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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. Erb - Duchenne palsy
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age

2. Myxedema
Calf pseudohypertrophy
Cherry- red spot on macula
Cutaneous/dermal edema due to CT expansion
Severe jaundice in neonate

3. Parkinson's
Thrombi made of white/red layers
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Resting tremor - rigidity - akinesia - postural instability
Yellow CSF

4. Pick bodies
Silver - staining spherical aggregation of tau proteins in neurons
Resting tremor - rigidity - akinesia - postural instability
Bamboo spine on X- ray
Weight loss - diarrhea - arthritis - fever - adenopathy

5. Orphan Annie nuclei - or 'disbursed chromatin' (papillary carcinoma of the thyroid)
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Enlarged thyroid cells with ground - glass nuclei
Chocolate cyst of ovary
Heterophile antibodies

6. Osler's node (infective endocarditis)
Slow progressive muscle weakness in boys
Anti - topoisomerase antibodies
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Painful - raised red lesions on palms and soles

7. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Unilateral facial drooping involving forehead
Resting tremor - rigidity - akinesia - postural instability
Gout - MR - self - mutilating behavior in a boy
Green -yellow rings around peripheral iris

8. Enterobius
Antinuclear antibodies
Large lysosomal vesicles in phagocytes - immunodeficiency
perianal pruritis (parasite)
Sudden swollen/painful big toe joint - tophi

9. Chronic passive congestion of the liver due to right heart failure
Hypoxemia - polycythemia - hypercapnia
Bilateral hilar adenopathy - uveitis
Nutmeg liver
liver cysts (parasite)

10. Bibeck granules (histiocytosis X: eosinophilic granuloma)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Fibrous plaques in soft tissue of penis
hematuria - bladder cancer (parasite)
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)

11. Neurofibrillary tangles (Alzheimer's and CJD)
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Silver - staining spherical aggregation of tau proteins in neurons
Bamboo spine on X- ray
Protein aggregates in neurons from hyperphosphorylation of tau protein

12. Rouleax formation (high ESR - multiple myeloma)
Stacks of RBCs
Rash on palms and soles
Bronchogenic apical lung tumor
hematuria - bladder cancer (parasite)

13. Scarlet fever - Kawasaki disease - TSS
Bloody tap on LP
Strawberry tongue
B12 deficiency (parasite)
Chronic exercise intolerance with myalgia - fatigue - painful cramps

14. SLE (type III hypersensitivity)
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Silver - staining spherical aggregation of tau proteins in neurons
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Antinuclear antibodies

15. Pseudogout
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Cardiomegaly with apical atrophy
Antiplatelet antibodies
Rhomboid crystals - positively birefringent

16. Niemann - Pick disease (genetic sphingomyelinase deficiency)
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Increased uric acid levels
Thumb sign on lateral X- ray

17. Subarachnoid hemorrhage
Rapidly progressive leg weakness that ascend - following GI infection
Thumb sign on lateral X- ray
Bloody tap on LP
Thrombi made of white/red layers

18. Xanthochromia (subarachnoid hemorrhage)
Heterophile antibodies
Cutaneous/dermal edema due to CT expansion
Mucin - filled cell with peripheral nucleus
Yellow CSF

19. B symptoms or TB
High level of D dimers
Fever - night sweats - weight loss
Desquamated epithelium casts in sputum
Stippled vaginal epithelial cells

20. Ancylostoma - Necator (hook worms)
microcytic anemia (parasite)
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Hypersegmented neutrophils
Desquamated epithelium casts in sputum

21. Giant cell tumor of bone (generally benign)
Palpable purpura - joint pain - abdominal pain in a child
Anticentromere antibodies
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Soap bubble in femur or tibia on X- ray

22. Babinski (UMN lesion)
Child with fever develops red rash on face that spreads to body
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Enlarged thyroid cells with ground - glass nuclei
Toe extension / fanning upon plantar scrape

23. Gout/podagra (hyperuricemia)
Sudden swollen/painful big toe joint - tophi
Pink complexion - dypnea - hyperventilation
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age

24. MEN 2A (Sipple)
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Green -yellow rings around peripheral iris
Eosinophilic cytoplasmic inclusion in nerve cell
Polyuria - acidosis - growth failure - electrolyte imbalances

25. Raynaud's syndrome (vasospasm)
Painful - pale - cold fingers / toes
Heart nodules (inflammatory)
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Smooth - flat - moist white lesions on genitals

26. Chvostek's sign (hypocalcemia)
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Heterophile antibodies
Anti - IgG antibodies
Facial muscle spasm upon tapping

27. SLE nephropathy
WBCs that look smudged
Bilateral hilar adenopathy - uveitis
Wire loop glomerular appearance on LM
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

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

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29. Koplick spots (measles)
Small - irregular red spots on buccal mucosa with blue - white centers
Spikes on basement membrane - dome - like endothelial deposits
Heterophile antibodies
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age

30. Bell's palsy (LMN CN VII)
High level of D dimers
Disarrayed granulosa cells in eosinophilic fluid
Athlete with polycythemia
Unilateral facial drooping involving forehead

31. Charcot's triad (ascending cholangitis)
biliary tract disease - cholangiocarcinoma (parasite)
Small - irregular red spots on buccal mucosa with blue - white centers
Jaundice - RUQ pain - fever
Indurated - ulcerated genital lesion

32. 'b - thalassemia - sickle cell anemia (extramedullary hematopoiesis). ''Hair on end'' means marrow expansion (skull)
Adrenal hemorrhage - hypotension - DIC
Cellular crescents in Bowman's capsule
Hair - on - end (crewcut) appearance on X- ray
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells

33. RA (systemic inflammation - joint pannus - boutonniere deformity) - IgM anti IgG
Tram - track on LM
Anti - IgG antibodies
Yellow CSF
No lactation postpartum - absent menstruation - cold intolerance

34. Sheehan's syndrome
WBCs that look smudged
Hypercoagulability leading to thrombophlebitis
No lactation postpartum - absent menstruation - cold intolerance
Fibrous plaques in soft tissue of penis

35. Chagas disease (Trypanosoma cruzi)
Cardiomegaly with apical atrophy
Child with fever develops red rash on face that spreads to body
Severe jaundice in neonate
Necrotizing vasculitis (lungs) and necrotizing GN

36. Tetralogy of Fallot - RVH
Antidesmoglein (epithelial) antibodies
Heart nodules (inflammatory)
Boot - shaped heart on X- ray
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

37. Alport's syndrome (type IV collagen)
Monoclonal globulin protein in blood/urine
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Hereditary nephritis - sensorineural hearing loss - cataracts
Enlarged thyroid cells with ground - glass nuclei

38. Idiopathic thrombocytopenic purpura (ITP - bleeding diathesis)
Athlete with polycythemia
Antiplatelet antibodies
Heterophile antibodies
Child uses arms to stand up from squat

39. Sjogren's syndrome
Podocyte fusion on EM
Disarrayed granulosa cells in eosinophilic fluid
Dry eyes - dry mouth - arthritis
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance

40. Diphyllobothrium latum
Antidesmoglein (epithelial) antibodies
Soap bubble in femur or tibia on X- ray
B12 deficiency (parasite)
Onion - skin periosteal reaction

41. Codman's triangle on X- ray (osteosarcoma - Ewing's - pyogenic osteomyelitis)
Needle - shaped - negatively birefringent crystals
Periosteum raised from bone - creating triangular area
Depigmentation of neurons in substantia nigra
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)

42. Erythropoietin injection
Jaundice - RUQ pain - fever
Athlete with polycythemia
Heart nodules (inflammatory)
Chronic exercise intolerance with myalgia - fatigue - painful cramps

43. Cold agglutinin disease (autoimmune from Mp or mono - from IgM)
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Painful blue fingers / toes - hemolytic anemia
Anti - topoisomerase antibodies
Hair - on - end (crewcut) appearance on X- ray

44. Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to hyperparathyroidism or osteitis fibrosa cystica
Enlarged cells with intranuclear inclusion bodies
Necrotizing vasculitis (lungs) and necrotizing GN
Cellular crescents in Bowman's capsule
Brown tumor of bone

45. Gardner's syndrome
Resting tremor - rigidity - akinesia - postural instability
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
High level of D dimers
Protein aggregates in neurons from hyperphosphorylation of tau protein

46. Condylomata lata (2* syphilis)
Smooth - flat - moist white lesions on genitals
High level of D dimers
Soap bubble in femur or tibia on X- ray
Sudden swollen/painful big toe joint - tophi

47. Paget's
Swollen - hard - painful finger joints
Red 'current jelly' sputum in alcoholic or diabetic patients
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Honeycomb lung on X- ray

48. Sarcoid
Circular grouping of dark tumor cells surrounding pale neurofibrils
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration
Lucid interval after TBI
Bilateral hilar adenopathy - uveitis

49. Kartagener's syndrome (dynein)
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Necrotizing vasculitis (lungs) and necrotizing GN
portal hypertension (parasite)
Slow progressive muscle weakness in boys

50. Ewing's sarcoma (malignant round cell tumor)
Degeneration of dorsal column nerves
Severe RLQ pain with rebound tenderness
Antidesmoglein (epithelial) antibodies
Onion - skin periosteal reaction