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USMLE Step 2

Subjects : health-sciences, usmle-step-2

Instructions:

Answer 50 questions in 15 minutes.
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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. Classic physical findings for endocarditis.

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2. Drugs that slow AV node transmission.
Pseudogout
Beta- blockers - digoxin - calcium channel blockers
Oral surgery
Spinal stenosis

3. The most common cause of seizures in children (2-10 years).
IgA nephropathy (Berger's disease)
Lesions of 1
Nephrogenic diabetes insipidus (DI)
Infection - febrile seizures - trauma - idiopathic

4. Treatment of AF.
B12 deficiency
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Rate control - rhythm conversion - and anticoagulation
Regresses after menopause

5. Relative risk?
Reye's syndrome
Headache
Basal cell carcinoma
The IR of a disease in a population exposed to a particular factor

6. The most common type of nephrolithiasis.
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Betamethasone or dexamethasone
Factitious disorder (Munchausen syndrome)
Calcium oxalate

7. 'Stuck - on' appearance.
Menometrorrhagia
Seborrheic keratosis
SSRIs
Selective IgA deficiency

8. How to diagnose and follow a leiomyoma.
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
CF or Hirschsprung's disease
Ultrasound
Frotteurism (a paraphilia)

9. An autosomal - recessive disorder with a defect in the GPIIbIIIa platelet receptor and ? platelet aggregation.

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10. The most common histology of bladder cancer.
Transitional cell carcinoma
Trauma - alcohol withdrawal - brain tumor
Trauma; the second most common is berry aneurysm
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)

11. Cross - sectional survey
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Identify cause; fluid and blood repletion
Isolation
Prevalence

12. Treatment for bacterial vaginosis.
Oral or topical metronidazole
HGPRTase deficiency)
Salmonella
Anemia of chronic disease

13. Treatment for opioid overdose.
Naloxone
Inevitable abortion
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Sporothrix schenckii

14. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Never
Septic or anaphylactic shock
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Duchenne muscular dystrophy

15. Characteristics of 2

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16. The most common cause of bloody nipple discharge.
Glomerulonephritis/nephritic syndrome
1
Intraductal papilloma
Administration of DDAVP ? serum osmolality and free water restriction

17. Name the defense mechanism:
Regression
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Protamine
Infection - cancer - and autoimmune disease

18. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Bladder rupture or urethral injury
Osteogenesis imperfecta
HBV - DTaP - Hib - IPV - PCV
Distal radius (Colles' fracture)

19. Hematuria - hypertension - and oliguria.
Retrograde cystourethrogram
Nephritic syndrome
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Glomerulonephritis/nephritic syndrome

20. What should always be done prior to LP?
Check for ? ICP; look for papilledema
Cerebral berry aneurysms (AD PCKD)
High reliability - low validity
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful

21. Class of drugs that may cause syndrome of muscle rigidity - hyperthermia - autonomic instability - and extrapyramidal symptoms.
Angina is new - is worsening - or occurs at rest
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Antipsychotics (neuroleptic malignant syndrome)
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

22. Galactorrhea - impotence - menstrual dysfunction - and ? libido.
Malignancy and hyperparathyroidism
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Patient on dopamine antagonist
Weight gain - type 2 DM - QT prolongation

23. Definition of unstable angina.
Endometriosis
Angina is new - is worsening - or occurs at rest
Ulcerative colitis
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination

24. Tanner stage 3 in a six-year - old female.
Precocious puberty
Ulcerative colitis
Hypoxia and hypocarbia
Hypocalcemia

25. A 40-year - old obese female with elevated alkaline phosphatase - elevated bilirubin - pruritus - dark urine - and clay- colored stools.
Depersonalization disorder
Factitious disorder (Munchausen syndrome)
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Biliary tract obstruction

26. Pure RBC aplasia.
Pityriasis rosea
Edrophonium
Diamond - Blackfan anemia
Excessive EtOH

27. T- wave flattening and U waves.
Glanzmann's thrombasthenia
Number of deaths from birth to 28 days per 1000 live births
Distal radius (Colles' fracture)
Hypokalemia

28. Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow - up evaluation?
Colposcopy and endocervical curettage
Frotteurism (a paraphilia)
Fluid restriction - demeclocycline
ACEI

29. A child has loss of red light reflex. Diagnosis?
Bacillus cereus
Neisseria meningitidis
Suspect retinoblastoma
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms

30. A 35-year - old male has recurrent episodes of palpitations - diaphoresis - and fear of going crazy.
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Substance abuse
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Panic disorder

31. A young patient with a family history of sudden death collapses and dies while exercising.
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
Hypertrophic cardiomyopathy
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Phencyclidine hydrochloride (PCP) intoxication

32. Symptoms of placenta previa.
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Seborrheic keratosis
Self - limited - painless vaginal bleeding
Crohn's disease

33. A violent patient has vertical and horizontal nystagmus.
Antipsychotics (neuroleptic malignant syndrome)
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
Phencyclidine hydrochloride (PCP) intoxication
Osteoarthritis

34. The first test to perform when a woman presents with amenorrhea.
Lesions of 1
Factitious disorder (Munchausen syndrome)
Iron deficiency anemia
Beta- hCG; the most common cause of amenorrhea is pregnancy

35. Combined UMN and LMN disorder.
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Neuroleptic malignant syndrome
Sporothrix schenckii
ALS

36. A 30-year - old woman has unpredictable urine loss. Examination is normal. Medical options?
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Incidence and prevalence
Parvovirus B19
Hypertension - bradycardia - and abnormal respirations

37. Laparoscopic findings in endometriosis.

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38. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Lead - time bias
Allergic interstitial nephritis
INH - penicillamine - hydralazine - procainamide

39. The most serious side effect of clozapine.
Agranulocytosis
IgA nephropathy (Berger's disease)
Niacin
AP chest - AP/lateral C- spine - AP pelvis

40. Name the organism:
B12 deficiency
Klebsiella
46 -XX
IVIG or plasmapheresis

41. Neonatal mortality?
Number of deaths from birth to 28 days per 1000 live births
Amoxicillin
Higher prevalence
Subdural hematoma

42. Salicylate ingestion ? In What type of acid - base disorder?
Anion gap acidosis and 1
OCP and barrier contraception
Pentad of TTP
Sarcoidosis

43. Beck's triad for cardiac tamponade.
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
N- acetylcysteine
Hypotension - distant heart sounds - and JVD
Murphy's sign - seen in acute cholecystitis

44. Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
Fanconi's anemia
Number of deaths from birth to 28 days per 1000 live births
Inevitable abortion
Ampulla of the oviduct

45. Should a - or Beta- antagonists be used first in treating pheochromocytoma?
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
Osteogenesis imperfecta
Absence seizures
a - antagonists (phentolamine and phenoxybenzamine)

46. Presence of red cell casts in urine sediment.
Patent ductus arteriosus (PDA)
Conversion disorder
Glomerulonephritis/nephritic syndrome
SCLC

47. Supportive treatment for ARDS.
Cluster headache
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Continuous positive airway pressure
Neuroleptics

48. Amenorrhea - bradycardia - and abnormal body image in a young female.
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Anorexia
Intussusception
Pseudogout

49. Defect in an X- linked syndrome with mental retardation -
Immediate needle thoracostomy
Lesion of 1
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Lesch - Nyhan syndrome (purine salvage problem with

50. 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
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Rubella
Infection - cancer - and autoimmune disease

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USMLE Step 2

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