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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. A 55-year - old man presents with irritative and obstructive urinary symptoms. Treatment options?
Salmonella
'Chocolate cysts -' powder burns
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
MAOIs
2. Therapy for polycystic ovarian syndrome.
1
False. Withdrawing and withholding life are the same from an ethical standpoint
Continuous positive airway pressure
Weight loss and OCPs
3. Classic physical findings for endocarditis.
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4. Diagnostic test for hereditary spherocytosis.
Endometrial biopsy
Osmotic fragility test
Hypotension - distant heart sounds - and JVD
Dissociative fugue
5. Nonpainful chancre.
1
Nephrogenic diabetes insipidus (DI)
Lesion of 1
Higher prevalence
6. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Parvovirus B19
Wait - surgical resection - radiation and/or androgen suppression
Pheochromocytoma
Out
7. Acid - base disorder in pulmonary embolism.
Lobular carcinoma in situ
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Benzodiazepines
Hypoxia and hypocarbia
8. Antibiotics with teratogenic effects.
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Out
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Guillain - Barr
9. The most common cause of hypertension in young men.
Klebsiella
Excessive EtOH
Erythema multiforme
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
10. Causes of hypoxemia.
Incidence and prevalence
Ulcerative colitis
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Nitroprusside
11. A patient continues to use cocaine after being in jail - losing his job - and not paying child support.
Higher prevalence
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Substance abuse
Guillain - Barr
12. First - line medication for status epilepticus.
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
IV benzodiazepine
Pasteurella multocida
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
13. Heinz bodies?
Giardia
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
14. Neonatal mortality?
Number of deaths from birth to 28 days per 1000 live births
Lobular carcinoma in situ
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Bacillus cereus
15. Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?
Anticoagulation - rate control - cardioversion
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Seminoma
Placental abruption and placenta previa
16. The most common 1
Factitious disorder (Munchausen syndrome)
7-10 days
Osmotic fragility test
Lung - breast - skin (melanoma) - kidney - GI tract
17. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
'Chocolate cysts -' powder burns
Guillain - Barr
Lead - time bias
Conflict of interest
18. A child has loss of red light reflex. Diagnosis?
Bacillus cereus
Suspect retinoblastoma
Flumazenil
Prevalence
19. After a minor fender bender - a man wears a neck brace and requests permanent disability.
105 bacteria/mL
Exercise stress treadmill with ECG
Actinomyces israelii
Malingering
20. Lung cancer highly related to cigarette exposure.
SCLC
Bacillus cereus
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
68% - 95.5% - 99.7%
21. Hematuria - flank pain - and palpable flank mass.
Patent ductus arteriosus (PDA)
Naloxone
Renal cell carcinoma (RCC)
Avascular necrosis
22. Chromosomal pattern of a complete mole.
46 -XX
DI
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
Agranulocytosis
23. A 24-year - old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
Fat - female - fertile - forty - flatulent
Coarctation of the aorta
HGPRTase deficiency)
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
24. Indications for surgical repair of abdominal aortic aneurysm.
BP > 140/90 on three separate occasions two weeks apart
Asymmetry - border irregularity - color variation - large diameter
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
25. The most common histology of bladder cancer.
Uremic syndrome seen in patients with renal failure
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Klebsiella
Transitional cell carcinoma
26. The most common cause of hypertension in young women.
OCPs
Check for ? ICP; look for papilledema
Malignancy and hyperparathyroidism
Seventy percent if the stenosis is symptomatic
27. Name the organism:
Salmonella
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
Pulsus paradoxus (seen in cardiac tamponade)
Intussusception
28. Normalizing PCO2 in a patient having an asthma exacerbation may indicate?
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Treat existing heart failure and replace the tricuspid valve
Fatigue and impending respiratory failure
Flumazenil
29. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Lobular carcinoma in situ
OCP and barrier contraception
Infection - cancer - and autoimmune disease
30. An autosomal - recessive disorder with a defect in the GPIIbIIIa platelet receptor and ? platelet aggregation.
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31. Inflammatory disease of the colon with ? risk of colon cancer.
Establish the ABCs
Choriocarcinoma
Ulcerative colitis
Impetigo
32. Name the organism:
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
Sporothrix schenckii
Lichen sclerosus
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
33. What is the immunodeficiency?
Alzheimer's and multi - infarct
Renal cell carcinoma (RCC)
Wiskott - Aldrich syndrome
Retinoic acid
34. Name the organism:
Toxoplasma gondii
Basal cell carcinoma
Conduct disorder
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
35. Signs of neurogenic shock.
Continuous positive airway pressure
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first - degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer
Hypotension and bradycardia
36. Confusion - confabulation - ophthalmoplegia - ataxia.
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37. A 16-year - old presents with an annular patch of alopecia with broken - off - stubby hairs.
Alopecia areata (autoimmune process)
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Bacillus cereus
Infection - febrile seizures - trauma - idiopathic
38. Treatment for opioid overdose.
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Naloxone
Lichen planus
Lead - time bias
39. Virchow's triad.
PT
Legionella pneumonia
Stasis - hypercoagulability - endothelial damage
Diverticulosis
40. Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
IV hydration and loop diuretics (furosemide)
Clomiphene citrate
Suspect ankylosing spondylitis. Check HLA- B27
Number of deaths from 20 weeks' gestation to birth per 1000 total births
41. An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Fat - female - fertile - forty - flatulent
Febrile seizures (roseola infantum)
Obstructive pulmonary disease (e.g. - asthma)
42. Name the organism:
Osteogenesis imperfecta
Pasteurella multocida
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Ophthalmologic exam - CT - and MRI
43. Risk factors for cholelithiasis.
Rubella
Third - degree heart block
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Fat - female - fertile - forty - flatulent
44. The most common form of nephritic syndrome.
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
HBV immunoglobulin
Membranous glomerulonephritis
Acute mania. Start a mood stabilizer (e.g. - lithium)
45. The most common 1
Regresses after menopause
Erythema multiforme
Multiple myeloma
Trauma; the second most common is berry aneurysm
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)
OCPs
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Pseudomonas
47. Radiographic indications for surgery in patients with acute abdomen.
Wait - surgical resection - radiation and/or androgen suppression
Malignancy and hyperparathyroidism
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Weight loss and OCPs
48. The most frequent presentation of intracranial neoplasm.
Asherman's syndrome
SCLC
Headache
Wrist drop - loss of thumb abduction
49. Complication of scaphoid fracture.
Febrile seizures (roseola infantum)
Avascular necrosis
Beta- hCG; the most common cause of amenorrhea is pregnancy
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
50. First step in the management of a patient with acute GI bleed.
Polymyalgia rheumatica
Sensitivity
Establish the ABCs
Avascular necrosis
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