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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. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Type I (distal) RTA
Dissociative fugue
Out
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)

2. A fall in systolic BP of > 10 mmHg with inspiration.
B12 deficiency
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Pulsus paradoxus (seen in cardiac tamponade)
Hypernatremia

3. Name the defense mechanism:
Edrophonium
Displacement
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Febrile seizures (roseola infantum)

4. Treatment for mild and severe unconjugated hyperbilirubinemia.
Yersinia
Diphenhydramine or epinephrine 1:1000
Infection - cancer - and autoimmune disease
Phototherapy (mild) or exchange transfusion (severe)

5. ? CO - ? PCWP - ? PVR.
Fatigue and impending respiratory failure
Cardiogenic shock
Aseptic (viral) meningitis
Asherman's syndrome

6. A son asks that his mother not be told about her recently discovered cancer.

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7. A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
Osmotic fragility test
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Chronic lymphocytic leukemia (CLL)
HBV - DTaP - Hib - IPV - PCV

8. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Clostridium difficile
Lobular carcinoma in situ
Aseptic (viral) meningitis
Highly sensitive for TB

9. Name the defense mechanism:
Out
Regression
Squamous cell carcinoma
Osgood - Schlatter disease

10. Confusion - confabulation - ophthalmoplegia - ataxia.

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11. The most common organism in burn - related infections.
Pseudomonas
Fat - female - fertile - forty - flatulent
Pemphigus vulgaris
Selective IgA deficiency

12. A woman who was abused as a child frequently feels outside of or detached from her body.
Betamethasone or dexamethasone
Depersonalization disorder
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Dissociative fugue

13. Goal hemoglobin A1c for a patient with DM.
Alport's syndrome
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
< 7.0
Respiratory alkalosis

14. Four signs and symptoms of streptococcal pharyngitis.
O2 - analgesia - hydration - and - if severe - transfusion
Fanconi's anemia
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
A patient's family cannot require that a doctor withhold information from the patient

15. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Observational bias
Multiple myeloma
Seventy percent if the stenosis is symptomatic
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine

16. A 49-year - old male presents with acute - onset flank pain and hematuria.
Diverticulosis
Nephrolithiasis
V/Q scan
Parkland formula

17. Type of ARF in a patient with FeNa < 1%.
Higher prevalence
Benzodiazepines
Prerenal
Varicella zoster

18. Virchow's triad.
Wegener's granulomatosis and Goodpasture's syndrome
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Threatened abortion
Stasis - hypercoagulability - endothelial damage

19. A patient hasn't slept for days - lost $20 -000 gambling - is agitated - and has pressured speech. Diagnosis? Treatment?
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Iron overload; use deferoxamine
Acute mania. Start a mood stabilizer (e.g. - lithium)
Alopecia areata (autoimmune process)

20. The coagulation parameter affected by warfarin.
Allergic interstitial nephritis
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
PT
Malingering

21. PFT showing ? FEV1/FVC.
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
High reliability - low validity
Restrictive pulmonary disease
Inhaled Beta- agonists and inhaled corticosteroids

22. A patient presents with pain on passive movement - pallor - poikilothermia - paresthesias - paralysis - and pulselessness. Treatment?
All - compartment fasciotomy for suspected compartment syndrome
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
46 -XX
False. Withdrawing and withholding life are the same from an ethical standpoint

23. Laparoscopic findings in endometriosis.

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24. Infection of small airways with epidemics in winter and spring.
Vibrio - HAV
Bladder rupture or urethral injury
RSV bronchiolitis
Cellulitis

25. The most common type of nephrolithiasis.
Calcium oxalate
MCP and PIP joints; DIP joints are spared
Central pontine myelinolysis
Factitious disorder (Munchausen syndrome)

26. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
PT
Pheochromocytoma
Multiple myeloma
Beta- blockers - digoxin - calcium channel blockers

27. How to distinguish polycythemia vera from 2
O2 - analgesia - hydration - and - if severe - transfusion
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis

28. Identify key organisms causing diarrhea:
Pheochromocytoma
N- acetylcysteine
Yersinia
Multiple myeloma

29. Name the organism:
AP chest - AP/lateral C- spine - AP pelvis
Bladder rupture or urethral injury
Neisseria meningitidis
Parkland formula

30. Prophylactic treatment for migraine.
IV hydration and loop diuretics (furosemide)
Reye's syndrome
Beta- blockers - Ca2+ channel blockers - TCAs
SSRIs

31. AML subtype associated with DIC.
Seminoma
M3
Threatened abortion
Continuous positive airway pressure

32. Treatment for TTP.
Prerenal
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Pityriasis rosea
Pseudomonas

33. Identify key organisms causing diarrhea:
? Ca2+ - ? K- - ? phosphate - ? uric acid
Diphenhydramine or epinephrine 1:1000
E. coli O157:H7
Klebsiella

34. Symptoms of placental abruption.
Avascular necrosis
Continuous - painful vaginal bleeding
IVIG or plasmapheresis
Bacterial meningitis

35. Fertility rate?
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Number of live births per 1000 women 15-44 years of age
68% - 95.5% - 99.7%
ETEC

36. A 55-year - old man is diagnosed with prostate cancer. Treatment options?
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Never
1
Wait - surgical resection - radiation and/or androgen suppression

37. Acceptable urine output in a stable patient.
30 cc/hour
Endometrial or estrogen receptor - breast cancer
Paget's disease
Number of deaths from 20 weeks' gestation to birth per 1000 total births

38. Identify key organisms causing diarrhea:
Elevated ICP - RBCs - xanthochromia
Intraductal papilloma
Clostridium difficile
Frotteurism (a paraphilia)

39. Vaccinations at a six- month well - child visit.
Type I (distal) RTA
Threatened abortion
HBV - DTaP - Hib - IPV - PCV
ALS

40. Acid - base disorder in pulmonary embolism.
Nitroprusside
OCPs
Malingering
Hypoxia and hypocarbia

41. The most common inherited cause of hypercoagulability.
Lyme disease - Ixodes tick - doxycycline
Vibrio - HAV
Factor V Leiden mutation
Hypoparathyroidism

42. Antihypertensive for a diabetic patient with proteinuria.
Parvovirus B19
ACEI
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Higher incidence

43. 'Doughy skin.'
Malignancy and hyperparathyroidism
Osteoarthritis
Hypernatremia
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis

44. The most common cause of seizures in young adults (18-35 years).
Osmotic fragility test
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Trauma - alcohol withdrawal - brain tumor

45. CSF findings:
Nitroprusside
Seminoma
Bacterial meningitis
BP > 140/90 on three separate occasions two weeks apart

46. Name the organism:
SCLC
Klebsiella
Pityriasis versicolor
Surfactant deficiency

47. Amenorrhea - bradycardia - and abnormal body image in a young female.
Type I (distal) RTA
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Endometriosis
Anorexia

48. Which healthy population is susceptible to UTIs?
Transitional cell carcinoma
False. Withdrawing and withholding life are the same from an ethical standpoint
'Sawtooth' P waves
Pregnant women. Treat this group aggressively because of potential complications

49. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Klebsiella
Sporothrix schenckii

50. Name the organism:
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Hypertension - bradycardia - and abnormal respirations
Pseudomonas
O2 - analgesia - hydration - and - if severe - transfusion