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Test your basic knowledge |
USMLE Step 2
Start Test
Study First
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. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Lesch - Nyhan syndrome (purine salvage problem with
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Inevitable abortion
Basal cell carcinoma
2. Inspiratory arrest during palpation of the RUQ.
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3. The most common form of nephritic syndrome.
Regression
Klebsiella
Membranous glomerulonephritis
Chronic lymphocytic leukemia (CLL)
4. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Calcium oxalate
Pityriasis versicolor
Number of deaths per 1000 population
Out
5. When can a physician refuse to continue treating a patient on the grounds of futility?
Normal
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
Sulfonamides - antimalarial drugs - fava beans
ACEI
6. A 17-year - old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Uremic syndrome seen in patients with renal failure
Haemophilus ducreyi
Antipsychotics (neuroleptic malignant syndrome)
Conversion disorder
7. A 50-year - old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?
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8. Unilateral - severe periorbital headache with tearing and conjunctival erythema.
S. aureus
Hypotension and bradycardia
Cluster headache
Naloxone
9. Acute - phase treatment for Kawasaki disease.
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
105 bacteria/mL
68% - 95.5% - 99.7%
10. Albuminocytologic dissociation.
Diphenhydramine or epinephrine 1:1000
? Ca2+ - ? K- - ? phosphate - ? uric acid
High TSH - low T4 - antimicrosomal antibodies
Guillain - Barr
11. Neutropenic nadir postchemotherapy.
Renal cell carcinoma (RCC)
7-10 days
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Panic disorder
12. Symptoms of placenta previa.
Immediate needle thoracostomy
Self - limited - painless vaginal bleeding
Iron overload; use deferoxamine
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
13. A 49-year - old male presents with acute - onset flank pain and hematuria.
Clomiphene citrate
Seborrheic dermatitis. Treat with antifungals
Nephrolithiasis
Campylobacter
14. The number of true positives divided by the number of patients with the disease is _____.
Regresses after menopause
O2 - analgesia - hydration - and - if severe - transfusion
Sensitivity
CHF - shock - and altered mental status
15. Findings in 3
Lesions of 1
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Number of deaths per 1000 population
Placental abruption and placenta previa
16. Glomerulonephritis with hemoptysis.
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17. Hypercholesterolemia treatment that ? flushing and pruritus.
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
DI
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Niacin
18. The most common form of glomerulonephritis.
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19. A 25-year - old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.
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20. Characteristics favoring carcinoma in an isolated pulmonary nodule.
Dissociative fugue
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
21. A young patient with a family history of sudden death collapses and dies while exercising.
Hypertrophic cardiomyopathy
Chronic granulomatous disease
Iron deficiency anemia
Identify cause; fluid and blood repletion
22. Beck's triad for cardiac tamponade.
Angina is new - is worsening - or occurs at rest
Hypotension - distant heart sounds - and JVD
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
IV benzodiazepine
23. The coagulation parameter affected by warfarin.
Squamous cell carcinoma
Salmonella
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
PT
24. A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.
Parkland formula
Factitious disorder (Munchausen syndrome)
Malingering
Allergic interstitial nephritis
25. Treatment for neuroleptic malignant syndrome.
Dantrolene or bromocriptine
Hypotension - distant heart sounds - and JVD
Septic or anaphylactic shock
RCC or other erythropoietin - producing tumor; evaluate with CT scan
26. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
Nitroprusside
Asherman's syndrome
68% - 95.5% - 99.7%
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
27. Type of ARF in a patient with FeNa < 1%.
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Prerenal
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
28. Name the defense mechanism:
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Isolation
Neuroleptic malignant syndrome
Acne vulgaris
29. If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status - then socioeconomic status is a _____.
Surfactant deficiency
Confounding variable
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Trauma; the second most common is berry aneurysm
30. Administer to a symptomatic patient to diagnose myasthenia gravis.
Substance abuse
Edrophonium
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
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
31. Nonpainful chancre.
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
IV hydration and loop diuretics (furosemide)
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
1
32. A woman who was abused as a child frequently feels outside of or detached from her body.
Pseudogout
Anemia of chronic disease
Hypokalemia
Depersonalization disorder
33. Antidepressants associated with hypertensive crisis.
DM - SLE - and amyloidosis
Neither
MAOIs
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
34. Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
Squamous cell carcinoma
Anemia - thrombocytopenia - and acute renal failure
Parkland formula
Usually resolves spontaneously; may require IVIG and/or corticosteroids
35. An agent that reverses the effects of heparin.
Fanconi's anemia
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Protamine
Biliary tract obstruction
36. Contraceptive methods that protect against PID.
Exercise stress treadmill with ECG
RSV bronchiolitis
Crohn's disease
OCP and barrier contraception
37. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Contact dermatitis
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Substance abuse
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
38. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Pseudogout
Self - limited - painless vaginal bleeding
Treat existing heart failure and replace the tricuspid valve
Neuroleptic malignant syndrome
39. Treatment of hypovolemic shock.
Mycoplasma
CML
Identify cause; fluid and blood repletion
Renal cell carcinoma (RCC)
40. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
Lead - time bias
Chronic lymphocytic leukemia (CLL)
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
HGPRTase deficiency)
41. Endocarditis prophylaxis regimens.
Lyme disease - Ixodes tick - doxycycline
Oral surgery
Elevated ICP - RBCs - xanthochromia
Higher incidence
42. Defect in an X- linked syndrome with mental retardation -
Hypernatremia
Uremic syndrome seen in patients with renal failure
Membranous glomerulonephritis
Lesch - Nyhan syndrome (purine salvage problem with
43. Identify key organisms causing diarrhea:
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
S. aureus
Uterine atony
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
44. PFT showing ? FEV1/FVC.
Diamond - Blackfan anemia
Obstructive pulmonary disease (e.g. - asthma)
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
45. Rigidity and stiffness with resting tremor and masked facies.
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46. Involuntary psychiatric hospitalization can be undertaken for which three reasons?
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Malignancy and hyperparathyroidism
Low - voltage - diffuse ST- segment elevation
47. Treatment for acetaminophen overdose.
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
N- acetylcysteine
Identify cause; pressors (e.g. - dobutamine)
Alzheimer's and multi - infarct
48. The most common cause of hypothyroidism.
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49. What is the metabolic syndrome?
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Hypertrophic cardiomyopathy
Bruton's X- linked agammaglobulinemia
Fanconi's anemia
50. A 15-year - old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
Identify cause; pressors (e.g. - dobutamine)
Self - limited - painless vaginal bleeding
Pemphigus vulgaris
No. Parental consent is not necessary for the medical treatment of pregnant minors
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