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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. Measles
Unilateral facial drooping involving forehead
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Sheets of medium - sized lymphoid cells (starry sky)
HTN - hypoK - metabolic alkalosis

2. Ancylostoma - Necator (hook worms)
microcytic anemia (parasite)
Spikes on basement membrane - dome - like endothelial deposits
Eosinophilic globule in liver
Mammary gland (blue - domed) cyst

3. Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
Desquamated epithelium casts in sputum
Mammary gland (blue - domed) cyst
Mucosal bleeding and prolonged bleeding time
Anti - transglutaminase/antigliadin/anti - endomysial antibodies

4. 'b - thalassemia - sickle cell anemia (extramedullary hematopoiesis). ''Hair on end'' means marrow expansion (skull)
Hair - on - end (crewcut) appearance on X- ray
Pupil accommodates but doesn't react
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Degeneration of dorsal column nerves

5. DVT - PE - DIC - Budd - Chiari (D dimer is fibrin breakdown products)
Smooth - flat - moist white lesions on genitals
High level of D dimers
Protein aggregates in neurons from hyperphosphorylation of tau protein
Monoclonal globulin protein in blood/urine

6. Diffuse systemic scleroderma
Nodular hyaline deposits in glomeruli
Anti - topoisomerase antibodies
Keratin pearls
Swollen - hard - painful finger joints

7. MEN 2A (Sipple)
Rusty sputum
Onion - skin periosteal reaction
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Sheets of medium - sized lymphoid cells (starry sky)

8. Pick bodies
Silver - staining spherical aggregation of tau proteins in neurons
Fever - night sweats - weight loss
Azurophilic granular needles in leukemic blasts
Infant with hypoglycemia - failure to thrive - and hepatomegaly

9. Aortic regurg
Eosinophilic cytoplasmic inclusion in liver cell
Red 'current jelly' sputum in alcoholic or diabetic patients
Blue sclera
Bounding pulses - diastolic hear murmur - head bobbing

10. Familial hypercholesterolemia
Stippled vaginal epithelial cells
Achilles tendon xanthoma
Rapidly progressive leg weakness that ascend - following GI infection
Streak ovaries - congenital heart disease - horseshoe kidney

11. Turner syndrome (X0 - short stature - webbed neck - lymphedema)
Dog or cat bite resulting in infection
Child with fever develops red rash on face that spreads to body
Streak ovaries - congenital heart disease - horseshoe kidney
Hereditary nephritis - sensorineural hearing loss - cataracts

12. Pompe's disease (lysosomal glucosidase deficiency)
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
perianal pruritis (parasite)
Azurophilic granular needles in leukemic blasts
Back pain - fever - night sweats - weight loss

13. Crigler - Najjar syndrome (congenital unconj hyper bilirubinemia)
Enlarged. hard left supraclavicular node
Stippled vaginal epithelial cells
Painless erythematous lesions on palms and soles
Severe jaundice in neonate

14. Neurofibrillary tangles (Alzheimer's and CJD)
Nodular hyaline deposits in glomeruli
Painless jaundice
Protein aggregates in neurons from hyperphosphorylation of tau protein
Conjugate lateral gaze palsy - horizontal diplopia

15. Xanthochromia (subarachnoid hemorrhage)
Yellow CSF
Thyroid - like appearance of kidney
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Anticentromere antibodies

16. Tetralogy of Fallot - RVH
Boot - shaped heart on X- ray
Vomiting blood following esophagogastric lacerations
Eosinophilic globule in liver
Calf pseudohypertrophy

17. Edward's syndrome (Trisomy 18)
WBC casts in urine
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
WBCs that look smudged
Hair - on - end (crewcut) appearance on X- ray

18. Condylomata lata (2* syphilis)
Smooth - flat - moist white lesions on genitals
Increased a - fetoprotein in amniotic fluid / maternal serum
Podocyte fusion on EM
Tram - track on LM

19. Niemann - Pick disease (genetic sphingomyelinase deficiency)
Unilateral facial drooping involving forehead
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Bounding pulses - diastolic hear murmur - head bobbing
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

20. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Dermatitis - dementia - diarrhea
Deep - labored breathing / hyperventilation
Dilated cardiomyopathy - edema - polyneuropathy
Green -yellow rings around peripheral iris

21. Cowdry type A bodies (HSV or CMV)
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Intranuclear eosinophilic droplet - like bodies
Swollen gums - mucous bleeding - poor wound healing - spots on skin

22. Plummer - Vinson syndrome
No lactation postpartum - absent menstruation - cold intolerance
Painful blue fingers / toes - hemolytic anemia
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Calf pseudohypertrophy

23. Paragonimus westermani
Intranuclear eosinophilic droplet - like bodies
Degeneration of dorsal column nerves
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
hemoptysis (parasite)

24. Hemangioma (benign - associated with Sturge - Weber syndrome - in which case it's V1 distribution)
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Vascular birthmark (port - wine stain)
Dermatitis - dementia - diarrhea

25. Shwartzman reaction (follows second exposure to endotoxin)
brain cysts - seizures (parasite)
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Dilated cardiomyopathy - edema - polyneuropathy
Vasculitis from exposure to endotoxin casuing glomerular thrombosis

26. Infectious mono (HBV). IgM that agglutinates sheep RBCs
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Heterophile antibodies
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Fat - female - fertile - forty

27. B symptoms or TB
Fever - night sweats - weight loss
Yellow CSF
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
portal hypertension (parasite)

28. Coarctation of the aorta
Rib notching
Current jelly stool
hemoptysis (parasite)
Large lysosomal vesicles in phagocytes - immunodeficiency

29. Wet beriberi (B1 / thiamine deficiency)
Unilateral facial drooping involving forehead
Sheets of medium - sized lymphoid cells (starry sky)
Sudden swollen/painful big toe joint - tophi
Dilated cardiomyopathy - edema - polyneuropathy

30. Acute toxic/viral nephrosis
Increased a - fetoprotein in amniotic fluid / maternal serum
Mucin - filled cell with peripheral nucleus
Thumb sign on lateral X- ray
Renal epithelial casts in urine

31. Von Hippel - Lindau diease
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
High level of D dimers
Athlete with polycythemia
Hyperphagia - hypersexuality - hyperorality - hyperdocility

32. Celiac (diarrhea - distention - weight loss)
hCG elevated
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Pupil accommodates but doesn't react
Antihistone antibodies

33. Reiter's syndrome (reactive arthritis associated with HLA B27)
Urethritis - conjunctivitis - arthritis in a male
Disarrayed granulosa cells in eosinophilic fluid
Recurrent colds - unusual eczema - high serum IgE
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth

34. Echinococcus granulosus
liver cysts (parasite)
Enlarged cells with intranuclear inclusion bodies
WBC casts in urine
Desquamated epithelium casts in sputum

35. Pancoast tumor (can cause Horner's)
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Bronchogenic apical lung tumor
Heterophile antibodies
Bilateral hilar adenopathy - uveitis

36. Burton's line - lead poisoning
Smooth - flat - moist white lesions on genitals
Bloody tap on LP
Bluish line on gingiva
Swollen gums - mucous bleeding - poor wound healing - spots on skin

37. Scleroderma (CREST)
Anticentromere antibodies
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Antinuclear antibodies
Gout - MR - self - mutilating behavior in a boy

38. Lines of Zahn (arterial thrombus - layers of platelets/RBCs)
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Thrombi made of white/red layers
Cherry- red spot on macula
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration

39. Eburnation (OA resulting in bony sclerosis)
Polished - ivory- like appearance of bone at cartilage erosion
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Basophilic nuclear remnants in RBCs
Mammary gland (blue - domed) cyst

40. RA (systemic inflammation - joint pannus - boutonniere deformity) - IgM anti IgG
Antimitochondrial antibodies
biliary tract disease - cholangiocarcinoma (parasite)
Resting tremor - rigidity - akinesia - postural instability
Anti - IgG antibodies

41. Osler's node (infective endocarditis)
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Honeycomb lung on X- ray
Painful - raised red lesions on palms and soles
WBCs that look smudged

42. Kluver - Bucy syndrome (bilateral amygdala)
Hereditary nephritis - sensorineural hearing loss - cataracts
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Infant with hypoglycemia - failure to thrive - and hepatomegaly

43. Sheehan's syndrome
Hypoxemia - polycythemia - hypercapnia
Low serum ceruloplasmin
Cold intolerance
No lactation postpartum - absent menstruation - cold intolerance

44. CF
Lytic (punched - out) bone lesions on X- ray
Yellow CSF
Colonies of mucoid Pseudomonas in lungs
Necrotizing vasculitis (lungs) and necrotizing GN

45. Sarcoid
Achilles tendon xanthoma
Bilateral hilar adenopathy - uveitis
Recurrent colds - unusual eczema - high serum IgE
Hair - on - end (crewcut) appearance on X- ray

46. Ewing's sarcoma (malignant round cell tumor)
Onion - skin periosteal reaction
Red - itchy - swollen rash of nipple/areola
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Adrenal hemorrhage - hypotension - DIC

47. Gout - Lesch - Nyhan syndrome - tumor lysis syndrome - loop and thiazide diuretics
Disarrayed granulosa cells in eosinophilic fluid
Increased uric acid levels
Achilles tendon xanthoma
Cherry- red spot on macula

48. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Vomiting blood following esophagogastric lacerations
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Systolic ejection murmur (crescendo - decrescendo)

49. SLE nephropathy
Boot - shaped heart on X- ray
Rusty sputum
Antihistone antibodies
Wire loop glomerular appearance on LM

50. Tabes dorsalis - lose proprioception (3* syphilis)
Degeneration of dorsal column nerves
Eosinophilic cytoplasmic inclusion in nerve cell
Enlarged cells with intranuclear inclusion bodies
Monoclonal antibody spike