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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. Koilocytes (HPV) 'perrinuclear cytoplasmic clearing'
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Basophilic stipplling of RBCs

2. Roth's spots (bacterial endocarditis)
Thumb sign on lateral X- ray
Enlarged cells with intranuclear inclusion bodies
Retinal hemorrhages with pale centers
Back pain - fever - night sweats - weight loss

3. MEN 2A (Sipple)
Achilles tendon xanthoma
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Soap bubble in femur or tibia on X- ray
Tram - track on LM

4. Chronic bacterial pyelo
perianal pruritis (parasite)
Thyroid - like appearance of kidney
Basophilic nuclear remnants in RBCs
Eosinophilic globule in liver

5. Paget's
biliary tract disease - cholangiocarcinoma (parasite)
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Large lysosomal vesicles in phagocytes - immunodeficiency
RBC casts in urine

6. Niemann - Pick disease (genetic sphingomyelinase deficiency)
Pupil accommodates but doesn't react
Single palm crease
Conjugate lateral gaze palsy - horizontal diplopia
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration

7. Waterhouse - Friderichsen syndrome (meningococcemia)
Spikes on basement membrane - dome - like endothelial deposits
Adrenal hemorrhage - hypotension - DIC
Depigmentation of neurons in substantia nigra
Brown tumor of bone

8. Bell's palsy (LMN CN VII)
Unilateral facial drooping involving forehead
Hypochromic - microcytic anemia
Palpable purpura - joint pain - abdominal pain in a child
Soap bubble in femur or tibia on X- ray

9. Internuclear ophthalmoplegia (MS or stroke)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
biliary tract disease - cholangiocarcinoma (parasite)
Rhomboid crystals - positively birefringent
Conjugate lateral gaze palsy - horizontal diplopia

10. Subarachnoid hemorrhage
Bloody tap on LP
Rib notching
Single palm crease
Triglyceride accumulation in liver cell vacuoles

11. Clue cells (Gardenella vaginalis)
Branching gram + rods with sulfur granules
Stippled vaginal epithelial cells
Antidesmoglein (epithelial) antibodies
Polyuria - acidosis - growth failure - electrolyte imbalances

12. OA (osteophytes on PIP (Bouchard) and DIP (Heberden)
Keratin pearls
Swollen - hard - painful finger joints
biliary tract disease - cholangiocarcinoma (parasite)
Infant with hypoglycemia - failure to thrive - and hepatomegaly

13. Sarcoid
Bilateral hilar adenopathy - uveitis
Cherry- red spot on macula
Swollen gums - mucous bleeding - poor wound healing - spots on skin
hCG elevated

14. Echinococcus granulosus
Yellow CSF
Child with fever develops red rash on face that spreads to body
liver cysts (parasite)
Anti - topoisomerase antibodies

15. Koplick spots (measles)
Podocyte fusion on EM
Small - irregular red spots on buccal mucosa with blue - white centers
Thumb sign on lateral X- ray
hemoptysis (parasite)

16. Neurofibrillary tangles (Alzheimer's and CJD)
Protein aggregates in neurons from hyperphosphorylation of tau protein
Colonies of mucoid Pseudomonas in lungs
Oscillating slow / fast breathing
Rash on palms and soles

17. Marfan's (fibrillin defect)
Enlarged cells with intranuclear inclusion bodies
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
High level of D dimers
Keratin pearls

18. Diffuse systemic scleroderma
Mucosal bleeding and prolonged bleeding time
Back pain - fever - night sweats - weight loss
Anti - topoisomerase antibodies
Painful blue fingers / toes - hemolytic anemia

19. Pancoast tumor (can cause Horner's)
WBC casts in urine
Bronchogenic apical lung tumor
Pancreatic - pituitary - parathyroid tumors
Increased uric acid levels

20. Conn's (1* hyperaldosterone)
Narrowing of bowel lumen on barium radiograph
HTN - hypoK - metabolic alkalosis
Bronchogenic apical lung tumor
Red 'current jelly' sputum in alcoholic or diabetic patients

21. Call - Exner bodies (granulosa - theca cell tumor of the ovary)
Nodular hyaline deposits in glomeruli
Disarrayed granulosa cells in eosinophilic fluid
Enlarged cells with intranuclear inclusion bodies
Renal epithelial casts in urine

22. Shwartzman reaction (follows second exposure to endotoxin)
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Slow progressive muscle weakness in boys
Antineutrophil cytoplasmic antibodies (ANCA)

23. Job's syndrome
Large rash with bull's eye appearance
Recurrent colds - unusual eczema - high serum IgE
Narrowing of bowel lumen on barium radiograph
Rhomboid crystals - positively birefringent

24. Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to hyperparathyroidism or osteitis fibrosa cystica
Brown tumor of bone
Athlete with polycythemia
Fat - female - fertile - forty
Degeneration of dorsal column nerves

25. Gout/podagra (hyperuricemia)
Antimitochondrial antibodies
Rash on palms and soles
Desquamated epithelium casts in sputum
Sudden swollen/painful big toe joint - tophi

26. Osteogenesis imperfecta
Blue sclera
Palpable purpura - joint pain - abdominal pain in a child
Worst headache of my life
Vasculitis from exposure to endotoxin casuing glomerular thrombosis

27. Plummer - Vinson syndrome
Periosteum raised from bone - creating triangular area
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Bloody tap on LP
Polyuria - acidosis - growth failure - electrolyte imbalances

28. Slapped cheek - B19
microcytic anemia (parasite)
Fibrous plaques in soft tissue of penis
Child with fever develops red rash on face that spreads to body
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration

29. Condylomata lata (2* syphilis)
Rash on palms and soles
Adrenal hemorrhage - hypotension - DIC
Smooth - flat - moist white lesions on genitals
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia

30. Duchenne's muscular dystrophy
Sudden swollen/painful big toe joint - tophi
Calf pseudohypertrophy
WBC casts in urine
Monoclonal globulin protein in blood/urine

31. Klebsiella pneumoniae

32. Gardner's syndrome
Pseudopalisading tumor cells on brain biopsy
Periosteum raised from bone - creating triangular area
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Rash on palms and soles

33. Rouleax formation (high ESR - multiple myeloma)
hemoptysis (parasite)
Intranuclear eosinophilic droplet - like bodies
Cellular crescents in Bowman's capsule
Stacks of RBCs

34. Pasteurella multocida (local cellulitis)
Dog or cat bite resulting in infection
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Triglyceride accumulation in liver cell vacuoles
Anticentromere antibodies

35. Parkinson's
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Dog or cat bite resulting in infection
Depigmentation of neurons in substantia nigra
Eosinophilic globule in liver

36. Parkinson's
Honeycomb lung on X- ray
Toe extension / fanning upon plantar scrape
Resting tremor - rigidity - akinesia - postural instability
Colonies of mucoid Pseudomonas in lungs

37. Chvostek's sign (hypocalcemia)
Facial muscle spasm upon tapping
Pupil accommodates but doesn't react
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Enlarged cells with intranuclear inclusion bodies

38. Lead poisoning or sideroblastic anemia
Necrotizing vasculitis (lungs) and necrotizing GN
Thrombi made of white/red layers
Basophilic stipplling of RBCs
Painful - pale - cold fingers / toes

39. Von Hippel - Lindau diease
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Deep - labored breathing / hyperventilation
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma

40. Scarlet fever - Kawasaki disease - TSS
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Chorea - dementia - caudate degeneration
Gout - MR - self - mutilating behavior in a boy
Strawberry tongue

41. Blue bloater (chronic bronchitis)
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Hypoxemia - polycythemia - hypercapnia
Disarrayed granulosa cells in eosinophilic fluid
Cellular crescents in Bowman's capsule

42. Crigler - Najjar syndrome (congenital unconj hyper bilirubinemia)
Severe jaundice in neonate
Strawberry tongue
Needle - shaped - negatively birefringent crystals
Antiplatelet antibodies

43. Ghon complex (1* TB)
Small - irregular red spots on buccal mucosa with blue - white centers
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Stacks of RBCs
Vomiting blood following esophagogastric lacerations

44. Tay- Sachs - Niemann - Pick - central retinal artery occlusion
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Back pain - fever - night sweats - weight loss
Spikes on basement membrane - dome - like endothelial deposits
Cherry- red spot on macula

45. Ferruginous bodies (asbestosis: risk of mesothelioma)
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Male child - recurrent infections - no mature B cells
Indurated - ulcerated genital lesion
Iron - containing nodules in alveolar septum

46. CF
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Dog or cat bite resulting in infection
Elastic skin - hypermobility of joints
Colonies of mucoid Pseudomonas in lungs

47. Aortic valve stenosis
Systolic ejection murmur (crescendo - decrescendo)
Rash on palms and soles
Current jelly stool
Resting tremor - rigidity - akinesia - postural instability

48. Bruton's disease (X- linked agammaglobulinemia)
Thyroid - like appearance of kidney
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Male child - recurrent infections - no mature B cells
Onion - skin periosteal reaction

49. Acute toxic/viral nephrosis
Renal epithelial casts in urine
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Fibrous plaques in soft tissue of penis
Antihistone antibodies

50. Fibrocystic change of the breast
Chocolate cyst of ovary
Mammary gland (blue - domed) cyst
Thumb sign on lateral X- ray
Severe RLQ pain with rebound tenderness