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USMLE Step 1 Rapid Review Questions And Answers Graded A 2022

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USMLE Step 1 Rapid Review Questions And Answers Graded A 2022 Abdominal pain, ascites, hepatomegaly, (also high D dimer, CHF without JVD) Correct Answer: Budd-Chiari syndrome Achilles tendon xa... nthoma Correct Answer: Familial hypercholesterolemia Adrenal hemorrhage, hypotension, DIC Correct Answer: Waterhouse-Friderichsen syndrome (meningococcemia) Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints Correct Answer: Marfan's (fibrillin defect) Athlete with polycythemia Correct Answer: Erythropoietin injection Back pain, fever, night sweats, weight loss Correct Answer: Pott's (TB to the vertebrae) Bilateral hilar adenopathy, uveitis Correct Answer: Sarcoid Blue sclera Correct Answer: Osteogenesis imperfecta Bluish line on gingiva Correct Answer: Burton's line - lead poisoning Bone pain, bone enlargement, arthritis, (also increased hat size, fracture, increased alk phos) Correct Answer: Paget's Bounding pulses, diastolic hear murmur, head bobbing Correct Answer: Aortic regurg Café-au-lait spots, Lisch nodules Correct Answer: NF (1 = optic glimoas and pheo, 2 = acoustic Schwannomas) Café-au-lait spots, polyostotic fibrous dysplasia, precocious puberty Correct Answer: McCune-Albright syndome (G protein problem) Calf pseudohypertrophy Correct Answer: Duchenne's muscular dystrophy Cherry-red spot on macula Correct Answer: Tay-Sachs, Niemann-Pick, central retinal artery occlusion Chest pain, pericardial effusion/friction rub, persistent fever following MI Correct Answer: Dressler's (autoimmune post-MI) Child uses arms to stand up from squat Correct Answer: Gower's sign (Duchenne's) Child with fever develops red rash on face that spreads to body Correct Answer: Slapped cheek - B19 Chorea, dementia, caudate degeneration Correct Answer: Huntington's Chronic exercise intolerance with myalgia, fatigue, painful cramps Correct Answer: McArdle's (muscle phosphorylase deficiency) Cold intolerance Correct Answer: Hypothyroidism Conjugate lateral gaze palsy, horizontal diplopia Correct Answer: Internuclear ophthalmoplegia (MS or stroke) Continuous machinery heart murmur Correct Answer: PDA Cutaneous/dermal edema due to CT expansion Correct Answer: Myxedema Dark purple skin / mouth nodules Correct Answer: Kaposi's sarcoma Deep, labored breathing / hyperventilation Correct Answer: Kussmaul breathing, DKA Dermatitis, dementia, diarrhea Correct Answer: Pellagra (B3 / niacin deficiency) Dilated cardiomyopathy, edema, polyneuropathy Correct Answer: Wet beriberi (B1 / thiamine deficiency) Dog or cat bite resulting in infection Correct Answer: Pasteurella multocida (local cellulitis) Dry eyes, dry mouth, arthritis Correct Answer: Sjogren's syndrome Dysphagia (esophageal webs), glossitis (smooth tongue), iron deficiency anemia Correct Answer: Plummer-Vinson syndrome Elastic skin, hypermobility of joints Correct Answer: Ehler-Danlos (type III collagen) Enlarged. hard left supraclavicular node Correct Answer: VIrchow's node (abdominal met) Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells Correct Answer: Sezary syndrome (cutaneous T cell lymphoma) Facial muscle spasm upon tapping Correct Answer: Chvostek's sign (hypocalcemia) Fat, female, fertile, forty Correct Answer: Gallstones Fever, chills, headache, myalgia following antibiotic treatment for syphillis Correct Answer: Jarisch-Herxheimer reaction (lysis of spirochetes results in toxin release) Fever, cough, conjunctivitis, coryza, diffuse rash, Koplick spots Correct Answer: Measles Fever, night sweats, weight loss Correct Answer: B symptoms or TB Fibrous plaques in soft tissue of penis Correct Answer: Peyronie's disease Gout, MR, self-mutilating behavior in a boy Correct Answer: Lesch-Nyhan syndrome (HGPRT deficiency, X-linked recessive) Green-yellow rings around peripheral iris Correct Answer: Kayser-Fleischer rings (copper accumulation from Wilson's disease) Hamartomatous GI polyps, hyperpigmentation of mouth, feet and hands Correct Answer: Peutz-Jeghers syndrome Hepatosplenomegaly, osteoporosis, neurologic symptoms, crinkled cytoplasm Correct Answer: Gaucher's disease (glucocerebrosidase deficiency) Hereditary nephritis, sensorineural hearing loss, cataracts Correct Answer: Alport's syndrome (type IV collagen) Hypercoagulability leading to thrombophlebitis Correct Answer: Trousseau's sign (adenocarcinoma of pancreas or lung) Hyperphagia, hypersexuality, hyperorality, hyperdocility Correct Answer: Kluver-Bucy syndrome (bilateral amygdala) HTN, hypoK, metabolic alkalosis Correct Answer: Conn's (1* hyperaldosterone) Hypoxemia, polycythemia, hypercapnia Correct Answer: Blue bloater (chronic bronchitis) Indurated, ulcerated genital lesion Correct Answer: Nonpainful = syphillis. Painful with exudate = chancroid Infant with failure to thrive, hepatosplenomegaly, neurodegeneration Correct Answer: Niemann-Pick disease (genetic sphingomyelinase deficiency) Infant with hypoglycemia, failure to thrive, and hepatomegaly Correct Answer: Cori's disease (debranching enzyme deficiency, no glycogenolysis) or Von Gierke's Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect Correct Answer: Edward's syndrome (Trisomy 18) Jaundice, RUQ pain, fever Correct Answer: Charcot's triad (ascending cholangitis) Keratin pearls Correct Answer: Squamous cell carcinoma Large rash with bull's eye appearance Correct Answer: Erythema chronicum migrans from Ixodes tick bite (Lyme) Lucid interval after TBI Correct Answer: Epidural hematoma (middle meningeal artery) Male child, recurrent infections, no mature B cells Correct Answer: Bruton's disease (X-linked agammaglobulinemia) Mucosal bleeding and prolonged bleeding time Correct Answer: Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa) Multiple colon polyps, osteomas / soft tissue tumors, impacted / supernumary teeth Correct Answer: Gardner's syndrome Necrotizing vasculitis (lungs) and necrotizing GN Correct Answer: Wegner's (c-ANCA) and Goodpasture's (anti-GBM). Wegner's can also have upper airway involvement Neonate with arm paralysis following difficult birth. Possible clavicle fx, probably large for gestational age Correct Answer: Erb-Duchenne palsy No lactation postpartum, absent menstruation, cold intolerance Correct Answer: Sheehan's syndrome Nystagmus, intention tremor, scanning speech, also bilateral internuclear ophthalmoplegia Correct Answer: MS (Charcot's) Oscillating slow / fast breathing Correct Answer: Cheyne-Stokes (central apnea from CHF or increased ICP) Painful blue fingers / toes, hemolytic anemia Correct Answer: Cold agglutinin disease (autoimmune from Mp or mono, from IgM) Painful, pale, cold fingers / toes Correct Answer: Raynaud's syndrome (vasospasm) Painful, raised red lesions on palms and soles Correct Answer: Osler's node (infective endocarditis) Painless erythematous lesions on palms and soles Correct Answer: Janeway lesions (infective endocarditis) Painless jaundice Correct Answer: Cancer at head of pancreas obstructing bile duct Palpable purpura, joint pain, abdominal pain in a child Correct Answer: Henoch-Schonlein purpura (IgA vasculitis) Pancreatic, pituitary, parathyroid tumors Correct Answer: MEN 1 (Wermer's) Pink complexion, dypnea, hyperventilation Correct Answer: Pink puffer (emphysema) Polyuria, acidosis, growth failure, electrolyte imbalances Correct Answer: Fanconi's syndrome (proximal tubular reabsorption defect) Ptosis, miosis, anhidrosis Correct Answer: Horner's syndrome (usually with Pancoast tumor in apex of lung) Pupil accommodates but doesn't react Correct Answer: Argyll Robertson pupil (neurosyphilis) Rapidly progressive leg weakness that ascend, following GI infection Correct Answer: Guillain-Barre syndrome Rash on palms and soles Correct Answer: 2* syphilis, Rocky Mountain spotted fever, coxsackie A Recurrent colds, unusual eczema, high serum IgE Correct Answer: Job's syndrome Red "current jelly" sputum in alcoholic or diabetic patients Correct Answer: Klebsiella pneumoniae Red, itchy, swollen rash of nipple/areola Correct Answer: Paget's disease of the breast Red urine in the morning, fragile RBCs Correct Answer: Paroxysmal nocturnal hemoglobinuria (C' mediated damage, lack of CD55/59) Renal cell carcinoma, hemangioblastomas, angiomatosis, pheochromocytoma Correct Answer: von Hippel-Lindau diease Resting tremor, rigidity, akinesia, postural instability Correct Answer: Parkinson's Restrictive cardiomyopathy (juvenile = cardiomegaly), exercise intolerance Correct Answer: Pompe's disease (lysosomal glucosidase deficiency) Retinal hemorrhages with pale centers Correct Answer: Roth's spots (bacterial endocarditis) Severe jaundice in neonate Correct Answer: Crigler-Najjar syndrome (congenital unconj hyper bilirubinemia) Severe RLQ pain with rebound tenderness Correct Answer: McBurney's sign Short stature, increased incidence of tumors / leukemia, aplastic anemia Correct Answer: Fanconi's anemia (esp AML) Single palm crease Correct Answer: Simian crease (Down's) Situs inversus, chronic sinusitis, bronchiectasis, infertility Correct Answer: Kartagener's syndrome (dynein) Skin hyperpigmentation Correct Answer: Addi [Show More]

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