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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. PFT showing ? FEV1/FVC.
Uterine massage; if that fails - give oxytocin
Obstructive pulmonary disease (e.g. - asthma)
Coccidioidomycosis. Amphotericin B
Sensitivity

2. Conditions in which confidentiality must be overridden.
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Frotteurism (a paraphilia)
Sporothrix schenckii
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse

3. Relative risk?
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
The IR of a disease in a population exposed to a particular factor
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Pharmacologic stress test (e.g. - dobutamine echo)

4. Amenorrhea - bradycardia - and abnormal body image in a young female.
Spinal stenosis
Anorexia
Pseudogout
Identify cause; fluid and blood repletion

5. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Graves' disease
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis

6. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Clostridium difficile
Basal cell carcinoma
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Anion gap acidosis and 1

7. Antihypertensive for a diabetic patient with proteinuria.
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Ultrasound
All - compartment fasciotomy for suspected compartment syndrome
ACEI

8. Difference between a cohort and a case - control study.
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
Low - voltage - diffuse ST- segment elevation
Fatigue and impending respiratory failure
Subdural hematoma

9. A 40-year - old obese female with elevated alkaline phosphatase - elevated bilirubin - pruritus - dark urine - and clay- colored stools.
Biliary tract obstruction
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Uterine massage; if that fails - give oxytocin
Lichen planus

10. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Angina is new - is worsening - or occurs at rest
Surfactant deficiency

11. A burn patient presents with cherry- red flushed skin and coma. SaO2 is normal - but carboxyhemoglobin is elevated. Treatment?
Neuroblastoma
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
No. Parental consent is not necessary for the medical treatment of pregnant minors
Mycobacterium tuberculosis

12. 'Stones - bones - groans - psychiatric overtones.'
ACEI
Asherman's syndrome
Wait - surgical resection - radiation and/or androgen suppression
Signs and symptoms of hypercalcemia

13. 'Stuck - on' appearance.
a - antagonists (phentolamine and phenoxybenzamine)
Seborrheic keratosis
Paget's disease
Hypernatremia

14. A febrile patient with a history of diabetes presents with a red - swollen - painful lower extremity.
Bacillus cereus
Cellulitis
Patient on dopamine antagonist
A patient with chest trauma who was previously stable suddenly dies

15. Birth rate?
Number of live births per 1000 population
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Pregnant women. Treat this group aggressively because of potential complications
Allergic interstitial nephritis

16. Inspiratory arrest during palpation of the RUQ.

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17. Cause of neonatal RDS.
Choriocarcinoma
Postinfectious glomerulonephritis
Huntington's disease
Surfactant deficiency

18. What is the immunodeficiency?

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19. A 25-year - old African - American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
Absence seizures
O2 - analgesia - hydration - and - if severe - transfusion
Campylobacter
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)

20. A 10-year - old child presents in status epilepticus - but her parents refuse treatment on religious grounds.

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21. The most common causes of hypercalcemia.
Crohn's disease
Malignancy and hyperparathyroidism
Distal radius (Colles' fracture)
Selective IgA deficiency

22. Annual screening for women with a strong family history of ovarian cancer.
CA-125 and transvaginal ultrasound
Number of deaths from 28 days to one year per 1000 live births
Chronic lymphocytic leukemia (CLL)
Identify cause; fluid and blood repletion

23. Name the organism:
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Hypoxia and hypocarbia
Neuroblastoma
Klebsiella

24. Signs of ? ICP (Cushing's triad).
Hypertension - bradycardia - and abnormal respirations
Subarachnoid hemorrhage (SAH)
Neurofibromatosis 1
Mycoplasma

25. Peaked T waves and widened QRS.
Hyperkalemia
Menometrorrhagia
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Pharmacologic stress test (e.g. - dobutamine echo)

26. Diagnostic test for hereditary spherocytosis.
Third - degree heart block
Osmotic fragility test
Signs and symptoms of hypercalcemia
Hypokalemia

27. 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.
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Actinomyces israelii
Amoxicillin

28. Unilateral - severe periorbital headache with tearing and conjunctival erythema.
Emergent laparotomy to repair perforated viscus - likely stomach
Higher prevalence
Type IV (distal) RTA
Cluster headache

29. Treatment for mild - persistent asthma.
Partial mole
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Inhaled Beta- agonists and inhaled corticosteroids
46 -XX

30. Heinz bodies?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
< 7.0
Seborrheic keratosis
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms

31. Fertility rate?
Hodgkin's lymphoma
Number of live births per 1000 women 15-44 years of age
INH - penicillamine - hydralazine - procainamide
Cluster headache

32. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Lobular carcinoma in situ
ARDS
Metformin
Folate deficiency

33. Number needed to treat?
1
MS
Reye's syndrome
Neuroleptics

34. Differential of hypervolemic hyponatremia.
Cirrhosis - CHF - nephritic syndrome
Pulsus paradoxus (seen in cardiac tamponade)
a - antagonists (phentolamine and phenoxybenzamine)
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs

35. Which of the following are ? in DIC: fibrin split products - D- dimer - fibrinogen - platelets - and hematocrit.
Patient on dopamine antagonist
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Regression

36. A patient with a history of lithium use presents with copious amounts of dilute urine.
Nephrogenic diabetes insipidus (DI)
Respiratory alkalosis
Rate control - rhythm conversion - and anticoagulation
Esophageal atresia with distal TEF (85%). Unable to pass NG tube

37. Treatment of central DI.
Administration of DDAVP ? serum osmolality and free water restriction
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Patent ductus arteriosus (PDA)
Hypernatremia

38. The first test to perform when a woman presents with amenorrhea.
Establish the ABCs
HIDA scan
Beta- hCG; the most common cause of amenorrhea is pregnancy
Fluids and antibiotics

39. Dermatomal distribution.
Isolation
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Varicella zoster
BP > 140/90 on three separate occasions two weeks apart

40. A four -year - old child presents with oliguria - petechiae - and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Respiratory alkalosis
High TSH - low T4 - antimicrosomal antibodies
Usually resolves spontaneously; may require IVIG and/or corticosteroids

41. Combined UMN and LMN disorder.
ALS
Taenia solium (cysticercosis)
Weight gain - type 2 DM - QT prolongation
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs

42. Not contraindications to vaccination.
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
AP chest - AP/lateral C- spine - AP pelvis
Acute myelogenous leukemia (AML)

43. A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?
S. aureus or S. epidermidis.
Pseudogout
Prevalence
DM - SLE - and amyloidosis

44. Radiographic indications for surgery in patients with acute abdomen.
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Selective IgA deficiency
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Subarachnoid hemorrhage (SAH)

45. Signs of neurogenic shock.
Hypotension and bradycardia
RCC or other erythropoietin - producing tumor; evaluate with CT scan
OCP and barrier contraception
Placental abruption and placenta previa

46. Goal hemoglobin A1c for a patient with DM.
Malingering
< 7.0
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states

47. Dyspnea - lateral hilar lymphodenopathy on CXR - noncaseating granulomas - increased ACE - and hypercalcemia.
Continuous positive airway pressure
Pityriasis rosea
A patient with chest trauma who was previously stable suddenly dies
Sarcoidosis

48. First - line medication for status epilepticus.
Lesch - Nyhan syndrome (purine salvage problem with
All - compartment fasciotomy for suspected compartment syndrome
IV benzodiazepine
Subdural hematoma

49. A 60-year - old African - American male presents with bone pain. Workup for multiple myeloma might reveal?

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50. Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
Small cell lung cancer (SCLC)
Chronic lymphocytic leukemia (CLL)
Squamous cell carcinoma
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse