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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. Treatment for SVC syndrome.
Radiation
Establish the ABCs
Wegener's granulomatosis and Goodpasture's syndrome
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)

2. Causes of drug - induced SLE.
INH - penicillamine - hydralazine - procainamide
Inhaled Beta- agonists and inhaled corticosteroids
Actinic keratosis
Diphenhydramine or epinephrine 1:1000

3. Medical treatment for IBD.
High reliability - low validity
Spinal stenosis
M3
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations

4. Medication to avoid in patients with a history of alcohol withdrawal seizures.
Anorexia
ALS
Infection - febrile seizures - trauma - idiopathic
Neuroleptics

5. Associated with Propionibacterium acnes and changes in androgen levels.
Acne vulgaris
1
Chronic granulomatous disease
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

6. Four characteristics of a nevus suggestive of melanoma.
Identify cause; pressors (e.g. - dobutamine)
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
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
Asymmetry - border irregularity - color variation - large diameter

7. Name the organism:
Sporothrix schenckii
Depersonalization disorder
Hodgkin's lymphoma
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy

8. Albuminocytologic dissociation.
Guillain - Barr
Ampulla of the oviduct
Exercise stress treadmill with ECG
Agranulocytosis

9. Infant mortality?
Graves' disease
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Spinal stenosis

10. Precipitants of hemolytic crisis in patients with G6PD deficiency.
Rate control with carotid massasge or other vagal stimulation
Alport's syndrome
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Sulfonamides - antimalarial drugs - fava beans

11. Meningitis in infants. Causes? Treatment?
Clostridium difficile
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin

12. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Fluid restriction - demeclocycline
Reaction formation
Hypotension and bradycardia
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine

13. Treatment of septic shock.
Fluids and antibiotics
Actinic keratosis
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Endometrial or estrogen receptor - breast cancer

14. Treatment for bacterial vaginosis.
Ophthalmologic exam - CT - and MRI
Oral or topical metronidazole
Neuroblastoma
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations

15. A patient from California or Arizona presents with fever - malaise - cough - and night sweats. Diagnosis? Treatment?
Coccidioidomycosis. Amphotericin B
HBV - DTaP - Hib - IPV - PCV
SIADH due to stress
Rate control with carotid massasge or other vagal stimulation

16. Macrocytic - megaloblastic anemia with neurologic symptoms.
B12 deficiency
Duchenne muscular dystrophy
Conduct disorder
Hodgkin's lymphoma

17. Involuntary psychiatric hospitalization can be undertaken for which three reasons?
Patent ductus arteriosus (PDA)
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Basal cell carcinoma
Number of deaths from birth to 28 days per 1000 live births

18. Name the defense mechanism:
Reaction formation
MCP and PIP joints; DIP joints are spared
Pheochromocytoma
Betamethasone or dexamethasone

19. Beck's triad for cardiac tamponade.
Parainfluenza virus type 1
Varicella zoster
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Hypotension - distant heart sounds - and JVD

20. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
1
Lobular carcinoma in situ
Paget's disease
Multiple myeloma

21. 'Doughy skin.'
Hypernatremia
Taenia solium (cysticercosis)
Factor V Leiden mutation
S. aureus or S. epidermidis.

22. Treatment of anaphylactic shock.
Identify cause; fluid and blood repletion
Lesions of 1
a - antagonists (phentolamine and phenoxybenzamine)
Diphenhydramine or epinephrine 1:1000

23. Four signs and symptoms of streptococcal pharyngitis.
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Phototherapy (mild) or exchange transfusion (severe)
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Metformin

24. True or false: Withdrawing life - sustaining care is ethically distinct from withholding sustaining care.
Confounding variable
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Hypoparathyroidism
False. Withdrawing and withholding life are the same from an ethical standpoint

25. Definition of hypertension.
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Lichen sclerosus
BP > 140/90 on three separate occasions two weeks apart
Headache

26. A patient fails to lactate after an emergency C- section with marked blood loss.

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27. The most common cancer in men and the most common cause of death from cancer in men.
Lichen sclerosus
Kegel exercises - estrogen - pessaries for stress incontinence
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths

28. Identify key organisms causing diarrhea:
Coarctation of the aorta
Asymmetry - border irregularity - color variation - large diameter
Prevalence
Clostridium difficile

29. Caf
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Neurofibromatosis 1
OCPs
Ulcerative colitis

30. Antidepressants associated with hypertensive crisis.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Respiratory alkalosis
MAOIs
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs

31. ? CO - ? PCWP - ? PVR.
Number of deaths per 1000 population
Number of live births per 1000 women 15-44 years of age
Cardiogenic shock
HBV - DTaP - Hib - IPV - PCV

32. 'Cradle cap.'
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Seborrheic dermatitis. Treat with antifungals
Prevalence

33. Name the organism:
Toxoplasma gondii
Clostridium difficile
Naloxone
Seborrheic dermatitis. Treat with antifungals

34. Treatment of central DI.
Normal
Intussusception
Administration of DDAVP ? serum osmolality and free water restriction
Anorexia

35. Cause of amenorrhea with normal prolactin - no response to estrogen - progesterone challenge - and a history of D&C.

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36. Medication given to accelerate fetal lung maturity.
Betamethasone or dexamethasone
? serum FSH
INH - penicillamine - hydralazine - procainamide
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

37. Treatment for mild - persistent asthma.
OCP and barrier contraception
Toxoplasma gondii
Patient on dopamine antagonist
Inhaled Beta- agonists and inhaled corticosteroids

38. An 11-year - old obese - African - American boy presents with sudden onset of limp. Diagnosis? Workup?
Murphy's sign - seen in acute cholecystitis
Confounding variable
A patient with chest trauma who was previously stable suddenly dies
Slipped capital femoral epiphyses. AP and frog - leg lateral view

39. Case - control study
Immediate cardioversion
Beta- hCG; the most common cause of amenorrhea is pregnancy
Calcium oxalate
Neither

40. An autosomal - recessive disorder with a defect in the GPIIbIIIa platelet receptor and ? platelet aggregation.

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41. Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
Hypoparathyroidism
Endometrial biopsy
Duodenal atresia
Conflict of interest

42. A 55-year - old man is diagnosed with prostate cancer. Treatment options?
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Colposcopy and endocervical curettage
Wait - surgical resection - radiation and/or androgen suppression
Multiple myeloma

43. Sentinel loop on AXR.
Asherman's syndrome
Type II (proximal) RTA
Acute pancreatitis
Excessive EtOH

44. Complication of overly rapid correction of hyponatremia.
Central pontine myelinolysis
Displacement
Nephrotic syndrome
Squamous cell carcinoma

45. Cause of neonatal RDS.
Surfactant deficiency
Actinic keratosis
Wiskott - Aldrich syndrome
Non - Hodgkin's lymphoma

46. Classic ultrasound and gross appearance of complete hydatidiform mole.

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47. Dermatomal distribution.
Rett's disorder
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Varicella zoster
Exercise stress treadmill with ECG

48. A significant cause of morbidity in thalassemia patients. Treatment?
Asymmetry - border irregularity - color variation - large diameter
CHF - shock - and altered mental status
Iron overload; use deferoxamine
Naloxone

49. PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific?
Highly sensitive for TB
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Crohn's disease

50. Test to rule out urethral injury.
Benzodiazepines
1
Retrograde cystourethrogram
Prevalence