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USMLE Step 2

Subjects : health-sciences, usmle-step-2

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Case - control study
Conversion disorder
Neither
Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first - degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer
OCP and barrier contraception

2. Cause of amenorrhea with normal prolactin - no response to estrogen - progesterone challenge - and a history of D&C.

3. Meningitis in neonates. Causes? Treatment?
OCP and barrier contraception
Depersonalization disorder
Mycoplasma
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin

4. CSF findings:
Cirrhosis - CHF - nephritic syndrome
Bacterial meningitis
Pityriasis rosea
Hypertension - bradycardia - and abnormal respirations

5. Patient presents with sudden onset of severe - diffuse abdominal pain. Exam reveals peritoneal signs and AXR reveals free air under the diaphragm. Management?
Phencyclidine hydrochloride (PCP) intoxication
SSRIs
Emergent laparotomy to repair perforated viscus - likely stomach
IVIG or plasmapheresis

6. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Allergic interstitial nephritis
Clomiphene citrate
Treat immediately. Consent is implied in emergency situations
Klebsiella

7. Acceptable urine output in a trauma patient.
IVIG or plasmapheresis
'Sawtooth' P waves
50 cc/hour
Rubella

8. Treatment for bacterial vaginosis.
Identify cause; pressors (e.g. - dobutamine)
Oral or topical metronidazole
MAOIs
Hashimoto's thyroiditis

9. Low urine specific gravity in the presence of high serum osmolality.
Nephrolithiasis
Febrile seizures (roseola infantum)
Pemphigus vulgaris
DI

10. PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific?
Lyme disease - Ixodes tick - doxycycline
Bacterial meningitis
Malingering
Highly sensitive for TB

11. Combined UMN and LMN disorder.
Acute pancreatitis
ALS
Oral or topical metronidazole
Usually resolves spontaneously; may require IVIG and/or corticosteroids

12. Hematuria - hypertension - and oliguria.
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
Nephritic syndrome
1

13. Name the organism:
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Threatened abortion
A patient with chest trauma who was previously stable suddenly dies
Pseudomonas

14. Acid - base disturbance commonly seen in pregnant women.
Respiratory alkalosis
S. aureus
1
Sarcoidosis

15. Honeycomb pattern on CXR. Diagnosis? Treatment?
Hypocalcemia
Isolation
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Frotteurism (a paraphilia)

16. Hematuria - flank pain - and palpable flank mass.
Cardiogenic shock
Renal cell carcinoma (RCC)
Nephrogenic diabetes insipidus (DI)
Wernicke's encephalopathy due to a deficiency of thiamine

17. Acute - phase treatment for Kawasaki disease.
Niacin
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Pentad of TTP
Septic or anaphylactic shock

18. A child has loss of red light reflex. Diagnosis?
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Suspect retinoblastoma
IV benzodiazepine
Weight gain - type 2 DM - QT prolongation

19. Difference between a cohort and a case - control study.
Cohort studies can be used to calculate relative risk (RR) - incidence - and/or odds ratio (OR). Case - control studies can be used to calculate an OR
Broca's aphasia. Frontal lobe - left MCA distribution
'Sawtooth' P waves
Number of deaths from 20 weeks' gestation to birth per 1000 total births

20. Diagnostic test for hypertrophic cardiomyopathy.
Infection - febrile seizures - trauma - idiopathic
Crohn's disease
Distal radius (Colles' fracture)
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)

21. Rigidity and stiffness that progress to choreiform movements - accompanied by moodiness and altered behavior.

22. Treatment for AML M3.
Nephrogenic diabetes insipidus (DI)
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Suspect retinoblastoma
Retinoic acid

23. Identify key organisms causing diarrhea:
Coarctation of the aorta
Prinzmetal's angina
Fluid restriction - demeclocycline
Yersinia

24. Treatment for atrial fibrillation.
Anticoagulation - rate control - cardioversion
IV hydration and loop diuretics (furosemide)
Seminoma
Alopecia areata (autoimmune process)

25. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
CML
Streptococcus pneumoniae
Phencyclidine hydrochloride (PCP) intoxication
Yersinia

26. Joints in the hand affected in rheumatoid arthritis.
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
MCP and PIP joints; DIP joints are spared
S. aureus
Anticoagulation - rate control - cardioversion

27. The number of true positives divided by the number of patients with the disease is _____.
Sensitivity
Lichen planus
Menometrorrhagia
Nephrotic syndrome

28. Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
Usually resolves spontaneously; may require IVIG and/or corticosteroids
30 cc/hour
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine

29. Rhomboid - shaped - positively birefringent crystals on joint fluid aspirate.
Intraductal papilloma
Pseudogout
ARDS
Third - degree heart block

30. Nikolsky's sign.
E. coli O157:H7
Cluster headache
Bullous pemphigoid
Endometrial or estrogen receptor - breast cancer

31. The most common 1
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Excessive EtOH
Angina is new - is worsening - or occurs at rest
Multiple myeloma

32. Medication given to accelerate fetal lung maturity.
O2 - analgesia - hydration - and - if severe - transfusion
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Betamethasone or dexamethasone
Actinic keratosis

33. Treatment for opioid overdose.
Hypokalemia
Naloxone
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
IVIG or plasmapheresis

34. Identify key organisms causing diarrhea:
1
Hypoxia and hypocarbia
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
E. coli O157:H7

35. Signs suggesting radial nerve damage with humeral fracture.
Reye's syndrome
Hereditary spherocytosis
Crohn's disease
Wrist drop - loss of thumb abduction

36. Acid - base disorder in pulmonary embolism.
Klebsiella
Kegel exercises - estrogen - pessaries for stress incontinence
Hypoxia and hypocarbia
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination

37. Key side effects of atypical antipsychotics.
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Conduct disorder
Weight gain - type 2 DM - QT prolongation

38. Side effects of corticosteroids.
Third - degree heart block
Polymyalgia rheumatica
Establish the ABCs
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies

39. Nontender abdominal mass associated with elevated VMA and HVA.
Prerenal
Neuroblastoma
Hypotension and bradycardia
Third - degree heart block

40. Inflammation and epithelial thinning of the anogenital area - predominantly in postmenopausal women.
Lichen sclerosus
Highly sensitive for TB
Bladder rupture or urethral injury
Fanconi's anemia

41. Causes of drug - induced SLE.
Number of deaths per 1000 population
Observational bias
Slipped capital femoral epiphyses. AP and frog - leg lateral view
INH - penicillamine - hydralazine - procainamide

42. Treatment for acetaminophen overdose.
Type II (proximal) RTA
7-10 days
N- acetylcysteine
Sporothrix schenckii

43. RTA associated with aldosterone defect.
Type IV (distal) RTA
46 -XX
RSV bronchiolitis
Colposcopy and endocervical curettage

44. Classic ultrasound and gross appearance of complete hydatidiform mole.

45. A patient presents with signs of hypocalcemia - high phosphorus - and low PTH.
Nephritic syndrome
MAOIs
Chronic lymphocytic leukemia (CLL)
Hypoparathyroidism

46. The most common inherited cause of hypercoagulability.
Factor V Leiden mutation
HIDA scan
Pseudomonas
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension

47. First - line treatment for moderate hypercalcemia.
Lesions of 1
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
IV hydration and loop diuretics (furosemide)
Fluid restriction - demeclocycline

48. Type of ARF in a patient with FeNa < 1%.
Prerenal
Lesions of 1
Number of deaths from birth to 28 days per 1000 live births
Neuroleptics

49. The most common cancer in men and the most common cause of death from cancer in men.
Oral surgery
HBV immunoglobulin
DI
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths

50. Therapy for polycystic ovarian syndrome.
Lesions of 1
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Angina is new - is worsening - or occurs at rest
Weight loss and OCPs