USMLE Step 1 Exam 2022/2023
Questions and Answers
What areas do the cervical lymph nodes drain? - ANSWER Head and neck
What areas do the hilar lymph nodes drain? - ANSWER Lungs
What areas do the mediastinal lymph nodes drain? - ANSWER Trachea and esophagus
What areas do the axillary lymph nodes drain? - ANSWER Upper limbs
breast
skin above umbilicus
What areas do the celiac lymph nodes drain? - ANSWER Liver
stomach
spleen
pancreas
upper duodenum
What areas do the superior mesenteric lymph nodes drain? - ANSWER Lower
duodenum
jejunum
ileum
colon to splenic flexure
What areas do the inferior mesenteric lymph nodes drain? - ANSWER Colon from
splenic flexure to upper rectum
What areas do the internal iliac lymph nodes drain? - ANSWER Lower rectum to anal
canal (above pectinate line)
bladder
vagina (middle 3rd)
prostate
What areas do the para-aortic lymph nodes drain? - ANSWER Testes
ovaries
kidneys
uterus
What areas do the superficial inguinal lymph nodes drain? - ANSWER Anal canal
(below pectinate line)
Skin below umbilicus (x/ popliteal territory)
scrotum
What areas do the popliteal lymph nodes drain? - ANSWER Dorsal foot
posterior calf
,USMLE Step 1 Exam 2022/2023
Questions and Answers
Right lymphatic duct drains _________________. - ANSWER Right lymphatic duct
drains right side of body above diaphragm. Thoracic duct drains everything else to left
SCV and internal jugular veins.
HLA-A3 is associated with what disease? - ANSWER Hemchromatosis
HLA-B27 is associated with what diseases? - ANSWER Psoriatic arthritis
Ankylosing spondylitis
Inflammatory bowel disease
Reactive arthritis
(sero-negative arthropathies)
HLA-DQ2/DQ8 is associated with what disease? - ANSWER Celiac disease
HLA-DR2 is associated with what disease? - ANSWER Multiple Sclerosis
Hay fever
SLE
Goodpastures syndrome
HLA-DR3 is associated with what disease? - ANSWER DM Type 1
SLE
Graves disease
Hashimoto thyroiditis
HLA-DR4 is associated with what disease? - ANSWER Rheumatoid arthritis
DM Type 1
HLA-DR5 is associated with what disease? - ANSWER Pernicious anemia (Vit B12
deficiency)
Hashimoto thyroiditis
Th-1 cells ...
are activated by: ________
secrete: ______
activate: _______
are inhibited by: ___________ - ANSWER Th-1 cells ...
are activated by: IFN-gamma and IL-12
secrete: IFN-gamma
activate: macrophages and cytotoxic Tcells
are inhibited by: IL-4 and IL-10 (from Th-2 cells)
Th-2 cells ...
are activated by: ________
secrete: ______
, USMLE Step 1 Exam 2022/2023
Questions and Answers
activate: _______
are inhibited by: ___________ - ANSWER Th-2 cells ...
are activated by: IL-4
secrete: IL-4, IL-5, IL-10, IL-13
activate: eosinophils (parasites), IgE by Bcells
are inhibited by: IFN-gamma (from Th-1 cells)
What microbes stain with Giemsa stain? - ANSWER Chlamydia
Borrelia
Rickettsia
Trypansomes
Plasmodium
What microbes stain with PAS stain (Periodic acid Schiff)? - ANSWER Tropheryma
whipplei (Whipple Disease)
(stains glycogen, mucopolysaccharides)
What microbes stain with Ziehl-Neelson (carbolfuchsin) - ANSWER Acid fast bacteria
(Nocardia, Mycobacteria)
Protozoa (Cryptosporidium oocysts)
(alternative is the auramine-rhodamine stain for screening - inexpensive, more sensitive
but less specific)
What microbes stain with India Ink? - ANSWER Cryptococcus neoformans
(encapsulated yeast that causes meningitis)
(mucicarmine can also be used to stain thick polysaccharide capsule red)
What microbes stain with Silver Stain? - ANSWER Fungi - pneumocystis (PCP in AIDS
patients)
Legionella (silver haired men at American Legion)
H. pylori
What media grows for H. influenzae? - ANSWER Chocolate agar
(has Factor V [NAD+] and Factor X [hematin])
What media grows Neisseria (gonorrhea, meningitidis) - ANSWER Thayer-Martin agar
has various antibiotics to inhibit growth of everything but Neisseria
Vancomycin (inhib Gm +)
Questions and Answers
What areas do the cervical lymph nodes drain? - ANSWER Head and neck
What areas do the hilar lymph nodes drain? - ANSWER Lungs
What areas do the mediastinal lymph nodes drain? - ANSWER Trachea and esophagus
What areas do the axillary lymph nodes drain? - ANSWER Upper limbs
breast
skin above umbilicus
What areas do the celiac lymph nodes drain? - ANSWER Liver
stomach
spleen
pancreas
upper duodenum
What areas do the superior mesenteric lymph nodes drain? - ANSWER Lower
duodenum
jejunum
ileum
colon to splenic flexure
What areas do the inferior mesenteric lymph nodes drain? - ANSWER Colon from
splenic flexure to upper rectum
What areas do the internal iliac lymph nodes drain? - ANSWER Lower rectum to anal
canal (above pectinate line)
bladder
vagina (middle 3rd)
prostate
What areas do the para-aortic lymph nodes drain? - ANSWER Testes
ovaries
kidneys
uterus
What areas do the superficial inguinal lymph nodes drain? - ANSWER Anal canal
(below pectinate line)
Skin below umbilicus (x/ popliteal territory)
scrotum
What areas do the popliteal lymph nodes drain? - ANSWER Dorsal foot
posterior calf
,USMLE Step 1 Exam 2022/2023
Questions and Answers
Right lymphatic duct drains _________________. - ANSWER Right lymphatic duct
drains right side of body above diaphragm. Thoracic duct drains everything else to left
SCV and internal jugular veins.
HLA-A3 is associated with what disease? - ANSWER Hemchromatosis
HLA-B27 is associated with what diseases? - ANSWER Psoriatic arthritis
Ankylosing spondylitis
Inflammatory bowel disease
Reactive arthritis
(sero-negative arthropathies)
HLA-DQ2/DQ8 is associated with what disease? - ANSWER Celiac disease
HLA-DR2 is associated with what disease? - ANSWER Multiple Sclerosis
Hay fever
SLE
Goodpastures syndrome
HLA-DR3 is associated with what disease? - ANSWER DM Type 1
SLE
Graves disease
Hashimoto thyroiditis
HLA-DR4 is associated with what disease? - ANSWER Rheumatoid arthritis
DM Type 1
HLA-DR5 is associated with what disease? - ANSWER Pernicious anemia (Vit B12
deficiency)
Hashimoto thyroiditis
Th-1 cells ...
are activated by: ________
secrete: ______
activate: _______
are inhibited by: ___________ - ANSWER Th-1 cells ...
are activated by: IFN-gamma and IL-12
secrete: IFN-gamma
activate: macrophages and cytotoxic Tcells
are inhibited by: IL-4 and IL-10 (from Th-2 cells)
Th-2 cells ...
are activated by: ________
secrete: ______
, USMLE Step 1 Exam 2022/2023
Questions and Answers
activate: _______
are inhibited by: ___________ - ANSWER Th-2 cells ...
are activated by: IL-4
secrete: IL-4, IL-5, IL-10, IL-13
activate: eosinophils (parasites), IgE by Bcells
are inhibited by: IFN-gamma (from Th-1 cells)
What microbes stain with Giemsa stain? - ANSWER Chlamydia
Borrelia
Rickettsia
Trypansomes
Plasmodium
What microbes stain with PAS stain (Periodic acid Schiff)? - ANSWER Tropheryma
whipplei (Whipple Disease)
(stains glycogen, mucopolysaccharides)
What microbes stain with Ziehl-Neelson (carbolfuchsin) - ANSWER Acid fast bacteria
(Nocardia, Mycobacteria)
Protozoa (Cryptosporidium oocysts)
(alternative is the auramine-rhodamine stain for screening - inexpensive, more sensitive
but less specific)
What microbes stain with India Ink? - ANSWER Cryptococcus neoformans
(encapsulated yeast that causes meningitis)
(mucicarmine can also be used to stain thick polysaccharide capsule red)
What microbes stain with Silver Stain? - ANSWER Fungi - pneumocystis (PCP in AIDS
patients)
Legionella (silver haired men at American Legion)
H. pylori
What media grows for H. influenzae? - ANSWER Chocolate agar
(has Factor V [NAD+] and Factor X [hematin])
What media grows Neisseria (gonorrhea, meningitidis) - ANSWER Thayer-Martin agar
has various antibiotics to inhibit growth of everything but Neisseria
Vancomycin (inhib Gm +)
