Step 1 First Aid Rapid Review LATEST VERSION [QUESTIONS AND
ANSWERS] WITH PRACTICE EXAM DETAILED AND VERIFIED FOR
GUARANTEED PASS- LATEST UPDATE 2025 GRADED A
Anaphylaxis and/or angioedema following blood transfusion - CORRECT 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 - CORRECT ANSWER Marfan Syndrome
(FBN1 gene mutation
chromosome 15 leads to defective fibrillin)
Autosomal Dominant
Athlete with polycythemia - CORRECT ANSWER Secondary to EPO injection
Back pain, fever, night sweats - CORRECT ANSWER Pott disease (vertebral TB)
Bilateral acoustic schwannomas - CORRECT 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 - CORRECT ANSWER Sarcoidosis (non-caseating granulomas)
Black eschar on face of patient with diabetic ketoacidosis - CORRECT ANSWER
Mucor or Rhizopus fungal infection
Travels through cribiform plate vessels
Blue sclera - CORRECT ANSWER Osteogenesis Imperfecta (Type I collagen
defect forming triple helix)
Blue due to exposure of choroidal veins
Bluish line on gingiva and basophilic stippling - CORRECT ANSWER Burton line
(lead poisoning)
Basophilic stippling (rRNA remnants)
Constipation, anemia, CNS impairment
Bone pain, bone enlargement (hat size or hearing loss), arthritis - CORRECT
ANSWER Paget disease of bone (Increased osteoclastic, then osteoblastic activity)
Osteosarcoma or heart failure
,Bounding pulses, wide pulse pressure, diastolic heart murmur, head bobbing -
CORRECT ANSWER Aortic Regurgitation
"Butterfly" facial rash or discoid rash and Raynaud phenomenon in a young female -
CORRECT ANSWER Systemic lupus erythematosus
Type III Hypersensitivity (antigen-antibody complexes deposit) with glomerulonephritis
Type II hypersensitivity with autoimmune hemolysis
Carcinoma spread - CORRECT ANSWER Lymphatics to lymph nodes (except
HCC, Renal cell, follicular thyroid and choriocarcinoma which spread hematogenously)
Sarcoma spread - CORRECT ANSWER Hematogenously
Cafe-au-lait spots, Lisch nodules (iris hemartoma), cutaneous neurofibromas -
CORRECT ANSWER Neurofibromatosis Type I, pheochromocytoma, optic
gliomas
Cafe-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty, multiple
endocrine abnormalities - CORRECT ANSWER McCune-Albright syndrome
(mosaicism, G-protein signaling mutation)
Calf pseudohypertrophy - CORRECT 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 - CORRECT ANSWER
Kawasaki disease (treat with IVIG and aspirin which inhibits TXA2)
"Cherry-red spots" on macula - CORRECT ANSWER Tay-Sachs (ganglioside
accumulation - NO hepatosplenomegaly)
Niemann-Pick (sphingomyelin accumulation)
Central retinal artery occlusion
Chest pain on exertion - CORRECT 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 -
CORRECT ANSWER Dressler syndrome (autoimmune reaction to necrotic tissue
causing fibrinous pericarditis, 2-12 weeks after acute episode)
,Chest pain with ST depressions EKG - CORRECT ANSWER Subendocaridal
ischemia
Unstable angina (troponins -, reversible) and NSTEMI (troponins +, irreversible)
Child uses arms to stand up - CORRECT ANSWER Duchenne Muscular
Dystrophy (Gowers sign)
Child with fever later develops red rash on face that spreads to body - CORRECT
ANSWER "Slapped cheeks" (Erythema infectiosum/fifth disease: parvovirus B19)
Single-stranded DNA virus
Aplastic Anemia in Sickle Cell, B-thalessemia
Chorea, dementia, caudate degeneration - CORRECT ANSWER Huntington
disease (AD, CAG repeat expansion)
Hamiballismus caused by subthalamic nuclei
Loss of GABAergic neurons
Chorioretinitis, hydrocephalus, intracranial calcifications - CORRECT ANSWER
Congenital Toxoplasmosis
Chronic exercise intolerance with myalgia, painful cramps, myoglobinuria - CORRECT
ANSWER AR McArdle disease (skeletal muscle glycogen phosphorylase deficiency)
Cold intolerance, weight gain, bradycardia, facial myxedema, *hypercholesterolemia* -
CORRECT ANSWER Hypothyroidism
Conjugate horizontal gaze palsy, horizontal diplopia - CORRECT ANSWER
Internuclear opthalmoplegia (damage to MLF; may be unilateral or bilateral)
Continuous "machine-like"heart murmur - CORRECT ANSWER PDA (close with
indomethacin; open or maintain with PGE analogs)
Congenital Rubella
*Late cyanosis in lower extremity*
Cutaneous/dermal edema due to connective tissue deposition - CORRECT
ANSWER Myxedema (caused by hypothyroidism, Graves disease [pretibial])
Cutaneous flushing, diarrhea, bronchospasm - CORRECT ANSWER Carcinoid
syndrome (right-sided cardiac valvular fibrous lesions, Increased 5-HIAA in urine, 5-HT
in serum)
Requires mets from GI to liver
, Dark purple skin/ mouth nodules in a patient with AIDs - CORRECT ANSWER
Kaposi Sarcoma, associated with HHV-8
Endothelial cell tumor, not of blood vessels (will not blanche)
Spindle cells
Spreads via blood
Deep, labored breathing/hypoventilation - CORRECT ANSWER Diabetic
Ketoacidosis (Kussmaul respirations)
Mild = glossitis
Severe = Broad collar Dermatitis, dementia, diarrhea, - CORRECT ANSWER
Pellagra (Niacin [B3] Deficiency)
Caused by Hartnups or isoniazid (B6)
Dilated cardiomyopathy, edema, alcoholism or malnutrition - CORRECT ANSWER
Wet Beriberi (Thiamine [B1] Deficiency)
Dog or cat bite resulting in infection - CORRECT ANSWER Pasteurella multocida
(cellulitis at inoculation site) gram neg. coccobacillus
Dry eyes, dry mouth, arthritis, recurrent dental caries - CORRECT ANSWER
Sjogren syndrome (autoimmune destruction of exocrine glands)
Can have RF, Anti-SSA or SSB
Lymphocytic sialadenitis
Risk of B-cell lymphoma
Dysphagia (esophageal webs), glossitis (beefy red tongue), iron deficiency anemia
(spoon nails) - CORRECT ANSWER Plummer-Vinson syndrome (may progress to
esophageal squamous cell carcinoma)
Elastic skin, hyper-mobility of joints, increased bleeding tendency - CORRECT
ANSWER Ehlers-Danlos syndrome (type V collagen defect, type III collagen defect
seen in vascular ED)
Pro collagen molecules are not cleaved (N/C removal impaired)
Enlarged, hard left supraclavicular node - CORRECT ANSWER Virchow node
(metastasis from gastric cancer)
Episodic vertigo, tinnitus, hearing loss - CORRECT ANSWER Meniere disease:
excess of endolymph fluid in the inner ear
Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T-cells - CORRECT
ANSWER Mycosis fungoides (Pautrier-cutaneous T-cell lymphoma) or Sezary
syndrome (mycosis fungoides and malignant T cells with cerebriform nuclei in blood)
ANSWERS] WITH PRACTICE EXAM DETAILED AND VERIFIED FOR
GUARANTEED PASS- LATEST UPDATE 2025 GRADED A
Anaphylaxis and/or angioedema following blood transfusion - CORRECT 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 - CORRECT ANSWER Marfan Syndrome
(FBN1 gene mutation
chromosome 15 leads to defective fibrillin)
Autosomal Dominant
Athlete with polycythemia - CORRECT ANSWER Secondary to EPO injection
Back pain, fever, night sweats - CORRECT ANSWER Pott disease (vertebral TB)
Bilateral acoustic schwannomas - CORRECT 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 - CORRECT ANSWER Sarcoidosis (non-caseating granulomas)
Black eschar on face of patient with diabetic ketoacidosis - CORRECT ANSWER
Mucor or Rhizopus fungal infection
Travels through cribiform plate vessels
Blue sclera - CORRECT ANSWER Osteogenesis Imperfecta (Type I collagen
defect forming triple helix)
Blue due to exposure of choroidal veins
Bluish line on gingiva and basophilic stippling - CORRECT ANSWER Burton line
(lead poisoning)
Basophilic stippling (rRNA remnants)
Constipation, anemia, CNS impairment
Bone pain, bone enlargement (hat size or hearing loss), arthritis - CORRECT
ANSWER Paget disease of bone (Increased osteoclastic, then osteoblastic activity)
Osteosarcoma or heart failure
,Bounding pulses, wide pulse pressure, diastolic heart murmur, head bobbing -
CORRECT ANSWER Aortic Regurgitation
"Butterfly" facial rash or discoid rash and Raynaud phenomenon in a young female -
CORRECT ANSWER Systemic lupus erythematosus
Type III Hypersensitivity (antigen-antibody complexes deposit) with glomerulonephritis
Type II hypersensitivity with autoimmune hemolysis
Carcinoma spread - CORRECT ANSWER Lymphatics to lymph nodes (except
HCC, Renal cell, follicular thyroid and choriocarcinoma which spread hematogenously)
Sarcoma spread - CORRECT ANSWER Hematogenously
Cafe-au-lait spots, Lisch nodules (iris hemartoma), cutaneous neurofibromas -
CORRECT ANSWER Neurofibromatosis Type I, pheochromocytoma, optic
gliomas
Cafe-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty, multiple
endocrine abnormalities - CORRECT ANSWER McCune-Albright syndrome
(mosaicism, G-protein signaling mutation)
Calf pseudohypertrophy - CORRECT 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 - CORRECT ANSWER
Kawasaki disease (treat with IVIG and aspirin which inhibits TXA2)
"Cherry-red spots" on macula - CORRECT ANSWER Tay-Sachs (ganglioside
accumulation - NO hepatosplenomegaly)
Niemann-Pick (sphingomyelin accumulation)
Central retinal artery occlusion
Chest pain on exertion - CORRECT 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 -
CORRECT ANSWER Dressler syndrome (autoimmune reaction to necrotic tissue
causing fibrinous pericarditis, 2-12 weeks after acute episode)
,Chest pain with ST depressions EKG - CORRECT ANSWER Subendocaridal
ischemia
Unstable angina (troponins -, reversible) and NSTEMI (troponins +, irreversible)
Child uses arms to stand up - CORRECT ANSWER Duchenne Muscular
Dystrophy (Gowers sign)
Child with fever later develops red rash on face that spreads to body - CORRECT
ANSWER "Slapped cheeks" (Erythema infectiosum/fifth disease: parvovirus B19)
Single-stranded DNA virus
Aplastic Anemia in Sickle Cell, B-thalessemia
Chorea, dementia, caudate degeneration - CORRECT ANSWER Huntington
disease (AD, CAG repeat expansion)
Hamiballismus caused by subthalamic nuclei
Loss of GABAergic neurons
Chorioretinitis, hydrocephalus, intracranial calcifications - CORRECT ANSWER
Congenital Toxoplasmosis
Chronic exercise intolerance with myalgia, painful cramps, myoglobinuria - CORRECT
ANSWER AR McArdle disease (skeletal muscle glycogen phosphorylase deficiency)
Cold intolerance, weight gain, bradycardia, facial myxedema, *hypercholesterolemia* -
CORRECT ANSWER Hypothyroidism
Conjugate horizontal gaze palsy, horizontal diplopia - CORRECT ANSWER
Internuclear opthalmoplegia (damage to MLF; may be unilateral or bilateral)
Continuous "machine-like"heart murmur - CORRECT ANSWER PDA (close with
indomethacin; open or maintain with PGE analogs)
Congenital Rubella
*Late cyanosis in lower extremity*
Cutaneous/dermal edema due to connective tissue deposition - CORRECT
ANSWER Myxedema (caused by hypothyroidism, Graves disease [pretibial])
Cutaneous flushing, diarrhea, bronchospasm - CORRECT ANSWER Carcinoid
syndrome (right-sided cardiac valvular fibrous lesions, Increased 5-HIAA in urine, 5-HT
in serum)
Requires mets from GI to liver
, Dark purple skin/ mouth nodules in a patient with AIDs - CORRECT ANSWER
Kaposi Sarcoma, associated with HHV-8
Endothelial cell tumor, not of blood vessels (will not blanche)
Spindle cells
Spreads via blood
Deep, labored breathing/hypoventilation - CORRECT ANSWER Diabetic
Ketoacidosis (Kussmaul respirations)
Mild = glossitis
Severe = Broad collar Dermatitis, dementia, diarrhea, - CORRECT ANSWER
Pellagra (Niacin [B3] Deficiency)
Caused by Hartnups or isoniazid (B6)
Dilated cardiomyopathy, edema, alcoholism or malnutrition - CORRECT ANSWER
Wet Beriberi (Thiamine [B1] Deficiency)
Dog or cat bite resulting in infection - CORRECT ANSWER Pasteurella multocida
(cellulitis at inoculation site) gram neg. coccobacillus
Dry eyes, dry mouth, arthritis, recurrent dental caries - CORRECT ANSWER
Sjogren syndrome (autoimmune destruction of exocrine glands)
Can have RF, Anti-SSA or SSB
Lymphocytic sialadenitis
Risk of B-cell lymphoma
Dysphagia (esophageal webs), glossitis (beefy red tongue), iron deficiency anemia
(spoon nails) - CORRECT ANSWER Plummer-Vinson syndrome (may progress to
esophageal squamous cell carcinoma)
Elastic skin, hyper-mobility of joints, increased bleeding tendency - CORRECT
ANSWER Ehlers-Danlos syndrome (type V collagen defect, type III collagen defect
seen in vascular ED)
Pro collagen molecules are not cleaved (N/C removal impaired)
Enlarged, hard left supraclavicular node - CORRECT ANSWER Virchow node
(metastasis from gastric cancer)
Episodic vertigo, tinnitus, hearing loss - CORRECT ANSWER Meniere disease:
excess of endolymph fluid in the inner ear
Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T-cells - CORRECT
ANSWER Mycosis fungoides (Pautrier-cutaneous T-cell lymphoma) or Sezary
syndrome (mycosis fungoides and malignant T cells with cerebriform nuclei in blood)
