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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. Unilateral - severe periorbital headache with tearing and conjunctival erythema.
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Toxoplasma gondii
M3
Cluster headache

2. The most common cause of female infertility.
B12 deficiency
Endometriosis
Seventy percent if the stenosis is symptomatic
Alport's syndrome

3. An agent that reverses the effects of heparin.
Benzodiazepines
Protamine
Conflict of interest
Sensitivity

4. Honeycomb pattern on CXR. Diagnosis? Treatment?
Uterine atony
Hypertension - bradycardia - and abnormal respirations
Hypovolemic shock
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help

5. The most common pathogen causing croup.
Panic disorder
Toxoplasma gondii
M3
Parainfluenza virus type 1

6. A violent patient has vertical and horizontal nystagmus.
Osmotic fragility test
Phencyclidine hydrochloride (PCP) intoxication
Coccidioidomycosis. Amphotericin B
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones

7. Heinz bodies?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Huntington's disease
Chronic lymphocytic leukemia (CLL)
Betamethasone or dexamethasone

8. Albuminocytologic dissociation.
Angina - ST- segment changes on ECG - or ? BP
HBV immunoglobulin
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Guillain - Barr

9. Aplastic crisis in sickle cell disease.
Infection - cancer - and autoimmune disease
Parvovirus B19
Chronic granulomatous disease
Ampulla of the oviduct

10. Common symptoms associated with silent MIs.
Calcium oxalate
Seventy percent if the stenosis is symptomatic
Number of deaths from birth to 28 days per 1000 live births
CHF - shock - and altered mental status

11. A 20-year - old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?
Diverticulosis
Cerebral berry aneurysms (AD PCKD)
Glomerulonephritis/nephritic syndrome
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins

12. Presence of red cell casts in urine sediment.
Bruton's X- linked agammaglobulinemia
Neither
Glomerulonephritis/nephritic syndrome
CA-125 and transvaginal ultrasound

13. Postnatal mortality?
Allergic interstitial nephritis
Weight loss and OCPs
Number of deaths from 28 days to one year per 1000 live births
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid

14. Amenorrhea - bradycardia - and abnormal body image in a young female.
Intussusception
Lesions of 1
Anorexia
Hodgkin's lymphoma

15. A postoperative patient with significant pain presents with hyponatremia and normal volume status.
Pseudomonas
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
SIADH due to stress
Normal

16. Lung cancer highly related to cigarette exposure.
Restrictive pulmonary disease
Absence seizures
SCLC
Retrograde cystourethrogram

17. Blood in the urethral meatus or high - riding prostate.
Bladder rupture or urethral injury
Infection - cancer - and autoimmune disease
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Number of deaths from birth to 28 days per 1000 live births

18. Test to rule out urethral injury.
Retrograde cystourethrogram
Huntington's disease
Observational bias
Hypotension and bradycardia

19. CSF findings:
MS
Streptococcus pneumoniae
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Iatrogenic steroid administration. The second most common cause is Cushing's disease

20. A condition associated with red 'currant - jelly' stools.
Intussusception
Phencyclidine hydrochloride (PCP) intoxication
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Taenia solium (cysticercosis)

21. Cannon 'a' waves.
Rate control with carotid massasge or other vagal stimulation
Third - degree heart block
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Parkinson's disease

22. Virchow's triad.
HGPRTase deficiency)
Stasis - hypercoagulability - endothelial damage
S. aureus
Central pontine myelinolysis

23. Name the organism:
Pseudomonas
Selective IgA deficiency
Lung - breast - skin (melanoma) - kidney - GI tract
Type II (proximal) RTA

24. Identify key organisms causing diarrhea:
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Giardia
Membranous glomerulonephritis
Biliary tract obstruction

25. Indications for surgical repair of abdominal aortic aneurysm.
68% - 95.5% - 99.7%
Lobular carcinoma in situ
Excessive EtOH
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured

26. 'Cradle cap.'
TICS
Seborrheic dermatitis. Treat with antifungals
Uremic syndrome seen in patients with renal failure
Beta- blockers - Ca2+ channel blockers - TCAs

27. Identify key organisms causing diarrhea:
Third - degree heart block
Naloxone
Salmonella
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)

28. The most common type of nephrolithiasis.
Calcium oxalate
Osteoarthritis
Lesion of 1
Chronic granulomatous disease

29. Treatment of anaphylactic shock.
50 cc/hour
Sheehan's syndrome (postpartum pituitary necrosis)
Diphenhydramine or epinephrine 1:1000
Hypoparathyroidism

30. Medical options for endometriosis.
OCPs - danazol - GnRH agonists
Substance abuse
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Rett's disorder

31. Acute - phase treatment for Kawasaki disease.
Klebsiella
Neuroblastoma
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)

32. Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV- positive patient At what CD4 count? Mycobacterium avium - intracellulare (MAI) prophylaxis?
Membranous glomerulonephritis
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Pentad of TTP
Phototherapy (mild) or exchange transfusion (severe)

33. ? CO - ? PCWP - ? PVR.
Wernicke's encephalopathy due to a deficiency of thiamine
Neuroleptic malignant syndrome
Cardiogenic shock
Acne vulgaris

34. A 17-year - old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Cirrhosis - CHF - nephritic syndrome
Consider Fitz - Hugh - Curtis syndrome
Conversion disorder
Treat immediately. Consent is implied in emergency situations

35. 1
Bacterial meningitis
Parvovirus B19
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Placental abruption and placenta previa

36. Prophylactic treatment for migraine.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Beta- blockers - Ca2+ channel blockers - TCAs
A patient's family cannot require that a doctor withhold information from the patient
Sporothrix schenckii

37. A painful - recurrent vesicular eruption of mucocutaneous surfaces.
Wegener's granulomatosis and Goodpasture's syndrome
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Herpes simplex
Parkland formula

38. Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
Obstructive pulmonary disease (e.g. - asthma)
Inevitable abortion
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Impetigo

39. Natural history of a leiomyoma.
Alopecia areata (autoimmune process)
No. Parental consent is not necessary for the medical treatment of pregnant minors
Hodgkin's lymphoma
Regresses after menopause

40. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Calcium oxalate
Hypovolemic shock
Diverticulosis

41. A 25-year - old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.

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42. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Normal
Septic or anaphylactic shock
ACEI
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs

43. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Postinfectious glomerulonephritis
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Hypoxia and hypocarbia

44. Endocarditis prophylaxis regimens.
Exercise stress treadmill with ECG
Elevated ICP - RBCs - xanthochromia
Uterine massage; if that fails - give oxytocin
Oral surgery

45. Treatment for atrial fibrillation.
Sulfonamides - antimalarial drugs - fava beans
Anticoagulation - rate control - cardioversion
Precocious puberty
Endometriosis

46. The three most common causes of fever of unknown origin (FUO).
Squamous cell carcinoma
Infection - cancer - and autoimmune disease
Number of deaths per 1000 population
Campylobacter

47. Not contraindications to vaccination.
Angina is new - is worsening - or occurs at rest
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Bruton's X- linked agammaglobulinemia
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)

48. Which of the following are ? in DIC: fibrin split products - D- dimer - fibrinogen - platelets - and hematocrit.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
HGPRTase deficiency)
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Intussusception

49. Combined UMN and LMN disorder.
Factor V Leiden mutation
Endometrial or estrogen receptor - breast cancer
Regression
ALS

50. Sudden onset of mental status changes - emesis - and liver dysfunction after taking aspirin.

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