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. Aplastic crisis in sickle cell disease.
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Klebsiella
Parvovirus B19
Absence seizures


2. Lab findings in Hashimoto's thyroiditis.
1
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
High TSH - low T4 - antimicrosomal antibodies
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes


3. The most common type of testicular cancer.
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Rate control - rhythm conversion - and anticoagulation
IV benzodiazepine
Seminoma


4. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
a - antagonists (phentolamine and phenoxybenzamine)
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Legionella pneumonia
68% - 95.5% - 99.7%


5. Tests to rule out shaken baby syndrome.
Edrophonium
Ophthalmologic exam - CT - and MRI
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Nephrotic syndrome


6. A fall in systolic BP of > 10 mmHg with inspiration.
Pulsus paradoxus (seen in cardiac tamponade)
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Ophthalmologic exam - CT - and MRI


7. A 15-year - old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
No. Parental consent is not necessary for the medical treatment of pregnant minors
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Sensitivity
INH - penicillamine - hydralazine - procainamide


8. Hematuria - hypertension - and oliguria.
Nephritic syndrome
Edrophonium
Pharmacologic stress test (e.g. - dobutamine echo)
Number of deaths from 20 weeks' gestation to birth per 1000 total births


9. Virchow's triad.
Neuroleptic malignant syndrome
Stasis - hypercoagulability - endothelial damage
Hypernatremia
Lichen planus


10. Acceptable urine output in a trauma patient.
Kegel exercises - estrogen - pessaries for stress incontinence
Aseptic (viral) meningitis
50 cc/hour
Postinfectious glomerulonephritis


11. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Salmonella
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Iatrogenic steroid administration. The second most common cause is Cushing's disease
1


12. A painful - recurrent vesicular eruption of mucocutaneous surfaces.
Herpes simplex
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Sensitivity
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)


13. Extraintestinal manifestations of IBD.
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Duchenne muscular dystrophy
IgA nephropathy (Berger's disease)
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements


14. A 55-year - old man has sudden - excruciating first MTP joint pain after a night of drinking red wine. Diagnosis - workup - and chronic treatment?
N- acetylcysteine
Stasis - hypercoagulability - endothelial damage
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
SSRIs


15. CSF findings:
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Nephrotic syndrome
Bacterial meningitis
Retrograde cystourethrogram


16. Reed - Sternberg cells

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


17. Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Cerebral berry aneurysms (AD PCKD)
Nephrotic syndrome
Frotteurism (a paraphilia)


18. ? CO - ? PCWP - ? PVR.
Sheehan's syndrome (postpartum pituitary necrosis)
Herpes simplex
Septic or anaphylactic shock
Infection - cancer - and autoimmune disease


19. Identify key organisms causing diarrhea:
Higher prevalence
Prevalence
Factor V Leiden mutation
Giardia


20. Amenorrhea - bradycardia - and abnormal body image in a young female.
Bruton's X- linked agammaglobulinemia
Anorexia
Hashimoto's thyroiditis
Asymmetry - border irregularity - color variation - large diameter


21. Salicylate ingestion ? In What type of acid - base disorder?
Elevated ICP - RBCs - xanthochromia
Pasteurella multocida
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Anion gap acidosis and 1


22. Bone is fractured in fall on outstretched hand.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


23. A young patient has angina at rest with ST- segment elevation. Cardiac enzymes are normal.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


24. Four characteristics of a nevus suggestive of melanoma.
Mycobacterium tuberculosis
Asymmetry - border irregularity - color variation - large diameter
Duodenal atresia
Benzodiazepines


25. Signs of air embolism.
Uterine massage; if that fails - give oxytocin
Non - Hodgkin's lymphoma
A patient with chest trauma who was previously stable suddenly dies
Iron overload; use deferoxamine


26. Sudden onset of mental status changes - emesis - and liver dysfunction after taking aspirin.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


27. Not contraindications to vaccination.
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Rate control - rhythm conversion - and anticoagulation
Bruton's X- linked agammaglobulinemia
Trauma - alcohol withdrawal - brain tumor


28. Type of ARF in a patient with FeNa < 1%.
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Actinic keratosis
Prerenal
Infection - cancer - and autoimmune disease


29. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Pheochromocytoma
Infection - febrile seizures - trauma - idiopathic
Suspect ankylosing spondylitis. Check HLA- B27


30. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Pityriasis versicolor
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Type I (distal) RTA
Rate control with carotid massasge or other vagal stimulation


31. Medical options for endometriosis.
OCPs - danazol - GnRH agonists
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
HIDA scan
Rate control with carotid massasge or other vagal stimulation


32. A 25-year - old African - American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
O2 - analgesia - hydration - and - if severe - transfusion
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
M3
Inhaled Beta- agonists and inhaled corticosteroids


33. Virus associated with aplastic anemia in patients with sickle cell anemia.
Parvovirus B19
N- acetylcysteine
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Pseudogout


34. Medication to avoid in patients with a history of alcohol withdrawal seizures.
Radiation
Murphy's sign - seen in acute cholecystitis
Neuroleptics
Hashimoto's thyroiditis


35. Unopposed estrogen is contraindicated in which cancers?
Endometrial or estrogen receptor - breast cancer
Hodgkin's lymphoma
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
30 cc/hour


36. Erythema migrans.
Hypocalcemia
Lesion of 1
Identify cause; pressors (e.g. - dobutamine)
Acute myelogenous leukemia (AML)


37. Premalignant lesion from sun exposure that can ? squamous cell carcinoma.
Factor V Leiden mutation
Stasis - hypercoagulability - endothelial damage
Actinic keratosis
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed


38. A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.
Regresses after menopause
< 7.0
Factitious disorder (Munchausen syndrome)
Chronic lymphocytic leukemia (CLL)


39. A 20-year - old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?
Cerebral berry aneurysms (AD PCKD)
TICS
Oral or topical metronidazole
Prinzmetal's angina


40. The most common cause of postpartum hemorrhage.
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Uterine atony
Beta- blockers - Ca2+ channel blockers - TCAs
Number of deaths from birth to 28 days per 1000 live births


41. The most common cause of hypertension in young women.
Pheochromocytoma
Patent ductus arteriosus (PDA)
CA-125 and transvaginal ultrasound
OCPs


42. A 16-year - old presents with an annular patch of alopecia with broken - off - stubby hairs.
RSV bronchiolitis
Pseudogout
Alopecia areata (autoimmune process)
Obstructive pulmonary disease (e.g. - asthma)


43. Treatment of cardiogenic shock.
Pharmacologic stress test (e.g. - dobutamine echo)
Bacillus cereus
Anemia of chronic disease
Identify cause; pressors (e.g. - dobutamine)


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

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


45. What is the metabolic syndrome?
Phototherapy (mild) or exchange transfusion (severe)
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Surfactant deficiency


46. Maternal mortality?
Kl
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Intussusception
Pentad of TTP


47. A 24-year - old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
Panic disorder
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
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
Uterine atony


48. Name the organism:
Pseudomonas
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Toxoplasma gondii
Seminoma


49. First - line medication for status epilepticus.
Spinal stenosis
No. Parental consent is not necessary for the medical treatment of pregnant minors
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
IV benzodiazepine


50. Treatment for opioid overdose.
Weight gain - type 2 DM - QT prolongation
Kwashiorkor (protein malnutrition)
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Naloxone