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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. Difference between Mallory- Weiss and Boerhaave tears.
Neither
Respiratory alkalosis
They can mask symptoms of hypoglycemia
Mallory- Weiss

2. Not contraindications to vaccination.
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Regression
Pasteurella multocida
Respiratory alkalosis

3. True or false: Withdrawing life - sustaining care is ethically distinct from withholding sustaining care.
Trichomonas vaginitis
False. Withdrawing and withholding life are the same from an ethical standpoint
Abdominal ultrasound and CT
Avascular necrosis

4. The most common inherited cause of hypercoagulability.
Factor V Leiden mutation
Bacillus cereus
Lyme disease - Ixodes tick - doxycycline
Radiation

5. First - line medication for status epilepticus.
Bacterial meningitis
Rate control - rhythm conversion - and anticoagulation
IV benzodiazepine
Displacement

6. Glomerulonephritis with deafness.

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7. A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
DM - SLE - and amyloidosis
? protein intake - lactulose - neomycin
Treat immediately. Consent is implied in emergency situations

8. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Basal cell carcinoma
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Identify cause; pressors (e.g. - dobutamine)
Signs and symptoms of hypercalcemia

9. Why are Beta- blockers contraindicated in diabetics?
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
They can mask symptoms of hypoglycemia
Placental abruption and placenta previa
Lichen planus

10. Lab values suggestive of menopause.
Clostridium difficile
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Threatened abortion
? serum FSH

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

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12. HUS triad?
Infection - cancer - and autoimmune disease
Elevated ICP - RBCs - xanthochromia
Anemia - thrombocytopenia - and acute renal failure
CF or Hirschsprung's disease

13. Treatment of supraventricular tachycardia (SVT).
Kwashiorkor (protein malnutrition)
Identify cause; fluid and blood repletion
Rate control with carotid massasge or other vagal stimulation
Fat - female - fertile - forty - flatulent

14. The most common cause of hypertension in young men.
Asherman's syndrome
ALS
Osgood - Schlatter disease
Excessive EtOH

15. RTA associated with abnormal HCO3 - and rickets.
Type II (proximal) RTA
ARDS
Intussusception
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

16. A middle - aged man presents with acute - onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis - and how did he get it? Treatment?
Lyme disease - Ixodes tick - doxycycline
Retinoic acid
Salmonella
Hodgkin's lymphoma

17. The most common type of nephrolithiasis.
A patient with chest trauma who was previously stable suddenly dies
Calcium oxalate
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Neuroblastoma

18. What % lesion is an indication for carotid endarterectomy?
Iron overload; use deferoxamine
Seventy percent if the stenosis is symptomatic
Kl
Conduct disorder

19. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
Transitional cell carcinoma
DI
Paget's disease
CML

20. The most common type of testicular cancer.
ACEI
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Seminoma
Actinomyces israelii

21. Exophthalmos - pretibial myxedema - and ? TSH.

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22. Infant mortality?
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Allergic interstitial nephritis
IV benzodiazepine

23. Treatment for benzodiazepine overdose.
Anemia of chronic disease
50 cc/hour
Flumazenil
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies

24. Testicular cancer associated with Beta- hCG - AFP.
Choriocarcinoma
Identify cause; pressors (e.g. - dobutamine)
Acne vulgaris
Hypernatremia

25. The most common histology of bladder cancer.
Transitional cell carcinoma
False. Withdrawing and withholding life are the same from an ethical standpoint
B12 deficiency
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)

26. The most common organism in burn - related infections.
Pseudomonas
Alopecia areata (autoimmune process)
Higher incidence
Cellulitis

27. Macrocytic - megaloblastic anemia with neurologic symptoms.
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
B12 deficiency
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
INH - penicillamine - hydralazine - procainamide

28. Tanner stage 3 in a six-year - old female.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Precocious puberty
105 bacteria/mL
Pseudomonas

29. Lab findings in Hashimoto's thyroiditis.
Type I (distal) RTA
High TSH - low T4 - antimicrosomal antibodies
Anticoagulation - rate control - cardioversion
46 -XX

30. A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.
Protamine
Factitious disorder (Munchausen syndrome)
Neuroleptic malignant syndrome
Oral or topical metronidazole

31. Treatment of central DI.
Nephrolithiasis
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Type I (distal) RTA
Administration of DDAVP ? serum osmolality and free water restriction

32. Iris - like target lesions.
Ampulla of the oviduct
Erythema multiforme
Subarachnoid hemorrhage (SAH)
1

33. The most common pathogen causing croup.
Osteogenesis imperfecta
Parainfluenza virus type 1
Multiple myeloma
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

34. The most common causes of hypercalcemia.
Lichen sclerosus
Malignancy and hyperparathyroidism
Pharmacologic stress test (e.g. - dobutamine echo)
Patent ductus arteriosus (PDA)

35. The most common cause of hypothyroidism.

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36. Gout - self - mutilation - and choreoathetosis.
Asymmetry - border irregularity - color variation - large diameter
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
HGPRTase deficiency)

37. Fertility rate?
Postinfectious glomerulonephritis
Conflict of interest
Number of live births per 1000 women 15-44 years of age
? protein intake - lactulose - neomycin

38. Defect in an X- linked syndrome with mental retardation -
Lesch - Nyhan syndrome (purine salvage problem with
Coarctation of the aorta
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Hypokalemia

39. A 49-year - old male presents with acute - onset flank pain and hematuria.
Septic or anaphylactic shock
Lesion of 1
Nephrolithiasis
HBV - DTaP - Hib - IPV - PCV

40. An agent that reverses the effects of heparin.
Aseptic (viral) meningitis
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Protamine
Sporothrix schenckii

41. Radiographic indications for surgery in patients with acute abdomen.
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
IVIG or plasmapheresis
Selective IgA deficiency
Trichomonas vaginitis

42. Non - small cell lung cancer (NSCLC) associated with hypercalcemia.
Squamous cell carcinoma
OCPs - danazol - GnRH agonists
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Angina is new - is worsening - or occurs at rest

43. First - line treatment for moderate hypercalcemia.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
IV hydration and loop diuretics (furosemide)
IV penicillin or ampicillin
Hypoparathyroidism

44. Extraintestinal manifestations of IBD.
Haemophilus ducreyi
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Dressler's syndrome: fever - pericarditis - ? ESR
Iatrogenic steroid administration. The second most common cause is Cushing's disease

45. Complication of overly rapid correction of hyponatremia.
Herpes simplex
Protamine
Diphenhydramine or epinephrine 1:1000
Central pontine myelinolysis

46. Acute - phase treatment for Kawasaki disease.
MAOIs
Cerebral berry aneurysms (AD PCKD)
A patient's family cannot require that a doctor withhold information from the patient
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms

47. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
Excessive EtOH
HIDA scan
Nephrotic syndrome
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

48. Amenorrhea - bradycardia - and abnormal body image in a young female.
CML
105 bacteria/mL
Treat existing heart failure and replace the tricuspid valve
Anorexia

49. Treatment for atrial fibrillation.
SIADH due to stress
False. Withdrawing and withholding life are the same from an ethical standpoint
Anticoagulation - rate control - cardioversion
Neurofibromatosis 1

50. A newborn female has continuous 'machinery murmur.'
RSV bronchiolitis
Wernicke's encephalopathy due to a deficiency of thiamine
Patent ductus arteriosus (PDA)
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.

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USMLE Step 2

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