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 patient hasn't slept for days - lost $20 -000 gambling - is agitated - and has pressured speech. Diagnosis? Treatment?
TICS
Psoriasis
Third - degree heart block
Acute mania. Start a mood stabilizer (e.g. - lithium)


2. The most serious side effect of clozapine.
Agranulocytosis
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Neuroblastoma
Endometrial biopsy


3. The most common organism in burn - related infections.
Suspect ankylosing spondylitis. Check HLA- B27
Pseudomonas
Spinal stenosis
Neurofibromatosis 1


4. Name the organism:
Pseudomonas
Kl
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Duchenne muscular dystrophy


5. Cause of neonatal RDS.
? serum FSH
ARDS
Surfactant deficiency
Frotteurism (a paraphilia)


6. The most common cause of hypertension in young women.
Folate deficiency
Osgood - Schlatter disease
Coccidioidomycosis. Amphotericin B
OCPs


7. Risk factors for pyelonephritis.
All - compartment fasciotomy for suspected compartment syndrome
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Hypovolemic shock
Lesch - Nyhan syndrome (purine salvage problem with


8. Side effects of corticosteroids.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Dressler's syndrome: fever - pericarditis - ? ESR
Immediate cardioversion
Biliary tract obstruction


9. A 55-year - old man is diagnosed with prostate cancer. Treatment options?
Neuroleptics
Actinomyces israelii
Wait - surgical resection - radiation and/or androgen suppression
Inevitable abortion


10. Medical treatment for hepatic encephalopathy.
Infection - febrile seizures - trauma - idiopathic
Pregnant women. Treat this group aggressively because of potential complications
Acute myelogenous leukemia (AML)
? protein intake - lactulose - neomycin


11. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Contact dermatitis
Threatened abortion
Biliary tract obstruction
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)


12. Sentinel loop on AXR.
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Nephritic syndrome
Acute pancreatitis
Endometriosis


13. Characteristics favoring carcinoma in an isolated pulmonary nodule.
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Salmonella
? protein intake - lactulose - neomycin
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins


14. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
RCC or other erythropoietin - producing tumor; evaluate with CT scan
'Sawtooth' P waves
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Type I (distal) RTA


15. Identify key organisms causing diarrhea:
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
S. aureus
High reliability - low validity
Clostridium difficile


16. Three systemic diseases ? nephrotic 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
Prevalence
CA-125 and transvaginal ultrasound
DM - SLE - and amyloidosis


17. A significant cause of morbidity in thalassemia patients. Treatment?
1
Suspect ankylosing spondylitis. Check HLA- B27
Metformin
Iron overload; use deferoxamine


18. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
? Ca2+ - ? K- - ? phosphate - ? uric acid
Factor V Leiden mutation
Threatened abortion
Emergent laparotomy to repair perforated viscus - likely stomach


19. Perinatal mortality?

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


20. Characteristics of 2

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


21. ? risk of what infection with silicosis?
Mycobacterium tuberculosis
Streptococcus pneumoniae
INH - penicillamine - hydralazine - procainamide
Restrictive pulmonary disease


22. Attributable risk?
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Streptococcus pneumoniae
Lead - time bias
Pemphigus vulgaris


23. Reed - Sternberg cells

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


24. Honey- crusted lesions.
Biliary tract obstruction
Impetigo
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Parvovirus B19


25. Glomerulonephritis with deafness.

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


26. A young patient with a family history of sudden death collapses and dies while exercising.
Endometriosis
Pentad of TTP
Hypovolemic shock
Hypertrophic cardiomyopathy


27. The most common cause of bloody nipple discharge.
Pentad of TTP
< 7.0
Neisseria meningitidis
Intraductal papilloma


28. Natural history of a leiomyoma.
Regresses after menopause
Lung - breast - skin (melanoma) - kidney - GI tract
Lead - time bias
IV benzodiazepine


29. Laparoscopic findings in endometriosis.

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


30. The most frequent presentation of intracranial neoplasm.
Angina - ST- segment changes on ECG - or ? BP
Obstructive pulmonary disease (e.g. - asthma)
< 7.0
Headache


31. The most common 1
Selective IgA deficiency
Abdominal ultrasound and CT
Malignancy and hyperparathyroidism
Anticoagulation - rate control - cardioversion


32. Name the organism:
Salmonella
Hodgkin's lymphoma
Subarachnoid hemorrhage (SAH)
Angina - ST- segment changes on ECG - or ? BP


33. An 80-year - old man presents with fatigue - lymphadenopathy - splenomegaly - and isolated lymphocytosis. Suspected diagnosis?
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Neisseria meningitidis
Chronic lymphocytic leukemia (CLL)
Septic or anaphylactic shock


34. Chromosomal pattern of a complete mole.
Non - Hodgkin's lymphoma
Angina is new - is worsening - or occurs at rest
Benzodiazepines
46 -XX


35. The most common cancer in men and the most common cause of death from cancer in men.
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Immediate cardioversion
Parkinson's disease
TICS


36. Acute - phase treatment for Kawasaki disease.
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Lichen planus
Rate control - rhythm conversion - and anticoagulation
Seminoma


37. Defect in an X- linked syndrome with mental retardation -
Benzodiazepines
Hereditary spherocytosis
Pseudomonas
Lesch - Nyhan syndrome (purine salvage problem with


38. Identify key organisms causing diarrhea:
Rate control with carotid massasge or other vagal stimulation
Neither
Hodgkin's lymphoma
Giardia


39. Treatment for Guillain - Barr
IVIG or plasmapheresis
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Factitious disorder (Munchausen syndrome)
Benzodiazepines


40. Treatment of hypovolemic shock.
Acute mania. Start a mood stabilizer (e.g. - lithium)
Biliary tract obstruction
Beta- hCG; the most common cause of amenorrhea is pregnancy
Identify cause; fluid and blood repletion


41. 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


42. Name the organism:
Seborrheic keratosis
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Streptococcus pneumoniae
Ultrasound


43. Reynolds' pentad.

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


44. Symptoms of placenta previa.
Continuous - painful vaginal bleeding
Basal cell carcinoma
The IR of a disease in a population exposed to a particular factor
Self - limited - painless vaginal bleeding


45. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Ophthalmologic exam - CT - and MRI
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Neuroblastoma
Pheochromocytoma


46. A 55-year - old obese patient presents with dirty - velvety patches on the back of the neck.
Septic or anaphylactic shock
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Hypertrophic cardiomyopathy


47. An elderly female presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ? ESR.
Psoriasis
Polymyalgia rheumatica
Multiple myeloma
Isolation


48. The coagulation parameter affected by warfarin.
Neuroblastoma
PT
TICS
Beta- hCG; the most common cause of amenorrhea is pregnancy


49. Erythema migrans.
Taenia solium (cysticercosis)
The IR of a disease in a population exposed to a particular factor
Diamond - Blackfan anemia
Lesion of 1


50. Key side effects of atypical antipsychotics.
Weight gain - type 2 DM - QT prolongation
Anticoagulation - rate control - cardioversion
Normal
Hypotension - distant heart sounds - and JVD