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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. A 35-year - old male has recurrent episodes of palpitations - diaphoresis - and fear of going crazy.
Panic disorder
Clostridium difficile
Flumazenil
Cluster headache

2. A 30-year - old woman has unpredictable urine loss. Examination is normal. Medical options?
Hypotension - distant heart sounds - and JVD
Lyme disease - Ixodes tick - doxycycline
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Fat - female - fertile - forty - flatulent

3. A 17-year - old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Conversion disorder
HBV - DTaP - Hib - IPV - PCV
Phencyclidine hydrochloride (PCP) intoxication

4. Inspiratory arrest during palpation of the RUQ.

5. Dermatomal distribution.
IVIG or plasmapheresis
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Varicella zoster
Coarctation of the aorta

6. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Hypovolemic shock
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
? serum FSH
Pseudomonas

7. A burn patient presents with cherry- red flushed skin and coma. SaO2 is normal - but carboxyhemoglobin is elevated. Treatment?
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Pulsus paradoxus (seen in cardiac tamponade)
Aseptic (viral) meningitis
Uremic syndrome seen in patients with renal failure

8. Tanner stage 3 in a six-year - old female.
Streptococcus pneumoniae
Precocious puberty
Wait - surgical resection - radiation and/or androgen suppression
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella

9. The most common cancer in men and the most common cause of death from cancer in men.
IVIG or plasmapheresis
Partial mole
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
IV benzodiazepine

10. A patient presents with signs of hypocalcemia - high phosphorus - and low PTH.
Abdominal ultrasound and CT
Dissociative fugue
Cardiogenic shock
Hypoparathyroidism

11. Virus associated with aplastic anemia in patients with sickle cell anemia.
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Parvovirus B19
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones

12. Treatment for DTs.
Benzodiazepines
Hashimoto's thyroiditis
Neuroblastoma
Avascular necrosis

13. Symptoms of placental abruption.
Higher incidence
Continuous - painful vaginal bleeding
Anorexia
Endometrial or estrogen receptor - breast cancer

14. + Nikolsky's sign.
Sheehan's syndrome (postpartum pituitary necrosis)
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Pemphigus vulgaris
Lyme disease - Ixodes tick - doxycycline

15. 'Stuck - on' appearance.
Seborrheic keratosis
HGPRTase deficiency)
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Respiratory alkalosis

16. Cold agglutinins.
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
Mycoplasma
CA-125 and transvaginal ultrasound

17. Bone is fractured in fall on outstretched hand.

18. Risk factors for pyelonephritis.
Inevitable abortion
Nitroprusside
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Weight loss and OCPs

19. Treatment for TTP.
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Squamous cell carcinoma

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

21. Name the organism:
They can mask symptoms of hypoglycemia
Actinomyces israelii
Regresses after menopause
Treat existing heart failure and replace the tricuspid valve

22. Treatment for postpartum hemorrhage.
Transitional cell carcinoma
Obstructive pulmonary disease (e.g. - asthma)
Lyme disease - Ixodes tick - doxycycline
Uterine massage; if that fails - give oxytocin

23. 'Cradle cap.'
68% - 95.5% - 99.7%
Seborrheic dermatitis. Treat with antifungals
Wegener's granulomatosis and Goodpasture's syndrome
Edrophonium

24. Lab values suggestive of menopause.
Seminoma
? serum FSH
SIADH due to stress
Diamond - Blackfan anemia

25. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Patent ductus arteriosus (PDA)
Nitroprusside
Type I (distal) RTA
Hypoxia and hypocarbia

26. The most common cause of hypothyroidism.

27. Attributable risk?
The IR of a disease in a population exposed to a particular factor
Parvovirus B19
Kegel exercises - estrogen - pessaries for stress incontinence
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed

28. What is the immunodeficiency?

29. Non - small cell lung cancer (NSCLC) associated with hypercalcemia.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
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
Signs and symptoms of hypercalcemia
Squamous cell carcinoma

30. Tests to rule out shaken baby syndrome.
Ophthalmologic exam - CT - and MRI
Chronic granulomatous disease
Absence seizures
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms

31. A neonate has meconium ileus.

32. Chvostek's and Trousseau's signs.
Osmotic fragility test
Hypocalcemia
Respiratory alkalosis
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation

33. Key side effects of atypical antipsychotics.
Alopecia areata (autoimmune process)
Higher prevalence
Weight gain - type 2 DM - QT prolongation
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)

34. A patient from California or Arizona presents with fever - malaise - cough - and night sweats. Diagnosis? Treatment?
Salmonella
Diverticulosis
Coccidioidomycosis. Amphotericin B
Betamethasone or dexamethasone

35. A 55-year - old obese patient presents with dirty - velvety patches on the back of the neck.
ACEI
Transitional cell carcinoma
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Legionella pneumonia

36. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Contact dermatitis
Establish the ABCs
Coccidioidomycosis. Amphotericin B
Fat - female - fertile - forty - flatulent

37. Case - control study
Neither
Uterine atony
Mallory- Weiss
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

38. Signs of air embolism.
A patient with chest trauma who was previously stable suddenly dies
Inhaled Beta- agonists and inhaled corticosteroids
Flumazenil
Nitroprusside

39. The 6 P's of ischemia due to peripheral vascular disease.
Cellulitis
Trichomonas vaginitis
DM - SLE - and amyloidosis
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia

40. Virchow's triad.
Ophthalmologic exam - CT - and MRI
High reliability - low validity
Acute mania. Start a mood stabilizer (e.g. - lithium)
Stasis - hypercoagulability - endothelial damage

41. Not contraindications to vaccination.
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Depersonalization disorder
Taenia solium (cysticercosis)
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity

42. An active 13-year - old boy has anterior knee pain. Diagnosis?
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
Hypernatremia
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Osgood - Schlatter disease

43. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Duchenne muscular dystrophy
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed

44. The most common cause of bloody nipple discharge.
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Intraductal papilloma
Neisseria meningitidis
HBV - DTaP - Hib - IPV - PCV

45. Endocarditis prophylaxis regimens.
Intussusception
Oral surgery
Incidence and prevalence
Dressler's syndrome: fever - pericarditis - ? ESR

46. Classic ECG findings in pericarditis.
Neisseria meningitidis
Trichomonas vaginitis
Low - voltage - diffuse ST- segment elevation
S. aureus or S. epidermidis.

47. Why are Beta- blockers contraindicated in diabetics?
A patient with chest trauma who was previously stable suddenly dies
Immediate needle thoracostomy
They can mask symptoms of hypoglycemia
Cellulitis

48. Therapy for polycystic ovarian syndrome.
Weight loss and OCPs
Osmotic fragility test
Dantrolene or bromocriptine
Threatened abortion

49. Confusion - confabulation - ophthalmoplegia - ataxia.

50. How to distinguish polycythemia vera from 2
Pharmacologic stress test (e.g. - dobutamine echo)
IgA nephropathy (Berger's disease)
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)