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Test your basic knowledge |

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. McBurney's sign
Severe RLQ pain with rebound tenderness
perianal pruritis (parasite)
Dry eyes - dry mouth - arthritis
Protein aggregates in neurons from hyperphosphorylation of tau protein

2. Conn's (1* hyperaldosterone)
Splinter hemorrhages in fingernails
HTN - hypoK - metabolic alkalosis
Elastic skin - hypermobility of joints
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells

3. CF
Rapidly progressive leg weakness that ascend - following GI infection
Painless erythematous lesions on palms and soles
Painful - raised red lesions on palms and soles
Colonies of mucoid Pseudomonas in lungs

4. Internuclear ophthalmoplegia (MS or stroke)
Conjugate lateral gaze palsy - horizontal diplopia
Low serum ceruloplasmin
Thyroid - like appearance of kidney
Worst headache of my life

5. Pseudogout
Red urine in the morning - fragile RBCs
Lucid interval after TBI
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Rhomboid crystals - positively birefringent

6. Bruton's disease (X- linked agammaglobulinemia)
Male child - recurrent infections - no mature B cells
Keratin pearls
Cutaneous/dermal edema due to CT expansion
Cardiomegaly with apical atrophy

7. Ehler - Danlos (type III collagen)
Enlarged. hard left supraclavicular node
Elastic skin - hypermobility of joints
Fever - night sweats - weight loss
Cherry- red spot on macula

8. Kussmaul breathing - DKA
liver cysts (parasite)
Deep - labored breathing / hyperventilation
Adrenal hemorrhage - hypotension - DIC
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth

9. Giant cell tumor of bone (generally benign)
Recurrent colds - unusual eczema - high serum IgE
Soap bubble in femur or tibia on X- ray
Slow progressive muscle weakness in boys
Spikes on basement membrane - dome - like endothelial deposits

10. Intussesseption
Thrombi made of white/red layers
Iron - containing nodules in alveolar septum
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Current jelly stool

11. Familial hypercholesterolemia
Glomerulus - like structure surrounding vessel in germ cells
Achilles tendon xanthoma
Painful - raised red lesions on palms and soles
Eosinophilic cytoplasmic inclusion in liver cell

12. Gout - Lesch - Nyhan syndrome - tumor lysis syndrome - loop and thiazide diuretics
Cold intolerance
Circular grouping of dark tumor cells surrounding pale neurofibrils
Gout - MR - self - mutilating behavior in a boy
Increased uric acid levels

13. Bacterial endocarditis
Small - irregular red spots on buccal mucosa with blue - white centers
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Splinter hemorrhages in fingernails
Continuous machinery heart murmur

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

15. Kayser - Fleischer rings (copper accumulation from Wilson's disease)
Indurated - ulcerated genital lesion
Chocolate cyst of ovary
Green -yellow rings around peripheral iris
RBC casts in urine

16. Aortic valve stenosis
Mucin - filled cell with peripheral nucleus
Systolic ejection murmur (crescendo - decrescendo)
Colonies of mucoid Pseudomonas in lungs
Antinuclear antibodies

17. OA (osteophytes on PIP (Bouchard) and DIP (Heberden)
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Intranuclear eosinophilic droplet - like bodies
Swollen - hard - painful finger joints
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia

18. Simian crease (Down's)
Necrotizing vasculitis (lungs) and necrotizing GN
Single palm crease
Low serum ceruloplasmin
Branching gram + rods with sulfur granules

19. Gower's sign (Duchenne's)
Facial muscle spasm upon tapping
Dark purple skin / mouth nodules
Child uses arms to stand up from squat
Single palm crease

20. Acute pyelo
Basophilic stipplling of RBCs
Facial muscle spasm upon tapping
Achilles tendon xanthoma
WBC casts in urine

21. Koilocytes (HPV) 'perrinuclear cytoplasmic clearing'
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Brown tumor of bone
hematuria - bladder cancer (parasite)
Hypochromic - microcytic anemia

22. Actinomyces israelii
Hypersegmented neutrophils
Red - itchy - swollen rash of nipple/areola
Narrowing of bowel lumen on barium radiograph
Branching gram + rods with sulfur granules

23. MEN 2A (Sipple)
Silver - staining spherical aggregation of tau proteins in neurons
Situs inversus - chronic sinusitis - bronchiectasis - infertility
WBCs that look smudged
Thyroid (medullary) and parathyroid tumors - pheochromocytoma

24. Reiter's syndrome (reactive arthritis associated with HLA B27)
Antineutrophil cytoplasmic antibodies (ANCA)
Urethritis - conjunctivitis - arthritis in a male
Red 'current jelly' sputum in alcoholic or diabetic patients
Disarrayed granulosa cells in eosinophilic fluid

25. Condylomata lata (2* syphilis)
Thyroid - like appearance of kidney
Child uses arms to stand up from squat
biliary tract disease - cholangiocarcinoma (parasite)
Smooth - flat - moist white lesions on genitals

26. Membranoproliferative glomerulonephritis
Eosinophilic globule in liver
Tram - track on LM
Slow progressive muscle weakness in boys
Red - itchy - swollen rash of nipple/areola

27. Lewy body (Parkinson's)
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Enlarged cells with intranuclear inclusion bodies
Rash on palms and soles
Eosinophilic cytoplasmic inclusion in nerve cell

28. 2* syphilis - Rocky Mountain spotted fever - coxsackie A
Child with fever develops red rash on face that spreads to body
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Rash on palms and soles
Large lysosomal vesicles in phagocytes - immunodeficiency

29. Myxedema
Cutaneous/dermal edema due to CT expansion
liver cysts (parasite)
Increased a - fetoprotein in amniotic fluid / maternal serum
Painless erythematous lesions on palms and soles

30. Gallstones
Blue sclera
Fat - female - fertile - forty
Child with fever develops red rash on face that spreads to body
No lactation postpartum - absent menstruation - cold intolerance

31. Ghon complex (1* TB)
Bamboo spine on X- ray
Renal epithelial casts in urine
Waxy casts with very low urine flow
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

32. Cancer at head of pancreas obstructing bile duct
Small - irregular red spots on buccal mucosa with blue - white centers
Hereditary nephritis - sensorineural hearing loss - cataracts
Blue sclera
Painless jaundice

33. Duchenne's muscular dystrophy
Calf pseudohypertrophy
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Pupil accommodates but doesn't react
Hexagonal - double - pointed - needle - like crystals in bronchial secretions

34. Poststrep glomerulonephritis (IgG and C3b deposition)
Achilles tendon xanthoma
Lumpy- bumpy appearance of glomeruli on immunofluorescence
Heterophile antibodies
Monoclonal antibody spike

35. Koplick spots (measles)
Urethritis - conjunctivitis - arthritis in a male
Small - irregular red spots on buccal mucosa with blue - white centers
Heterophile antibodies
Fibrous plaques in soft tissue of penis

36. Pellagra (B3 / niacin deficiency)
Large rash with bull's eye appearance
Dermatitis - dementia - diarrhea
Jaundice - RUQ pain - fever
Painless jaundice

37. Huntington's
Chorea - dementia - caudate degeneration
Sheets of medium - sized lymphoid cells (starry sky)
Brown tumor of bone
Tram - track on LM

38. Pancoast tumor (can cause Horner's)
Large lysosomal vesicles in phagocytes - immunodeficiency
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Bronchogenic apical lung tumor
Enlarged thyroid cells with ground - glass nuclei

39. Sezary syndrome (cutaneous T cell lymphoma)
Strawberry tongue
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Anticentromere antibodies
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells

40. Guillain - Barre syndrome
Hypochromic - microcytic anemia
Rapidly progressive leg weakness that ascend - following GI infection
Male child - recurrent infections - no mature B cells
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

41. Lead poisoning or sideroblastic anemia
Circular grouping of dark tumor cells surrounding pale neurofibrils
WBCs that look smudged
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Basophilic stipplling of RBCs

42. Lines of Zahn (arterial thrombus - layers of platelets/RBCs)
Basophilic stipplling of RBCs
Small - irregular red spots on buccal mucosa with blue - white centers
brain cysts - seizures (parasite)
Thrombi made of white/red layers

43. Pemphigus vulgaris (blistering)
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Desquamated epithelium casts in sputum
Antidesmoglein (epithelial) antibodies
Mucosal bleeding and prolonged bleeding time

44. Ancylostoma - Necator (hook worms)
Lucid interval after TBI
Smooth - flat - moist white lesions on genitals
microcytic anemia (parasite)
Cutaneous/dermal edema due to CT expansion

45. Addison's
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Adrenal hemorrhage - hypotension - DIC
Skin hyperpigmentation
Spikes on basement membrane - dome - like endothelial deposits

46. Chediak - Higashi disease (congenital failure of phagolysosome formation)
Waxy casts with very low urine flow
Pseudopalisading tumor cells on brain biopsy
Dilated cardiomyopathy - edema - polyneuropathy
Large lysosomal vesicles in phagocytes - immunodeficiency

47. Budd - Chiari syndrome
Rhomboid crystals - positively birefringent
Antiplatelet antibodies
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Vomiting blood following esophagogastric lacerations

48. Curschmann's spirals (bronchial asthma - can result in whorled mucous plugs)
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Desquamated epithelium casts in sputum
Hypochromic - microcytic anemia
Fever - night sweats - weight loss

49. Minimal change disease (child - nephrotic)
Iron - containing nodules in alveolar septum
microcytic anemia (parasite)
Podocyte fusion on EM
Onion - skin periosteal reaction

50. Gout
Needle - shaped - negatively birefringent crystals
Soap bubble in femur or tibia on X- ray
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Pseudopalisading tumor cells on brain biopsy