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. Caf
IVIG or plasmapheresis
Neurofibromatosis 1
Treat immediately. Consent is implied in emergency situations
Stasis - hypercoagulability - endothelial damage


2. The three most common causes of fever of unknown origin (FUO).
Menometrorrhagia
HBV immunoglobulin
Campylobacter
Infection - cancer - and autoimmune disease


3. Classic CXR findings for pulmonary edema.

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4. Lung cancer highly related to cigarette exposure.
SCLC
Nephrotic syndrome
Anticoagulation - rate control - cardioversion
Murphy's sign - seen in acute cholecystitis


5. Therapy for polycystic ovarian syndrome.
Weight loss and OCPs
Anion gap acidosis and 1
Sulfonamides - antimalarial drugs - fava beans
Aseptic (viral) meningitis


6. Supportive treatment for ARDS.
Continuous positive airway pressure
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Pheochromocytoma
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)


7. The diagnostic test for pulmonary embolism.
Wiskott - Aldrich syndrome
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
V/Q scan


8. Treatment for atrial fibrillation.
68% - 95.5% - 99.7%
Wegener's granulomatosis and Goodpasture's syndrome
Weight gain - type 2 DM - QT prolongation
Anticoagulation - rate control - cardioversion


9. Treatment for bacterial vaginosis.
Angina is new - is worsening - or occurs at rest
Oral or topical metronidazole
Number of deaths from 28 days to one year per 1000 live births
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella


10. A 'blueberry muffin' rash is characteristic of what congenital infection?
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Rubella
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Parkland formula


11. Unopposed estrogen is contraindicated in which cancers?
Diphenhydramine or epinephrine 1:1000
Lyme disease - Ixodes tick - doxycycline
Transitional cell carcinoma
Endometrial or estrogen receptor - breast cancer


12. Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
Inevitable abortion
ETEC
A patient with chest trauma who was previously stable suddenly dies
Endometriosis


13. Arthritis - conjunctivitis - and urethritis in young men. Associated organisms?

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14. Name the defense mechanism:
Angina is new - is worsening - or occurs at rest
< 7.0
Regression
E. coli O157:H7


15. The most common 1
SSRIs
Conduct disorder
Cluster headache
Multiple myeloma


16. 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 _____.
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Confounding variable
Bullous pemphigoid
Lyme disease - Ixodes tick - doxycycline


17. Chronic diseases such as SLE
Number of deaths per 1000 population
Endometrial biopsy
Higher prevalence
Toxoplasma gondii


18. CSF findings with SAH.
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Elevated ICP - RBCs - xanthochromia
Herpes simplex
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms


19. Treatment for malignant hypertension.
Nitroprusside
Herpes simplex
Amoxicillin
Excessive EtOH


20. An antidiabetic agent associated with lactic acidosis.
Sheehan's syndrome (postpartum pituitary necrosis)
Metformin
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Impetigo


21. Class of drugs that may cause syndrome of muscle rigidity - hyperthermia - autonomic instability - and extrapyramidal symptoms.
Antipsychotics (neuroleptic malignant syndrome)
Trichomonas vaginitis
Partial mole
Intraductal papilloma


22. Signs suggesting radial nerve damage with humeral fracture.
Wrist drop - loss of thumb abduction
Bacterial meningitis
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Taenia solium (cysticercosis)


23. Rigidity and stiffness with resting tremor and masked facies.

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24. Bone is fractured in fall on outstretched hand.

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25. Nontender abdominal mass associated with elevated VMA and HVA.
Wegener's granulomatosis and Goodpasture's syndrome
Neuroblastoma
Suspect retinoblastoma
Wait - surgical resection - radiation and/or androgen suppression


26. A 55-year - old obese patient presents with dirty - velvety patches on the back of the neck.
Hyperkalemia
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Confounding variable
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes


27. Identify key organisms causing diarrhea:
IV penicillin or ampicillin
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Prinzmetal's angina
Salmonella


28. Criteria for exudative effusion.
TICS
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Nephrotic syndrome
Ulcerative colitis


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

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30. Contraceptive methods that protect against PID.
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Kegel exercises - estrogen - pessaries for stress incontinence
OCP and barrier contraception
Niacin


31. Amenorrhea - bradycardia - and abnormal body image in a young female.
Conduct disorder
Squamous cell carcinoma
Anorexia
B12 deficiency


32. Name the organism:
Salmonella
Number of live births per 1000 women 15-44 years of age
Seventy percent if the stenosis is symptomatic
Femoral hernia


33. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Asherman's syndrome
Renal cell carcinoma (RCC)
Wrist drop - loss of thumb abduction
Type I (distal) RTA


34. Endocarditis prophylaxis regimens.
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Retinoic acid
105 bacteria/mL
Oral surgery


35. Acceptable urine output in a stable patient.
Radiation
30 cc/hour
Bladder rupture or urethral injury
Lesch - Nyhan syndrome (purine salvage problem with


36. A 14-year - old girl presents with prolonged bleeding after dental surgery and with menses - normal PT - normal or ? PTT - and ? bleeding time. Diagnosis? Treatment?

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37. What is the immunodeficiency?
Pemphigus vulgaris
Chronic granulomatous disease
Phencyclidine hydrochloride (PCP) intoxication
Identify cause; fluid and blood repletion


38. Common symptoms associated with silent MIs.
Identify cause; fluid and blood repletion
Beta- blockers - Ca2+ channel blockers - TCAs
TICS
CHF - shock - and altered mental status


39. Glomerulonephritis with hemoptysis.

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40. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Conflict of interest
Febrile seizures (roseola infantum)
Kegel exercises - estrogen - pessaries for stress incontinence
Displacement


41. A young patient with a family history of sudden death collapses and dies while exercising.
Stable - unruptured ectopic pregnancy of &lt; 3.5 cm at &lt; 6 weeks' gestation
Factor V Leiden mutation
Hypertrophic cardiomyopathy
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms


42. Treatment for acetaminophen overdose.
Intussusception
Crohn's disease
N- acetylcysteine
Frotteurism (a paraphilia)


43. Chvostek's and Trousseau's signs.
Hypocalcemia
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Number of live births per 1000 population
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms


44. A febrile patient with a history of diabetes presents with a red - swollen - painful lower extremity.
Cellulitis
No. Parental consent is not necessary for the medical treatment of pregnant minors
ACEI
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves


45. The most common pathogen causing croup.
Pityriasis rosea
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Parainfluenza virus type 1
TICS


46. Cross - sectional survey
Prevalence
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Lead - time bias
Hashimoto's thyroiditis


47. A patient continues to use cocaine after being in jail - losing his job - and not paying child support.
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Substance abuse
Administration of DDAVP ? serum osmolality and free water restriction


48. Name the defense mechanism:
Isolation
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Femoral hernia
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid


49. Treatment for postpartum hemorrhage.
Number of live births per 1000 women 15-44 years of age
Uterine massage; if that fails - give oxytocin
Stable - unruptured ectopic pregnancy of &lt; 3.5 cm at &lt; 6 weeks' gestation
Hypovolemic shock


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

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