USMLE Step 1 Rapid Review Exam Questions with
Answers
1. Abdominal pain, ascites, hepatomegaly, (also high D dimer,
CHF without JVD) correct answer: Budd-Chiari syndrome
2. Achilles tendon xanthoma correct answer: Familial hypercholesterolemia
3. Adrenal hemorrhage, hypotension, DIC correct answer: Waterhouse-
Friderichsen syndrome (meningococ- cemia)
4. Arachnodactyly, lens dislocation, aortic dissection, hyperflexible
joints correct answer: Marfan's (fibrillin defect)
5. Athlete with polycythemia correct answer: Erythropoietin injection
6. Back pain, fever, night sweats, weight loss correct answer: Pott's (TB to
the vertebrae)
7. Bilateral hilar adenopathy, uveitis correct answer: Sarcoid
8. Blue sclera correct answer: Osteogenesis imperfecta
9. Bluish line on gingiva correct answer: Burton's line - lead poisoning
10. Bone pain, bone enlargement, arthritis, (also increased hat
size, fracture, increased alk phos) correct answer: Paget's
11. Bounding pulses, diastolic hear murmur, head bobbing correct
answer: Aortic regurg
12. Café-au-lait spots, Lisch nodules correct answer: NF (1 = optic glimoas and
pheo, 2 = acoustic Schwannomas)
13. Café-au-lait spots, polyostotic fibrous dysplasia, precocious
puberty correct answer: McCune-Al- bright syndome (G protein problem)
14. Calf pseudohypertrophy correct answer: Duchenne's muscular dystrophy
15. Cherry-red spot on macula correct answer: Tay-Sachs, Niemann-Pick, central
retinal artery occlusion
16. Chest pain, pericardial effusion/friction rub, persistent fever
following MI correct answer: -
Dressler's (autoimmune post-MI)
17. Child uses arms to stand up from squat correct answer: Gower's
sign (Duchenne's)
,18. Child with fever develops red rash on face that spreads to body
correct answer: Slapped cheek - B19
19. Chorea, dementia, caudate degeneration correct answer:
Huntington's
20. Chronic exercise intolerance with myalgia, fatigue, painful
cramps correct answer: McArdle's (muscle phosphorylase deficiency)
21. Cold intolerance correct answer: Hypothyroidism
22. Conjugate lateral gaze palsy, horizontal diplopia correct answer:
Internuclear ophthalmoplegia (MS or stroke)
23. Continuous machinery heart murmur correct answer: PDA
, 24. Cutaneous/dermal edema due to CT expansion correct answer:
Myxedema
25. Dark purple skin / mouth nodules correct answer: Kaposi's sarcoma
26. Deep, labored breathing / hyperventilation correct answer: Kussmaul
breathing, DKA
27. Dermatitis, dementia, diarrhea correct answer: Pellagra (B3 / niacin
deficiency)
28. Dilated cardiomyopathy, edema, polyneuropathy correct answer: Wet
beriberi (B1 / thiamine deficiency)
29. Dog or cat bite resulting in infection correct answer: Pasteurella
multocida (local cellulitis)
30. Dry eyes, dry mouth, arthritis correct answer: Sjogren's syndrome
31. Dysphagia (esophageal webs), glossitis (smooth tongue),
iron deficiency anemia correct answer: Plummer-Vinson syndrome
32. Elastic skin, hypermobility of joints correct answer: Ehler-Danlos (type III
collagen)
33. Enlarged. hard left supraclavicular node correct answer: VIrchow's node
(abdominal met)
34. Erythroderma, lymphadenopathy, hepatosplenomegaly,
atypical T cells correct answer: -
Sezary syndrome (cutaneous T cell lymphoma)
35. Facial muscle spasm upon tapping correct answer: Chvostek's sign
(hypocalcemia)
36. Fat, female, fertile, forty correct answer: Gallstones
37. Fever, chills, headache, myalgia following antibiotic treatment
for syphillis correct answer: -
Jarisch-Herxheimer reaction (lysis of spirochetes results in toxin release)
38. Fever, cough, conjunctivitis, coryza, diffuse rash, Koplick spots
correct answer: Measles
39. Fever, night sweats, weight loss correct answer: B symptoms or TB
40. Fibrous plaques in soft tissue of penis correct answer: Peyronie's
disease
41. Gout, MR, self-mutilating behavior in a boy correct answer: Lesch-Nyhan
syndrome (HGPRT deficiency, X-linked recessive)
Answers
1. Abdominal pain, ascites, hepatomegaly, (also high D dimer,
CHF without JVD) correct answer: Budd-Chiari syndrome
2. Achilles tendon xanthoma correct answer: Familial hypercholesterolemia
3. Adrenal hemorrhage, hypotension, DIC correct answer: Waterhouse-
Friderichsen syndrome (meningococ- cemia)
4. Arachnodactyly, lens dislocation, aortic dissection, hyperflexible
joints correct answer: Marfan's (fibrillin defect)
5. Athlete with polycythemia correct answer: Erythropoietin injection
6. Back pain, fever, night sweats, weight loss correct answer: Pott's (TB to
the vertebrae)
7. Bilateral hilar adenopathy, uveitis correct answer: Sarcoid
8. Blue sclera correct answer: Osteogenesis imperfecta
9. Bluish line on gingiva correct answer: Burton's line - lead poisoning
10. Bone pain, bone enlargement, arthritis, (also increased hat
size, fracture, increased alk phos) correct answer: Paget's
11. Bounding pulses, diastolic hear murmur, head bobbing correct
answer: Aortic regurg
12. Café-au-lait spots, Lisch nodules correct answer: NF (1 = optic glimoas and
pheo, 2 = acoustic Schwannomas)
13. Café-au-lait spots, polyostotic fibrous dysplasia, precocious
puberty correct answer: McCune-Al- bright syndome (G protein problem)
14. Calf pseudohypertrophy correct answer: Duchenne's muscular dystrophy
15. Cherry-red spot on macula correct answer: Tay-Sachs, Niemann-Pick, central
retinal artery occlusion
16. Chest pain, pericardial effusion/friction rub, persistent fever
following MI correct answer: -
Dressler's (autoimmune post-MI)
17. Child uses arms to stand up from squat correct answer: Gower's
sign (Duchenne's)
,18. Child with fever develops red rash on face that spreads to body
correct answer: Slapped cheek - B19
19. Chorea, dementia, caudate degeneration correct answer:
Huntington's
20. Chronic exercise intolerance with myalgia, fatigue, painful
cramps correct answer: McArdle's (muscle phosphorylase deficiency)
21. Cold intolerance correct answer: Hypothyroidism
22. Conjugate lateral gaze palsy, horizontal diplopia correct answer:
Internuclear ophthalmoplegia (MS or stroke)
23. Continuous machinery heart murmur correct answer: PDA
, 24. Cutaneous/dermal edema due to CT expansion correct answer:
Myxedema
25. Dark purple skin / mouth nodules correct answer: Kaposi's sarcoma
26. Deep, labored breathing / hyperventilation correct answer: Kussmaul
breathing, DKA
27. Dermatitis, dementia, diarrhea correct answer: Pellagra (B3 / niacin
deficiency)
28. Dilated cardiomyopathy, edema, polyneuropathy correct answer: Wet
beriberi (B1 / thiamine deficiency)
29. Dog or cat bite resulting in infection correct answer: Pasteurella
multocida (local cellulitis)
30. Dry eyes, dry mouth, arthritis correct answer: Sjogren's syndrome
31. Dysphagia (esophageal webs), glossitis (smooth tongue),
iron deficiency anemia correct answer: Plummer-Vinson syndrome
32. Elastic skin, hypermobility of joints correct answer: Ehler-Danlos (type III
collagen)
33. Enlarged. hard left supraclavicular node correct answer: VIrchow's node
(abdominal met)
34. Erythroderma, lymphadenopathy, hepatosplenomegaly,
atypical T cells correct answer: -
Sezary syndrome (cutaneous T cell lymphoma)
35. Facial muscle spasm upon tapping correct answer: Chvostek's sign
(hypocalcemia)
36. Fat, female, fertile, forty correct answer: Gallstones
37. Fever, chills, headache, myalgia following antibiotic treatment
for syphillis correct answer: -
Jarisch-Herxheimer reaction (lysis of spirochetes results in toxin release)
38. Fever, cough, conjunctivitis, coryza, diffuse rash, Koplick spots
correct answer: Measles
39. Fever, night sweats, weight loss correct answer: B symptoms or TB
40. Fibrous plaques in soft tissue of penis correct answer: Peyronie's
disease
41. Gout, MR, self-mutilating behavior in a boy correct answer: Lesch-Nyhan
syndrome (HGPRT deficiency, X-linked recessive)
