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USMLE Step 2

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. Treatment for SVC syndrome.
Partial mole
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
ALS
Radiation

2. Classic ECG findings in pericarditis.
Suspect retinoblastoma
B12 deficiency
Low - voltage - diffuse ST- segment elevation
Conflict of interest

3. CSF findings:
Kegel exercises - estrogen - pessaries for stress incontinence
Aseptic (viral) meningitis
Rett's disorder
Mycoplasma

4. Postnatal mortality?
Angina - ST- segment changes on ECG - or ? BP
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Number of deaths from 28 days to one year per 1000 live births
Mycobacterium tuberculosis

5. Inspiratory arrest during palpation of the RUQ.

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6. Microcytic anemia with ? serum iron - ? ferritin - and ? TIBC.
Check for ? ICP; look for papilledema
RSV bronchiolitis
Iron deficiency anemia
Salmonella

7. Goal hemoglobin A1c for a patient with DM.
< 7.0
SSRIs
ACEI
Pseudomonas

8. A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Acne vulgaris
Central pontine myelinolysis

9. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Retinoic acid
Seborrheic dermatitis. Treat with antifungals
Neisseria meningitidis
Osteogenesis imperfecta

10. A crescent - shaped hyperdensity on CT that does not cross the midline.
Campylobacter
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Subdural hematoma
Esophageal atresia with distal TEF (85%). Unable to pass NG tube

11. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Kegel exercises - estrogen - pessaries for stress incontinence
OCP and barrier contraception
Pityriasis versicolor
Identify cause; fluid and blood repletion

12. Identify key organisms causing diarrhea:
Infection - febrile seizures - trauma - idiopathic
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
E. coli O157:H7
Rubella

13. Normalizing PCO2 in a patient having an asthma exacerbation may indicate?
Metformin
HBV immunoglobulin
Treat immediately. Consent is implied in emergency situations
Fatigue and impending respiratory failure

14. Classic physical findings for endocarditis.

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15. An antidiabetic agent associated with lactic acidosis.
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Mycoplasma
Metformin
Pemphigus vulgaris

16. Flat - topped papules.
Lichen planus
Neither
Beta- blockers - digoxin - calcium channel blockers
Chronic lymphocytic leukemia (CLL)

17. The most common cause of SAH.
Consider Fitz - Hugh - Curtis syndrome
Benzodiazepines
Reye's syndrome
Trauma; the second most common is berry aneurysm

18. Extraintestinal manifestations of IBD.
Inevitable abortion
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Pseudomonas
AP chest - AP/lateral C- spine - AP pelvis

19. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
HBV immunoglobulin
1
Neuroblastoma

20. An 80-year - old man presents with fatigue - lymphadenopathy - splenomegaly - and isolated lymphocytosis. Suspected diagnosis?
Small cell lung cancer (SCLC)
Chronic lymphocytic leukemia (CLL)
Anorexia
Renal cell carcinoma (RCC)

21. Findings in 3
Fluids and antibiotics
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Prinzmetal's angina
Mycoplasma

22. Treatment for bacterial vaginosis.
HBV - DTaP - Hib - IPV - PCV
Alzheimer's and multi - infarct
Oral or topical metronidazole
HGPRTase deficiency)

23. CSF findings with SAH.
Elevated ICP - RBCs - xanthochromia
Lesions of 1
Consider Fitz - Hugh - Curtis syndrome
Rate control with carotid massasge or other vagal stimulation

24. A 55-year - old patient presents with acute 'broken speech.' What type of aphasia? What lobe and vascular distribution?

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25. Attributable risk?
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Cirrhosis - CHF - nephritic syndrome
Neisseria meningitidis

26. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Pheochromocytoma
Alzheimer's and multi - infarct
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Higher prevalence

27. Treatment of tension pneumothorax.
Erythema multiforme
Immediate needle thoracostomy
Respiratory alkalosis
Vibrio - HAV

28. Glomerulonephritis with deafness.

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29. Nikolsky's sign.
Calcium oxalate
Establish the ABCs
Bullous pemphigoid
Crohn's disease

30. Name the organism:
Salmonella
Sarcoidosis
Number of deaths per 1000 population
Fat - female - fertile - forty - flatulent

31. Treatment of SIADH?
Malingering
Avascular necrosis
Stasis - hypercoagulability - endothelial damage
Fluid restriction - demeclocycline

32. AML subtype associated with DIC.
Amoxicillin
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
M3

33. A significant cause of morbidity in thalassemia patients. Treatment?
Wait - surgical resection - radiation and/or androgen suppression
Continuous - painful vaginal bleeding
Iron overload; use deferoxamine
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7

34. A fall in systolic BP of > 10 mmHg with inspiration.
Osteoarthritis
Pulsus paradoxus (seen in cardiac tamponade)
Toxoplasma gondii
Osteogenesis imperfecta

35. Chronic diseases such as SLE
Higher prevalence
Pseudomonas
Confounding variable
Squamous cell carcinoma

36. A 40-year - old obese female with elevated alkaline phosphatase - elevated bilirubin - pruritus - dark urine - and clay- colored stools.
Hodgkin's lymphoma
Duodenal atresia
Excessive EtOH
Biliary tract obstruction

37. Identify key organisms causing diarrhea:
ETEC
DM - SLE - and amyloidosis
RSV bronchiolitis
Number of deaths from 20 weeks' gestation to birth per 1000 total births

38. A febrile patient with a history of diabetes presents with a red - swollen - painful lower extremity.
Cellulitis
Uterine atony
Pityriasis rosea
Agranulocytosis

39. Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
Naloxone
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Endometrial biopsy
Patient on dopamine antagonist

40. How to diagnose and follow a leiomyoma.
1
Ultrasound
Number of deaths from birth to 28 days per 1000 live births
Herpes simplex

41. Risk factors for cholelithiasis.
Small cell lung cancer (SCLC)
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Colposcopy and endocervical curettage
Fat - female - fertile - forty - flatulent

42. If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status - then socioeconomic status is a _____.
Confounding variable
N- acetylcysteine
Endometrial biopsy
Mycobacterium tuberculosis

43. Identify key organisms causing diarrhea:
S. aureus or S. epidermidis.
CML
HBV - DTaP - Hib - IPV - PCV
Yersinia

44. Macrocytic - megaloblastic anemia without neurologic symptoms.
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Clomiphene citrate
High TSH - low T4 - antimicrosomal antibodies
Folate deficiency

45. Identify key organisms causing diarrhea:
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Renal cell carcinoma (RCC)
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6

46. Cold agglutinins.
Administration of DDAVP ? serum osmolality and free water restriction
Mycoplasma
Salmonella
Herpes simplex

47. Treatment of supraventricular tachycardia (SVT).
IV benzodiazepine
Pseudomonas
Rate control with carotid massasge or other vagal stimulation
Huntington's disease

48. Treatment of septic shock.
Neuroblastoma
Hereditary spherocytosis
Fluids and antibiotics
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy

49. Indications for surgical repair of abdominal aortic aneurysm.
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Administration of DDAVP ? serum osmolality and free water restriction
Membranous glomerulonephritis

50. Blood in the urethral meatus or high - riding prostate.
Bladder rupture or urethral injury
Cluster headache
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
'Sawtooth' P waves