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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 cause of hypertension in young men.
Excessive EtOH
Guillain - Barr
Neuroleptic malignant syndrome
DI
2. An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
Number of live births per 1000 women 15-44 years of age
Neurofibromatosis 1
Febrile seizures (roseola infantum)
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
3. A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Mycoplasma
Lung - breast - skin (melanoma) - kidney - GI tract
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Threatened abortion
4. The most common cause of hypertension in young women.
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
OCPs
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Usually resolves spontaneously; may require IVIG and/or corticosteroids
5. A painful - recurrent vesicular eruption of mucocutaneous surfaces.
Herpes simplex
Kl
Endometrial or estrogen receptor - breast cancer
Parkland formula
6. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
HIDA scan
OCPs - danazol - GnRH agonists
Trichomonas vaginitis
7. The most common cause of SAH.
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Sarcoidosis
Trauma; the second most common is berry aneurysm
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
8. After a minor fender bender - a man wears a neck brace and requests permanent disability.
Squamous cell carcinoma
Graves' disease
Malingering
Administration of DDAVP ? serum osmolality and free water restriction
9. Postnatal mortality?
IV penicillin or ampicillin
HBV immunoglobulin
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Number of deaths from 28 days to one year per 1000 live births
10. Cold agglutinins.
Squamous cell carcinoma
Prinzmetal's angina
Mycoplasma
Nephrolithiasis
11. A 10-year - old child presents in status epilepticus - but her parents refuse treatment on religious grounds.
12. Joints in the hand affected in rheumatoid arthritis.
MCP and PIP joints; DIP joints are spared
Ophthalmologic exam - CT - and MRI
Absence seizures
Beta- blockers - Ca2+ channel blockers - TCAs
13. Tanner stage 3 in a six-year - old female.
Elevated ICP - RBCs - xanthochromia
Precocious puberty
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Flumazenil
14. Reynolds' pentad.
15. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
Usually resolves spontaneously; may require IVIG and/or corticosteroids
CML
Mycoplasma
Septic or anaphylactic shock
16. The most common pituitary tumor. Treatment?
1
Pulsus paradoxus (seen in cardiac tamponade)
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Higher prevalence
17. A significant cause of morbidity in thalassemia patients. Treatment?
Identify cause; fluid and blood repletion
Regression
Protamine
Iron overload; use deferoxamine
18. Causes of exudative effusion.
Mallory- Weiss
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Placental abruption and placenta previa
Vibrio - HAV
19. A 55-year - old man is diagnosed with prostate cancer. Treatment options?
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Wait - surgical resection - radiation and/or androgen suppression
Hereditary spherocytosis
No. Parental consent is not necessary for the medical treatment of pregnant minors
20. Treatment for benzodiazepine overdose.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Patent ductus arteriosus (PDA)
Flumazenil
Exercise stress treadmill with ECG
21. Albuminocytologic dissociation.
Dantrolene or bromocriptine
Guillain - Barr
Choriocarcinoma
Beta- blockers - Ca2+ channel blockers - TCAs
22. The first test to perform when a woman presents with amenorrhea.
Malingering
Squamous cell carcinoma
Betamethasone or dexamethasone
Beta- hCG; the most common cause of amenorrhea is pregnancy
23. A patient continues to use cocaine after being in jail - losing his job - and not paying child support.
Inevitable abortion
OCPs - danazol - GnRH agonists
Substance abuse
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
24. Classic causes of drug - induced hepatitis.
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Giardia
25. Radiographic indications for surgery in patients with acute abdomen.
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Edrophonium
'Sawtooth' P waves
26. Bias introduced into a study when a clinician is aware of the patient's treatment type.
DI
Uterine atony
Number of deaths per 1000 population
Observational bias
27. Identify key organisms causing diarrhea:
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Vibrio - HAV
S. aureus
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
28. The number of bacterial culture on a clean - catch specimen to diagnose a UTI.
Number of live births per 1000 population
Clomiphene citrate
Aseptic (viral) meningitis
105 bacteria/mL
29. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Acute pancreatitis
Sulfonamides - antimalarial drugs - fava beans
Pemphigus vulgaris
Treat existing heart failure and replace the tricuspid valve
30. Treatment of AF.
Levodopa/carbidopa
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Seventy percent if the stenosis is symptomatic
Rate control - rhythm conversion - and anticoagulation
31. Risk factors for pyelonephritis.
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Acute myelogenous leukemia (AML)
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
32. Blood in the urethral meatus or high - riding prostate.
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Pheochromocytoma
Bladder rupture or urethral injury
HBV - DTaP - Hib - IPV - PCV
33. An agent that reverses the effects of heparin.
Sheehan's syndrome (postpartum pituitary necrosis)
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Protamine
34. Identify key organisms causing diarrhea:
ETEC
Allergic interstitial nephritis
Hypernatremia
Squamous cell carcinoma
35. Unilateral - severe periorbital headache with tearing and conjunctival erythema.
Iron overload; use deferoxamine
Identify cause; pressors (e.g. - dobutamine)
Cluster headache
Threatened abortion
36. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
S. aureus or S. epidermidis.
Frotteurism (a paraphilia)
Higher prevalence
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
37. First - line medication for status epilepticus.
Kl
IV benzodiazepine
Patent ductus arteriosus (PDA)
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
38. Findings in 3
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
< 7.0
Cluster headache
Bullous pemphigoid
39. Mortality rate?
Number of deaths per 1000 population
Uremic syndrome seen in patients with renal failure
Type IV (distal) RTA
Fluid restriction - demeclocycline
40. Charcot's triad.
Low - voltage - diffuse ST- segment elevation
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Malignancy and hyperparathyroidism
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
41. Involuntary commitment or isolation for medical treatment may be undertaken For what reason?
Haemophilus ducreyi
Pentad of TTP
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Fatigue and impending respiratory failure
42. Acid - base disorder in pulmonary embolism.
Hypoxia and hypocarbia
Bacillus cereus
Broca's aphasia. Frontal lobe - left MCA distribution
Prinzmetal's angina
43. The most common location for an ectopic pregnancy.
Asymmetry - border irregularity - color variation - large diameter
Hashimoto's thyroiditis
Osteogenesis imperfecta
Ampulla of the oviduct
44. Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
Higher prevalence
Anion gap acidosis and 1
Osteoarthritis
Check for ? ICP; look for papilledema
45. A young patient has angina at rest with ST- segment elevation. Cardiac enzymes are normal.
46. Acid - base disturbance commonly seen in pregnant women.
Respiratory alkalosis
Seventy percent if the stenosis is symptomatic
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
47. Chromosomal pattern of a complete mole.
Precocious puberty
Chronic granulomatous disease
46 -XX
Beta- blockers - digoxin - calcium channel blockers
48. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Highly sensitive for TB
Treat immediately. Consent is implied in emergency situations
Radiation
Lobular carcinoma in situ
49. Contraceptive methods that protect against PID.
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Usually resolves spontaneously; may require IVIG and/or corticosteroids
OCP and barrier contraception
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
50. A 30-year - old woman has unpredictable urine loss. Examination is normal. Medical options?
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Placental abruption and placenta previa