumor lysis syndrome - loop and thiazide diuretics
Bloody tap on LP
Painless jaundice
Increased uric acid levels
Thyroid (medullary) and parathyroid tumors - pheochromocytoma

10. Chvostek's sign (hypocalcemia)
Cellular crescents in Bowman's capsule
Facial muscle spasm upon tapping
Severe RLQ pain with rebound tenderness
Unilateral facial drooping involving forehead

11. Simian crease (Down's)
Single palm crease
Painful - raised red lesions on palms and soles
Cherry- red spot on macula
Honeycomb lung on X- ray

12. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Cherry- red spot on macula
No lactation postpartum - absent menstruation - cold intolerance
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Green -yellow rings around peripheral iris

13. 'b - thalassemia - sickle cell anemia (extramedullary hematopoiesis). ''Hair on end'' means marrow expansion (skull)
Hair - on - end (crewcut) appearance on X- ray
Hypercoagulability leading to thrombophlebitis
Wire loop glomerular appearance on LM
Dog or cat bite resulting in infection

14. Osler's node (infective endocarditis)
Wire loop glomerular appearance on LM
Cellular crescents in Bowman's capsule
hematuria - bladder cancer (parasite)
Painful - raised red lesions on palms and soles

15. CLL (almost always B cell - affects the elderly)
WBCs that look smudged
Intranuclear eosinophilic droplet - like bodies
Renal epithelial casts in urine
perianal pruritis (parasite)

16. Parkinson's
Resting tremor - rigidity - akinesia - postural instability
Keratin pearls
biliary tract disease - cholangiocarcinoma (parasite)
Severe RLQ pain with rebound tenderness

17. Enterobius
Streak ovaries - congenital heart disease - horseshoe kidney
Fever - night sweats - weight loss
Low serum ceruloplasmin
perianal pruritis (parasite)

18. Diphyllobothrium latum
Depigmentation of neurons in substantia nigra
Triglyceride accumulation in liver cell vacuoles
B12 deficiency (parasite)
Desquamated epithelium casts in sputum

19. Babinski (UMN lesion)
Narrowing of bowel lumen on barium radiograph
Toe extension / fanning upon plantar scrape
Spikes on basement membrane - dome - like endothelial deposits
Caf

20. Infectious mono (HBV). IgM that agglutinates sheep RBCs
Increased a - fetoprotein in amniotic fluid / maternal serum
Dry eyes - dry mouth - arthritis
Onion - skin periosteal reaction
Heterophile antibodies

21. Chronic passive congestion of the liver due to right heart failure
Red urine in the morning - fragile RBCs
Nutmeg liver
Pancreatic - pituitary - parathyroid tumors
Increased uric acid levels

22. Erb - Duchenne palsy
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Painless erythematous lesions on palms and soles
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)

23. Pancoast tumor (can cause Horner's)
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Cutaneous/dermal edema due to CT expansion
Bluish line on gingiva
Bronchogenic apical lung tumor

24. Poststrep glomerulonephritis (IgG and C3b deposition)
Child uses arms to stand up from squat
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Enlarged cells with intranuclear inclusion bodies
Antimitochondrial antibodies

25. Pink puffer (emphysema)
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Red urine in the morning - fragile RBCs
Pink complexion - dypnea - hyperventilation
Swollen - hard - painful finger joints

26. Aortic valve stenosis
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Systolic ejection murmur (crescendo - decrescendo)
Antineutrophil cytoplasmic antibodies (ANCA)
Cellular crescents in Bowman's capsule

27. Mallory bodies (alcoholic liver disease)
Strawberry tongue
Child with fever develops red rash on face that spreads to body
Eosinophilic cytoplasmic inclusion in liver cell
hCG elevated

28. Lines of Zahn (arterial thrombus - layers of platelets/RBCs)
Renal epithelial casts in urine
Thrombi made of white/red layers
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Small - irregular red spots on buccal mucosa with blue - white centers

29. Charcot's triad (ascending cholangitis)
liver cysts (parasite)
Rhomboid crystals - positively birefringent
Podocyte fusion on EM
Jaundice - RUQ pain - fever

30. Chronic bacterial pyelo
Keratin pearls
Thyroid - like appearance of kidney
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Enlarged thyroid cells with ground - glass nuclei

31. McArdle's (muscle phosphorylase deficiency)
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Painful blue fingers / toes - hemolytic anemia
Chocolate cyst of ovary

32. Raynaud's syndrome (vasospasm)
Thrombi made of white/red layers
Painful - pale - cold fingers / toes
Bamboo spine on X- ray
Narrowing of bowel lumen on barium radiograph

33. Pompe's disease (lysosomal glucosidase deficiency)
Systolic ejection murmur (crescendo - decrescendo)
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Single palm crease
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance

34. Kartagener's syndrome (dynein)
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Silver - staining spherical aggregation of tau proteins in neurons
Skin hyperpigmentation
hCG elevated

35. McBurney's sign
Severe RLQ pain with rebound tenderness
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Low serum ceruloplasmin
Swollen gums - mucous bleeding - poor wound healing - spots on skin

36. Marfan's (fibrillin defect)
Antinuclear antibodies
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Desquamated epithelium casts in sputum
Cherry- red spot on macula

37. Gaucher's disease (glucocerebrosidase deficiency)
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Bamboo spine on X- ray
Rusty sputum
Fibrous plaques in soft tissue of penis

38. Echinococcus granulosus
Large lysosomal vesicles in phagocytes - immunodeficiency
Dry eyes - dry mouth - arthritis
liver cysts (parasite)
Increased uric acid levels

39. Gout
Eosinophilic globule in liver
Cherry- red spot on macula
Yellow CSF
Needle - shaped - negatively birefringent crystals

40. String sign (Crohn's)
Cold intolerance
Narrowing of bowel lumen on barium radiograph
Extracellular amyloid deposition in gray matter of brain
Circular grouping of dark tumor cells surrounding pale neurofibrils

41. Owl's eye appearance of CMV - Cowdry A bodies
Rash on palms and soles
Enlarged cells with intranuclear inclusion bodies
Increased a - fetoprotein in amniotic fluid / maternal serum
Nutmeg liver

42. Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
Dog or cat bite resulting in infection
Indurated - ulcerated genital lesion
Mucosal bleeding and prolonged bleeding time
Jaundice - RUQ pain - fever

43. Schistosoma mansoni
liver cysts (parasite)
portal hypertension (parasite)
Single palm crease
Vascular birthmark (port - wine stain)

44. Wilson's disease (hepatolenticular degeneration)
Low serum ceruloplasmin
Vomiting blood following esophagogastric lacerations
Antineutrophil cytoplasmic antibodies (ANCA)
Oscillating slow / fast breathing

45. Budd - Chiari syndrome
Polished - ivory- like appearance of bone at cartilage erosion
Hereditary nephritis - sensorineural hearing loss - cataracts
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Bloody tap on LP

46. Gower's sign (Duchenne's)
Child uses arms to stand up from squat
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Hypoxemia - polycythemia - hypercapnia
Ptosis - miosis - anhidrosis

47. Endometriosis (usually bilateral)
Chocolate cyst of ovary
Boot - shaped heart on X- ray
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Fat - female - fertile - forty

48. Conn's (1* hyperaldosterone)
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Desquamated epithelium casts in sputum
Lucid interval after TBI
HTN - hypoK - metabolic alkalosis

49. Taenia solium (cysticercosis)
Antinuclear antibodies
brain cysts - seizures (parasite)
Vascular birthmark (port - wine stain)
Periosteum raised from bone - creating triangular area

50. Fanconi's syndrome (proximal tubular reabsorption defect)
Polyuria - acidosis - growth failure - electrolyte imbalances
Back pain - fever - night sweats - weight loss
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Oscillating slow / fast breathing