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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. Hypercholesterolemia treatment that ? flushing and pruritus.
Normal
? serum FSH
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Niacin

2. Conditions in which confidentiality must be overridden.
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Dantrolene or bromocriptine
Coccidioidomycosis. Amphotericin B
? Ca2+ - ? K- - ? phosphate - ? uric acid

3. A significant cause of morbidity in thalassemia patients. Treatment?
Iron overload; use deferoxamine
7-10 days
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
1

4. Identify key organisms causing diarrhea:
ETEC
Osgood - Schlatter disease
Trauma - alcohol withdrawal - brain tumor
N- acetylcysteine

5. A patient has ? vaginal discharge and petechial patches in the upper vagina and cervix.
Mycoplasma
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Radiation
Trichomonas vaginitis

6. Electrolyte changes in tumor lysis syndrome.
Trauma - alcohol withdrawal - brain tumor
? Ca2+ - ? K- - ? phosphate - ? uric acid
< 7.0
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis

7. Medication given to accelerate fetal lung maturity.
Betamethasone or dexamethasone
Beta- blockers - digoxin - calcium channel blockers
Folate deficiency
Consider Fitz - Hugh - Curtis syndrome

8. Post - HBV exposure treatment.
High TSH - low T4 - antimicrosomal antibodies
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Ampulla of the oviduct
HBV immunoglobulin

9. Macrocytic - megaloblastic anemia without neurologic symptoms.
Sensitivity
Folate deficiency
Prerenal
Lesch - Nyhan syndrome (purine salvage problem with

10. An antidiabetic agent associated with lactic acidosis.
Metformin
Elevated ICP - RBCs - xanthochromia
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
Prinzmetal's angina

11. A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Ulcerative colitis
Lichen sclerosus

12. Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
Endometrial biopsy
Conversion disorder
RSV bronchiolitis
Neisseria meningitidis

13. Treatment for SVC syndrome.
ARDS
Hereditary spherocytosis
Radiation
Incidence and prevalence

14. A man unexpectedly flies across the country - takes a new name - and has no memory of his prior life.
Phototherapy (mild) or exchange transfusion (severe)
Dissociative fugue
Choriocarcinoma
Taenia solium (cysticercosis)

15. Treatment for postpartum hemorrhage.
Niacin
A patient with chest trauma who was previously stable suddenly dies
Iron deficiency anemia
Uterine massage; if that fails - give oxytocin

16. RTA associated with abnormal HCO3 - and rickets.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Panic disorder
Type II (proximal) RTA
Trichomonas vaginitis

17. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
Endometrial biopsy
Higher prevalence
Parvovirus B19
ARDS

18. Precipitants of hemolytic crisis in patients with G6PD deficiency.
BP > 140/90 on three separate occasions two weeks apart
AP chest - AP/lateral C- spine - AP pelvis
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Sulfonamides - antimalarial drugs - fava beans

19. The most common form of nephritic syndrome.
Membranous glomerulonephritis
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Chronic granulomatous disease

20. Name the organism:
Duchenne muscular dystrophy
Bladder rupture or urethral injury
Sporothrix schenckii
Septic or anaphylactic shock

21. Treatment for acute coronary syndrome.
All - compartment fasciotomy for suspected compartment syndrome
Osteogenesis imperfecta
Naloxone
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin

22. Breast malignancy presenting as itching - burning - and erosion of the nipple.

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23. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Prinzmetal's angina
Number of deaths from birth to 28 days per 1000 live births
Type I (distal) RTA
Hypernatremia

24. Chromosomal pattern of a complete mole.
Giardia
Abdominal ultrasound and CT
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
46 -XX

25. Beck's triad for cardiac tamponade.
Observational bias
Hypotension - distant heart sounds - and JVD
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Paget's disease

26. Meningitis in infants. Causes? Treatment?
V/Q scan
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Vibrio - HAV
Administration of DDAVP ? serum osmolality and free water restriction

27. Rigidity and stiffness with resting tremor and masked facies.

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28. Key side effects of atypical antipsychotics.
Trichomonas vaginitis
Weight gain - type 2 DM - QT prolongation
Chronic lymphocytic leukemia (CLL)
Acne vulgaris

29. Four characteristics of a nevus suggestive of melanoma.
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Asymmetry - border irregularity - color variation - large diameter
Toxoplasma gondii
Squamous cell carcinoma

30. Class of drugs that may cause syndrome of muscle rigidity - hyperthermia - autonomic instability - and extrapyramidal symptoms.
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
Angina - ST- segment changes on ECG - or ? BP
Hypotension - distant heart sounds - and JVD
Antipsychotics (neuroleptic malignant syndrome)

31. Gout - self - mutilation - and choreoathetosis.
Alzheimer's and multi - infarct
Hashimoto's thyroiditis
HGPRTase deficiency)
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements

32. Fertility rate?
Lesion of 1
Neuroblastoma
Number of live births per 1000 women 15-44 years of age
Sensitivity

33. Name the organism:
Endometrial biopsy
Mycoplasma
Squamous cell carcinoma
Salmonella

34. Defect in an X- linked syndrome with mental retardation -
Lesch - Nyhan syndrome (purine salvage problem with
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
CML
Campylobacter

35. How to diagnose and follow a leiomyoma.
Exercise stress treadmill with ECG
Ultrasound
Impetigo
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

36. A young patient with a family history of sudden death collapses and dies while exercising.
Parkinson's disease
Hypertrophic cardiomyopathy
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Mycoplasma

37. Criteria for exudative effusion.
Calcium oxalate
Pseudomonas
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Wrist drop - loss of thumb abduction

38. A postoperative patient with significant pain presents with hyponatremia and normal volume status.
ARDS
Infection - febrile seizures - trauma - idiopathic
Threatened abortion
SIADH due to stress

39. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
ETEC
M3
Pityriasis versicolor

40. 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
INH - penicillamine - hydralazine - procainamide
Parainfluenza virus type 1
Haemophilus ducreyi

41. Treatment of supraventricular tachycardia (SVT).
Inevitable abortion
Fluids and antibiotics
Partial mole
Rate control with carotid massasge or other vagal stimulation

42. Premalignant lesion from sun exposure that can ? squamous cell carcinoma.
Actinic keratosis
MCP and PIP joints; DIP joints are spared
Intraductal papilloma
Acute pancreatitis

43. Exophthalmos - pretibial myxedema - and ? TSH.

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44. The most serious side effect of clozapine.
Huntington's disease
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Agranulocytosis
Number of deaths from 20 weeks' gestation to birth per 1000 total births

45. Inflammatory disease of the colon with ? risk of colon cancer.
Yersinia
Ulcerative colitis
Prevalence
? Ca2+ - ? K- - ? phosphate - ? uric acid

46. A febrile patient with a history of diabetes presents with a red - swollen - painful lower extremity.
Sheehan's syndrome (postpartum pituitary necrosis)
Hypotension and bradycardia
Cellulitis
Coccidioidomycosis. Amphotericin B

47. Treatment for AML M3.
Retinoic acid
N- acetylcysteine
Trauma - alcohol withdrawal - brain tumor
Ophthalmologic exam - CT - and MRI

48. Cannon 'a' waves.
Third - degree heart block
Endometrial biopsy
Nephrogenic diabetes insipidus (DI)
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy

49. A homeless child is small for his age and has peeling skin and a swollen belly.
Hypovolemic shock
OCPs
Kwashiorkor (protein malnutrition)
Acute mania. Start a mood stabilizer (e.g. - lithium)

50. Name the organism:
Flumazenil
HBV immunoglobulin
Osteogenesis imperfecta
Streptococcus pneumoniae