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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. NF (1 = optic glimoas and pheo - 2 = acoustic Schwannomas)
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Glomerulus - like structure surrounding vessel in germ cells
Systolic ejection murmur (crescendo - decrescendo)
Caf

2. Endometriosis (usually bilateral)
Single palm crease
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Chocolate cyst of ovary
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm

3. Pink puffer (emphysema)
Pink complexion - dypnea - hyperventilation
Periosteum raised from bone - creating triangular area
Worst headache of my life
Eosinophilic cytoplasmic inclusion in liver cell

4. Janeway lesions (infective endocarditis)
Basophilic stipplling of RBCs
Painless erythematous lesions on palms and soles
Cherry- red spot on macula
Enlarged cells with intranuclear inclusion bodies

5. Multiple myeloma
Triglyceride accumulation in liver cell vacuoles
Lucid interval after TBI
Vomiting blood following esophagogastric lacerations
Lytic (punched - out) bone lesions on X- ray

6. Horner's syndrome (usually with Pancoast tumor in apex of lung)
biliary tract disease - cholangiocarcinoma (parasite)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Ptosis - miosis - anhidrosis
Painful blue fingers / toes - hemolytic anemia

7. Wilson's disease (hepatolenticular degeneration)
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Low serum ceruloplasmin
Pupil accommodates but doesn't react
Nodular hyaline deposits in glomeruli

8. Diphyllobothrium latum
Mammary gland (blue - domed) cyst
Colonies of mucoid Pseudomonas in lungs
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
B12 deficiency (parasite)

9. Xanthochromia (subarachnoid hemorrhage)
Antihistone antibodies
Yellow CSF
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect

10. Neurofibrillary tangles (Alzheimer's and CJD)
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Basophilic stipplling of RBCs
Large lysosomal vesicles in phagocytes - immunodeficiency
Protein aggregates in neurons from hyperphosphorylation of tau protein

11. Owl's eye appearance of CMV - Cowdry A bodies
Eosinophilic globule in liver
Enlarged cells with intranuclear inclusion bodies
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Bamboo spine on X- ray

12. Choriocarcinoma - hydatidiform mole
Bronchogenic apical lung tumor
Nodular hyaline deposits in glomeruli
Painless jaundice
hCG elevated

13. Pemphigus vulgaris (blistering)
Protein aggregates in neurons from hyperphosphorylation of tau protein
Antidesmoglein (epithelial) antibodies
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
portal hypertension (parasite)

14. Erb - Duchenne palsy
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Swollen - hard - painful finger joints
Sudden swollen/painful big toe joint - tophi
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age

15. Codman's triangle on X- ray (osteosarcoma - Ewing's - pyogenic osteomyelitis)
Periosteum raised from bone - creating triangular area
Severe RLQ pain with rebound tenderness
Slow progressive muscle weakness in boys
Fever - chills - headache - myalgia following antibiotic treatment for syphillis

16. Raynaud's syndrome (vasospasm)
liver cysts (parasite)
HTN - hypoK - metabolic alkalosis
Painless jaundice
Painful - pale - cold fingers / toes

17. Duchenne's muscular dystrophy
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Calf pseudohypertrophy
Toe extension / fanning upon plantar scrape
Red 'current jelly' sputum in alcoholic or diabetic patients

18. Von Hippel - Lindau diease
Onion - skin periosteal reaction
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Enlarged thyroid cells with ground - glass nuclei
Sheets of medium - sized lymphoid cells (starry sky)

19. Peyronie's disease
Worst headache of my life
HTN - hypoK - metabolic alkalosis
Painless jaundice
Fibrous plaques in soft tissue of penis

20. MEN 2A (Sipple)
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Severe RLQ pain with rebound tenderness
Lucid interval after TBI
microcytic anemia (parasite)

21. Reed - Sternberg cells (Hodgkin's lymphoma)

22. Tabes dorsalis - lose proprioception (3* syphilis)
Hypochromic - microcytic anemia
Cardiomegaly with apical atrophy
Degeneration of dorsal column nerves
Severe jaundice in neonate

23. 1. Bence Jones proteins (multiple myeloma - kappa or lambda light chains in urine) 2. Waldenstrom's macroglobulinemia (IgM)
Monoclonal globulin protein in blood/urine
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Dog or cat bite resulting in infection
microcytic anemia (parasite)

24. Ewing's sarcoma (malignant round cell tumor)
Tram - track on LM
Caf
portal hypertension (parasite)
Onion - skin periosteal reaction

25. Wegner's (c - ANCA) and Goodpasture's (anti - GBM). Wegner's can also have upper airway involvement
Recurrent colds - unusual eczema - high serum IgE
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Necrotizing vasculitis (lungs) and necrotizing GN
High level of D dimers

26. McArdle's (muscle phosphorylase deficiency)
Azurophilic granular needles in leukemic blasts
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Podocyte fusion on EM
Retinal hemorrhages with pale centers

27. Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
Back pain - fever - night sweats - weight loss
Necrotizing vasculitis (lungs) and necrotizing GN
Athlete with polycythemia
Mucosal bleeding and prolonged bleeding time

28. Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to hyperparathyroidism or osteitis fibrosa cystica
Dark purple skin / mouth nodules
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Painful - pale - cold fingers / toes
Brown tumor of bone

29. 2* syphilis - Rocky Mountain spotted fever - coxsackie A
Basophilic nuclear remnants in RBCs
Rash on palms and soles
Podocyte fusion on EM
Cutaneous/dermal edema due to CT expansion

30. 1. Multiple myeloma (M protein - IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (aging) 3. Waldenstrom's macroglobulinemia (IgM) 4. Primary amyloidosis
Bamboo spine on X- ray
Monoclonal antibody spike
Pupil accommodates but doesn't react
HTN - hypoK - metabolic alkalosis

31. Signet ring (gastric carcinoma)
Mucin - filled cell with peripheral nucleus
Vomiting blood following esophagogastric lacerations
Sudden swollen/painful big toe joint - tophi
Tram - track on LM

32. Burton's line - lead poisoning
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Pupil accommodates but doesn't react
Fat - female - fertile - forty
Bluish line on gingiva

33. Plummer - Vinson syndrome
Facial muscle spasm upon tapping
Mucin - filled cell with peripheral nucleus
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Antiplatelet antibodies

34. Pompe's disease (lysosomal glucosidase deficiency)
Desquamated epithelium casts in sputum
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Vomiting blood following esophagogastric lacerations
Monoclonal globulin protein in blood/urine

35. Scleroderma (CREST)
Anticentromere antibodies
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Lucid interval after TBI
Recurrent colds - unusual eczema - high serum IgE

36. Whipple's disease (Tropheryma whippelii)
Iron - containing nodules in alveolar septum
Protein aggregates in neurons from hyperphosphorylation of tau protein
Weight loss - diarrhea - arthritis - fever - adenopathy
Chest pain - pericardial effusion/friction rub - persistent fever following MI

37. Schistosoma haematobium
Bluish line on gingiva
hematuria - bladder cancer (parasite)
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Yellow CSF

38. Ankylosing spondylitis (chronic inflammatory arthritis - HLA B27)
Fibrous plaques in soft tissue of penis
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Bamboo spine on X- ray
Athlete with polycythemia

39. Clue cells (Gardenella vaginalis)
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Red 'current jelly' sputum in alcoholic or diabetic patients
Stippled vaginal epithelial cells
Current jelly stool

40. Rouleax formation (high ESR - multiple myeloma)
biliary tract disease - cholangiocarcinoma (parasite)
Stacks of RBCs
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Worst headache of my life

41. Diffuse systemic scleroderma
hematuria - bladder cancer (parasite)
Anti - topoisomerase antibodies
Pseudopalisading tumor cells on brain biopsy
Small - irregular red spots on buccal mucosa with blue - white centers

42. Mallory bodies (alcoholic liver disease)
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Eosinophilic cytoplasmic inclusion in liver cell
Heterophile antibodies
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)

43. Shwartzman reaction (follows second exposure to endotoxin)
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Green -yellow rings around peripheral iris
Podocyte fusion on EM
Azurophilic granular needles in leukemic blasts

44. Fanconi's syndrome (proximal tubular reabsorption defect)
Hypoxemia - polycythemia - hypercapnia
Polyuria - acidosis - growth failure - electrolyte imbalances
Triglyceride accumulation in liver cell vacuoles
Pseudopalisading tumor cells on brain biopsy

45. Dressler's (autoimmune post - MI)
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Rusty sputum
Dilated cardiomyopathy - edema - polyneuropathy
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

46. 'b - thalassemia - sickle cell anemia (extramedullary hematopoiesis). ''Hair on end'' means marrow expansion (skull)
Rash on palms and soles
Worst headache of my life
Hair - on - end (crewcut) appearance on X- ray
Green -yellow rings around peripheral iris

47. Idiopathic thrombocytopenic purpura (ITP - bleeding diathesis)
Antiplatelet antibodies
Fibrous plaques in soft tissue of penis
Splinter hemorrhages in fingernails
Oscillating slow / fast breathing

48. Lewy body (Parkinson's)
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Eosinophilic cytoplasmic inclusion in nerve cell
AntiGBM antibodies
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age

49. Kluver - Bucy syndrome (bilateral amygdala)
Male child - recurrent infections - no mature B cells
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Fever - night sweats - weight loss

50. OA (osteophytes on PIP (Bouchard) and DIP (Heberden)
Triglyceride accumulation in liver cell vacuoles
Branching gram + rods with sulfur granules
Child with fever develops red rash on face that spreads to body
Swollen - hard - painful finger joints