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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. Neonatal mortality?
'Sawtooth' P waves
Pseudomonas
Number of deaths from birth to 28 days per 1000 live births
Cirrhosis - CHF - nephritic syndrome

2. Medications and viruses that ? aplastic anemia.
BP > 140/90 on three separate occasions two weeks apart
Squamous cell carcinoma
Incidence and prevalence
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV

3. Sensitive tests have few false negatives and are used to rule _____ a disease.
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Out
Depersonalization disorder
Identify cause; pressors (e.g. - dobutamine)

4. Conditions in which confidentiality must be overridden.
Actinic keratosis
Hodgkin's lymphoma
Lesions of 1
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse

5. Treatment for ventricular fibrillation.
Immediate cardioversion
Metformin
Ulcerative colitis
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements

6. First - line pharmacotherapy for depression.
SSRIs
Anion gap acidosis and 1
Displacement
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms

7. The most common form of glomerulonephritis.

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8. The mainstay of Parkinson's therapy.
Levodopa/carbidopa
Conflict of interest
< 7.0
OCPs

9. Supportive treatment for ARDS.
Trauma - alcohol withdrawal - brain tumor
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Trauma; the second most common is berry aneurysm
Continuous positive airway pressure

10. Case - control study
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Neither
Depersonalization disorder
IgA nephropathy (Berger's disease)

11. Premalignant lesion from sun exposure that can ? squamous cell carcinoma.
Antipsychotics (neuroleptic malignant syndrome)
Actinic keratosis
Wiskott - Aldrich syndrome
Acute myelogenous leukemia (AML)

12. Treatment of septic shock.
Mallory- Weiss
Fluids and antibiotics
Elevated ICP - RBCs - xanthochromia
Iatrogenic steroid administration. The second most common cause is Cushing's disease

13. Endocarditis prophylaxis regimens.
Oral surgery
Iron overload; use deferoxamine
Low - voltage - diffuse ST- segment elevation
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer

14. Associated with Propionibacterium acnes and changes in androgen levels.
Acne vulgaris
Selective IgA deficiency
M3
Glanzmann's thrombasthenia

15. Radiographic evidence of aortic disruption or dissection.
Glomerulonephritis/nephritic syndrome
1
50 cc/hour
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus

16. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
Cirrhosis - CHF - nephritic syndrome
BP > 140/90 on three separate occasions two weeks apart
HIDA scan
Retinoic acid

17. An 80-year - old man presents with fatigue - lymphadenopathy - splenomegaly - and isolated lymphocytosis. Suspected diagnosis?
Sensitivity
Lyme disease - Ixodes tick - doxycycline
Chronic lymphocytic leukemia (CLL)
Non - Hodgkin's lymphoma

18. Name the organism:
Neisseria meningitidis
Pulsus paradoxus (seen in cardiac tamponade)
Lyme disease - Ixodes tick - doxycycline
Salmonella

19. A child has loss of red light reflex. Diagnosis?
Klebsiella
Bacterial meningitis
Endometrial or estrogen receptor - breast cancer
Suspect retinoblastoma

20. Electrolyte changes in tumor lysis syndrome.
Ultrasound
Avascular necrosis
Wait - surgical resection - radiation and/or androgen suppression
? Ca2+ - ? K- - ? phosphate - ? uric acid

21. Beck's triad for cardiac tamponade.
Hypotension - distant heart sounds - and JVD
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia

22. Natural history of a leiomyoma.
Hypocalcemia
Regresses after menopause
Depersonalization disorder
Suspect ankylosing spondylitis. Check HLA- B27

23. Dermatomal distribution.
Wait - surgical resection - radiation and/or androgen suppression
Anemia of chronic disease
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Varicella zoster

24. Glomerulonephritis with deafness.

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25. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Treat immediately. Consent is implied in emergency situations
Cluster headache
Observational bias
Lobular carcinoma in situ

26. Fertility rate?
Lead - time bias
Number of live births per 1000 women 15-44 years of age
Subarachnoid hemorrhage (SAH)
Type IV (distal) RTA

27. Salicylate ingestion ? In What type of acid - base disorder?
Anion gap acidosis and 1
Impetigo
ARDS
B12 deficiency

28. Gout - self - mutilation - and choreoathetosis.
Wiskott - Aldrich syndrome
HGPRTase deficiency)
Identify cause; fluid and blood repletion
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

29. A patient presents with weakness - nausea - vomiting - weight loss - and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
OCP and barrier contraception
30 cc/hour
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
1

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

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31. The most common 1
O2 - analgesia - hydration - and - if severe - transfusion
AP chest - AP/lateral C- spine - AP pelvis
Seborrheic keratosis
Selective IgA deficiency

32. An 11-year - old obese - African - American boy presents with sudden onset of limp. Diagnosis? Workup?
Graves' disease
Dissociative fugue
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Slipped capital femoral epiphyses. AP and frog - leg lateral view

33. ? CO - ? PCWP - ? PVR.
Septic or anaphylactic shock
Hereditary spherocytosis
Hypotension - distant heart sounds - and JVD
Lesions of 1

34. Chronic diseases such as SLE
Rubella
Neisseria meningitidis
Duodenal atresia
Higher prevalence

35. CSF findings:
Fat - female - fertile - forty - flatulent
Pentad of TTP
Hypertension - bradycardia - and abnormal respirations
Aseptic (viral) meningitis

36. Extraintestinal manifestations of IBD.
Hypertension - bradycardia - and abnormal respirations
Endometrial or estrogen receptor - breast cancer
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
AP chest - AP/lateral C- spine - AP pelvis

37. Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow - up evaluation?
30 cc/hour
Colposcopy and endocervical curettage
Hypotension and bradycardia
OCPs

38. Criteria for exudative effusion.
Higher incidence
Iron deficiency anemia
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Hypertrophic cardiomyopathy

39. The most common location for an ectopic pregnancy.
Ampulla of the oviduct
Sensitivity
Lichen sclerosus
Trauma - alcohol withdrawal - brain tumor

40. A 25-year - old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.

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41. When should a vaginal exam be performed with suspected placenta previa?
Never
Conduct disorder
HIDA scan
Hypotension and bradycardia

42. Antibiotics with teratogenic effects.
Fluids and antibiotics
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Pasteurella multocida

43. Iris - like target lesions.
Iron deficiency anemia
Varicella zoster
Erythema multiforme
Pseudogout

44. Amenorrhea - bradycardia - and abnormal body image in a young female.
Alopecia areata (autoimmune process)
Anorexia
Osteoarthritis
Observational bias

45. A febrile patient with a history of diabetes presents with a red - swollen - painful lower extremity.
Cellulitis
Chronic lymphocytic leukemia (CLL)
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Salmonella

46. The most common inherited hemolytic anemia.
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
Coarctation of the aorta
Suspect retinoblastoma
Hereditary spherocytosis

47. HUS triad?
Fanconi's anemia
Anemia - thrombocytopenia - and acute renal failure
Angina - ST- segment changes on ECG - or ? BP
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline

48. A woman who was abused as a child frequently feels outside of or detached from her body.
50 cc/hour
Depersonalization disorder
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Hypocalcemia

49. The most common inherited cause of hypercoagulability.
Factor V Leiden mutation
Dressler's syndrome: fever - pericarditis - ? ESR
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Crohn's disease

50. 'Doughy skin.'
Hypernatremia
S. aureus or S. epidermidis.
Agranulocytosis
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism