USMLE Step 1 First Aid Rapid Review Questions And
Correct Answers With Complete Solutions | New
Update 2025
Abdominal pain, ascites, hepatomegaly - ANSWER Budd-Chiari Syndrome
(post hepatic venous thrombosis). Associated with Polycythemia vera.
Achilles tendon Xanthoma - ANSWER Familial Hypercholesterolemia
(absent/defective LDL receptors)
May have MI before age 20
Autosomal dominant
Adrenal hemorrhage, hypotension, DIC - ANSWER Waterhouse-Friedrichsen
syndrome (Neisseria meningitidis)
Anaphylaxis and/or angioedema following blood transfusion - ANSWER IgA
deficiency; C1 inhibitor deficiency would only cause angioedema, not anaphylaxis
Arachnodactyly (spider fingers), lens dislocation, aortic dissection or aneurysm,
hyperflexible joints, pectus excavatum - ANSWER Marfan Syndrome (FBN1
gene mutation
chromosome 15 leads to defective fibrillin)
Autosomal Dominant
Athlete with polycythemia - ANSWER Secondary to EPO injection
,Back pain, fever, night sweats - ANSWER Pott disease (vertebral TB)
Bilateral acoustic schwannomas - ANSWER Neurofibromatosis type 2
S-100+, cerebellopontine angle
Bilateral hilar adenopathy, uveitis, high ACE, hypercalcemia (activated
macrophages for Vit D), interstitial fibrosis, erythema nodosum, elevated CD4:CD8
ratio on lavage; asteroid bodies - ANSWER Sarcoidosis (non-caseating
granulomas)
Black eschar on face of patient with diabetic ketoacidosis - ANSWER Mucor or
Rhizopus fungal infection
Travels through cribiform plate vessels
Blue sclera - ANSWER Osteogenesis Imperfecta (Type I collagen defect forming
triple helix)
Blue due to exposure of choroidal veins
Bluish line on gingiva and basophilic stippling - ANSWER Burton line (lead
poisoning)
Basophilic stippling (rRNA remnants)
Constipation, anemia, CNS impairment
Bone pain, bone enlargement (hat size or hearing loss), arthritis - ANSWER
Paget disease of bone (Increased osteoclastic, then osteoblastic activity)
Osteosarcoma or heart failure
,Bounding pulses, wide pulse pressure, diastolic heart murmur, head bobbing -
ANSWER Aortic Regurgitation
"Butterfly" facial rash or discoid rash and Raynaud phenomenon in a young female
- ANSWER Systemic lupus erythematosus
Type III Hypersensitivity (antigen-antibody complexes deposit) with
glomerulonephritis
Type II hypersensitivity with autoimmune hemolysis
Carcinoma spread - ANSWER Lymphatics to lymph nodes (except HCC, Renal
cell, follicular thyroid and choriocarcinoma which spread hematogenously)
Sarcoma spread - ANSWER Hematogenously
Cafe-au-lait spots, Lisch nodules (iris hemartoma), cutaneous neurofibromas -
ANSWER Neurofibromatosis Type I, pheochromocytoma, optic gliomas
Cafe-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty,
multiple endocrine abnormalities - ANSWER McCune-Albright syndrome
(mosaicism, G-protein signaling mutation)
Calf pseudohypertrophy - ANSWER Muscular dystrophy (Duchenne, due to X-
linked frameshift > truncated dystrophin)
Dilated cardiomyopathy
High CK
, Cervical lymphadenopathy, desquamating rash on palms and soles, coronary
aneurysms, red conjuctivae, and strawberry tongue - ANSWER Kawasaki
disease (treat with IVIG and aspirin which inhibits TXA2)
"Cherry-red spots" on macula - ANSWER Tay-Sachs (ganglioside accumulation -
NO hepatosplenomegaly)
Niemann-Pick (sphingomyelin accumulation)
Central retinal artery occlusion
Chest pain on exertion - ANSWER Angina (stable: with moderate exertion,
*cellular swelling indicates reversibility*, atherosclerosis; unstable: with minimal
exertion or at rest, partial occlusion)
Chest pain, pericardial effusion/friction rub, persistent fever weeks after an MI -
ANSWER Dressler syndrome (autoimmune reaction to necrotic tissue causing
fibrinous pericarditis, 2-12 weeks after acute episode)
Chest pain with ST depressions EKG - ANSWER Subendocaridal ischemia
Unstable angina (troponins -, reversible) and NSTEMI (troponins +, irreversible)
Child uses arms to stand up - ANSWER Duchenne Muscular Dystrophy (Gowers
sign)
Child with fever later develops red rash on face that spreads to body - ANSWER
"Slapped cheeks" (Erythema infectiosum/fifth disease: parvovirus B19)
Single-stranded DNA virus
Correct Answers With Complete Solutions | New
Update 2025
Abdominal pain, ascites, hepatomegaly - ANSWER Budd-Chiari Syndrome
(post hepatic venous thrombosis). Associated with Polycythemia vera.
Achilles tendon Xanthoma - ANSWER Familial Hypercholesterolemia
(absent/defective LDL receptors)
May have MI before age 20
Autosomal dominant
Adrenal hemorrhage, hypotension, DIC - ANSWER Waterhouse-Friedrichsen
syndrome (Neisseria meningitidis)
Anaphylaxis and/or angioedema following blood transfusion - ANSWER IgA
deficiency; C1 inhibitor deficiency would only cause angioedema, not anaphylaxis
Arachnodactyly (spider fingers), lens dislocation, aortic dissection or aneurysm,
hyperflexible joints, pectus excavatum - ANSWER Marfan Syndrome (FBN1
gene mutation
chromosome 15 leads to defective fibrillin)
Autosomal Dominant
Athlete with polycythemia - ANSWER Secondary to EPO injection
,Back pain, fever, night sweats - ANSWER Pott disease (vertebral TB)
Bilateral acoustic schwannomas - ANSWER Neurofibromatosis type 2
S-100+, cerebellopontine angle
Bilateral hilar adenopathy, uveitis, high ACE, hypercalcemia (activated
macrophages for Vit D), interstitial fibrosis, erythema nodosum, elevated CD4:CD8
ratio on lavage; asteroid bodies - ANSWER Sarcoidosis (non-caseating
granulomas)
Black eschar on face of patient with diabetic ketoacidosis - ANSWER Mucor or
Rhizopus fungal infection
Travels through cribiform plate vessels
Blue sclera - ANSWER Osteogenesis Imperfecta (Type I collagen defect forming
triple helix)
Blue due to exposure of choroidal veins
Bluish line on gingiva and basophilic stippling - ANSWER Burton line (lead
poisoning)
Basophilic stippling (rRNA remnants)
Constipation, anemia, CNS impairment
Bone pain, bone enlargement (hat size or hearing loss), arthritis - ANSWER
Paget disease of bone (Increased osteoclastic, then osteoblastic activity)
Osteosarcoma or heart failure
,Bounding pulses, wide pulse pressure, diastolic heart murmur, head bobbing -
ANSWER Aortic Regurgitation
"Butterfly" facial rash or discoid rash and Raynaud phenomenon in a young female
- ANSWER Systemic lupus erythematosus
Type III Hypersensitivity (antigen-antibody complexes deposit) with
glomerulonephritis
Type II hypersensitivity with autoimmune hemolysis
Carcinoma spread - ANSWER Lymphatics to lymph nodes (except HCC, Renal
cell, follicular thyroid and choriocarcinoma which spread hematogenously)
Sarcoma spread - ANSWER Hematogenously
Cafe-au-lait spots, Lisch nodules (iris hemartoma), cutaneous neurofibromas -
ANSWER Neurofibromatosis Type I, pheochromocytoma, optic gliomas
Cafe-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty,
multiple endocrine abnormalities - ANSWER McCune-Albright syndrome
(mosaicism, G-protein signaling mutation)
Calf pseudohypertrophy - ANSWER Muscular dystrophy (Duchenne, due to X-
linked frameshift > truncated dystrophin)
Dilated cardiomyopathy
High CK
, Cervical lymphadenopathy, desquamating rash on palms and soles, coronary
aneurysms, red conjuctivae, and strawberry tongue - ANSWER Kawasaki
disease (treat with IVIG and aspirin which inhibits TXA2)
"Cherry-red spots" on macula - ANSWER Tay-Sachs (ganglioside accumulation -
NO hepatosplenomegaly)
Niemann-Pick (sphingomyelin accumulation)
Central retinal artery occlusion
Chest pain on exertion - ANSWER Angina (stable: with moderate exertion,
*cellular swelling indicates reversibility*, atherosclerosis; unstable: with minimal
exertion or at rest, partial occlusion)
Chest pain, pericardial effusion/friction rub, persistent fever weeks after an MI -
ANSWER Dressler syndrome (autoimmune reaction to necrotic tissue causing
fibrinous pericarditis, 2-12 weeks after acute episode)
Chest pain with ST depressions EKG - ANSWER Subendocaridal ischemia
Unstable angina (troponins -, reversible) and NSTEMI (troponins +, irreversible)
Child uses arms to stand up - ANSWER Duchenne Muscular Dystrophy (Gowers
sign)
Child with fever later develops red rash on face that spreads to body - ANSWER
"Slapped cheeks" (Erythema infectiosum/fifth disease: parvovirus B19)
Single-stranded DNA virus
