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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. Coarctation of the aorta
Anti - topoisomerase antibodies
Rib notching
Bluish line on gingiva
No lactation postpartum - absent menstruation - cold intolerance

2. Aortic valve stenosis
Dog or cat bite resulting in infection
Cardiomegaly with apical atrophy
Polished - ivory- like appearance of bone at cartilage erosion
Systolic ejection murmur (crescendo - decrescendo)

3. Pasteurella multocida (local cellulitis)
Dog or cat bite resulting in infection
Nutmeg liver
Glomerulus - like structure surrounding vessel in germ cells
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth

4. Burton's line - lead poisoning
Urethritis - conjunctivitis - arthritis in a male
Bluish line on gingiva
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

5. Vasculitis (c - ANCA = Wegener's - p - ANCA = microscopic polyangiitis or Churg - Strauss syndrome)
Anticentromere antibodies
Increased uric acid levels
Smooth - flat - moist white lesions on genitals
Antineutrophil cytoplasmic antibodies (ANCA)

6. OA (osteophytes on PIP (Bouchard) and DIP (Heberden)
Pseudopalisading tumor cells on brain biopsy
Toe extension / fanning upon plantar scrape
Monoclonal antibody spike
Swollen - hard - painful finger joints

7. McArdle's (muscle phosphorylase deficiency)
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Periosteum raised from bone - creating triangular area
Extracellular amyloid deposition in gray matter of brain

8. Pemphigus vulgaris (blistering)
hemoptysis (parasite)
Antidesmoglein (epithelial) antibodies
Indurated - ulcerated genital lesion
Sudden swollen/painful big toe joint - tophi

9. Nonpainful = syphillis. Painful with exudate = chancroid
Indurated - ulcerated genital lesion
Rib notching
Heart nodules (inflammatory)
Extracellular amyloid deposition in gray matter of brain

10. Membranous glomerulonephritis (may progress to nephrotic)
Weight loss - diarrhea - arthritis - fever - adenopathy
Spikes on basement membrane - dome - like endothelial deposits
Bluish line on gingiva
RBC casts in urine

11. Clue cells (Gardenella vaginalis)
Skin hyperpigmentation
Stippled vaginal epithelial cells
HTN - hypoK - metabolic alkalosis
Cherry- red spot on macula

12. Paroxysmal nocturnal hemoglobinuria (C' mediated damage - lack of CD55/59)
High level of D dimers
Red urine in the morning - fragile RBCs
Antidesmoglein (epithelial) antibodies
Narrowing of bowel lumen on barium radiograph

13. Anencephaly - spina bifida (neural tube defects) - gastrocesis - omphalmocele
Nutmeg liver
Palpable purpura - joint pain - abdominal pain in a child
Extracellular amyloid deposition in gray matter of brain
Increased a - fetoprotein in amniotic fluid / maternal serum

14. Councilman body (toxic or viral hepatitis - often yellow fever)
Pupil accommodates but doesn't react
hematuria - bladder cancer (parasite)
Dilated cardiomyopathy - edema - polyneuropathy
Eosinophilic globule in liver

15. Trousseau's sign (adenocarcinoma of pancreas or lung)
Urethritis - conjunctivitis - arthritis in a male
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Antiplatelet antibodies
Hypercoagulability leading to thrombophlebitis

16. Parkinson's
Resting tremor - rigidity - akinesia - postural instability
Rib notching
Azurophilic granular needles in leukemic blasts
Short stature - increased incidence of tumors / leukemia - aplastic anemia

17. Henoch - Schonlein purpura (IgA vasculitis)
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Rapidly progressive leg weakness that ascend - following GI infection
Palpable purpura - joint pain - abdominal pain in a child
Chest pain - pericardial effusion/friction rub - persistent fever following MI

18. Osteogenesis imperfecta
hCG elevated
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Blue sclera

19. Subarachnoid hemorrhage
liver cysts (parasite)
Eosinophilic globule in liver
Bloody tap on LP
Adrenal hemorrhage - hypotension - DIC

20. Poststrep glomerulonephritis (IgG and C3b deposition)
Small - irregular red spots on buccal mucosa with blue - white centers
Weight loss - diarrhea - arthritis - fever - adenopathy
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Boot - shaped heart on X- ray

21. Pseudogout
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Polished - ivory- like appearance of bone at cartilage erosion
Rhomboid crystals - positively birefringent
Unilateral facial drooping involving forehead

22. Crigler - Najjar syndrome (congenital unconj hyper bilirubinemia)
Intranuclear eosinophilic droplet - like bodies
Palpable purpura - joint pain - abdominal pain in a child
Dark purple skin / mouth nodules
Severe jaundice in neonate

23. Codman's triangle on X- ray (osteosarcoma - Ewing's - pyogenic osteomyelitis)
Enlarged cells with intranuclear inclusion bodies
Achilles tendon xanthoma
Periosteum raised from bone - creating triangular area
Hyperphagia - hypersexuality - hyperorality - hyperdocility

24. DVT - PE - DIC - Budd - Chiari (D dimer is fibrin breakdown products)
Swollen gums - mucous bleeding - poor wound healing - spots on skin
High level of D dimers
Antinuclear antibodies
Increased uric acid levels

25. Curschmann's spirals (bronchial asthma - can result in whorled mucous plugs)
Painful blue fingers / toes - hemolytic anemia
Heart nodules (inflammatory)
Anticentromere antibodies
Desquamated epithelium casts in sputum

26. Aschoff bodies = focal myocardial inflammation with giant cells (rheumatic fever)
Current jelly stool
Antiplatelet antibodies
Heart nodules (inflammatory)
Silver - staining spherical aggregation of tau proteins in neurons

27. Bronchial asthma (Charcot - Leyden crystals: eosinophilic granules)
Vomiting blood following esophagogastric lacerations
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Slow progressive muscle weakness in boys
Oscillating slow / fast breathing

28. MS (Charcot's)
Rusty sputum
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Urethritis - conjunctivitis - arthritis in a male
Polished - ivory- like appearance of bone at cartilage erosion

29. Ghon complex (1* TB)
Iron - containing nodules in alveolar septum
Thyroid - like appearance of kidney
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Gout - MR - self - mutilating behavior in a boy

30. 1. Multiple myeloma (M protein - IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (aging) 3. Waldenstrom's macroglobulinemia (IgM) 4. Primary amyloidosis
Degeneration of dorsal column nerves
microcytic anemia (parasite)
Monoclonal antibody spike
Oscillating slow / fast breathing

31. VIrchow's node (abdominal met)
Enlarged. hard left supraclavicular node
Hypercoagulability leading to thrombophlebitis
Rib notching
Caf

32. SLE (type III hypersensitivity)
Anticentromere antibodies
Skin hyperpigmentation
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Antinuclear antibodies

33. Turner syndrome (X0 - short stature - webbed neck - lymphedema)
Elastic skin - hypermobility of joints
Streak ovaries - congenital heart disease - horseshoe kidney
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration

34. Iron deficiency anemia - lead poisoning - thalassemia (HbF sometimes present)
Necrotizing vasculitis (lungs) and necrotizing GN
Hypochromic - microcytic anemia
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Toe extension / fanning upon plantar scrape

35. Tay- Sachs - Niemann - Pick - central retinal artery occlusion
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Skin hyperpigmentation
Cherry- red spot on macula
Painful - pale - cold fingers / toes

36. Echinococcus granulosus
Hypochromic - microcytic anemia
Enlarged. hard left supraclavicular node
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
liver cysts (parasite)

37. Acute pyelo
Azurophilic granular needles in leukemic blasts
Severe RLQ pain with rebound tenderness
WBC casts in urine
B12 deficiency (parasite)

38. Hemangioma (benign - associated with Sturge - Weber syndrome - in which case it's V1 distribution)
Thyroid - like appearance of kidney
Retinal hemorrhages with pale centers
Vascular birthmark (port - wine stain)
Hereditary nephritis - sensorineural hearing loss - cataracts

39. Lesch - Nyhan syndrome (HGPRT deficiency - X- linked recessive)
Gout - MR - self - mutilating behavior in a boy
Chest pain - pericardial effusion/friction rub - persistent fever following MI
Calf pseudohypertrophy
Iron - containing nodules in alveolar septum

40. Pick bodies
Dark purple skin / mouth nodules
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Wire loop glomerular appearance on LM
Silver - staining spherical aggregation of tau proteins in neurons

41. Condylomata lata (2* syphilis)
Smooth - flat - moist white lesions on genitals
brain cysts - seizures (parasite)
Bilateral hilar adenopathy - uveitis
Tram - track on LM

42. GBM (cells may be called 'serpentine')
Nodular hyaline deposits in glomeruli
Heart nodules (inflammatory)
Pseudopalisading tumor cells on brain biopsy
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

43. Fanconi's anemia (esp AML)
Fat - female - fertile - forty
Streak ovaries - congenital heart disease - horseshoe kidney
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Antihistone antibodies

44. Schiller - Duval bodies (yolk sac tumor)
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Eosinophilic cytoplasmic inclusion in nerve cell
Glomerulus - like structure surrounding vessel in germ cells
Resting tremor - rigidity - akinesia - postural instability

45. USMLE Step 1 (or subarachnoid hemorrhage)
Worst headache of my life
Red 'current jelly' sputum in alcoholic or diabetic patients
Cutaneous/dermal edema due to CT expansion
Hereditary nephritis - sensorineural hearing loss - cataracts

46. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Fever - night sweats - weight loss
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Vomiting blood following esophagogastric lacerations
Desquamated epithelium casts in sputum

47. Megaloblastic anemia (B12 - folate deficiency)
Thrombi made of white/red layers
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Hypersegmented neutrophils
Gout - MR - self - mutilating behavior in a boy

48. Rouleax formation (high ESR - multiple myeloma)
Dry eyes - dry mouth - arthritis
Antidesmoglein (epithelial) antibodies
Stacks of RBCs
Splinter hemorrhages in fingernails

49. Bacterial endocarditis
Splinter hemorrhages in fingernails
RBC casts in urine
Fat - female - fertile - forty
Antinuclear antibodies

50. Guillain - Barre syndrome
Nutmeg liver
Monoclonal antibody spike
Child uses arms to stand up from squat
Rapidly progressive leg weakness that ascend - following GI infection