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USMLE Step 2

Subjects : health-sciences, usmle-step-2

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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. Complication of overly rapid correction of hyponatremia.
Intussusception
Hypertension - bradycardia - and abnormal respirations
Central pontine myelinolysis
TICS

2. The most common 1
Hypertension - bradycardia - and abnormal respirations
Multiple myeloma
Osteogenesis imperfecta
Iatrogenic steroid administration. The second most common cause is Cushing's disease

3. Identify key organisms causing diarrhea:
Administration of DDAVP ? serum osmolality and free water restriction
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
S. aureus
Mallory- Weiss

4. Albuminocytologic dissociation.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Reaction formation
Guillain - Barr
Lesch - Nyhan syndrome (purine salvage problem with

5. Treatment for benzodiazepine overdose.
Broca's aphasia. Frontal lobe - left MCA distribution
Small cell lung cancer (SCLC)
OCP and barrier contraception
Flumazenil

6. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Suspect retinoblastoma
Endometrial or estrogen receptor - breast cancer
Contact dermatitis
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia

7. The three most common causes of fever of unknown origin (FUO).
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Infection - cancer - and autoimmune disease
Hypernatremia
Haemophilus ducreyi

8. Peaked T waves and widened QRS.
Hyperkalemia
Number of deaths from 28 days to one year per 1000 live births
Small cell lung cancer (SCLC)
Non - Hodgkin's lymphoma

9. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Betamethasone or dexamethasone
S. aureus or S. epidermidis.
Beta- hCG; the most common cause of amenorrhea is pregnancy
Observational bias

10. Treatment for SVC syndrome.
Metformin
Kl
Consider Fitz - Hugh - Curtis syndrome
Radiation

11. Cross - sectional survey
Prevalence
Fluid restriction - demeclocycline
Oral or topical metronidazole
Cirrhosis - CHF - nephritic syndrome

12. Proteinuria - hypoalbuminemia - hyperlipidemia - hyperlipiduria - edema.
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Nephrotic syndrome
Fat - female - fertile - forty - flatulent
Stasis - hypercoagulability - endothelial damage

13. ? risk of what infection with silicosis?
Membranous glomerulonephritis
Malingering
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Mycobacterium tuberculosis

14. Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV- positive patient At what CD4 count? Mycobacterium avium - intracellulare (MAI) prophylaxis?
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Lyme disease - Ixodes tick - doxycycline
The IR of a disease in a population exposed to a particular factor
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)

15. Natural history of a leiomyoma.
50 cc/hour
Radiation
Bladder rupture or urethral injury
Regresses after menopause

16. Causes of hypoxemia.
Precocious puberty
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Factor V Leiden mutation
Cerebral berry aneurysms (AD PCKD)

17. The most common cancer in men and the most common cause of death from cancer in men.
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful

18. Treatment of cardiogenic shock.
Pseudomonas
Identify cause; pressors (e.g. - dobutamine)
Reaction formation
OCP and barrier contraception

19. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Pityriasis versicolor
Trichomonas vaginitis
MS
HIDA scan

20. A 55-year - old man presents with irritative and obstructive urinary symptoms. Treatment options?
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
? Ca2+ - ? K- - ? phosphate - ? uric acid
Iron overload; use deferoxamine

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

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22. Why are Beta- blockers contraindicated in diabetics?
Bullous pemphigoid
Incidence and prevalence
They can mask symptoms of hypoglycemia
Fever - pharyngeal erythema - tonsillar exudate - lack of cough

23. Treatment of SIADH?
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Fluid restriction - demeclocycline
Edrophonium
Mallory- Weiss

24. Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
Pityriasis versicolor
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Elevated ICP - RBCs - xanthochromia
Spinal stenosis

25. Presents with a herald patch - Christmas - tree pattern.
Kegel exercises - estrogen - pessaries for stress incontinence
Hypovolemic shock
OCPs - danazol - GnRH agonists
Pityriasis rosea

26. Asplenic patients are particularly susceptible to these organisms.
Intraductal papilloma
Alopecia areata (autoimmune process)
Factitious disorder (Munchausen syndrome)
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella

27. Medical treatment for hepatic encephalopathy.
Iron overload; use deferoxamine
Calcium oxalate
Neurofibromatosis 1
? protein intake - lactulose - neomycin

28. What should always be done prior to LP?
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
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Check for ? ICP; look for papilledema
Fever - pharyngeal erythema - tonsillar exudate - lack of cough

29. Acid - base disturbance commonly seen in pregnant women.
Respiratory alkalosis
Kl
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Haemophilus ducreyi

30. Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow - up evaluation?
Colposcopy and endocervical curettage
Intraductal papilloma
Absence seizures
Number of deaths from birth to 28 days per 1000 live births

31. Caf
Neurofibromatosis 1
Klebsiella
Frotteurism (a paraphilia)
Sensitivity

32. Identify key organisms causing diarrhea:
Vibrio - HAV
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Sarcoidosis
Malignancy and hyperparathyroidism

33. A 13-year - old male has a history of theft - vandalism - and violence toward family pets.
Pseudogout
Nephrotic syndrome
Conduct disorder
Subarachnoid hemorrhage (SAH)

34. 'Dewdrop on a rose petal.'
Hyperkalemia
Pulsus paradoxus (seen in cardiac tamponade)
HBV - DTaP - Hib - IPV - PCV
Lesions of 1

35. Hyperphagia - hypersexuality - hyperorality - and hyperdocility.
Fatigue and impending respiratory failure
Kl
OCP and barrier contraception
Selective IgA deficiency

36. May be seen in children who are accused of inattention in class and confused with ADHD.
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Absence seizures
Parvovirus B19
Impetigo

37. Life - threatening muscle rigidity - fever - and rhabdomyolysis.
Neuroleptic malignant syndrome
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Antipsychotics (neuroleptic malignant syndrome)
Anion gap acidosis and 1

38. Trauma series.
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Pheochromocytoma
AP chest - AP/lateral C- spine - AP pelvis
Lichen sclerosus

39. Post - HBV exposure treatment.
Angina is new - is worsening - or occurs at rest
Asymmetry - border irregularity - color variation - large diameter
HBV immunoglobulin
Paget's disease

40. A six-year - old girl presents with a port - wine stain in the V2 distribution as well as with mental retardation - seizures - and leptomeningeal angioma.
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Malignancy and hyperparathyroidism
Threatened abortion
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful

41. Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
Observational bias
Pseudomonas
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Endometrial biopsy

42. Lab findings in Hashimoto's thyroiditis.
Hodgkin's lymphoma
High TSH - low T4 - antimicrosomal antibodies
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Femoral hernia

43. CSF findings:
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Bacterial meningitis
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Weight loss and OCPs

44. Classic CXR findings for pulmonary edema.

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45. Glomerulonephritis with deafness.

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46. Nonpainful chancre.
Conversion disorder
Uremic syndrome seen in patients with renal failure
1
Cluster headache

47. Identify key organisms causing diarrhea:
Confounding variable
Campylobacter
Ampulla of the oviduct
Levodopa/carbidopa

48. The most common causes of hypercalcemia.
PT
HIDA scan
Osmotic fragility test
Malignancy and hyperparathyroidism

49. Postnatal mortality?
Osgood - Schlatter disease
Number of deaths from 28 days to one year per 1000 live births
V/Q scan
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

50. A 'blueberry muffin' rash is characteristic of what congenital infection?
Squamous cell carcinoma
MAOIs
Rubella
Yersinia

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USMLE Step 2

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