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. Acid - base disorder in pulmonary embolism.
Number of deaths from birth to 28 days per 1000 live births
Restrictive pulmonary disease
Hypoxia and hypocarbia
Reye's syndrome


2. How to distinguish polycythemia vera from 2
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Signs and symptoms of hypercalcemia
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels


3. Medical options for endometriosis.
Regression
OCPs - danazol - GnRH agonists
a - antagonists (phentolamine and phenoxybenzamine)
Number of live births per 1000 women 15-44 years of age


4. The first test to perform when a woman presents with amenorrhea.
Beta- hCG; the most common cause of amenorrhea is pregnancy
Broca's aphasia. Frontal lobe - left MCA distribution
Sporothrix schenckii
Parvovirus B19


5. Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV- positive patient At what CD4 count? Mycobacterium avium - intracellulare (MAI) prophylaxis?
Nephrogenic diabetes insipidus (DI)
< 7.0
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma


6. Not contraindications to vaccination.
105 bacteria/mL
Hereditary spherocytosis
Menometrorrhagia
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity


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

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8. Exophthalmos - pretibial myxedema - and ? TSH.

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9. The most likely cause of acute lower GI bleed in patients > 40 years old.
Beta- blockers - digoxin - calcium channel blockers
Diverticulosis
Depersonalization disorder
Pentad of TTP


10. Anemia associated with absent radii and thumbs - diffuse hyperpigmentation - caf

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11. RTA associated with aldosterone defect.
Type IV (distal) RTA
Asymmetry - border irregularity - color variation - large diameter
Absence seizures
Lesch - Nyhan syndrome (purine salvage problem with


12. Cross - sectional survey
Prevalence
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Murphy's sign - seen in acute cholecystitis
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin


13. Lab findings in Hashimoto's thyroiditis.
Acne vulgaris
Out
High TSH - low T4 - antimicrosomal antibodies
Cirrhosis - CHF - nephritic syndrome


14. A man unexpectedly flies across the country - takes a new name - and has no memory of his prior life.
Dissociative fugue
Partial mole
Squamous cell carcinoma
Asherman's syndrome


15. Life - threatening muscle rigidity - fever - and rhabdomyolysis.
Neuroleptic malignant syndrome
Neither
Folate deficiency
Hypovolemic shock


16. 'Dewdrop on a rose petal.'
Intraductal papilloma
O2 - analgesia - hydration - and - if severe - transfusion
Lesions of 1
Rett's disorder


17. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
Hypovolemic shock
Excessive EtOH
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6


18. Beck's triad for cardiac tamponade.
Kwashiorkor (protein malnutrition)
Hypertension - bradycardia - and abnormal respirations
Hypotension - distant heart sounds - and JVD
SSRIs


19. Lung cancer highly related to cigarette exposure.
Wrist drop - loss of thumb abduction
SCLC
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
'Chocolate cysts -' powder burns


20. Nontender abdominal mass associated with elevated VMA and HVA.
Neuroblastoma
Seventy percent if the stenosis is symptomatic
Varicella zoster
Acne vulgaris


21. Treatment for opioid overdose.
Acute myelogenous leukemia (AML)
Naloxone
Levodopa/carbidopa
Bacillus cereus


22. Type of ARF in a patient with FeNa < 1%.
Prerenal
Osteoarthritis
Nephrogenic diabetes insipidus (DI)
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)


23. Maternal mortality?
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Metformin


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

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25. Odds ratio?
OCPs
Parainfluenza virus type 1
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Nephrogenic diabetes insipidus (DI)


26. The most common cause of hypothyroidism.

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27. The most common 1
a - antagonists (phentolamine and phenoxybenzamine)
Multiple myeloma
Anemia of chronic disease
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine


28. May be seen in children who are accused of inattention in class and confused with ADHD.
Absence seizures
Flumazenil
Patent ductus arteriosus (PDA)
Check for ? ICP; look for papilledema


29. Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
Highly sensitive for TB
Endometrial biopsy
SCLC
Graves' disease


30. Difference between a cohort and a case - control study.
SCLC
Clostridium difficile
Nephrolithiasis
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


31. Characteristics of 2

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32. A neonate has meconium ileus.

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33. CSF findings:
Pseudomonas
MS
Cluster headache
Non - Hodgkin's lymphoma


34. The diagnostic test for pulmonary embolism.
MS
Inevitable abortion
Ultrasound
V/Q scan


35. Treatment of cardiogenic shock.
Dissociative fugue
HIDA scan
Identify cause; pressors (e.g. - dobutamine)
Iron overload; use deferoxamine


36. A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.
Huntington's disease
Non - Hodgkin's lymphoma
Factitious disorder (Munchausen syndrome)
1


37. Identify key organisms causing diarrhea:
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Vibrio - HAV
Cellulitis
SSRIs


38. Administer to a symptomatic patient to diagnose myasthenia gravis.
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Lung - breast - skin (melanoma) - kidney - GI tract
Edrophonium
Hypertension - bradycardia - and abnormal respirations


39. The most common cause of SAH.
Trauma; the second most common is berry aneurysm
Cardiogenic shock
Kwashiorkor (protein malnutrition)
Erythema multiforme


40. Signs of ? ICP (Cushing's triad).
46 -XX
Duchenne muscular dystrophy
Antipsychotics (neuroleptic malignant syndrome)
Hypertension - bradycardia - and abnormal respirations


41. Glomerulonephritis with hemoptysis.

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42. Treatment for neuroleptic malignant syndrome.
Dantrolene or bromocriptine
Beta- hCG; the most common cause of amenorrhea is pregnancy
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Coarctation of the aorta


43. Low urine specific gravity in the presence of high serum osmolality.
Nephrotic syndrome
B12 deficiency
Endometrial biopsy
DI


44. The most common cause of seizures in children (2-10 years).
BP > 140/90 on three separate occasions two weeks apart
Check for ? ICP; look for papilledema
Infection - febrile seizures - trauma - idiopathic
Klebsiella


45. Laparoscopic findings in endometriosis.

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46. Name the organism:
Pasteurella multocida
Metformin
< 7.0
46 -XX


47. What should always be done prior to LP?
Check for ? ICP; look for papilledema
Number of deaths per 1000 population
Biliary tract obstruction
Sarcoidosis


48. Treatment for acute coronary syndrome.
Broca's aphasia. Frontal lobe - left MCA distribution
Femoral hernia
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin


49. 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
46 -XX
Immediate needle thoracostomy
Glanzmann's thrombasthenia


50. T- wave flattening and U waves.
Hypoxia and hypocarbia
Herpes simplex
Sporothrix schenckii
Hypokalemia