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USMLE Step 2

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. Iris - like target lesions.
Erythema multiforme
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Septic or anaphylactic shock
Kegel exercises - estrogen - pessaries for stress incontinence

2. + Nikolsky's sign.
Oral or topical metronidazole
Higher incidence
Pemphigus vulgaris
1

3. Caf
Angina is new - is worsening - or occurs at rest
No. Parental consent is not necessary for the medical treatment of pregnant minors
Neurofibromatosis 1
46 -XX

4. Classic ECG findings in pericarditis.
ALS
Hypocalcemia
Low - voltage - diffuse ST- segment elevation
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis

5. True or false: Withdrawing life - sustaining care is ethically distinct from withholding sustaining care.
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
False. Withdrawing and withholding life are the same from an ethical standpoint
Parkland formula
Fat - female - fertile - forty - flatulent

6. Associated with Propionibacterium acnes and changes in androgen levels.
Acne vulgaris
Placental abruption and placenta previa
Streptococcus pneumoniae
Ophthalmologic exam - CT - and MRI

7. The number of bacterial culture on a clean - catch specimen to diagnose a UTI.
Acne vulgaris
Excessive EtOH
105 bacteria/mL
Depersonalization disorder

8. A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
Ultrasound
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Bladder rupture or urethral injury
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful

9. Anemia associated with absent radii and thumbs - diffuse hyperpigmentation - caf

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10. Name the organism:
Neisseria meningitidis
Amoxicillin
Nephrolithiasis
IVIG or plasmapheresis

11. Method of calculating fluid repletion in burn patients.
Normal
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Parkland formula
Establish the ABCs

12. Test to rule out urethral injury.
Hypoxia and hypocarbia
Retrograde cystourethrogram
Normal
Reye's syndrome

13. Hematuria - flank pain - and palpable flank mass.
Suspect ankylosing spondylitis. Check HLA- B27
Confounding variable
Renal cell carcinoma (RCC)
Identify cause; pressors (e.g. - dobutamine)

14. A patient continues to use cocaine after being in jail - losing his job - and not paying child support.
Salmonella
Parvovirus B19
Substance abuse
? serum FSH

15. Difference between a cohort and a case - control study.
Murphy's sign - seen in acute cholecystitis
Klebsiella
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
Biliary tract obstruction

16. An agent that reverses the effects of heparin.
30 cc/hour
Protamine
Selective IgA deficiency
Bruton's X- linked agammaglobulinemia

17. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
Surfactant deficiency
Neisseria meningitidis
Betamethasone or dexamethasone
ARDS

18. Identify key organisms causing diarrhea:
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
OCPs
Endometriosis
Neuroleptics

19. Confusion - confabulation - ophthalmoplegia - ataxia.

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20. PFT showing ? FEV1/FVC.
SCLC
HGPRTase deficiency)
Obstructive pulmonary disease (e.g. - asthma)
Avascular necrosis

21. Presence of red cell casts in urine sediment.
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Pasteurella multocida
Anticoagulation - rate control - cardioversion
Glomerulonephritis/nephritic syndrome

22. The most serious side effect of clozapine.
ACEI
Weight gain - type 2 DM - QT prolongation
Type II (proximal) RTA
Agranulocytosis

23. Chvostek's and Trousseau's signs.
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Hypocalcemia
IVIG or plasmapheresis
Paget's disease

24. A crescent - shaped hyperdensity on CT that does not cross the midline.
Lyme disease - Ixodes tick - doxycycline
Bullous pemphigoid
Central pontine myelinolysis
Subdural hematoma

25. Neutropenic nadir postchemotherapy.
MAOIs
Acute pancreatitis
7-10 days
Wrist drop - loss of thumb abduction

26. A 25-year - old African - American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
1
Higher prevalence
O2 - analgesia - hydration - and - if severe - transfusion
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births

27. Signs of active ischemia during stress testing.
Angina - ST- segment changes on ECG - or ? BP
Huntington's disease
Uremic syndrome seen in patients with renal failure
Lyme disease - Ixodes tick - doxycycline

28. CSF findings:
Alzheimer's and multi - infarct
Aseptic (viral) meningitis
Paget's disease
Neither

29. Sensitive tests have few false negatives and are used to rule _____ a disease.
Out
Non - Hodgkin's lymphoma
Retrograde cystourethrogram
Iatrogenic steroid administration. The second most common cause is Cushing's disease

30. The most common cause of female infertility.
Vibrio - HAV
Oral or topical metronidazole
Endometriosis
Giardia

31. Classic physical findings for endocarditis.

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32. ? risk of what infection with silicosis?
Sarcoidosis
Mycobacterium tuberculosis
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)

33. Lab findings in Hashimoto's thyroiditis.
Naloxone
Acute myelogenous leukemia (AML)
Fatigue and impending respiratory failure
High TSH - low T4 - antimicrosomal antibodies

34. A 55-year - old obese patient presents with dirty - velvety patches on the back of the neck.
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
? protein intake - lactulose - neomycin
Pseudogout

35. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
Campylobacter
Patient on dopamine antagonist
Hypovolemic shock
? protein intake - lactulose - neomycin

36. Common symptoms associated with silent MIs.
Consider Fitz - Hugh - Curtis syndrome
CHF - shock - and altered mental status
Respiratory alkalosis
MS

37. The three most common causes of fever of unknown origin (FUO).
Parvovirus B19
Infection - cancer - and autoimmune disease
Rubella
Seminoma

38. True or false: Once patients sign a statement giving consent - they must continue treatment.
Amoxicillin
Hypertrophic cardiomyopathy
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
Conduct disorder

39. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Diverticulosis
SCLC
False. Withdrawing and withholding life are the same from an ethical standpoint
Postinfectious glomerulonephritis

40. Acid - base disorder in pulmonary embolism.
Lesions of 1
Diamond - Blackfan anemia
Hypoxia and hypocarbia
Sheehan's syndrome (postpartum pituitary necrosis)

41. Joints in the hand affected in rheumatoid arthritis.
MCP and PIP joints; DIP joints are spared
Contact dermatitis
Avascular necrosis
IV penicillin or ampicillin

42. Nonpainful chancre.
Mallory- Weiss
1
Alport's syndrome
Flumazenil

43. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Ulcerative colitis
Hypocalcemia
Actinomyces israelii
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

44. Treatment for ventricular fibrillation.
Immediate cardioversion
Headache
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Hashimoto's thyroiditis

45. Medical treatment for IBD.
Malingering
Ophthalmologic exam - CT - and MRI
Prevalence
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations

46. Shortest AP diameter of the pelvis.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Uterine massage; if that fails - give oxytocin
Dantrolene or bromocriptine
Campylobacter

47. The most common cause of hypertension in young men.
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Consider Fitz - Hugh - Curtis syndrome
E. coli O157:H7
Excessive EtOH

48. ? CO - ? PCWP - ? PVR.
Observational bias
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Cardiogenic shock
Calcium oxalate

49. Blood in the urethral meatus or high - riding prostate.
Bladder rupture or urethral injury
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Normal

50. A patient presents with recent PID with RUQ pain.
Immediate needle thoracostomy
50 cc/hour
Mallory- Weiss
Consider Fitz - Hugh - Curtis syndrome