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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. Involuntary psychiatric hospitalization can be undertaken for which three reasons?
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Factitious disorder (Munchausen syndrome)
Malignancy and hyperparathyroidism

2. Antidepressants associated with hypertensive crisis.
False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision - making capacity
Bacterial meningitis
MAOIs
The IR of a disease in a population exposed to a particular factor

3. Treatment of septic shock.
30 cc/hour
Out
Vibrio - HAV
Fluids and antibiotics

4. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
68% - 95.5% - 99.7%
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Anorexia

5. Cause of neonatal RDS.
Immediate cardioversion
M3
Acute pancreatitis
Surfactant deficiency

6. PFT showing ? FEV1/FVC.
Sarcoidosis
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Obstructive pulmonary disease (e.g. - asthma)

7. The most common cause of postpartum hemorrhage.
Inevitable abortion
Uterine atony
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Campylobacter

8. An agent that reverses the effects of heparin.
Protamine
Ampulla of the oviduct
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Headache

9. A patient presents with pain on passive movement - pallor - poikilothermia - paresthesias - paralysis - and pulselessness. Treatment?
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
All - compartment fasciotomy for suspected compartment syndrome
Signs and symptoms of hypercalcemia
Suspect ankylosing spondylitis. Check HLA- B27

10. Cohort study
Benzodiazepines
Osteoarthritis
Incidence and prevalence
Haemophilus ducreyi

11. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Confounding variable
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Lyme disease - Ixodes tick - doxycycline
Lobular carcinoma in situ

12. Identify key organisms causing diarrhea:
Lobular carcinoma in situ
Depersonalization disorder
Diamond - Blackfan anemia
Vibrio - HAV

13. A child has loss of red light reflex. Diagnosis?
Intussusception
Coccidioidomycosis. Amphotericin B
Suspect retinoblastoma
Fluids and antibiotics

14. Antibiotics with teratogenic effects.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Nitroprusside
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)

15. First - line pharmacotherapy for depression.
SSRIs
Acne vulgaris
Kegel exercises - estrogen - pessaries for stress incontinence
Bruton's X- linked agammaglobulinemia

16. Salicylate ingestion ? In What type of acid - base disorder?
Observational bias
Pemphigus vulgaris
MAOIs
Anion gap acidosis and 1

17. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Edrophonium
Osteogenesis imperfecta
Basal cell carcinoma
Flumazenil

18. Definition of unstable angina.
Angina is new - is worsening - or occurs at rest
Legionella pneumonia
Sulfonamides - antimalarial drugs - fava beans
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves

19. Blood in the urethral meatus or high - riding prostate.
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Edrophonium
Trichomonas vaginitis
Bladder rupture or urethral injury

20. Identify key organisms causing diarrhea:
Trauma - alcohol withdrawal - brain tumor
Conversion disorder
Pityriasis rosea
Salmonella

21. A newborn female has continuous 'machinery murmur.'
Patent ductus arteriosus (PDA)
The IR of a disease in a population exposed to a particular factor
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Hashimoto's thyroiditis

22. ECG findings suggesting MI.
Parvovirus B19
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Antipsychotics (neuroleptic malignant syndrome)
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction

23. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
46 -XX
Normal
Pasteurella multocida
Pseudogout

24. Treatment of supraventricular tachycardia (SVT).
Rate control with carotid massasge or other vagal stimulation
Squamous cell carcinoma
Placental abruption and placenta previa
Osmotic fragility test

25. Chromosomal pattern of a complete mole.
HGPRTase deficiency)
Malignancy and hyperparathyroidism
46 -XX
Lung - breast - skin (melanoma) - kidney - GI tract

26. ? risk of what infection with silicosis?
Basal cell carcinoma
Hypernatremia
Nephrotic syndrome
Mycobacterium tuberculosis

27. What is the immunodeficiency?
Fluid restriction - demeclocycline
Chronic granulomatous disease
Subarachnoid hemorrhage (SAH)
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6

28. Diagnostic test for hereditary spherocytosis.
Diamond - Blackfan anemia
Osmotic fragility test
Chronic lymphocytic leukemia (CLL)
MAOIs

29. The most common form of nephritic syndrome.
Membranous glomerulonephritis
Alport's syndrome
Ultrasound
Anemia - thrombocytopenia - and acute renal failure

30. 'Cradle cap.'
Type II (proximal) RTA
Seborrheic dermatitis. Treat with antifungals
Sensitivity
Ulcerative colitis

31. Name the organism:
Erythema multiforme
Alzheimer's and multi - infarct
Weight gain - type 2 DM - QT prolongation
Toxoplasma gondii

32. Reynolds' pentad.

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33. Ring - enhancing brain lesion on CT with seizures
Wernicke's encephalopathy due to a deficiency of thiamine
Septic or anaphylactic shock
Femoral hernia
Taenia solium (cysticercosis)

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

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35. Nonpainful chancre.
Endometrial biopsy
Pemphigus vulgaris
RSV bronchiolitis
1

36. Fertility rate?
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Number of live births per 1000 women 15-44 years of age
Check for ? ICP; look for papilledema
Treat because the disease represents an immediate threat to the child's life. Then seek a court order

37. Amenorrhea - bradycardia - and abnormal body image in a young female.
MAOIs
Anorexia
Broca's aphasia. Frontal lobe - left MCA distribution
Actinic keratosis

38. Side effects of corticosteroids.
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Uterine massage; if that fails - give oxytocin
Clostridium difficile
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies

39. CSF findings:
Oral or topical metronidazole
MS
Patient on dopamine antagonist
Confounding variable

40. The most common cause of female infertility.
HBV immunoglobulin
Lichen sclerosus
Nephrogenic diabetes insipidus (DI)
Endometriosis

41. What is the metabolic syndrome?
Highly sensitive for TB
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
7-10 days
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis

42. Albuminocytologic dissociation.
Pityriasis versicolor
Guillain - Barr
Pseudomonas
Actinic keratosis

43. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
CML
Septic or anaphylactic shock
Mycobacterium tuberculosis
Iron overload; use deferoxamine

44. The most common cause of SAH.
Nephrogenic diabetes insipidus (DI)
Infection - febrile seizures - trauma - idiopathic
Trauma; the second most common is berry aneurysm
Beta- hCG; the most common cause of amenorrhea is pregnancy

45. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Observational bias
Anticoagulation - rate control - cardioversion
Restrictive pulmonary disease
Depersonalization disorder

46. AML subtype associated with DIC.
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
M3
Self - limited - painless vaginal bleeding
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)

47. CSF findings:
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Betamethasone or dexamethasone
Subarachnoid hemorrhage (SAH)
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis

48. Criteria for exudative effusion.
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
MAOIs
Number of deaths from birth to 28 days per 1000 live births
1

49. Extraintestinal manifestations of IBD.
Inhaled Beta- agonists and inhaled corticosteroids
Multiple myeloma
N- acetylcysteine
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1

50. Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?
Radiation
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Benzodiazepines
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism