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 24-year - old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Hereditary spherocytosis


2. Fertility rate?
Displacement
Nephrotic syndrome
Avascular necrosis
Number of live births per 1000 women 15-44 years of age


3. Classic ECG findings in pericarditis.
Chronic lymphocytic leukemia (CLL)
Metformin
Low - voltage - diffuse ST- segment elevation
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones


4. Identify key organisms causing diarrhea:
Campylobacter
Hypovolemic shock
MCP and PIP joints; DIP joints are spared
DM - SLE - and amyloidosis


5. Caf
Exercise stress treadmill with ECG
Conversion disorder
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Neurofibromatosis 1


6. Antibiotics with teratogenic effects.
High TSH - low T4 - antimicrosomal antibodies
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
MCP and PIP joints; DIP joints are spared
Identify cause; pressors (e.g. - dobutamine)


7. Salicylate ingestion ? In What type of acid - base disorder?
Taenia solium (cysticercosis)
Anion gap acidosis and 1
ARDS
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate


8. Infection of small airways with epidemics in winter and spring.
DM - SLE - and amyloidosis
RSV bronchiolitis
Hodgkin's lymphoma
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma


9. Identify key organisms causing diarrhea:
Reye's syndrome
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Amoxicillin


10. Definition of hypertension.
Diverticulosis
Bruton's X- linked agammaglobulinemia
BP > 140/90 on three separate occasions two weeks apart
Psoriasis


11. Fetal mortality?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


12. The three most common causes of fever of unknown origin (FUO).
Infection - cancer - and autoimmune disease
Bullous pemphigoid
Metformin
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)


13. A violent patient has vertical and horizontal nystagmus.
Phencyclidine hydrochloride (PCP) intoxication
Fanconi's anemia
IV hydration and loop diuretics (furosemide)
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)


14. Odds ratio?
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
Hypovolemic shock
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Fever - pharyngeal erythema - tonsillar exudate - lack of cough


15. ? risk of what infection with silicosis?
1
Mycobacterium tuberculosis
Elevated ICP - RBCs - xanthochromia
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths


16. Acid - base disturbance commonly seen in pregnant women.
Respiratory alkalosis
Continuous - painful vaginal bleeding
a - antagonists (phentolamine and phenoxybenzamine)
Malignancy and hyperparathyroidism


17. Contraceptive methods that protect against PID.
OCP and barrier contraception
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Third - degree heart block
Neisseria meningitidis


18. Asplenic patients are particularly susceptible to these organisms.
Intraductal papilloma
Identify cause; fluid and blood repletion
SSRIs
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella


19. Attributable risk?
Kl
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed


20. Glomerulonephritis with hemoptysis.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


21. Classic physical findings for endocarditis.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


22. The number of true positives divided by the number of patients with the disease is _____.
Niacin
Sensitivity
Anorexia
Suspect retinoblastoma


23. Treatment for atrial fibrillation.
Anticoagulation - rate control - cardioversion
Pityriasis rosea
Malignancy and hyperparathyroidism
Number of deaths from birth to 28 days per 1000 live births


24. If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status - then socioeconomic status is a _____.
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Confounding variable
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Klebsiella


25. Which healthy population is susceptible to UTIs?
Pregnant women. Treat this group aggressively because of potential complications
Excessive EtOH
? Ca2+ - ? K- - ? phosphate - ? uric acid
Mallory- Weiss


26. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
105 bacteria/mL
Basal cell carcinoma
Duodenal atresia
OCPs - danazol - GnRH agonists


27. The most common cause of Cushing's syndrome.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


28. A patient has ? vaginal discharge and petechial patches in the upper vagina and cervix.
Trichomonas vaginitis
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Angina is new - is worsening - or occurs at rest
Neither


29. Premalignant lesion from sun exposure that can ? squamous cell carcinoma.
Actinic keratosis
False. Withdrawing and withholding life are the same from an ethical standpoint
Isolation
Fanconi's anemia


30. CSF findings:
Bacterial meningitis
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Protamine
Lesion of 1


31. Name the organism:
Selective IgA deficiency
Threatened abortion
Klebsiella
Reaction formation


32. Name the defense mechanism:
Amoxicillin
Bacterial meningitis
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Isolation


33. Sensitive tests have few false negatives and are used to rule _____ a disease.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Out
Administration of DDAVP ? serum osmolality and free water restriction
Radiation


34. Eight surgically correctable causes of hypertension.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


35. A patient fails to lactate after an emergency C- section with marked blood loss.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


36. A patient with a history of lithium use presents with copious amounts of dilute urine.
Immediate needle thoracostomy
Dantrolene or bromocriptine
Nephrogenic diabetes insipidus (DI)
A patient's family cannot require that a doctor withhold information from the patient


37. Heinz bodies?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Mallory- Weiss
Partial mole
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'


38. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Identify cause; fluid and blood repletion
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Pregnant women. Treat this group aggressively because of potential complications
Pheochromocytoma


39. Treatment of DKA.
Depersonalization disorder
Threatened abortion
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6


40. A painful - recurrent vesicular eruption of mucocutaneous surfaces.
Herpes simplex
A patient's family cannot require that a doctor withhold information from the patient
Prevalence
Protamine


41. Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
Diamond - Blackfan anemia
Klebsiella
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin


42. Findings in 3
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Slipped capital femoral epiphyses. AP and frog - leg lateral view
TICS
Postinfectious glomerulonephritis


43. The most common cause of female infertility.
Hereditary spherocytosis
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Febrile seizures (roseola infantum)
Endometriosis


44. A patient continues to use cocaine after being in jail - losing his job - and not paying child support.
Substance abuse
Obstructive pulmonary disease (e.g. - asthma)
OCP and barrier contraception
Conflict of interest


45. How to diagnose and follow a leiomyoma.
Guillain - Barr
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Ultrasound
Rett's disorder


46. A burn patient presents with cherry- red flushed skin and coma. SaO2 is normal - but carboxyhemoglobin is elevated. Treatment?
Non - Hodgkin's lymphoma
Neither
Low - voltage - diffuse ST- segment elevation
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant


47. Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
Squamous cell carcinoma
Legionella pneumonia
Uremic syndrome seen in patients with renal failure
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)


48. Four causes of microcytic anemia.
TICS
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Osmotic fragility test
Seventy percent if the stenosis is symptomatic


49. Treatment for mild and severe unconjugated hyperbilirubinemia.
Phototherapy (mild) or exchange transfusion (severe)
Bacillus cereus
False. Withdrawing and withholding life are the same from an ethical standpoint
Partial mole


50. Acceptable urine output in a trauma patient.
50 cc/hour
Infection - cancer - and autoimmune disease
HIDA scan
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)