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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 most common 1
IV penicillin or ampicillin
Protamine
SSRIs
Selective IgA deficiency

2. Key side effects of atypical antipsychotics.
Amoxicillin
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Type IV (distal) RTA
Weight gain - type 2 DM - QT prolongation

3. The most common cause of seizures in children (2-10 years).
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Prevalence
Infection - febrile seizures - trauma - idiopathic
Nephrotic syndrome

4. How to diagnose and follow a leiomyoma.
Mallory- Weiss
Ultrasound
Spinal stenosis
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6

5. Treatment for malignant hypertension.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Nitroprusside
Hodgkin's lymphoma
Administration of DDAVP ? serum osmolality and free water restriction

6. The most common cause of bloody nipple discharge.
MS
Retinoic acid
Weight loss and OCPs
Intraductal papilloma

7. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Paget's disease
CHF - shock - and altered mental status
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

8. Causes of transudative effusion.
Rett's disorder
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Rate control with carotid massasge or other vagal stimulation

9. Life - threatening muscle rigidity - fever - and rhabdomyolysis.
a - antagonists (phentolamine and phenoxybenzamine)
Neuroleptic malignant syndrome
Endometrial biopsy
Placental abruption and placenta previa

10. The most common type of testicular cancer.
Seminoma
B12 deficiency
< 7.0
Osmotic fragility test

11. 'Doughy skin.'
Herpes simplex
Reye's syndrome
Hypernatremia
Anemia - thrombocytopenia - and acute renal failure

12. Treatment for Guillain - Barr
IVIG or plasmapheresis
TICS
Incidence and prevalence
Parvovirus B19

13. The three most common causes of fever of unknown origin (FUO).
Osteoarthritis
Identify cause; fluid and blood repletion
Number of deaths per 1000 population
Infection - cancer - and autoimmune disease

14. ECG findings suggesting MI.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Frotteurism (a paraphilia)
The IR of a disease in a population exposed to a particular factor
Crohn's disease

15. ? CO - ? PCWP - ? PVR.
IVIG or plasmapheresis
Hypoxia and hypocarbia
Septic or anaphylactic shock
Cerebral berry aneurysms (AD PCKD)

16. Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
Nephrotic syndrome
Parainfluenza virus type 1
Endometrial biopsy
Patient on dopamine antagonist

17. Proteinuria - hypoalbuminemia - hyperlipidemia - hyperlipiduria - edema.
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Ampulla of the oviduct
Nephrotic syndrome
Anorexia

18. Birth rate?
Number of live births per 1000 population
Nephrolithiasis
Headache
Oral surgery

19. An antidiabetic agent associated with lactic acidosis.
DM - SLE - and amyloidosis
30 cc/hour
Metformin
Confounding variable

20. Identify key organisms causing diarrhea:
E. coli O157:H7
Hashimoto's thyroiditis
30 cc/hour
Patent ductus arteriosus (PDA)

21. Three systemic diseases ? nephrotic syndrome.
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Administration of DDAVP ? serum osmolality and free water restriction
DM - SLE - and amyloidosis

22. Trauma series.
AP chest - AP/lateral C- spine - AP pelvis
Panic disorder
CML
Threatened abortion

23. The most common type of nephrolithiasis.
E. coli O157:H7
Pharmacologic stress test (e.g. - dobutamine echo)
Lesion of 1
Calcium oxalate

24. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
Patient on dopamine antagonist
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
RCC or other erythropoietin - producing tumor; evaluate with CT scan
SCLC

25. Dermatomal distribution.
Varicella zoster
Legionella pneumonia
Klebsiella
Continuous - painful vaginal bleeding

26. Associated with Propionibacterium acnes and changes in androgen levels.
Anticoagulation - rate control - cardioversion
Hodgkin's lymphoma
Acne vulgaris
Bacillus cereus

27. A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?
S. aureus or S. epidermidis.
Treat immediately. Consent is implied in emergency situations
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Endometrial or estrogen receptor - breast cancer

28. Four causes of microcytic anemia.
Immediate needle thoracostomy
Sporothrix schenckii
TICS
Administration of DDAVP ? serum osmolality and free water restriction

29. Charcot's triad.
Number of deaths per 1000 population
HBV immunoglobulin
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis

30. Treatment for TTP.
Lesion of 1
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Wait - surgical resection - radiation and/or androgen suppression
Hypocalcemia

31. How to distinguish polycythemia vera from 2
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Emergent laparotomy to repair perforated viscus - likely stomach
Betamethasone or dexamethasone
Weight loss and OCPs

32. A burn patient presents with cherry- red flushed skin and coma. SaO2 is normal - but carboxyhemoglobin is elevated. Treatment?
S. aureus or S. epidermidis.
Retrograde cystourethrogram
Pentad of TTP
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant

33. Iris - like target lesions.
Emergent laparotomy to repair perforated viscus - likely stomach
Erythema multiforme
Number of deaths from 28 days to one year per 1000 live births
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis

34. A 40-year - old obese female with elevated alkaline phosphatase - elevated bilirubin - pruritus - dark urine - and clay- colored stools.
Biliary tract obstruction
Number of live births per 1000 women 15-44 years of age
7-10 days
CF or Hirschsprung's disease

35. Treatment for ventricular fibrillation.
Flumazenil
46 -XX
Immediate cardioversion
Coarctation of the aorta

36. Identify key organisms causing diarrhea:
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Kwashiorkor (protein malnutrition)
Trauma - alcohol withdrawal - brain tumor
ETEC

37. The most common cause of hypothyroidism.

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38. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
AP chest - AP/lateral C- spine - AP pelvis
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Number of live births per 1000 population
CML

39. Infection of small airways with epidemics in winter and spring.
Duodenal atresia
Contact dermatitis
RSV bronchiolitis
Neuroleptic malignant syndrome

40. Aplastic crisis in sickle cell disease.
'Sawtooth' P waves
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
Parvovirus B19
Glomerulonephritis/nephritic syndrome

41. Identify key organisms causing diarrhea:
Endometrial or estrogen receptor - breast cancer
Salmonella
Parainfluenza virus type 1
1

42. Vaccinations at a six- month well - child visit.
Kegel exercises - estrogen - pessaries for stress incontinence
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
HBV - DTaP - Hib - IPV - PCV
Bacterial meningitis

43. The most common causes of dementia.

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44. Appropriate diagnostic test?
Headache
Exercise stress treadmill with ECG
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Third - degree heart block

45. Complication of scaphoid fracture.
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Conduct disorder
Avascular necrosis

46. Signs suggesting radial nerve damage with humeral fracture.
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Neuroblastoma
Wrist drop - loss of thumb abduction

47. Sentinel loop on AXR.
Acute pancreatitis
Intraductal papilloma
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
M3

48. Albuminocytologic dissociation.
Lesions of 1
? Ca2+ - ? K- - ? phosphate - ? uric acid
Fanconi's anemia
Guillain - Barr

49. A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
AP chest - AP/lateral C- spine - AP pelvis
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Dantrolene or bromocriptine
Fluids and antibiotics

50. Microcytic anemia with ? serum iron - ? ferritin - and ? TIBC.
Stasis - hypercoagulability - endothelial damage
Iron deficiency anemia
Varicella zoster
Aseptic (viral) meningitis