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. Heinz bodies?
BP > 140/90 on three separate occasions two weeks apart
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Iron overload; use deferoxamine


2. Tanner stage 3 in a six-year - old female.
Incidence and prevalence
Seborrheic keratosis
Higher incidence
Precocious puberty


3. Symptoms of placental abruption.
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Duodenal atresia
Continuous - painful vaginal bleeding
Lesch - Nyhan syndrome (purine salvage problem with


4. Honey- crusted lesions.
IVIG or plasmapheresis
Impetigo
Pityriasis rosea
Malignancy and hyperparathyroidism


5. Vaccinations at a six- month well - child visit.
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Cerebral berry aneurysms (AD PCKD)
Regression
HBV - DTaP - Hib - IPV - PCV


6. A late - life - threatening complication of chronic myelogenous leukemia (CML).
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Pseudogout
Graves' disease
Pseudomonas


7. Chvostek's and Trousseau's signs.
No. Parental consent is not necessary for the medical treatment of pregnant minors
Hypocalcemia
Elevated ICP - RBCs - xanthochromia
Glanzmann's thrombasthenia


8. PFT showing ? FEV1/FVC.
All - compartment fasciotomy for suspected compartment syndrome
ETEC
Obstructive pulmonary disease (e.g. - asthma)
Usually resolves spontaneously; may require IVIG and/or corticosteroids


9. A newborn female has continuous 'machinery murmur.'
Seventy percent if the stenosis is symptomatic
Hereditary spherocytosis
Patent ductus arteriosus (PDA)
SSRIs


10. The most common type of testicular cancer.
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Seminoma
Stasis - hypercoagulability - endothelial damage
Septic or anaphylactic shock


11. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
30 cc/hour
1
Guillain - Barr
Type I (distal) RTA


12. Treatment for ventricular fibrillation.
Varicella zoster
Immediate cardioversion
Lesion of 1
Identify cause; pressors (e.g. - dobutamine)


13. Exophthalmos - pretibial myxedema - and ? TSH.

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14. Not contraindications to vaccination.
Uterine atony
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Duchenne muscular dystrophy


15. A woman who was abused as a child frequently feels outside of or detached from her body.
Depersonalization disorder
Anemia - thrombocytopenia - and acute renal failure
A patient with chest trauma who was previously stable suddenly dies
Asherman's syndrome


16. A doctor refers a patient for an MRI at a facility he/she owns.
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
'Chocolate cysts -' powder burns
Conflict of interest


17. Beck's triad for cardiac tamponade.
Lyme disease - Ixodes tick - doxycycline
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Headache
Hypotension - distant heart sounds - and JVD


18. A 13-year - old male has a history of theft - vandalism - and violence toward family pets.
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
Conduct disorder
Pityriasis versicolor
Paget's disease


19. 'Cradle cap.'
Seborrheic dermatitis. Treat with antifungals
Anion gap acidosis and 1
High reliability - low validity
Dressler's syndrome: fever - pericarditis - ? ESR


20. Causes of transudative effusion.
Ulcerative colitis
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Kwashiorkor (protein malnutrition)
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy


21. Conditions in which confidentiality must be overridden.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Choriocarcinoma
Treat immediately. Consent is implied in emergency situations
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse


22. Risk factors for DVT.

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23. Appropriate diagnostic test?
Precocious puberty
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Pharmacologic stress test (e.g. - dobutamine echo)
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)


24. The most common cause of bloody nipple discharge.
Type IV (distal) RTA
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
SSRIs
Intraductal papilloma


25. Treatment for mild and severe unconjugated hyperbilirubinemia.
Phototherapy (mild) or exchange transfusion (severe)
Patent ductus arteriosus (PDA)
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Stasis - hypercoagulability - endothelial damage


26. Eight surgically correctable causes of hypertension.

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27. Classic causes of drug - induced hepatitis.
Conduct disorder
Identify cause; pressors (e.g. - dobutamine)
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
MS


28. Definition of hypertension.
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
7-10 days
Precocious puberty
BP > 140/90 on three separate occasions two weeks apart


29. CSF findings with SAH.
Lyme disease - Ixodes tick - doxycycline
Elevated ICP - RBCs - xanthochromia
Spinal stenosis
Pheochromocytoma


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

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31. Associated with Propionibacterium acnes and changes in androgen levels.
Aseptic (viral) meningitis
Frotteurism (a paraphilia)
Acne vulgaris
Allergic interstitial nephritis


32. Medication given to accelerate fetal lung maturity.
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Kl
Betamethasone or dexamethasone
CF or Hirschsprung's disease


33. Testicular cancer associated with Beta- hCG - AFP.
Herpes simplex
30 cc/hour
Choriocarcinoma
Amoxicillin


34. 'Stones - bones - groans - psychiatric overtones.'
Levodopa/carbidopa
Hypocalcemia
Signs and symptoms of hypercalcemia
? protein intake - lactulose - neomycin


35. A five - month - old girl has ? head growth - truncal dyscoordination - and ? social interaction.

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36. A 10-year - old boy presents with fever - weight loss - and night sweats. Examination shows anterior mediastinal mass. Suspected diagnosis?

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37. Evaluation of a pulsatile abdominal mass and bruit.
Hypotension and bradycardia
Abdominal ultrasound and CT
Rate control - rhythm conversion - and anticoagulation
Immediate cardioversion


38. Erythema migrans.
Bladder rupture or urethral injury
Betamethasone or dexamethasone
Lesion of 1
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins


39. Identify key organisms causing diarrhea:
Benzodiazepines
Salmonella
Septic or anaphylactic shock
Psoriasis


40. Classic ECG findings in pericarditis.
Campylobacter
Sheehan's syndrome (postpartum pituitary necrosis)
Low - voltage - diffuse ST- segment elevation
Intussusception


41. Which healthy population is susceptible to UTIs?
Angina is new - is worsening - or occurs at rest
Calcium oxalate
Pregnant women. Treat this group aggressively because of potential complications
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)


42. Contraceptive methods that protect against PID.
Rett's disorder
Regresses after menopause
OCP and barrier contraception
Low - voltage - diffuse ST- segment elevation


43. Name the organism:
Intraductal papilloma
Pasteurella multocida
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Seborrheic dermatitis. Treat with antifungals


44. Key side effects of atypical antipsychotics.
? serum FSH
Klebsiella
Weight gain - type 2 DM - QT prolongation
Number of deaths from 28 days to one year per 1000 live births


45. Classic ECG finding in atrial flutter.

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46. Treatment for SVC syndrome.
Small cell lung cancer (SCLC)
Radiation
Colposcopy and endocervical curettage
Consider Fitz - Hugh - Curtis syndrome


47. Test to rule out urethral injury.
Retrograde cystourethrogram
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
IV benzodiazepine


48. Identify key organisms causing diarrhea:
Depersonalization disorder
Legionella pneumonia
Bacillus cereus
Hypoparathyroidism


49. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Lyme disease - Ixodes tick - doxycycline
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Elevated ICP - RBCs - xanthochromia
Duchenne muscular dystrophy


50. Supportive treatment for ARDS.
Toxoplasma gondii
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Regression
Continuous positive airway pressure