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. Side effects of corticosteroids.
IV benzodiazepine
Basal cell carcinoma
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Agranulocytosis


2. Radiographic indications for surgery in patients with acute abdomen.
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Distal radius (Colles' fracture)
Fanconi's anemia


3. Endocarditis prophylaxis regimens.
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
M3
Cirrhosis - CHF - nephritic syndrome
Oral surgery


4. Acute - phase treatment for Kawasaki disease.
Pasteurella multocida
Oral surgery
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
IV penicillin or ampicillin


5. The most common cause of Cushing's syndrome.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


6. The most common pathogen causing croup.
Malignancy and hyperparathyroidism
Parainfluenza virus type 1
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
M3


7. Infant mortality?
50 cc/hour
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination


8. Four causes of microcytic anemia.
Coarctation of the aorta
HBV - DTaP - Hib - IPV - PCV
TICS
Duchenne muscular dystrophy


9. Lung cancer associated with SIADH.
Basal cell carcinoma
Small cell lung cancer (SCLC)
Graves' disease
Displacement


10. Glomerulonephritis with deafness.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


11. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Type I (distal) RTA
? serum FSH
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Continuous - painful vaginal bleeding


12. Unopposed estrogen is contraindicated in which cancers?
Neisseria meningitidis
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Endometrial or estrogen receptor - breast cancer
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


13. Treatment for mild - persistent asthma.
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Depersonalization disorder
Inhaled Beta- agonists and inhaled corticosteroids
Panic disorder


14. Involuntary commitment or isolation for medical treatment may be undertaken For what reason?
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Restrictive pulmonary disease
Nitroprusside
MS


15. A postoperative patient with significant pain presents with hyponatremia and normal volume status.
Erythema multiforme
SIADH due to stress
Cardiogenic shock
? serum FSH


16. A son asks that his mother not be told about her recently discovered cancer.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


17. True or false: Once patients sign a statement giving consent - they must continue treatment.
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
Colposcopy and endocervical curettage
HBV immunoglobulin
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births


18. Rigidity and stiffness that progress to choreiform movements - accompanied by moodiness and altered behavior.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


19. Signs of neurogenic shock.
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Hypotension and bradycardia
Campylobacter
Dressler's syndrome: fever - pericarditis - ? ESR


20. Cause of amenorrhea with normal prolactin - no response to estrogen - progesterone challenge - and a history of D&C.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


21. Radiographic evidence of aortic disruption or dissection.
Oral surgery
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Menometrorrhagia
Emergent laparotomy to repair perforated viscus - likely stomach


22. When can a physician refuse to continue treating a patient on the grounds of futility?
Kegel exercises - estrogen - pessaries for stress incontinence
Beta- blockers - digoxin - calcium channel blockers
Sulfonamides - antimalarial drugs - fava beans
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


23. Classic causes of drug - induced hepatitis.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Low - voltage - diffuse ST- segment elevation
Angina is new - is worsening - or occurs at rest
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline


24. Identify key organisms causing diarrhea:
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
CF or Hirschsprung's disease
Panic disorder
S. aureus


25. Nontender abdominal mass associated with elevated VMA and HVA.
? Ca2+ - ? K- - ? phosphate - ? uric acid
Elevated ICP - RBCs - xanthochromia
Neuroblastoma
HBV immunoglobulin


26. 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.
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Self - limited - painless vaginal bleeding
Nephrotic syndrome
Hodgkin's lymphoma


27. Medication given to accelerate fetal lung maturity.
ACEI
Lichen sclerosus
Betamethasone or dexamethasone
Phototherapy (mild) or exchange transfusion (severe)


28. Administer to a symptomatic patient to diagnose myasthenia gravis.
Dantrolene or bromocriptine
Actinic keratosis
Edrophonium
Kl


29. Birth rate?
Sensitivity
Number of live births per 1000 population
B12 deficiency
Multiple myeloma


30. Molar pregnancy containing fetal tissue.
Partial mole
Calcium oxalate
Beta- hCG; the most common cause of amenorrhea is pregnancy
Naloxone


31. Salicylate ingestion ? In What type of acid - base disorder?
Graves' disease
Anion gap acidosis and 1
Broca's aphasia. Frontal lobe - left MCA distribution
OCPs


32. Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV- positive patient At what CD4 count? Mycobacterium avium - intracellulare (MAI) prophylaxis?
Nephrogenic diabetes insipidus (DI)
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Varicella zoster
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis


33. Hematuria - hypertension - and oliguria.
Choriocarcinoma
Iron deficiency anemia
Oral surgery
Nephritic syndrome


34. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Impetigo
Treat immediately. Consent is implied in emergency situations
Broca's aphasia. Frontal lobe - left MCA distribution
Reaction formation


35. Findings in 3
Hypokalemia
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Osteogenesis imperfecta


36. Honeycomb pattern on CXR. Diagnosis? Treatment?
Dressler's syndrome: fever - pericarditis - ? ESR
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Salmonella
ACEI


37. ? CO - ? PCWP - ? PVR.
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
Seborrheic dermatitis. Treat with antifungals
Huntington's disease
Septic or anaphylactic shock


38. Proteinuria - hypoalbuminemia - hyperlipidemia - hyperlipiduria - edema.
Intraductal papilloma
Hereditary spherocytosis
Central pontine myelinolysis
Nephrotic syndrome


39. Evaluation of a pulsatile abdominal mass and bruit.
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Abdominal ultrasound and CT
Clostridium difficile
Suspect ankylosing spondylitis. Check HLA- B27


40. Odds ratio?
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Pregnant women. Treat this group aggressively because of potential complications
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths


41. Dyspnea - lateral hilar lymphodenopathy on CXR - noncaseating granulomas - increased ACE - and hypercalcemia.
SSRIs
Sarcoidosis
Beta- hCG; the most common cause of amenorrhea is pregnancy
Contact dermatitis


42. Test to rule out urethral injury.
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
RSV bronchiolitis
Retrograde cystourethrogram


43. Treatment of tension pneumothorax.
Fat - female - fertile - forty - flatulent
Immediate needle thoracostomy
Subdural hematoma
Lesch - Nyhan syndrome (purine salvage problem with


44. Cannon 'a' waves.
Sporothrix schenckii
Third - degree heart block
Parvovirus B19
Herpes simplex


45. Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Retinoic acid
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Suspect ankylosing spondylitis. Check HLA- B27
Renal cell carcinoma (RCC)


46. Three systemic diseases ? nephrotic syndrome.
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
DM - SLE - and amyloidosis
Respiratory alkalosis
Erythema multiforme


47. Post - HBV exposure treatment.
Neuroblastoma
B12 deficiency
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
HBV immunoglobulin


48. A first - born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Precocious puberty
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Pseudomonas


49. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Observational bias
Actinomyces israelii
False. Withdrawing and withholding life are the same from an ethical standpoint
Clostridium difficile


50. CSF findings with SAH.
The IR of a disease in a population exposed to a particular factor
HBV - DTaP - Hib - IPV - PCV
Elevated ICP - RBCs - xanthochromia
ARDS