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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. The most common location for an ectopic pregnancy.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Ampulla of the oviduct
Dressler's syndrome: fever - pericarditis - ? ESR
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed

2. Contraceptive methods that protect against PID.
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Type I (distal) RTA
OCP and barrier contraception
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones

3. Identify key organisms causing diarrhea:
Antipsychotics (neuroleptic malignant syndrome)
S. aureus
105 bacteria/mL
Kl

4. The most common 1
Selective IgA deficiency
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Fanconi's anemia
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)

5. A five - month - old girl has ? head growth - truncal dyscoordination - and ? social interaction.

6. Testicular cancer associated with Beta- hCG - AFP.
Dissociative fugue
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Choriocarcinoma
Neuroleptic malignant syndrome

7. Inflammatory disease of the colon with ? risk of colon cancer.
Kegel exercises - estrogen - pessaries for stress incontinence
Ulcerative colitis
Asymmetry - border irregularity - color variation - large diameter
Nephrolithiasis

8. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Contact dermatitis

9. Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV- positive patient At what CD4 count? Mycobacterium avium - intracellulare (MAI) prophylaxis?
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
50 cc/hour
Actinic keratosis
Dantrolene or bromocriptine

10. Natural history of a leiomyoma.
Excessive EtOH
Regresses after menopause
Neuroblastoma
Prinzmetal's angina

11. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Hereditary spherocytosis
Basal cell carcinoma
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
V/Q scan

12. Defect in an X- linked syndrome with mental retardation -
Klebsiella
Pentad of TTP
Lesch - Nyhan syndrome (purine salvage problem with
Fever - pharyngeal erythema - tonsillar exudate - lack of cough

13. Electrolyte changes in tumor lysis syndrome.
? Ca2+ - ? K- - ? phosphate - ? uric acid
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Hereditary spherocytosis

14. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Kegel exercises - estrogen - pessaries for stress incontinence
Basal cell carcinoma
Precocious puberty
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births

15. Differential of hypervolemic hyponatremia.
Cirrhosis - CHF - nephritic syndrome
? protein intake - lactulose - neomycin
RSV bronchiolitis
Lichen planus

16. Name the organism:
Pseudomonas
Hypernatremia
Hodgkin's lymphoma
Number of live births per 1000 women 15-44 years of age

17. A patient with a history of lithium use presents with copious amounts of dilute urine.
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Nephrogenic diabetes insipidus (DI)
Aseptic (viral) meningitis
Kl

18. Acceptable urine output in a stable patient.
Multiple myeloma
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Substance abuse
30 cc/hour

19. Pure RBC aplasia.
Uremic syndrome seen in patients with renal failure
Prinzmetal's angina
Diamond - Blackfan anemia
Coccidioidomycosis. Amphotericin B

20. Fetal mortality?

21. Arthritis - conjunctivitis - and urethritis in young men. Associated organisms?

22. Diagnostic test for hereditary spherocytosis.
IV penicillin or ampicillin
Nephritic syndrome
Osmotic fragility test
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin

23. Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
Precocious puberty
Incidence and prevalence
? Ca2+ - ? K- - ? phosphate - ? uric acid
Inevitable abortion

24. An 11-year - old obese - African - American boy presents with sudden onset of limp. Diagnosis? Workup?
Pityriasis rosea
Slipped capital femoral epiphyses. AP and frog - leg lateral view
V/Q scan
Nephritic syndrome

25. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
Pseudomonas
High reliability - low validity
1
Hypoparathyroidism

26. Classic ultrasound and gross appearance of complete hydatidiform mole.

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

28. CSF findings with SAH.
Rate control with carotid massasge or other vagal stimulation
Wiskott - Aldrich syndrome
Highly sensitive for TB
Elevated ICP - RBCs - xanthochromia

29. Extraintestinal manifestations of IBD.
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Nephritic syndrome

30. Treatment of septic shock.
Non - Hodgkin's lymphoma
Fluids and antibiotics
The IR of a disease in a population exposed to a particular factor
Hashimoto's thyroiditis

31. Cross - sectional survey
Prevalence
Number of deaths from 28 days to one year per 1000 live births
Glomerulonephritis/nephritic syndrome
Conduct disorder

32. Attributable risk?
Avascular necrosis
Weight loss and OCPs
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Treat existing heart failure and replace the tricuspid valve

33. Test to rule out urethral injury.
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Dantrolene or bromocriptine
Retrograde cystourethrogram
Higher prevalence

34. A fall in systolic BP of > 10 mmHg with inspiration.
Pulsus paradoxus (seen in cardiac tamponade)
Folate deficiency
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Sensitivity

35. Name the defense mechanism:
Conflict of interest
Number of live births per 1000 women 15-44 years of age
Displacement
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies

36. Three systemic diseases ? nephrotic syndrome.
DM - SLE - and amyloidosis
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Signs and symptoms of hypercalcemia
CA-125 and transvaginal ultrasound

37. Identify key organisms causing diarrhea:
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Administration of DDAVP ? serum osmolality and free water restriction
Campylobacter
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction

38. Cause of neonatal RDS.
Nitroprusside
Establish the ABCs
Surfactant deficiency
Nephritic syndrome

39. Nikolsky's sign.
Bullous pemphigoid
Pseudogout
Higher incidence
Crohn's disease

40. The most common form of glomerulonephritis.

41. Characteristics favoring carcinoma in an isolated pulmonary nodule.
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Endometrial biopsy
Basal cell carcinoma
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)

42. The most common causes of dementia.

43. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
Hypovolemic shock
Basal cell carcinoma
Rate control - rhythm conversion - and anticoagulation
Excessive EtOH

44. Criteria for exudative effusion.
Yersinia
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Type IV (distal) RTA

45. Case - control study
Surfactant deficiency
Ampulla of the oviduct
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Neither

46. What is the immunodeficiency?
1
1
Chronic granulomatous disease
Pseudomonas

47. An agent that reverses the effects of heparin.
Protamine
Patient on dopamine antagonist
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Rubella

48. Four characteristics of a nevus suggestive of melanoma.
Asymmetry - border irregularity - color variation - large diameter
Mycobacterium tuberculosis
Ophthalmologic exam - CT - and MRI
Higher prevalence

49. A woman who was abused as a child frequently feels outside of or detached from her body.
Subarachnoid hemorrhage (SAH)
BP > 140/90 on three separate occasions two weeks apart
Depersonalization disorder
Wiskott - Aldrich syndrome

50. The three most common causes of fever of unknown origin (FUO).
Type IV (distal) RTA
Pseudomonas
Sporothrix schenckii
Infection - cancer - and autoimmune disease