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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. Peutz - Jeghers syndrome
hematuria - bladder cancer (parasite)
Athlete with polycythemia
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Short stature - increased incidence of tumors / leukemia - aplastic anemia

2. Burkitt's lymphoma (t(8:14) c - myc - EBV)
Sheets of medium - sized lymphoid cells (starry sky)
Deep - labored breathing / hyperventilation
Swollen - hard - painful finger joints
Glomerulus - like structure surrounding vessel in germ cells

3. Chronic ESRD
Achilles tendon xanthoma
Narrowing of bowel lumen on barium radiograph
Waxy casts with very low urine flow
WBCs that look smudged

4. Janeway lesions (infective endocarditis)
Systolic ejection murmur (crescendo - decrescendo)
Painless erythematous lesions on palms and soles
Multiple colon polyps - osteomas / soft tissue tumors - impacted / supernumary teeth
Mucin - filled cell with peripheral nucleus

5. USMLE Step 1 (or subarachnoid hemorrhage)
Infant with hypoglycemia - failure to thrive - and hepatomegaly
Red urine in the morning - fragile RBCs
Toe extension / fanning upon plantar scrape
Worst headache of my life

6. Cold agglutinin disease (autoimmune from Mp or mono - from IgM)
Stippled vaginal epithelial cells
Painful blue fingers / toes - hemolytic anemia
Bilateral hilar adenopathy - uveitis
RBC casts in urine

7. Roth's spots (bacterial endocarditis)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Retinal hemorrhages with pale centers
Neonate with arm paralysis following difficult birth. Possible clavicle fx - probably large for gestational age
Brown tumor of bone

8. B symptoms or TB
Hamartomatous GI polyps - hyperpigmentation of mouth - feet and hands
Silver - staining spherical aggregation of tau proteins in neurons
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Fever - night sweats - weight loss

9. Acute glomerulonephritis
Indurated - ulcerated genital lesion
RBC casts in urine
Colonies of mucoid Pseudomonas in lungs
WBC casts in urine

10. Acute toxic/viral nephrosis
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Renal epithelial casts in urine
hemoptysis (parasite)
Narrowing of bowel lumen on barium radiograph

11. Chronic passive congestion of the liver due to right heart failure
Nutmeg liver
Blue sclera
Degeneration of dorsal column nerves
Mucosal bleeding and prolonged bleeding time

12. Waterhouse - Friderichsen syndrome (meningococcemia)
Painful blue fingers / toes - hemolytic anemia
Urethritis - conjunctivitis - arthritis in a male
Adrenal hemorrhage - hypotension - DIC
Cherry- red spot on macula

13. Paget's
Bone pain - bone enlargement - arthritis - (also increased hat size - fracture - increased alk phos)
Resting tremor - rigidity - akinesia - postural instability
Enlarged cells with intranuclear inclusion bodies
Severe jaundice in neonate

14. Subarachnoid hemorrhage
Bloody tap on LP
Bronchogenic apical lung tumor
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Low serum ceruloplasmin

15. Pick bodies
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Keratin pearls
Silver - staining spherical aggregation of tau proteins in neurons
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance

16. Pemphigus vulgaris (blistering)
Basophilic nuclear remnants in RBCs
Nutmeg liver
Antidesmoglein (epithelial) antibodies
Depigmentation of neurons in substantia nigra

17. Horner's syndrome (usually with Pancoast tumor in apex of lung)
Heart nodules (inflammatory)
Painful blue fingers / toes - hemolytic anemia
Ptosis - miosis - anhidrosis
Worst headache of my life

18. Becker's muscular dystrophy
Degeneration of dorsal column nerves
Cold intolerance
Renal epithelial casts in urine
Slow progressive muscle weakness in boys

19. Celiac (diarrhea - distention - weight loss)
Pink complexion - dypnea - hyperventilation
Disarrayed granulosa cells in eosinophilic fluid
Anti - transglutaminase/antigliadin/anti - endomysial antibodies
Tram - track on LM

20. Conn's (1* hyperaldosterone)
HTN - hypoK - metabolic alkalosis
Green -yellow rings around peripheral iris
Erythroderma - lymphadenopathy - hepatosplenomegaly - atypical T cells
Needle - shaped - negatively birefringent crystals

21. PDA
Rib notching
Bloody tap on LP
Continuous machinery heart murmur
Azurophilic granular needles in leukemic blasts

22. Babinski (UMN lesion)
Hair - on - end (crewcut) appearance on X- ray
Rib notching
Painless jaundice
Toe extension / fanning upon plantar scrape

23. Henoch - Schonlein purpura (IgA vasculitis)
Desquamated epithelium casts in sputum
Palpable purpura - joint pain - abdominal pain in a child
Large lysosomal vesicles in phagocytes - immunodeficiency
Child with fever develops red rash on face that spreads to body

24. Von Hippel - Lindau diease
Red 'current jelly' sputum in alcoholic or diabetic patients
Bounding pulses - diastolic hear murmur - head bobbing
Renal cell carcinoma - hemangioblastomas - angiomatosis - pheochromocytoma
Eosinophilic cytoplasmic inclusion in nerve cell

25. Kimmelstiel - Wilson nodules (diabetic)
Nodular hyaline deposits in glomeruli
Mammary gland (blue - domed) cyst
Antimitochondrial antibodies
WBC casts in urine

26. Chronic bacterial pyelo
Severe jaundice in neonate
Chocolate cyst of ovary
Thyroid - like appearance of kidney
Rash on palms and soles

27. Interstitial fibrosis
Heterophile antibodies
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Colonies of mucoid Pseudomonas in lungs
Honeycomb lung on X- ray

28. Erythema chronicum migrans from Ixodes tick bite (Lyme)

29. Osler's node (infective endocarditis)
Indurated - ulcerated genital lesion
Red 'current jelly' sputum in alcoholic or diabetic patients
Painful - raised red lesions on palms and soles
Gout - MR - self - mutilating behavior in a boy

30. Peyronie's disease
Brown tumor of bone
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Fibrous plaques in soft tissue of penis
Chocolate cyst of ovary

31. Auer rods (AML - esp promyelocytic type)
Bloody tap on LP
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Male child - recurrent infections - no mature B cells
Azurophilic granular needles in leukemic blasts

32. Lines of Zahn (arterial thrombus - layers of platelets/RBCs)
Eosinophilic globule in liver
Red - itchy - swollen rash of nipple/areola
Painless erythematous lesions on palms and soles
Thrombi made of white/red layers

33. Bibeck granules (histiocytosis X: eosinophilic granuloma)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Achilles tendon xanthoma
Nutmeg liver
Male child - recurrent infections - no mature B cells

34. Pink puffer (emphysema)
Honeycomb lung on X- ray
Pink complexion - dypnea - hyperventilation
Extracellular amyloid deposition in gray matter of brain
Periosteum raised from bone - creating triangular area

35. Klebsiella pneumoniae

36. Xanthochromia (subarachnoid hemorrhage)
Yellow CSF
Rusty sputum
Rapidly progressive leg weakness that ascend - following GI infection
Depigmentation of neurons in substantia nigra

37. Gout
Fever - chills - headache - myalgia following antibiotic treatment for syphillis
Skin hyperpigmentation
Hyperphagia - hypersexuality - hyperorality - hyperdocility
Needle - shaped - negatively birefringent crystals

38. Bruton's disease (X- linked agammaglobulinemia)
Colonies of mucoid Pseudomonas in lungs
Severe jaundice in neonate
Male child - recurrent infections - no mature B cells
Branching gram + rods with sulfur granules

39. Edward's syndrome (Trisomy 18)
Periosteum raised from bone - creating triangular area
Infant with microcephaly - rocker - bottom feet - clenched hands - and structural heart defect
Chronic exercise intolerance with myalgia - fatigue - painful cramps
Swollen - hard - painful finger joints

40. Simian crease (Down's)
Child uses arms to stand up from squat
Single palm crease
Vasculitis from exposure to endotoxin casuing glomerular thrombosis
Arachnodactyly - lens dislocation - aortic dissection - hyperflexible joints

41. Tetralogy of Fallot - RVH
Continuous machinery heart murmur
Pupil accommodates but doesn't react
Boot - shaped heart on X- ray
Dry eyes - dry mouth - arthritis

42. NF (1 = optic glimoas and pheo - 2 = acoustic Schwannomas)
Caf
Urethritis - conjunctivitis - arthritis in a male
Mucosal bleeding and prolonged bleeding time
Restrictive cardiomyopathy (juvenile = cardiomegaly) - exercise intolerance

43. Scarlet fever - Kawasaki disease - TSS
Cherry- red spot on macula
Anticentromere antibodies
Strawberry tongue
Increased a - fetoprotein in amniotic fluid / maternal serum

44. Call - Exner bodies (granulosa - theca cell tumor of the ovary)
Disarrayed granulosa cells in eosinophilic fluid
Red 'current jelly' sputum in alcoholic or diabetic patients
Current jelly stool
HTN - hypoK - metabolic alkalosis

45. Job's syndrome
Hepatosplenomegaly - osteoporosis - neurologic symptoms - crinkled cytoplasm
Recurrent colds - unusual eczema - high serum IgE
Hexagonal - double - pointed - needle - like crystals in bronchial secretions
Red urine in the morning - fragile RBCs

46. Paragonimus westermani
Cellular crescents in Bowman's capsule
Red - itchy - swollen rash of nipple/areola
brain cysts - seizures (parasite)
hemoptysis (parasite)

47. Pancoast tumor (can cause Horner's)
Bronchogenic apical lung tumor
Pupil accommodates but doesn't react
Lytic (punched - out) bone lesions on X- ray
Rusty sputum

48. Gower's sign (Duchenne's)
Basophilic stipplling of RBCs
Swollen gums - mucous bleeding - poor wound healing - spots on skin
Elastic skin - hypermobility of joints
Child uses arms to stand up from squat

49. Scleroderma (CREST)
Caf
hemoptysis (parasite)
Nystagmus - intention tremor - scanning speech - also bilateral internuclear ophthalmoplegia
Anticentromere antibodies

50. Ancylostoma - Necator (hook worms)
microcytic anemia (parasite)
Triglyceride accumulation in liver cell vacuoles
Single palm crease
Pseudopalisading tumor cells on brain biopsy