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. Signs of neurogenic shock.
Inhaled Beta- agonists and inhaled corticosteroids
Regression
Hypotension and bradycardia
Aseptic (viral) meningitis


2. Galactorrhea - impotence - menstrual dysfunction - and ? libido.
Choriocarcinoma
Ophthalmologic exam - CT - and MRI
ARDS
Patient on dopamine antagonist


3. Relative risk?
< 7.0
Ophthalmologic exam - CT - and MRI
The IR of a disease in a population exposed to a particular factor
Actinomyces israelii


4. AML subtype associated with DIC.
M3
Septic or anaphylactic shock
Immediate needle thoracostomy
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)


5. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
Threatened abortion
Uterine atony
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
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed


6. A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.
Radiation
Factitious disorder (Munchausen syndrome)
46 -XX
Endometriosis


7. Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Rubella
Hypoparathyroidism
Suspect ankylosing spondylitis. Check HLA- B27
Bladder rupture or urethral injury


8. 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?

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


9. How to distinguish polycythemia vera from 2
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
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
Agranulocytosis
Neurofibromatosis 1


10. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Phototherapy (mild) or exchange transfusion (severe)
Squamous cell carcinoma
Neither
Lobular carcinoma in situ


11. Medication to avoid in patients with a history of alcohol withdrawal seizures.
Pasteurella multocida
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Neuroleptics
Treat immediately. Consent is implied in emergency situations


12. First - line pharmacotherapy for depression.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Contact dermatitis
Number of live births per 1000 women 15-44 years of age
SSRIs


13. Lung cancer associated with SIADH.
Pityriasis rosea
Endometriosis
Neurofibromatosis 1
Small cell lung cancer (SCLC)


14. Administer to a symptomatic patient to diagnose myasthenia gravis.
Edrophonium
Surfactant deficiency
Niacin
? serum FSH


15. Nontender abdominal mass associated with elevated VMA and HVA.
Fanconi's anemia
Neuroblastoma
Wiskott - Aldrich syndrome
Rubella


16. Virchow's triad.
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Number of deaths per 1000 population
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Stasis - hypercoagulability - endothelial damage


17. Difference between a cohort and a case - control study.
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
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Psoriasis
Malingering


18. Treatment for malignant hypertension.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Nitroprusside
Factitious disorder (Munchausen syndrome)
1


19. Four causes of microcytic anemia.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
TICS
ACEI
Hypovolemic shock


20. Presents with a herald patch - Christmas - tree pattern.
Identify cause; pressors (e.g. - dobutamine)
Non - Hodgkin's lymphoma
Hypokalemia
Pityriasis rosea


21. Glomerulonephritis with hemoptysis.

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


22. Characteristics of 2

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


23. True or false: Once patients sign a statement giving consent - they must continue treatment.
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
Bullous pemphigoid
Suspect retinoblastoma
Number of deaths from birth to 28 days per 1000 live births


24. Drowsiness - asterixis - nausea - and a pericardial friction rub.
Uremic syndrome seen in patients with renal failure
Herpes simplex
Agranulocytosis
O2 - analgesia - hydration - and - if severe - transfusion


25. A 60-year - old African - American male presents with bone pain. Workup for multiple myeloma might reveal?

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


26. Therapy for polycystic ovarian syndrome.
Immediate cardioversion
Clostridium difficile
Conversion disorder
Weight loss and OCPs


27. Treatment for DTs.
Nephrolithiasis
Benzodiazepines
Polymyalgia rheumatica
Dressler's syndrome: fever - pericarditis - ? ESR


28. The most common causes of dementia.

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


29. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Rubella
Normal
Prerenal
Highly sensitive for TB


30. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Higher prevalence
Hodgkin's lymphoma
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Headache


31. A middle - aged man presents with acute - onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis - and how did he get it? Treatment?
Iatrogenic steroid administration. The second most common cause is Cushing's disease
RSV bronchiolitis
Postinfectious glomerulonephritis
Lyme disease - Ixodes tick - doxycycline


32. The most common 1
Suspect ankylosing spondylitis. Check HLA- B27
30 cc/hour
Pseudomonas
Multiple myeloma


33. May be seen in children who are accused of inattention in class and confused with ADHD.
A patient with chest trauma who was previously stable suddenly dies
Dantrolene or bromocriptine
50 cc/hour
Absence seizures


34. Key side effects of atypical antipsychotics.
Acute mania. Start a mood stabilizer (e.g. - lithium)
1
Toxoplasma gondii
Weight gain - type 2 DM - QT prolongation


35. Maternal mortality?
Avascular necrosis
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Normal


36. Definition of unstable angina.
Angina is new - is worsening - or occurs at rest
Parvovirus B19
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
False. Withdrawing and withholding life are the same from an ethical standpoint


37. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Treat existing heart failure and replace the tricuspid valve
Prevalence
Placental abruption and placenta previa
Administration of DDAVP ? serum osmolality and free water restriction


38. When can a physician refuse to continue treating a patient on the grounds of futility?
Parainfluenza virus type 1
Basal cell carcinoma
Type II (proximal) RTA
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


39. Treatment of cardiogenic shock.
Iron deficiency anemia
Identify cause; pressors (e.g. - dobutamine)
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Placental abruption and placenta previa


40. Reynolds' pentad.

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


41. Type of ARF in a patient with FeNa < 1%.
a - antagonists (phentolamine and phenoxybenzamine)
Nephrotic syndrome
Prerenal
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones


42. A patient from California or Arizona presents with fever - malaise - cough - and night sweats. Diagnosis? Treatment?
? serum FSH
Broca's aphasia. Frontal lobe - left MCA distribution
Coccidioidomycosis. Amphotericin B
MS


43. Identify key organisms causing diarrhea:
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Malingering
ETEC


44. A patient has ? vaginal discharge and petechial patches in the upper vagina and cervix.
Trichomonas vaginitis
Nephrotic syndrome
Anticoagulation - rate control - cardioversion
Kwashiorkor (protein malnutrition)


45. Prophylactic treatment for migraine.
Beta- blockers - Ca2+ channel blockers - TCAs
Partial mole
OCPs
Colposcopy and endocervical curettage


46. 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)
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Erythema multiforme


47. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
Panic disorder
Phencyclidine hydrochloride (PCP) intoxication
Antipsychotics (neuroleptic malignant syndrome)
ARDS


48. Aplastic crisis in sickle cell disease.
Parvovirus B19
Identify cause; fluid and blood repletion
Fluid restriction - demeclocycline
Cluster headache


49. A two - month - old presents with nonbilious projectile emesis. What are the appropriate steps in management?
Seventy percent if the stenosis is symptomatic
Rate control with carotid massasge or other vagal stimulation
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Parvovirus B19


50. After a minor fender bender - a man wears a neck brace and requests permanent disability.
Malingering
Clomiphene citrate
Stable - unruptured ectopic pregnancy of &lt; 3.5 cm at &lt; 6 weeks' gestation
Anemia of chronic disease