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Test your basic knowledge |
USMLE Step 2
Start Test
Study First
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. Presence of red cell casts in urine sediment.
Neuroleptic malignant syndrome
? Ca2+ - ? K- - ? phosphate - ? uric acid
A patient with chest trauma who was previously stable suddenly dies
Glomerulonephritis/nephritic syndrome
2. A 49-year - old male presents with acute - onset flank pain and hematuria.
Malignancy and hyperparathyroidism
ARDS
Nephrolithiasis
Renal cell carcinoma (RCC)
3. Presents with a herald patch - Christmas - tree pattern.
Pityriasis rosea
Seminoma
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Klebsiella
4. A patient has ? vaginal discharge and petechial patches in the upper vagina and cervix.
Weight gain - type 2 DM - QT prolongation
? serum FSH
Pityriasis rosea
Trichomonas vaginitis
5. Four causes of microcytic anemia.
Inhaled Beta- agonists and inhaled corticosteroids
TICS
Type II (proximal) RTA
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
6. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
Displacement
HIDA scan
Clomiphene citrate
Clostridium difficile
7. Associated with Propionibacterium acnes and changes in androgen levels.
V/Q scan
Acne vulgaris
Number of deaths from birth to 28 days per 1000 live births
Observational bias
8. Identify key organisms causing diarrhea:
Lobular carcinoma in situ
S. aureus
ETEC
Actinomyces israelii
9. Drugs that slow AV node transmission.
Hyperkalemia
Dantrolene or bromocriptine
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
Beta- blockers - digoxin - calcium channel blockers
10. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Seborrheic dermatitis. Treat with antifungals
Normal
Infection - febrile seizures - trauma - idiopathic
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
11. A six-year - old girl presents with a port - wine stain in the V2 distribution as well as with mental retardation - seizures - and leptomeningeal angioma.
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Conduct disorder
46 -XX
Parkinson's disease
12. Sentinel loop on AXR.
Wait - surgical resection - radiation and/or androgen suppression
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Acute pancreatitis
13. Red plaques with silvery- white scales and sharp margins.
Psoriasis
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Avascular necrosis
Pseudogout
14. The number of true positives divided by the number of patients with the disease is _____.
Stasis - hypercoagulability - endothelial damage
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Sensitivity
Continuous positive airway pressure
15. Amenorrhea - bradycardia - and abnormal body image in a young female.
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Neuroblastoma
Anorexia
16. A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Endometriosis
They can mask symptoms of hypoglycemia
Higher prevalence
17. In which patients do you initiate colorectal cancer screening early?
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
Levodopa/carbidopa
Lead - time bias
Vibrio - HAV
18. Signs of active ischemia during stress testing.
Endometriosis
Angina - ST- segment changes on ECG - or ? BP
Rate control - rhythm conversion - and anticoagulation
Slipped capital femoral epiphyses. AP and frog - leg lateral view
19. True or false: Once patients sign a statement giving consent - they must continue treatment.
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
They can mask symptoms of hypoglycemia
No. Parental consent is not necessary for the medical treatment of pregnant minors
Betamethasone or dexamethasone
20. Neonatal mortality?
46 -XX
Number of deaths from birth to 28 days per 1000 live births
Coarctation of the aorta
Calcium oxalate
21. Honey- crusted lesions.
Psoriasis
Impetigo
Fanconi's anemia
Patent ductus arteriosus (PDA)
22. 1
Lichen planus
Placental abruption and placenta previa
Patient on dopamine antagonist
Hypoxia and hypocarbia
23. The most common form of nephritic syndrome.
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Membranous glomerulonephritis
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Hypoparathyroidism
24. Hypercholesterolemia treatment that ? flushing and pruritus.
Niacin
Sporothrix schenckii
Number of deaths from birth to 28 days per 1000 live births
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
25. A first - born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Paget's disease
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
IgA nephropathy (Berger's disease)
'Chocolate cysts -' powder burns
26. Eosinophils in urine sediment.
Allergic interstitial nephritis
Cerebral berry aneurysms (AD PCKD)
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Retrograde cystourethrogram
27. Identify key organisms causing diarrhea:
E. coli O157:H7
Excessive EtOH
Taenia solium (cysticercosis)
Identify cause; fluid and blood repletion
28. Defect in an X- linked syndrome with mental retardation -
Inhaled Beta- agonists and inhaled corticosteroids
Lesch - Nyhan syndrome (purine salvage problem with
Neuroblastoma
Lead - time bias
29. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Partial mole
Flumazenil
Frotteurism (a paraphilia)
Bullous pemphigoid
30. Risk factors for cholelithiasis.
Fat - female - fertile - forty - flatulent
Ulcerative colitis
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Prerenal
31. When can a physician refuse to continue treating a patient on the grounds of futility?
Oral surgery
Nephrolithiasis
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
Rett's disorder
32. Evaluation of a pulsatile abdominal mass and bruit.
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Abdominal ultrasound and CT
Broca's aphasia. Frontal lobe - left MCA distribution
Prinzmetal's angina
33. Identify key organisms causing diarrhea:
Benzodiazepines
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
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
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
34. The mainstay of Parkinson's therapy.
RSV bronchiolitis
Levodopa/carbidopa
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Pheochromocytoma
35. Should a - or Beta- antagonists be used first in treating pheochromocytoma?
Varicella zoster
a - antagonists (phentolamine and phenoxybenzamine)
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
36. Classic ECG findings in pericarditis.
Never
Low - voltage - diffuse ST- segment elevation
Alopecia areata (autoimmune process)
Wait - surgical resection - radiation and/or androgen suppression
37. Annual screening for women with a strong family history of ovarian cancer.
Aseptic (viral) meningitis
Sensitivity
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
CA-125 and transvaginal ultrasound
38. A woman who was abused as a child frequently feels outside of or detached from her body.
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
Dantrolene or bromocriptine
Sarcoidosis
Depersonalization disorder
39. Relative risk?
The IR of a disease in a population exposed to a particular factor
Folate deficiency
Polymyalgia rheumatica
Pseudomonas
40. A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Absence seizures
Suspect ankylosing spondylitis. Check HLA- B27
Alopecia areata (autoimmune process)
41. The most common cause of SAH.
Choriocarcinoma
Nephrotic syndrome
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Trauma; the second most common is berry aneurysm
42. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
Treat existing heart failure and replace the tricuspid valve
Incidence and prevalence
Duchenne muscular dystrophy
1
43. Birth rate?
Number of live births per 1000 population
OCPs - danazol - GnRH agonists
Paget's disease
IV hydration and loop diuretics (furosemide)
44. First step in the management of a patient with acute GI bleed.
Treat existing heart failure and replace the tricuspid valve
Parvovirus B19
Establish the ABCs
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
45. The three most common causes of fever of unknown origin (FUO).
Incidence and prevalence
Infection - cancer - and autoimmune disease
50 cc/hour
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
46. 'Cradle cap.'
Seborrheic dermatitis. Treat with antifungals
Highly sensitive for TB
Acne vulgaris
Folate deficiency
47. Vaccinations at a six- month well - child visit.
Femoral hernia
Pulsus paradoxus (seen in cardiac tamponade)
Contact dermatitis
HBV - DTaP - Hib - IPV - PCV
48. A patient hasn't slept for days - lost $20 -000 gambling - is agitated - and has pressured speech. Diagnosis? Treatment?
Protamine
O2 - analgesia - hydration - and - if severe - transfusion
Acute mania. Start a mood stabilizer (e.g. - lithium)
Angina is new - is worsening - or occurs at rest
49. Classic causes of drug - induced hepatitis.
Iron overload; use deferoxamine
Klebsiella
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Weight loss and OCPs
50. Dyspnea - lateral hilar lymphodenopathy on CXR - noncaseating granulomas - increased ACE - and hypercalcemia.
Malignancy and hyperparathyroidism
Highly sensitive for TB
Never
Sarcoidosis