Page | 1
First Aid-USMLE STEP 1 High Yield
Questions and Verified Answers
Q: Abdominal pain, ascites, and hepatomegaly
ANS: Budd-Chiari syndrome (posthepatic venous thrombosis)
-Absence of JVD
Q:
Abdominal pain, diarrhea, leukocytosis, recent antibiotic use
ANS: Clostridium difficile infection
Q:
Achilles tendon xanthoma
ANS: Familial hypercholesterolemia (decreased LDL receptor signaling)
Q:
Adrenal hemorrhage, hypotension, DIC
ANS: Waterhouse-Friderichsen syndrome (menengococcemia)
Q:
Anaphylaxis following blood transfusion
ANS: IgA deficiency
Q:
Anterior "drawer sign" ⊕
ANS: Anterior cruciate ligament injury
Q:
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
ANS: Marfan syndrome (fibrillin defect)
Q:
, Page | 2
Athlete with polycythemia
ANS: 2° to erythropoietin injection
Q:
Back pain, fever, night sweats
ANS: Pott disease (vertebral TB)
Q:
Bilateral acoustic schwannomas
ANS: Neurofibromatosis type 2
Q:
Bilateral hilar adenopathy, uveitis
ANS: Sarcoidosis (noncaseating granulomas)
Q:
Black eschar on face of patient with diabetic ketoacidosis
ANS: Mucor or Rhizopus fungal infection
Q:
Blue sclera, brittle bones
ANS: Osteogenesis imperfecta (type I collagen defect)
Q:
Bluish line on gingiva
ANS: Burton line (lead poisoning)
Q:
Bone pain, bone enlargement, arthritis
ANS: Paget disease of bone (osteoblastic and osteoclastic activity)
Q:
Bounding pulses, diastolic heart murmur, head bobbing
ANS: Aortic regurgitation
, Page | 3
Q:
"Butterfly" facial rash and Raynaud phenomenon in a young female
ANS: Systemic lupus erythematosus
Q:
Café-au-lait spots, Lisch nodules (iris hamartoma), cutaneous neurofibromas,
pheochromocytomas, optic gliomas
ANS: Neurofibromatosis type I, pheochromocytoma, optic gliomas
Q:
Café-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty, multiple
endocrine abnormalities
ANS: McCune-Albright syndrome (mosaic G-protein signaling mutation)
Q:
Calf pseudohypertrophy
ANS: Muscular dystrophy (most commonly Duchenne, due to X-linked recessive
frameshift mutation of dystrophin gene)
Q:
Child with cervical lymphadenopathy, desquamating rash, coronary aneurysms, red
conjunctivae and tongue
ANS: Kawasaki disease (treat with IVIG and aspirin)
Q:
"Cherry-red spots" on macula
ANS: Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin
accumulation), central retinal artery occlusion
Q:
Chest pain on exertion
ANS: Angina (stable: with moderate exertion; unstable: with minimal exertion or at
rest)
Q:
Chest pain, pericardial effusion/friction rub, persistent fever following MI
, Page | 4
ANS: Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 2-
12 weeks after acute episode
Q:
Chest pain with ST depressions on EKG
ANS: Unstable angina (troponins −) or NSTEMI (troponins +)
Q:
Child uses arms to stand up from squat
ANS: Gowers sign (Duchenne muscular dystrophy)
Q:
Child with fever later develops red rash on face that spreads to body
ANS: "Slapped cheeks" (erythema infectiosum/fifth disease: parvovirus B19)
Q:
Chorea, dementia, caudate degeneration
ANS: Huntington disease (autosomal dominant CAG repeat expansion)
Q:
Chorioretinitis, hydrocephalus, intracranial calcifications
ANS: Congenital toxoplasmosis
Q:
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria
ANS: McArdle disease (skeletal muscle glycogen phosphorylase deficiency)
Q:
Cold intolerance
ANS: Hypothyroidism
Q:
Conjugate horizontal gaze palsy, horizontal diplopia
ANS: Internuclear ophthalmoplegia (damage to MLF; may be unilateral or
bilateral)
First Aid-USMLE STEP 1 High Yield
Questions and Verified Answers
Q: Abdominal pain, ascites, and hepatomegaly
ANS: Budd-Chiari syndrome (posthepatic venous thrombosis)
-Absence of JVD
Q:
Abdominal pain, diarrhea, leukocytosis, recent antibiotic use
ANS: Clostridium difficile infection
Q:
Achilles tendon xanthoma
ANS: Familial hypercholesterolemia (decreased LDL receptor signaling)
Q:
Adrenal hemorrhage, hypotension, DIC
ANS: Waterhouse-Friderichsen syndrome (menengococcemia)
Q:
Anaphylaxis following blood transfusion
ANS: IgA deficiency
Q:
Anterior "drawer sign" ⊕
ANS: Anterior cruciate ligament injury
Q:
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
ANS: Marfan syndrome (fibrillin defect)
Q:
, Page | 2
Athlete with polycythemia
ANS: 2° to erythropoietin injection
Q:
Back pain, fever, night sweats
ANS: Pott disease (vertebral TB)
Q:
Bilateral acoustic schwannomas
ANS: Neurofibromatosis type 2
Q:
Bilateral hilar adenopathy, uveitis
ANS: Sarcoidosis (noncaseating granulomas)
Q:
Black eschar on face of patient with diabetic ketoacidosis
ANS: Mucor or Rhizopus fungal infection
Q:
Blue sclera, brittle bones
ANS: Osteogenesis imperfecta (type I collagen defect)
Q:
Bluish line on gingiva
ANS: Burton line (lead poisoning)
Q:
Bone pain, bone enlargement, arthritis
ANS: Paget disease of bone (osteoblastic and osteoclastic activity)
Q:
Bounding pulses, diastolic heart murmur, head bobbing
ANS: Aortic regurgitation
, Page | 3
Q:
"Butterfly" facial rash and Raynaud phenomenon in a young female
ANS: Systemic lupus erythematosus
Q:
Café-au-lait spots, Lisch nodules (iris hamartoma), cutaneous neurofibromas,
pheochromocytomas, optic gliomas
ANS: Neurofibromatosis type I, pheochromocytoma, optic gliomas
Q:
Café-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty, multiple
endocrine abnormalities
ANS: McCune-Albright syndrome (mosaic G-protein signaling mutation)
Q:
Calf pseudohypertrophy
ANS: Muscular dystrophy (most commonly Duchenne, due to X-linked recessive
frameshift mutation of dystrophin gene)
Q:
Child with cervical lymphadenopathy, desquamating rash, coronary aneurysms, red
conjunctivae and tongue
ANS: Kawasaki disease (treat with IVIG and aspirin)
Q:
"Cherry-red spots" on macula
ANS: Tay-Sachs (ganglioside accumulation) or Niemann-Pick (sphingomyelin
accumulation), central retinal artery occlusion
Q:
Chest pain on exertion
ANS: Angina (stable: with moderate exertion; unstable: with minimal exertion or at
rest)
Q:
Chest pain, pericardial effusion/friction rub, persistent fever following MI
, Page | 4
ANS: Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 2-
12 weeks after acute episode
Q:
Chest pain with ST depressions on EKG
ANS: Unstable angina (troponins −) or NSTEMI (troponins +)
Q:
Child uses arms to stand up from squat
ANS: Gowers sign (Duchenne muscular dystrophy)
Q:
Child with fever later develops red rash on face that spreads to body
ANS: "Slapped cheeks" (erythema infectiosum/fifth disease: parvovirus B19)
Q:
Chorea, dementia, caudate degeneration
ANS: Huntington disease (autosomal dominant CAG repeat expansion)
Q:
Chorioretinitis, hydrocephalus, intracranial calcifications
ANS: Congenital toxoplasmosis
Q:
Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria
ANS: McArdle disease (skeletal muscle glycogen phosphorylase deficiency)
Q:
Cold intolerance
ANS: Hypothyroidism
Q:
Conjugate horizontal gaze palsy, horizontal diplopia
ANS: Internuclear ophthalmoplegia (damage to MLF; may be unilateral or
bilateral)
