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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. A young patient with a family history of sudden death collapses and dies while exercising.
Edrophonium
OCPs - danazol - GnRH agonists
Displacement
Hypertrophic cardiomyopathy

2. An antidiabetic agent associated with lactic acidosis.
Phencyclidine hydrochloride (PCP) intoxication
Metformin
Sarcoidosis
Bullous pemphigoid

3. Name the organism:
Asymmetry - border irregularity - color variation - large diameter
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Reye's syndrome
Actinomyces israelii

4. Causes of drug - induced SLE.
Number of live births per 1000 women 15-44 years of age
Osgood - Schlatter disease
INH - penicillamine - hydralazine - procainamide
Radiation

5. Classic causes of drug - induced hepatitis.
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Campylobacter
Immediate needle thoracostomy
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction

6. Definition of unstable angina.
Bacterial meningitis
Aseptic (viral) meningitis
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Angina is new - is worsening - or occurs at rest

7. Signs of active ischemia during stress testing.
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Intraductal papilloma
Angina - ST- segment changes on ECG - or ? BP
Neuroblastoma

8. Risk factors for DVT.

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9. Diagnostic test for hypertrophic cardiomyopathy.
IV penicillin or ampicillin
Sulfonamides - antimalarial drugs - fava beans
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
HIDA scan

10. Breast malignancy presenting as itching - burning - and erosion of the nipple.

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11. ? CO - ? PCWP - ? PVR.
Immediate needle thoracostomy
Bladder rupture or urethral injury
Lichen sclerosus
Cardiogenic shock

12. Treatment of central DI.
Squamous cell carcinoma
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Acne vulgaris
Administration of DDAVP ? serum osmolality and free water restriction

13. Four causes of microcytic anemia.
TICS
Cluster headache
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
S. aureus

14. Signs of ? ICP (Cushing's triad).
Hypertension - bradycardia - and abnormal respirations
Out
Wernicke's encephalopathy due to a deficiency of thiamine
30 cc/hour

15. Virus associated with aplastic anemia in patients with sickle cell anemia.
Parvovirus B19
Reaction formation
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Check for ? ICP; look for papilledema

16. The most common cause of female infertility.
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
Endometriosis
Weight gain - type 2 DM - QT prolongation
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy

17. The most serious side effect of clozapine.
Agranulocytosis
Crohn's disease
Type II (proximal) RTA
Anorexia

18. ? risk of what infection with silicosis?
Mycobacterium tuberculosis
30 cc/hour
Establish the ABCs
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots

19. Diagnostic test for hereditary spherocytosis.
Sheehan's syndrome (postpartum pituitary necrosis)
Trichomonas vaginitis
Cerebral berry aneurysms (AD PCKD)
Osmotic fragility test

20. Treatment for neuroleptic malignant syndrome.
Number of live births per 1000 population
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Dantrolene or bromocriptine
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin

21. Signs suggesting radial nerve damage with humeral fracture.
Wrist drop - loss of thumb abduction
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
Asymmetry - border irregularity - color variation - large diameter
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate

22. Molar pregnancy containing fetal tissue.
Infection - febrile seizures - trauma - idiopathic
SIADH due to stress
Partial mole
Pheochromocytoma

23. Vaccinations at a six- month well - child visit.
Hypotension and bradycardia
HBV - DTaP - Hib - IPV - PCV
Lesion of 1
Distal radius (Colles' fracture)

24. 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?
Lyme disease - Ixodes tick - doxycycline
Levodopa/carbidopa
Exercise stress treadmill with ECG
Inhaled Beta- agonists and inhaled corticosteroids

25. The most common organism in burn - related infections.
Pseudomonas
Diphenhydramine or epinephrine 1:1000
Squamous cell carcinoma
Bacillus cereus

26. Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
No. Parental consent is not necessary for the medical treatment of pregnant minors
Suspect ankylosing spondylitis. Check HLA- B27

27. Typical antibiotics for group B streptococcus (GBS) prophylaxis.
Pemphigus vulgaris
Hypocalcemia
IV penicillin or ampicillin
Mycoplasma

28. Inflammatory disease of the colon with ? risk of colon cancer.
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Protamine
Ulcerative colitis
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots

29. The most common type of nephrolithiasis.
Dressler's syndrome: fever - pericarditis - ? ESR
Calcium oxalate
MS
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy

30. Treatment for opioid overdose.
Displacement
Squamous cell carcinoma
Reaction formation
Naloxone

31. When should a vaginal exam be performed with suspected placenta previa?
Glanzmann's thrombasthenia
? protein intake - lactulose - neomycin
Never
Malingering

32. 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
Absence seizures
IVIG or plasmapheresis
Selective IgA deficiency

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

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34. A doctor refers a patient for an MRI at a facility he/she owns.
Conflict of interest
Parvovirus B19
Levodopa/carbidopa
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful

35. Treatment of cardiogenic shock.
Identify cause; pressors (e.g. - dobutamine)
Prevalence
Number of deaths from 28 days to one year per 1000 live births
Folate deficiency

36. Post - HBV exposure treatment.
HBV immunoglobulin
Dressler's syndrome: fever - pericarditis - ? ESR
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Cellulitis

37. The most frequent presentation of intracranial neoplasm.
SSRIs
Colposcopy and endocervical curettage
Headache
Phencyclidine hydrochloride (PCP) intoxication

38. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
Bladder rupture or urethral injury
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones

39. Not contraindications to vaccination.
Obstructive pulmonary disease (e.g. - asthma)
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
High TSH - low T4 - antimicrosomal antibodies
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity

40. Defect in an X- linked syndrome with mental retardation -
Erythema multiforme
OCP and barrier contraception
IV penicillin or ampicillin
Lesch - Nyhan syndrome (purine salvage problem with

41. A 24-year - old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Never
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Bacillus cereus

42. A congenital heart disease that cause 2
Murphy's sign - seen in acute cholecystitis
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Clomiphene citrate
Coarctation of the aorta

43. What is the metabolic syndrome?
Kwashiorkor (protein malnutrition)
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Coarctation of the aorta
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states

44. Antihypertensive for a diabetic patient with proteinuria.
Crohn's disease
Hypotension - distant heart sounds - and JVD
ACEI
Pharmacologic stress test (e.g. - dobutamine echo)

45. A 16-year - old presents with an annular patch of alopecia with broken - off - stubby hairs.
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Anticoagulation - rate control - cardioversion
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Alopecia areata (autoimmune process)

46. Name the defense mechanism:
Factitious disorder (Munchausen syndrome)
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Sporothrix schenckii
Displacement

47. Name the organism:
Impetigo
Obstructive pulmonary disease (e.g. - asthma)
Pseudomonas
Parvovirus B19

48. Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
105 bacteria/mL
Squamous cell carcinoma
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing

49. Fetal mortality?

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50. Identify key organisms causing diarrhea:
Wegener's granulomatosis and Goodpasture's syndrome
Colposcopy and endocervical curettage
Vibrio - HAV
Excessive EtOH