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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.
Cluster headache
Osteoarthritis
1
Continuous positive airway pressure

2. Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
Immediate needle thoracostomy
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Lesions of 1
Endometrial biopsy

3. Medications and viruses that ? aplastic anemia.
Respiratory alkalosis
Acute pancreatitis
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Retinoic acid

4. Odds ratio?
Crohn's disease
S. aureus or S. epidermidis.
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed

5. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
The IR of a disease in a population exposed to a particular factor
Parkinson's disease
Threatened abortion
Osteoarthritis

6. ? CO - ? PCWP - ? PVR.
Septic or anaphylactic shock
Kl
Prinzmetal's angina
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline

7. Which healthy population is susceptible to UTIs?
Hodgkin's lymphoma
Pregnant women. Treat this group aggressively because of potential complications
Trauma - alcohol withdrawal - brain tumor
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

8. Aplastic crisis in sickle cell disease.
ETEC
Parvovirus B19
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Crohn's disease

9. Involuntary psychiatric hospitalization can be undertaken for which three reasons?
Polymyalgia rheumatica
Beta- hCG; the most common cause of amenorrhea is pregnancy
Third - degree heart block
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)

10. Hypercholesterolemia treatment that ? flushing and pruritus.
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Hypovolemic shock
Niacin
IV benzodiazepine

11. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Treat existing heart failure and replace the tricuspid valve
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
Benzodiazepines
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing

12. Antidepressants associated with hypertensive crisis.
Obstructive pulmonary disease (e.g. - asthma)
Neurofibromatosis 1
MAOIs
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation

13. Name the organism:
Yersinia
MS
Actinomyces israelii
< 7.0

14. Joints in the hand affected in rheumatoid arthritis.
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
SSRIs
Lesch - Nyhan syndrome (purine salvage problem with
MCP and PIP joints; DIP joints are spared

15. CSF findings with SAH.
Elevated ICP - RBCs - xanthochromia
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
Pseudogout
Neurofibromatosis 1

16. Glomerulonephritis with hemoptysis.

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17. Identify key organisms causing diarrhea:
Pentad of TTP
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
BP > 140/90 on three separate occasions two weeks apart
Salmonella

18. Appropriate diagnostic test?
Exercise stress treadmill with ECG
Rett's disorder
Hypertension - bradycardia - and abnormal respirations
Stasis - hypercoagulability - endothelial damage

19. The most common 1
Ophthalmologic exam - CT - and MRI
Multiple myeloma
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Coarctation of the aorta

20. Treatment for acetaminophen overdose.
Agranulocytosis
Huntington's disease
N- acetylcysteine
Taenia solium (cysticercosis)

21. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Cluster headache
Observational bias
Lichen sclerosus
Paget's disease

22. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
Actinomyces israelii
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Endometriosis
Lesions of 1

23. The diagnostic test for pulmonary embolism.
Transitional cell carcinoma
Klebsiella
V/Q scan
Crohn's disease

24. Complication of overly rapid correction of hyponatremia.
Central pontine myelinolysis
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
IgA nephropathy (Berger's disease)
Mycoplasma

25. A patient continues to use cocaine after being in jail - losing his job - and not paying child support.
Conversion disorder
Mallory- Weiss
Substance abuse
ACEI

26. Treatment of anaphylactic shock.
IVIG or plasmapheresis
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Check for ? ICP; look for papilledema
Diphenhydramine or epinephrine 1:1000

27. Diagnostic test for hypertrophic cardiomyopathy.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Asymmetry - border irregularity - color variation - large diameter
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
B12 deficiency

28. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Multiple myeloma
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
Basal cell carcinoma

29. After a minor fender bender - a man wears a neck brace and requests permanent disability.
Out
Malingering
Immediate cardioversion
1

30. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Osteogenesis imperfecta
Beta- blockers - digoxin - calcium channel blockers
Asherman's syndrome
Neurofibromatosis 1

31. Life - threatening muscle rigidity - fever - and rhabdomyolysis.
Normal
Pasteurella multocida
Neuroleptic malignant syndrome
CF or Hirschsprung's disease

32. Fetal mortality?

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33. A patient presents with recent PID with RUQ pain.
Consider Fitz - Hugh - Curtis syndrome
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Pharmacologic stress test (e.g. - dobutamine echo)
Iatrogenic steroid administration. The second most common cause is Cushing's disease

34. Definition of unstable angina.
Angina is new - is worsening - or occurs at rest
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Haemophilus ducreyi

35. Name the organism:
Broca's aphasia. Frontal lobe - left MCA distribution
High TSH - low T4 - antimicrosomal antibodies
Elevated ICP - RBCs - xanthochromia
Pseudomonas

36. CSF findings:
Diverticulosis
Pityriasis rosea
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
MS

37. Identify key organisms causing diarrhea:
Self - limited - painless vaginal bleeding
DI
Yersinia
A patient's family cannot require that a doctor withhold information from the patient

38. Treatment for postpartum hemorrhage.
Seminoma
Conduct disorder
HBV immunoglobulin
Uterine massage; if that fails - give oxytocin

39. Treatment for DTs.
Benzodiazepines
Vibrio - HAV
Number of deaths from 28 days to one year per 1000 live births
CML

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

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41. Hyperphagia - hypersexuality - hyperorality - and hyperdocility.
Kl
Hypoparathyroidism
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
MCP and PIP joints; DIP joints are spared

42. Thrombotic thrombocytopenic purpura (TTP) pentad?
Pentad of TTP
Regression
< 7.0
Osteoarthritis

43. PFT showing ? FEV1/FVC.
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Obstructive pulmonary disease (e.g. - asthma)
Regresses after menopause
Incidence and prevalence

44. Identify key organisms causing diarrhea:
E. coli O157:H7
Giardia
Self - limited - painless vaginal bleeding
Third - degree heart block

45. Four signs and symptoms of streptococcal pharyngitis.
Parvovirus B19
SIADH due to stress
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Fever - pharyngeal erythema - tonsillar exudate - lack of cough

46. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Acne vulgaris
Herpes simplex
Duchenne muscular dystrophy
Lichen sclerosus

47. Charcot's triad.
Dissociative fugue
Flumazenil
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful

48. Hematuria - flank pain - and palpable flank mass.
Wegener's granulomatosis and Goodpasture's syndrome
Renal cell carcinoma (RCC)
MAOIs
Low - voltage - diffuse ST- segment elevation

49. Low urine specific gravity in the presence of high serum osmolality.
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Beta- blockers - Ca2+ channel blockers - TCAs
DI
Respiratory alkalosis

50. In which patients do you initiate colorectal cancer screening early?
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Non - Hodgkin's lymphoma
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