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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. Parkinson's
Depigmentation of neurons in substantia nigra
Antineutrophil cytoplasmic antibodies (ANCA)
Painless erythematous lesions on palms and soles
Dark purple skin / mouth nodules

2. String sign (Crohn's)
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Narrowing of bowel lumen on barium radiograph
Calf pseudohypertrophy
hematuria - bladder cancer (parasite)

3. Iron deficiency anemia - lead poisoning - thalassemia (HbF sometimes present)
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Green -yellow rings around peripheral iris
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Hypochromic - microcytic anemia

4. Clue cells (Gardenella vaginalis)
Antidesmoglein (epithelial) antibodies
Tram - track on LM
Stippled vaginal epithelial cells
Pink complexion - dypnea - hyperventilation

5. Von Hippel - Lindau diease
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
AntiGBM antibodies
Soap bubble in femur or tibia on X- ray

6. Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to hyperparathyroidism or osteitis fibrosa cystica
Disarrayed granulosa cells in eosinophilic fluid
Mammary gland (blue - domed) cyst
Mucin - filled cell with peripheral nucleus
Brown tumor of bone

7. 1. Bence Jones proteins (multiple myeloma - kappa or lambda light chains in urine) 2. Waldenstrom's macroglobulinemia (IgM)
Monoclonal globulin protein in blood/urine
Child uses arms to stand up from squat
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Current jelly stool

8. Ehler - Danlos (type III collagen)
Elastic skin - hypermobility of joints
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Glomerulus - like structure surrounding vessel in germ cells
Monoclonal globulin protein in blood/urine

9. Waterhouse - Friderichsen syndrome (meningococcemia)
Heart nodules (inflammatory)
Bloody tap on LP
WBC casts in urine
Adrenal hemorrhage - hypotension - DIC

10. Turner syndrome (X0 - short stature - webbed neck - lymphedema)
Dilated cardiomyopathy - edema - polyneuropathy
Streak ovaries - congenital heart disease - horseshoe kidney
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Splinter hemorrhages in fingernails

11. Schistosoma mansoni
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
portal hypertension (parasite)
Pupil accommodates but doesn't react
Blue sclera

12. Aschoff bodies = focal myocardial inflammation with giant cells (rheumatic fever)
Heart nodules (inflammatory)
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Urethritis - conjunctivitis - arthritis in a male
Bronchogenic apical lung tumor

13. CLL (almost always B cell - affects the elderly)
Eosinophilic globule in liver
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Eosinophilic cytoplasmic inclusion in nerve cell
WBCs that look smudged

14. Kartagener's syndrome (dynein)
Pupil accommodates but doesn't react
Mucosal bleeding and prolonged bleeding time
Situs inversus - chronic sinusitis - bronchiectasis - infertility
Hexagonal - double - pointed - needle - like crystals in bronchial secretions

15. Slapped cheek - B19
Child with fever develops red rash on face that spreads to body
Hypochromic - microcytic anemia
Urethritis - conjunctivitis - arthritis in a male
Circular grouping of dark tumor cells surrounding pale neurofibrils

16. Rapidly progressive crescentic glomerulonephritis

17. Drug - induced SLE (hydralazine - isoniazid - phenytoin - procainamide)
Bronchogenic apical lung tumor
Antihistone antibodies
Cutaneous/dermal edema due to CT expansion
Dog or cat bite resulting in infection

18. Gardner's syndrome
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Green -yellow rings around peripheral iris
Streak ovaries - congenital heart disease - horseshoe kidney
Painful - pale - cold fingers / toes

19. Mallory- Weiss syndrome (alcoholic and bulimic patients)
Weight loss - diarrhea - arthritis - fever - adenopathy
Current jelly stool
Vomiting blood following esophagogastric lacerations
B12 deficiency (parasite)

20. Homer Wright rosettes (adrenal neuroblastoma - medulloblastoma - Ewing's sarcoma)
microcytic anemia (parasite)
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells
Circular grouping of dark tumor cells surrounding pale neurofibrils
Mucosal bleeding and prolonged bleeding time

21. Codman's triangle on X- ray (osteosarcoma - Ewing's - pyogenic osteomyelitis)
Periosteum raised from bone - creating triangular area
Narrowing of bowel lumen on barium radiograph
Eosinophilic cytoplasmic inclusion in liver cell
Keratin pearls

22. Kussmaul breathing - DKA
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Enlarged. hard left supraclavicular node
Deep - labored breathing / hyperventilation
Needle - shaped - negatively birefringent crystals

23. CF
Colonies of mucoid Pseudomonas in lungs
Cherry- red spot on macula
Current jelly stool
Gout - MR - self - mutilating behavior in a boy

24. McBurney's sign
Needle - shaped - negatively birefringent crystals
Severe RLQ pain with rebound tenderness
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Heart nodules (inflammatory)

25. Epidural hematoma (middle meningeal artery)
Oscillating slow / fast breathing
Lucid interval after TBI
Painful - raised red lesions on palms and soles
Vomiting blood following esophagogastric lacerations

26. Babinski (UMN lesion)
Resting tremor - rigidity - akinesia - postural instability
Continuous machinery heart murmur
Basophilic nuclear remnants in RBCs
Toe extension / fanning upon plantar scrape

27. MEN 2A (Sipple)
Painful blue fingers / toes - hemolytic anemia
Cellular crescents in Bowman's capsule
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
Facial muscle spasm upon tapping

28. Pick bodies
Keratin pearls
Silver - staining spherical aggregation of tau proteins in neurons
AntiGBM antibodies
Calf pseudohypertrophy

29. Bibeck granules (histiocytosis X: eosinophilic granuloma)
Strawberry tongue
Degeneration of dorsal column nerves
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Heterophile antibodies

30. Whipple's disease (Tropheryma whippelii)
Weight loss - diarrhea - arthritis - fever - adenopathy
Waxy casts with very low urine flow
Enlarged thyroid cells with ground - glass nuclei
Continuous machinery heart murmur

31. Jarisch - Herxheimer reaction (lysis of spirochetes results in toxin release)
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Spikes on basement membrane - dome - like endothelial deposits
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

32. Sezary syndrome (cutaneous T cell lymphoma)
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Fever - night sweats - weight loss
Rectangular - crystal - like - cytoplasmic inclusions in Leydig cells

33. Chvostek's sign (hypocalcemia)
Soap bubble in femur or tibia on X- ray
Resting tremor - rigidity - akinesia - postural instability
Facial muscle spasm upon tapping
Basophilic stipplling of RBCs

34. Paget's
Cardiomegaly with apical atrophy
Urethritis - conjunctivitis - arthritis in a male
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Splinter hemorrhages in fingernails

35. Trousseau's sign (adenocarcinoma of pancreas or lung)
Monoclonal globulin protein in blood/urine
Hypercoagulability leading to thrombophlebitis
Dilated cardiomyopathy - edema - polyneuropathy
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma

36. Simian crease (Down's)
Single palm crease
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Painful blue fingers / toes - hemolytic anemia
Basophilic stipplling of RBCs

37. Lesch - Nyhan syndrome (HGPRT deficiency - X- linked recessive)
Gout - MR - self - mutilating behavior in a boy
Achilles tendon xanthoma
Cherry- red spot on macula
No lactation postpartum - absent menstruation - cold intolerance

38. Scurvy (vit C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
Glomerulus - like structure surrounding vessel in germ cells
RBC casts in urine
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Eosinophilic cytoplasmic inclusion in nerve cell

39. McArdle's (muscle phosphorylase deficiency)
Resting tremor - rigidity - akinesia - postural instability
Needle - shaped - negatively birefringent crystals
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Short stature - increased incidence of tumors / leukemia - aplastic anemia

40. Condylomata lata (2* syphilis)
Dilated cardiomyopathy - edema - polyneuropathy
Current jelly stool
Thrombi made of white/red layers
Smooth - flat - moist white lesions on genitals

41. Burton's line - lead poisoning
Stippled vaginal epithelial cells
Facial muscle spasm upon tapping
Bluish line on gingiva
liver cysts (parasite)

42. Parkinson's
Achilles tendon xanthoma
Basophilic stipplling of RBCs
Resting tremor - rigidity - akinesia - postural instability
Eosinophilic cytoplasmic inclusion in nerve cell

43. Diphyllobothrium latum
Increased a - fetoprotein in amniotic fluid / maternal serum
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
microcytic anemia (parasite)
B12 deficiency (parasite)

44. Blue bloater (chronic bronchitis)
Bronchogenic apical lung tumor
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Mammary gland (blue - domed) cyst
Hypoxemia - polycythemia - hypercapnia

45. MS (Charcot's)
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Lucid interval after TBI
Polished - ivory- like appearance of bone at cartilage erosion
Bilateral hilar adenopathy - uveitis

46. 2* syphilis - Rocky Mountain spotted fever - coxsackie A
Nutmeg liver
RBC casts in urine
Rash on palms and soles
Anti - IgG antibodies

47. DVT - PE - DIC - Budd - Chiari (D dimer is fibrin breakdown products)
High level of D dimers
Fever - night sweats - weight loss
Increased uric acid levels
Antidesmoglein (epithelial) antibodies

48. Becker's muscular dystrophy
Cherry- red spot on macula
Sheets of medium - sized lymphoid cells (starry sky)
Slow progressive muscle weakness in boys
Heart nodules (inflammatory)

49. Curschmann's spirals (bronchial asthma - can result in whorled mucous plugs)
Desquamated epithelium casts in sputum
Glomerulus - like structure surrounding vessel in germ cells
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Antinuclear antibodies

50. Intussesseption
Current jelly stool
Severe jaundice in neonate
Red - itchy - swollen rash of nipple/areola
Polyuria - acidosis - growth failure - electrolyte imbalances