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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. The three most common causes of fever of unknown origin (FUO).
Nephrotic syndrome
Prerenal
Infection - cancer - and autoimmune disease
Nitroprusside

2. Classic physical findings for endocarditis.

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3. The mainstay of Parkinson's therapy.
Frotteurism (a paraphilia)
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Levodopa/carbidopa
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch

4. Blood in the urethral meatus or high - riding prostate.
MCP and PIP joints; DIP joints are spared
? serum FSH
Bladder rupture or urethral injury
TICS

5. A postoperative patient with significant pain presents with hyponatremia and normal volume status.
SIADH due to stress
The IR of a disease in a population exposed to a particular factor
O2 - analgesia - hydration - and - if severe - transfusion
Diverticulosis

6. Endocarditis prophylaxis regimens.
Sensitivity
Oral surgery
False. Withdrawing and withholding life are the same from an ethical standpoint
Immediate needle thoracostomy

7. Caf
Number of deaths from 28 days to one year per 1000 live births
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Herpes simplex
Neurofibromatosis 1

8. The number of true positives divided by the number of patients with the disease is _____.
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Phototherapy (mild) or exchange transfusion (severe)
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Sensitivity

9. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
a - antagonists (phentolamine and phenoxybenzamine)
1
Central pontine myelinolysis
Hypernatremia

10. Treatment for mild - persistent asthma.
Ultrasound
Inhaled Beta- agonists and inhaled corticosteroids
Edrophonium
Out

11. Involuntary psychiatric hospitalization can be undertaken for which three reasons?
Pityriasis versicolor
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Hypocalcemia
Hypovolemic shock

12. Hematuria - hypertension - and oliguria.
High reliability - low validity
Nephritic syndrome
Factitious disorder (Munchausen syndrome)
S. aureus

13. Name the defense mechanism:
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
IgA nephropathy (Berger's disease)
Antipsychotics (neuroleptic malignant syndrome)
Regression

14. Treatment for atrial fibrillation.
Anticoagulation - rate control - cardioversion
50 cc/hour
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births

15. Microcytic anemia with ? serum iron - ? total iron - binding capacity (TIBC) - and normal or ? ferritin.
Regresses after menopause
S. aureus
Toxoplasma gondii
Anemia of chronic disease

16. Symptoms of placental abruption.
Ulcerative colitis
105 bacteria/mL
Malingering
Continuous - painful vaginal bleeding

17. Administer to a symptomatic patient to diagnose myasthenia gravis.
Hypocalcemia
Exercise stress treadmill with ECG
Edrophonium
Membranous glomerulonephritis

18. The most common cause of postpartum hemorrhage.
Bacillus cereus
Uterine atony
MAOIs
Number of deaths from birth to 28 days per 1000 live births

19. Difference between Mallory- Weiss and Boerhaave tears.
Mallory- Weiss
Hereditary spherocytosis
Rett's disorder
Low - voltage - diffuse ST- segment elevation

20. A 24-year - old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
Squamous cell carcinoma
Malignancy and hyperparathyroidism
Clomiphene citrate
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension

21. Signs suggesting radial nerve damage with humeral fracture.
Hypovolemic shock
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Wrist drop - loss of thumb abduction
Kwashiorkor (protein malnutrition)

22. What is the immunodeficiency?
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Nephrotic syndrome
Vibrio - HAV
Wiskott - Aldrich syndrome

23. First step in the management of a patient with acute GI bleed.
Neisseria meningitidis
OCPs
Establish the ABCs
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)

24. What is the immunodeficiency?
Chronic granulomatous disease
Uterine massage; if that fails - give oxytocin
Osteogenesis imperfecta
Alport's syndrome

25. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
ARDS
Benzodiazepines
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Non - Hodgkin's lymphoma

26. Neutropenic nadir postchemotherapy.
7-10 days
Retinoic acid
Coarctation of the aorta
IgA nephropathy (Berger's disease)

27. Gout - self - mutilation - and choreoathetosis.
HIDA scan
Streptococcus pneumoniae
HGPRTase deficiency)
Herpes simplex

28. Treatment of hypovolemic shock.
Identify cause; fluid and blood repletion
Partial mole
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Reye's syndrome

29. A homeless child is small for his age and has peeling skin and a swollen belly.
Kwashiorkor (protein malnutrition)
Acute mania. Start a mood stabilizer (e.g. - lithium)
Pregnant women. Treat this group aggressively because of potential complications
Treat because the disease represents an immediate threat to the child's life. Then seek a court order

30. Hypercholesterolemia treatment that ? flushing and pruritus.
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Establish the ABCs
Wernicke's encephalopathy due to a deficiency of thiamine
Niacin

31. Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
a - antagonists (phentolamine and phenoxybenzamine)
Squamous cell carcinoma
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Lyme disease - Ixodes tick - doxycycline

32. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Threatened abortion
Treat existing heart failure and replace the tricuspid valve
Squamous cell carcinoma
1

33. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
MAOIs
Prevalence
Postinfectious glomerulonephritis
Parkland formula

34. What is the immunodeficiency?

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35. Side effects of corticosteroids.
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Retinoic acid
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
ACEI

36. A 55-year - old man presents with irritative and obstructive urinary symptoms. Treatment options?
Nephrotic syndrome
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Type IV (distal) RTA
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states

37. Common symptoms associated with silent MIs.
Type II (proximal) RTA
Hypokalemia
CHF - shock - and altered mental status
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured

38. Name the organism:
Highly sensitive for TB
Lesion of 1
Benzodiazepines
Streptococcus pneumoniae

39. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Hypocalcemia
Lobular carcinoma in situ
CF or Hirschsprung's disease
Administration of DDAVP ? serum osmolality and free water restriction

40. Identify key organisms causing diarrhea:
Bacillus cereus
Highly sensitive for TB
Infection - cancer - and autoimmune disease
Chronic granulomatous disease

41. After a minor fender bender - a man wears a neck brace and requests permanent disability.
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Malingering
Bullous pemphigoid
Fat - female - fertile - forty - flatulent

42. Electrolyte changes in tumor lysis syndrome.
Alport's syndrome
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
? Ca2+ - ? K- - ? phosphate - ? uric acid
M3

43. A patient hasn't slept for days - lost $20 -000 gambling - is agitated - and has pressured speech. Diagnosis? Treatment?
O2 - analgesia - hydration - and - if severe - transfusion
7-10 days
Acute mania. Start a mood stabilizer (e.g. - lithium)
DI

44. Medical treatment for IBD.
Self - limited - painless vaginal bleeding
Trauma - alcohol withdrawal - brain tumor
The IR of a disease in a population exposed to a particular factor
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations

45. Arthritis - conjunctivitis - and urethritis in young men. Associated organisms?

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46. Drugs that slow AV node transmission.
IV benzodiazepine
Wrist drop - loss of thumb abduction
Beta- blockers - digoxin - calcium channel blockers
Threatened abortion

47. A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
Herpes simplex
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Pityriasis versicolor
Bacillus cereus

48. The first test to perform when a woman presents with amenorrhea.
Beta- hCG; the most common cause of amenorrhea is pregnancy
Signs and symptoms of hypercalcemia
Acne vulgaris
68% - 95.5% - 99.7%

49. What should always be done prior to LP?
Endometriosis
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Check for ? ICP; look for papilledema

50. Treatment of central DI.
Acute myelogenous leukemia (AML)
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Administration of DDAVP ? serum osmolality and free water restriction
Actinomyces israelii