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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. Gout/podagra (hyperuricemia)
Honeycomb lung on X- ray
Red urine in the morning - fragile RBCs
Sudden swollen/painful big toe joint - tophi
Waxy casts with very low urine flow

2. Pancoast tumor (can cause Horner's)
Lucid interval after TBI
Bronchogenic apical lung tumor
Pink complexion - dypnea - hyperventilation
Anti - transglutaminase/antigliadin/anti - endomysial antibodies

3. Koilocytes (HPV) 'perrinuclear cytoplasmic clearing'
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Thyroid (medullary) and parathyroid tumors - pheochromocytoma
brain cysts - seizures (parasite)
WBC casts in urine

4. Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Mucosal bleeding and prolonged bleeding time
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
microcytic anemia (parasite)

5. GBM (cells may be called 'serpentine')
Elastic skin - hypermobility of joints
Sudden swollen/painful big toe joint - tophi
Stacks of RBCs
Pseudopalisading tumor cells on brain biopsy

6. Von Hippel - Lindau diease
Waxy casts with very low urine flow
Unilateral facial drooping involving forehead
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Brown tumor of bone

7. Charcot's triad (ascending cholangitis)
Hereditary nephritis - sensorineural hearing loss - cataracts
Mucosal bleeding and prolonged bleeding time
Wire loop glomerular appearance on LM
Jaundice - RUQ pain - fever

8. Drug - induced SLE (hydralazine - isoniazid - phenytoin - procainamide)
Polished - ivory- like appearance of bone at cartilage erosion
Slow progressive muscle weakness in boys
Antihistone antibodies
Thyroid (medullary) and parathyroid tumors - pheochromocytoma

9. Howell - Jolly bodies (due to splenectomy or nonfunctional spleen)
Heterophile antibodies
Basophilic nuclear remnants in RBCs
Spikes on basement membrane - dome - like endothelial deposits
perianal pruritis (parasite)

10. Hemangioma (benign - associated with Sturge - Weber syndrome - in which case it's V1 distribution)
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Vascular birthmark (port - wine stain)
Jaundice - RUQ pain - fever
brain cysts - seizures (parasite)

11. Membranoproliferative glomerulonephritis
Degeneration of dorsal column nerves
Antineutrophil cytoplasmic antibodies (ANCA)
Tram - track on LM
Cellular crescents in Bowman's capsule

12. NF (1 = optic glimoas and pheo - 2 = acoustic Schwannomas)
Needle - shaped - negatively birefringent crystals
Hyperphagia - hypersexuality - hyperorality - hyperdocility
WBCs that look smudged
Caf

13. Mallory bodies (alcoholic liver disease)
Antinuclear antibodies
Eosinophilic cytoplasmic inclusion in liver cell
Chocolate cyst of ovary
Renal epithelial casts in urine

14. Argyll Robertson pupil (neurosyphilis)

15. Acute pyelo
Azurophilic granular needles in leukemic blasts
WBC casts in urine
Heart nodules (inflammatory)
Single palm crease

16. Gout
AntiGBM antibodies
Needle - shaped - negatively birefringent crystals
Monoclonal antibody spike
Enlarged thyroid cells with ground - glass nuclei

17. Squamous cell carcinoma
Dry eyes - dry mouth - arthritis
Splinter hemorrhages in fingernails
Hilar lymphadenopathy - peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Keratin pearls

18. Familial hypercholesterolemia
Large rash with bull's eye appearance
Achilles tendon xanthoma
Strawberry tongue
Indurated - ulcerated genital lesion

19. Scleroderma (CREST)
Anticentromere antibodies
Narrowing of bowel lumen on barium radiograph
Streak ovaries - congenital heart disease - horseshoe kidney
Increased a - fetoprotein in amniotic fluid / maternal serum

20. McBurney's sign
Increased a - fetoprotein in amniotic fluid / maternal serum
Severe RLQ pain with rebound tenderness
Hypercoagulability leading to thrombophlebitis
Situs inversus - chronic sinusitis - bronchiectasis - infertility

21. Diffuse systemic scleroderma
Anti - topoisomerase antibodies
Soap bubble in femur or tibia on X- ray
Hypoxemia - polycythemia - hypercapnia
Urethritis - conjunctivitis - arthritis in a male

22. Strep pneumo
Red 'current jelly' sputum in alcoholic or diabetic patients
No lactation postpartum - absent menstruation - cold intolerance
Cutaneous/dermal edema due to CT expansion
Rusty sputum

23. Taenia solium (cysticercosis)
Severe jaundice in neonate
Swollen - hard - painful finger joints
brain cysts - seizures (parasite)
Strawberry tongue

24. Clue cells (Gardenella vaginalis)
Bounding pulses - diastolic hear murmur - head bobbing
Current jelly stool
Stippled vaginal epithelial cells
Periosteum raised from bone - creating triangular area

25. Wilson's disease (hepatolenticular degeneration)
Low serum ceruloplasmin
Abdominal pain - ascites - hepatomegaly - (also high D dimer - CHF without JVD)
Indurated - ulcerated genital lesion
Thyroid (medullary) and parathyroid tumors - pheochromocytoma

26. Codman's triangle on X- ray (osteosarcoma - Ewing's - pyogenic osteomyelitis)
Periosteum raised from bone - creating triangular area
Fever - night sweats - weight loss
Dilated cardiomyopathy - edema - polyneuropathy
Keratin pearls

27. Sheehan's syndrome
Hypersegmented neutrophils
Cardiomegaly with apical atrophy
Thumb sign on lateral X- ray
No lactation postpartum - absent menstruation - cold intolerance

28. Turner syndrome (X0 - short stature - webbed neck - lymphedema)
hCG elevated
biliary tract disease - cholangiocarcinoma (parasite)
Painful - raised red lesions on palms and soles
Streak ovaries - congenital heart disease - horseshoe kidney

29. B symptoms or TB
Strawberry tongue
Ptosis - miosis - anhidrosis
Fever - night sweats - weight loss
Circular grouping of dark tumor cells surrounding pale neurofibrils

30. Becker's muscular dystrophy
Rash on palms and soles
Basophilic nuclear remnants in RBCs
Fever - night sweats - weight loss
Slow progressive muscle weakness in boys

31. String sign (Crohn's)
Hair - on - end (crewcut) appearance on X- ray
Onion - skin periosteal reaction
Narrowing of bowel lumen on barium radiograph
Pink complexion - dypnea - hyperventilation

32. Paget's
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
B12 deficiency (parasite)
Infant with failure to thrive - hepatosplenomegaly - neurodegeneration

33. Wet beriberi (B1 / thiamine deficiency)
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Achilles tendon xanthoma
Dilated cardiomyopathy - edema - polyneuropathy
Thyroid - like appearance of kidney

34. Owl's eye appearance of CMV - Cowdry A bodies
Fever - cough - conjunctivitis - coryza - diffuse rash - Koplick spots
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Enlarged cells with intranuclear inclusion bodies
Chorea - dementia - caudate degeneration

35. Pasteurella multocida (local cellulitis)
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Polished - ivory- like appearance of bone at cartilage erosion
Dog or cat bite resulting in infection
Bronchogenic apical lung tumor

36. Marfan's (fibrillin defect)
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints
Boot - shaped heart on X- ray
Facial muscle spasm upon tapping

37. Bibeck granules (histiocytosis X: eosinophilic granuloma)
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance
Lucid interval after TBI
Mucosal bleeding and prolonged bleeding time
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

38. Gower's sign (Duchenne's)
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Thrombi made of white/red layers
Child uses arms to stand up from squat
Red - itchy - swollen rash of nipple/areola

39. Giant cell tumor of bone (generally benign)
Soap bubble in femur or tibia on X- ray
Adrenal hemorrhage - hypotension - DIC
Mammary gland (blue - domed) cyst
Single palm crease

40. Schistosoma haematobium
hematuria - bladder cancer (parasite)
Increased a - fetoprotein in amniotic fluid / maternal serum
Severe RLQ pain with rebound tenderness
Vasculitis from exposure to endotoxin casuing glomerular thrombosis

41. Huntington's
Polyuria - acidosis - growth failure - electrolyte imbalances
Short stature - increased incidence of tumors / leukemia - aplastic anemia
Yellow CSF
Chorea - dementia - caudate degeneration

42. Kartagener's syndrome (dynein)
Large lysosomal vesicles in phagocytes - immunodeficiency
Unilateral facial drooping involving forehead
Dysphagia (esophageal webs) - glossitis (smooth tongue) - iron deficiency anemia
Situs inversus - chronic sinusitis - bronchiectasis - infertility

43. Cancer at head of pancreas obstructing bile duct
Painless jaundice
Hypochromic - microcytic anemia
HTN - hypoK - metabolic alkalosis
Conjugate lateral gaze palsy - horizontal diplopia

44. Chronic passive congestion of the liver due to right heart failure
Needle - shaped - negatively birefringent crystals
Thrombi made of white/red layers
Nutmeg liver
Eosinophilic cytoplasmic inclusion in liver cell

45. Osler's node (infective endocarditis)
Podocyte fusion on EM
Chocolate cyst of ovary
Caf
Painful - raised red lesions on palms and soles

46. 1* biliary cirrhosis (female - cholestasis - portal HTN)
Painless jaundice
Severe RLQ pain with rebound tenderness
Antimitochondrial antibodies
Vascular birthmark (port - wine stain)

47. Xanthochromia (subarachnoid hemorrhage)
Azurophilic granular needles in leukemic blasts
B12 deficiency (parasite)
Yellow CSF
Worst headache of my life

48. Parkinson's
Pink complexion - dypnea - hyperventilation
Small - irregular red spots on buccal mucosa with blue - white centers
Sudden swollen/painful big toe joint - tophi
Resting tremor - rigidity - akinesia - postural instability

49. Peutz - Jeghers syndrome
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Indurated - ulcerated genital lesion
Basophilic stipplling of RBCs
High level of D dimers

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