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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. Treatment for acetaminophen overdose.
N- acetylcysteine
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch

2. Medication used to induce ovulation.
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
CA-125 and transvaginal ultrasound
Substance abuse
Clomiphene citrate

3. A six-year - old girl presents with a port - wine stain in the V2 distribution as well as with mental retardation - seizures - and leptomeningeal angioma.
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Frotteurism (a paraphilia)
Hypertrophic cardiomyopathy

4. A 55-year - old man presents with irritative and obstructive urinary symptoms. Treatment options?
Endometrial or estrogen receptor - breast cancer
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Renal cell carcinoma (RCC)
Herpes simplex

5. A first - born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Weight gain - type 2 DM - QT prolongation
Precocious puberty
Femoral hernia
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction

6. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
SSRIs
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Self - limited - painless vaginal bleeding

7. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
Fatigue and impending respiratory failure
Parvovirus B19
Cardiogenic shock
1

8. Medical options for endometriosis.
OCPs - danazol - GnRH agonists
Reaction formation
Klebsiella
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)

9. Caf
Immediate needle thoracostomy
Normal
Neurofibromatosis 1
Conduct disorder

10. A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?
Coarctation of the aorta
MS
Highly sensitive for TB
S. aureus or S. epidermidis.

11. The most common cause of female infertility.
Paget's disease
Kl
'Sawtooth' P waves
Endometriosis

12. What is the immunodeficiency?

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13. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
OCPs - danazol - GnRH agonists
Pityriasis versicolor
Identify cause; fluid and blood repletion
CA-125 and transvaginal ultrasound

14. Prophylactic treatment for migraine.
Hypotension and bradycardia
Legionella pneumonia
Intraductal papilloma
Beta- blockers - Ca2+ channel blockers - TCAs

15. Eight surgically correctable causes of hypertension.

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16. First - line pharmacotherapy for depression.
Cellulitis
SSRIs
CML
Acute pancreatitis

17. 1
Placental abruption and placenta previa
Continuous positive airway pressure
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Acute myelogenous leukemia (AML)

18. The most common causes of dementia.

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19. T- wave flattening and U waves.
Hypokalemia
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Osmotic fragility test

20. Signs of active ischemia during stress testing.
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Angina - ST- segment changes on ECG - or ? BP
Hypotension - distant heart sounds - and JVD
Metformin

21. Lab values suggestive of menopause.
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
? serum FSH
Central pontine myelinolysis
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations

22. An agent that reverses the effects of heparin.
Acne vulgaris
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
? protein intake - lactulose - neomycin
Protamine

23. Treatment for opioid overdose.
Beta- blockers - digoxin - calcium channel blockers
Naloxone
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Type IV (distal) RTA

24. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
Lead - time bias
Rubella
Lesions of 1
Multiple myeloma

25. Glomerulonephritis with hemoptysis.

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26. Which healthy population is susceptible to UTIs?
Phencyclidine hydrochloride (PCP) intoxication
Subarachnoid hemorrhage (SAH)
Chronic lymphocytic leukemia (CLL)
Pregnant women. Treat this group aggressively because of potential complications

27. PFT showing ? FEV1/FVC.
Treat existing heart failure and replace the tricuspid valve
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
105 bacteria/mL
Restrictive pulmonary disease

28. When can a physician refuse to continue treating a patient on the grounds of futility?
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
Confounding variable
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
68% - 95.5% - 99.7%

29. Four causes of microcytic anemia.
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Erythema multiforme
TICS
Seborrheic dermatitis. Treat with antifungals

30. Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
ALS
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella

31. Hyperphagia - hypersexuality - hyperorality - and hyperdocility.
Endometrial or estrogen receptor - breast cancer
Asherman's syndrome
Membranous glomerulonephritis
Kl

32. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Treat immediately. Consent is implied in emergency situations
CHF - shock - and altered mental status
Threatened abortion
Glomerulonephritis/nephritic syndrome

33. Cause of neonatal RDS.
Amoxicillin
Surfactant deficiency
BP > 140/90 on three separate occasions two weeks apart
CHF - shock - and altered mental status

34. A postoperative patient with significant pain presents with hyponatremia and normal volume status.
Cluster headache
SIADH due to stress
Prerenal
Prinzmetal's angina

35. Difference between a cohort and a case - control study.
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Pseudomonas
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

36. Microcytic anemia with ? serum iron - ? total iron - binding capacity (TIBC) - and normal or ? ferritin.
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Anemia of chronic disease
Salmonella
50 cc/hour

37. Macrocytic - megaloblastic anemia without neurologic symptoms.
Pemphigus vulgaris
Mycoplasma
Betamethasone or dexamethasone
Folate deficiency

38. Chronic diseases such as SLE
Neurofibromatosis 1
Higher prevalence
Headache
Varicella zoster

39. Blood in the urethral meatus or high - riding prostate.
Bladder rupture or urethral injury
Acute mania. Start a mood stabilizer (e.g. - lithium)
Uremic syndrome seen in patients with renal failure
Hypoxia and hypocarbia

40. 'Cradle cap.'
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Isolation
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Seborrheic dermatitis. Treat with antifungals

41. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
Lichen sclerosus
Hypertension - bradycardia - and abnormal respirations
68% - 95.5% - 99.7%
Allergic interstitial nephritis

42. Iris - like target lesions.
'Sawtooth' P waves
Erythema multiforme
Elevated ICP - RBCs - xanthochromia
Ampulla of the oviduct

43. A newborn female has continuous 'machinery murmur.'
Hypernatremia
HGPRTase deficiency)
Patent ductus arteriosus (PDA)
Stasis - hypercoagulability - endothelial damage

44. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
Absence seizures
Hypovolemic shock
Ultrasound
Sheehan's syndrome (postpartum pituitary necrosis)

45. What is the immunodeficiency?
Chronic granulomatous disease
Neuroleptic malignant syndrome
CML
Glanzmann's thrombasthenia

46. Meningitis in infants. Causes? Treatment?
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Wegener's granulomatosis and Goodpasture's syndrome
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Nephrogenic diabetes insipidus (DI)

47. ECG findings suggesting MI.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Patent ductus arteriosus (PDA)
Contact dermatitis
Restrictive pulmonary disease

48. A 15-year - old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
Hodgkin's lymphoma
Postinfectious glomerulonephritis
Incidence and prevalence
No. Parental consent is not necessary for the medical treatment of pregnant minors

49. Name the organism:
Pasteurella multocida
Small cell lung cancer (SCLC)
Uremic syndrome seen in patients with renal failure
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)

50. First - line treatment for otitis media.
1
Acute mania. Start a mood stabilizer (e.g. - lithium)
Amoxicillin
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch