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 crescent - shaped hyperdensity on CT that does not cross the midline.
Number of deaths per 1000 population
Pseudomonas
Alzheimer's and multi - infarct
Subdural hematoma


2. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Normal
Impetigo
Reye's syndrome
Lyme disease - Ixodes tick - doxycycline


3. Treatment for benzodiazepine overdose.
Seborrheic dermatitis. Treat with antifungals
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Flumazenil
Bacterial meningitis


4. Acid - base disturbance commonly seen in pregnant women.
Bacillus cereus
N- acetylcysteine
Immediate cardioversion
Respiratory alkalosis


5. Treatment for AML M3.
TICS
Naloxone
Retinoic acid
Weight loss and OCPs


6. Drugs that slow AV node transmission.
Beta- blockers - digoxin - calcium channel blockers
Parkinson's disease
Benzodiazepines
Kl


7. Perinatal mortality?

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8. Medical treatment for hepatic encephalopathy.
? protein intake - lactulose - neomycin
a - antagonists (phentolamine and phenoxybenzamine)
Spinal stenosis
Lobular carcinoma in situ


9. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Yersinia
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
CF or Hirschsprung's disease


10. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Bladder rupture or urethral injury
Treat immediately. Consent is implied in emergency situations
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate


11. Treatment for acute coronary syndrome.
Varicella zoster
Infection - febrile seizures - trauma - idiopathic
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination


12. Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
Out
Nephrotic syndrome
Rate control with carotid massasge or other vagal stimulation
Salmonella


13. Mortality rate?
Transitional cell carcinoma
? serum FSH
Number of deaths per 1000 population
Taenia solium (cysticercosis)


14. The most common pathogen causing croup.
Parainfluenza virus type 1
Bacterial meningitis
7-10 days
Pseudomonas


15. A 55-year - old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram - negative rods. What is the diagnosis?
HBV immunoglobulin
Campylobacter
Legionella pneumonia
Obstructive pulmonary disease (e.g. - asthma)


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

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17. Cause of neonatal RDS.
Surfactant deficiency
30 cc/hour
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Haemophilus ducreyi


18. A 49-year - old male presents with acute - onset flank pain and hematuria.
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
? protein intake - lactulose - neomycin
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Nephrolithiasis


19. Treatment of SIADH?
Basal cell carcinoma
Fluid restriction - demeclocycline
105 bacteria/mL
Distal radius (Colles' fracture)


20. Glomerulonephritis with deafness.

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21. Risk factors for pyelonephritis.
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Subdural hematoma
E. coli O157:H7
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones


22. Name the organism:
Factor V Leiden mutation
Actinic keratosis
Neisseria meningitidis
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.


23. Medication used to induce ovulation.
Erythema multiforme
Taenia solium (cysticercosis)
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Clomiphene citrate


24. Meningitis in infants. Causes? Treatment?
Impetigo
Type II (proximal) RTA
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Prevalence


25. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
Hypovolemic shock
Observational bias
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Esophageal atresia with distal TEF (85%). Unable to pass NG tube


26. The most common cause of hypertension in young women.
Erythema multiforme
OCPs
Beta- blockers - Ca2+ channel blockers - TCAs
Seborrheic dermatitis. Treat with antifungals


27. Erythema migrans.
RSV bronchiolitis
Lesion of 1
OCP and barrier contraception
Exercise stress treadmill with ECG


28. Name the organism:
Retrograde cystourethrogram
OCP and barrier contraception
Levodopa/carbidopa
Klebsiella


29. A patient presents with pain on passive movement - pallor - poikilothermia - paresthesias - paralysis - and pulselessness. Treatment?
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
All - compartment fasciotomy for suspected compartment syndrome
Factor V Leiden mutation
Naloxone


30. Albuminocytologic dissociation.
Guillain - Barr
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
68% - 95.5% - 99.7%
Subarachnoid hemorrhage (SAH)


31. Identify key organisms causing diarrhea:
Acute pancreatitis
Diverticulosis
Nephrotic syndrome
Yersinia


32. Treatment of AF.
Sarcoidosis
Salmonella
Rate control - rhythm conversion - and anticoagulation
ETEC


33. What should always be done prior to LP?
Check for ? ICP; look for papilledema
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Pemphigus vulgaris


34. ? risk of what infection with silicosis?
Immediate needle thoracostomy
Mycobacterium tuberculosis
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Intraductal papilloma


35. First - line pharmacotherapy for depression.
Hypertension - bradycardia - and abnormal respirations
SSRIs
Pulsus paradoxus (seen in cardiac tamponade)
Anion gap acidosis and 1


36. Treatment for TTP.
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Seborrheic keratosis
Elevated ICP - RBCs - xanthochromia
Vibrio - HAV


37. Galactorrhea - impotence - menstrual dysfunction - and ? libido.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Lichen sclerosus
Patient on dopamine antagonist
INH - penicillamine - hydralazine - procainamide


38. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Parainfluenza virus type 1
Fanconi's anemia
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Reye's syndrome


39. Virus associated with aplastic anemia in patients with sickle cell anemia.
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Parvovirus B19
Angina is new - is worsening - or occurs at rest
HGPRTase deficiency)


40. Sensitive tests have few false negatives and are used to rule _____ a disease.
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Herpes simplex
Out
1


41. The most common cause of seizures in young adults (18-35 years).
Duchenne muscular dystrophy
Trauma - alcohol withdrawal - brain tumor
Non - Hodgkin's lymphoma
Beta- hCG; the most common cause of amenorrhea is pregnancy


42. After a minor fender bender - a man wears a neck brace and requests permanent disability.
Alport's syndrome
Benzodiazepines
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Malingering


43. Asplenic patients are particularly susceptible to these organisms.
When there is no rationale for treatment - maximal intervention is failing - a given intervention has already failed - and treatment will not achieve the goals of care
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Acute mania. Start a mood stabilizer (e.g. - lithium)
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella


44. Antibiotics with teratogenic effects.
Lyme disease - Ixodes tick - doxycycline
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Sporothrix schenckii
Slipped capital femoral epiphyses. AP and frog - leg lateral view


45. Risk factors for DVT.

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46. Fetal mortality?

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47. Chromosomal pattern of a complete mole.
Surfactant deficiency
The IR of a disease in a population exposed to a particular factor
46 -XX
Non - Hodgkin's lymphoma


48. Difference between Mallory- Weiss and Boerhaave tears.
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Bullous pemphigoid
Mallory- Weiss
Kl


49. Inflammation and epithelial thinning of the anogenital area - predominantly in postmenopausal women.
Lichen sclerosus
105 bacteria/mL
Malingering
SIADH due to stress


50. Breast malignancy presenting as itching - burning - and erosion of the nipple.

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