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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. Classic ECG findings in pericarditis.
Low - voltage - diffuse ST- segment elevation
'Chocolate cysts -' powder burns
Uterine atony
SCLC

2. Treatment for SVC syndrome.
Nephrolithiasis
Radiation
Osmotic fragility test
Salmonella

3. A significant cause of morbidity in thalassemia patients. Treatment?
Threatened abortion
Iron overload; use deferoxamine
Lichen planus
Osgood - Schlatter disease

4. Drowsiness - asterixis - nausea - and a pericardial friction rub.
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Uremic syndrome seen in patients with renal failure
Hypocalcemia
Conflict of interest

5. Number needed to treat?
1
Wernicke's encephalopathy due to a deficiency of thiamine
? Ca2+ - ? K- - ? phosphate - ? uric acid
Endometrial or estrogen receptor - breast cancer

6. Name the organism:
Intraductal papilloma
Calcium oxalate
Sporothrix schenckii
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)

7. If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status - then socioeconomic status is a _____.
Confounding variable
Alopecia areata (autoimmune process)
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Panic disorder

8. Medication used to induce ovulation.
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Clomiphene citrate
Bacterial meningitis

9. Postnatal mortality?
a - antagonists (phentolamine and phenoxybenzamine)
Uremic syndrome seen in patients with renal failure
Number of deaths from 28 days to one year per 1000 live births
ETEC

10. The most common inherited cause of hypercoagulability.
A patient with chest trauma who was previously stable suddenly dies
Factor V Leiden mutation
Parkinson's disease
Lesions of 1

11. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Duodenal atresia
Postinfectious glomerulonephritis
Prinzmetal's angina
Obstructive pulmonary disease (e.g. - asthma)

12. A 55-year - old man is diagnosed with prostate cancer. Treatment options?
Osgood - Schlatter disease
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Never
Wait - surgical resection - radiation and/or androgen suppression

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

14. Trauma series.
Glanzmann's thrombasthenia
N- acetylcysteine
High reliability - low validity
AP chest - AP/lateral C- spine - AP pelvis

15. Virus associated with aplastic anemia in patients with sickle cell anemia.
Biliary tract obstruction
Parvovirus B19
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Huntington's disease

16. When can a physician refuse to continue treating a patient on the grounds of futility?
MAOIs
Pityriasis versicolor
Dantrolene or bromocriptine
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

17. An active 13-year - old boy has anterior knee pain. Diagnosis?
A patient with chest trauma who was previously stable suddenly dies
Sarcoidosis
Osgood - Schlatter disease
Out

18. Blood in the urethral meatus or high - riding prostate.
Bladder rupture or urethral injury
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Third - degree heart block
68% - 95.5% - 99.7%

19. Erythema migrans.
Lesion of 1
Retinoic acid
Psoriasis
Nephritic syndrome

20. Perinatal mortality?

21. Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?
Retinoic acid
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
a - antagonists (phentolamine and phenoxybenzamine)
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin

22. Premalignant lesion from sun exposure that can ? squamous cell carcinoma.
Spinal stenosis
Murphy's sign - seen in acute cholecystitis
Actinic keratosis
Basal cell carcinoma

23. Life - threatening muscle rigidity - fever - and rhabdomyolysis.
Neuroleptic malignant syndrome
Biliary tract obstruction
Kwashiorkor (protein malnutrition)
Displacement

24. Identify key organisms causing diarrhea:
Excessive EtOH
Polymyalgia rheumatica
E. coli O157:H7
Osteogenesis imperfecta

25. May be seen in children who are accused of inattention in class and confused with ADHD.
Radiation
Absence seizures
Mallory- Weiss
Patient on dopamine antagonist

26. Cause of neonatal RDS.
Hypertension - bradycardia - and abnormal respirations
Surfactant deficiency
Continuous - painful vaginal bleeding
Calcium oxalate

27. Diagnostic test for hypertrophic cardiomyopathy.
Sheehan's syndrome (postpartum pituitary necrosis)
Legionella pneumonia
S. aureus
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)

28. A patient from California or Arizona presents with fever - malaise - cough - and night sweats. Diagnosis? Treatment?
Rubella
Beta- hCG; the most common cause of amenorrhea is pregnancy
Rett's disorder
Coccidioidomycosis. Amphotericin B

29. A patient presents with weakness - nausea - vomiting - weight loss - and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
1
Nephrogenic diabetes insipidus (DI)
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant

30. Chvostek's and Trousseau's signs.
Infection - febrile seizures - trauma - idiopathic
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Hypocalcemia

31. Acceptable urine output in a stable patient.
Sulfonamides - antimalarial drugs - fava beans
Acute myelogenous leukemia (AML)
Excessive EtOH
30 cc/hour

32. + Nikolsky's sign.
Herpes simplex
Inhaled Beta- agonists and inhaled corticosteroids
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Pemphigus vulgaris

33. Treatment for ventricular fibrillation.
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Immediate cardioversion
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Regression

34. The 6 P's of ischemia due to peripheral vascular disease.
Fluid restriction - demeclocycline
1
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Number of live births per 1000 population

35. Low urine specific gravity in the presence of high serum osmolality.
Fat - female - fertile - forty - flatulent
Rubella
HBV - DTaP - Hib - IPV - PCV
DI

36. The most common form of glomerulonephritis.

37. Shortest AP diameter of the pelvis.
Frotteurism (a paraphilia)
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Yersinia
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)

38. A doctor refers a patient for an MRI at a facility he/she owns.
Klebsiella
A patient with chest trauma who was previously stable suddenly dies
Conflict of interest
Femoral hernia

39. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Normal
Acute mania. Start a mood stabilizer (e.g. - lithium)
Polymyalgia rheumatica
Hypovolemic shock

40. A 30-year - old woman has unpredictable urine loss. Examination is normal. Medical options?
Factitious disorder (Munchausen syndrome)
Transitional cell carcinoma
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful

41. Treatment for malignant hypertension.
Huntington's disease
Nitroprusside
IVIG or plasmapheresis
Prevalence

42. Name the organism:
Salmonella
Treat immediately. Consent is implied in emergency situations
Hypertension - bradycardia - and abnormal respirations
They can mask symptoms of hypoglycemia

43. Medical treatment for IBD.
Neither
Immediate cardioversion
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Uremic syndrome seen in patients with renal failure

44. Salicylate ingestion ? In What type of acid - base disorder?
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Anion gap acidosis and 1
'Sawtooth' P waves
Phototherapy (mild) or exchange transfusion (severe)

45. Method of calculating fluid repletion in burn patients.
Continuous - painful vaginal bleeding
Parkland formula
Toxoplasma gondii
Transitional cell carcinoma

46. Three systemic diseases ? nephrotic syndrome.
Parkinson's disease
Usually resolves spontaneously; may require IVIG and/or corticosteroids
DM - SLE - and amyloidosis
Anemia of chronic disease

47. Rhomboid - shaped - positively birefringent crystals on joint fluid aspirate.
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Pseudogout
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction

48. Autoimmune complication occurring 2-4 weeks post - MI.

49. AML subtype associated with DIC.
Murphy's sign - seen in acute cholecystitis
Diphenhydramine or epinephrine 1:1000
M3
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction

50. Identify key organisms causing diarrhea:
Alopecia areata (autoimmune process)
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing