USMLE STEP 1 EXAM QUESTIONS AND ANSWERS

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