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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. Name the organism:
Actinomyces israelii
Patent ductus arteriosus (PDA)
Suspect ankylosing spondylitis. Check HLA- B27
DI

2. A middle - aged man presents with acute - onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis - and how did he get it? Treatment?
Lyme disease - Ixodes tick - doxycycline
MCP and PIP joints; DIP joints are spared
Continuous positive airway pressure
Febrile seizures (roseola infantum)

3. Name the defense mechanism:
PT
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
IVIG or plasmapheresis
Regression

4. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Iron deficiency anemia
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Kwashiorkor (protein malnutrition)
Observational bias

5. Beck's triad for cardiac tamponade.
Neither
Hypotension - distant heart sounds - and JVD
Pseudomonas
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states

6. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Headache
Contact dermatitis
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
1

7. Name the organism:
Klebsiella
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Inevitable abortion
Wernicke's encephalopathy due to a deficiency of thiamine

8. Involuntary psychiatric hospitalization can be undertaken for which three reasons?
Benzodiazepines
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Febrile seizures (roseola infantum)
Pseudomonas

9. A crescent - shaped hyperdensity on CT that does not cross the midline.
Type IV (distal) RTA
INH - penicillamine - hydralazine - procainamide
Subdural hematoma
Vibrio - HAV

10. The diagnostic test for pulmonary embolism.
Rubella
Benzodiazepines
Nephrotic syndrome
V/Q scan

11. Cohort study
Parvovirus B19
Endometriosis
Clostridium difficile
Incidence and prevalence

12. The most common 1
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Multiple myeloma
Inevitable abortion
Seborrheic keratosis

13. An 80-year - old man presents with fatigue - lymphadenopathy - splenomegaly - and isolated lymphocytosis. Suspected diagnosis?
7-10 days
Erythema multiforme
Chronic lymphocytic leukemia (CLL)
Conversion disorder

14. A newborn female has continuous 'machinery murmur.'
Patent ductus arteriosus (PDA)
Factitious disorder (Munchausen syndrome)
Renal cell carcinoma (RCC)
Respiratory alkalosis

15. A patient hasn't slept for days - lost $20 -000 gambling - is agitated - and has pressured speech. Diagnosis? Treatment?
Acute mania. Start a mood stabilizer (e.g. - lithium)
Prinzmetal's angina
Squamous cell carcinoma
Pasteurella multocida

16. Hypercholesterolemia treatment that ? flushing and pruritus.
Niacin
Number of live births per 1000 population
50 cc/hour
HBV - DTaP - Hib - IPV - PCV

17. Infection of small airways with epidemics in winter and spring.
RSV bronchiolitis
Neuroleptic malignant syndrome
Higher prevalence
Alport's syndrome

18. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Klebsiella
HBV immunoglobulin
Basal cell carcinoma
Acne vulgaris

19. Administer to a symptomatic patient to diagnose myasthenia gravis.
Edrophonium
Confounding variable
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Pentad of TTP

20. Difference between Mallory- Weiss and Boerhaave tears.
Mallory- Weiss
M3
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Abdominal ultrasound and CT

21. Dyspnea - lateral hilar lymphodenopathy on CXR - noncaseating granulomas - increased ACE - and hypercalcemia.
Normal
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Sarcoidosis
Ampulla of the oviduct

22. Method of calculating fluid repletion in burn patients.
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Cirrhosis - CHF - nephritic syndrome
50 cc/hour
Parkland formula

23. Aplastic crisis in sickle cell disease.
1
Factitious disorder (Munchausen syndrome)
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Parvovirus B19

24. Mortality rate?
Neuroblastoma
IVIG or plasmapheresis
Sheehan's syndrome (postpartum pituitary necrosis)
Number of deaths per 1000 population

25. Identify key organisms causing diarrhea:
Diamond - Blackfan anemia
1
Wiskott - Aldrich syndrome
Yersinia

26. A 14-year - old girl presents with prolonged bleeding after dental surgery and with menses - normal PT - normal or ? PTT - and ? bleeding time. Diagnosis? Treatment?

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27. Inspiratory arrest during palpation of the RUQ.

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28. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Hyperkalemia
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Treat existing heart failure and replace the tricuspid valve
1

29. Glomerulonephritis with hemoptysis.

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30. Microcytic anemia with ? serum iron - ? ferritin - and ? TIBC.
Haemophilus ducreyi
Iron deficiency anemia
Kegel exercises - estrogen - pessaries for stress incontinence
Suspect retinoblastoma

31. 'Doughy skin.'
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Wrist drop - loss of thumb abduction
Hypernatremia
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)

32. 1
Placental abruption and placenta previa
MCP and PIP joints; DIP joints are spared
HBV immunoglobulin
Substance abuse

33. Differential of hypervolemic hyponatremia.
Dantrolene or bromocriptine
Glomerulonephritis/nephritic syndrome
Prinzmetal's angina
Cirrhosis - CHF - nephritic syndrome

34. The most common cause of SAH.
Bacterial meningitis
? Ca2+ - ? K- - ? phosphate - ? uric acid
Normal
Trauma; the second most common is berry aneurysm

35. The three most common causes of fever of unknown origin (FUO).
Pseudomonas
Dantrolene or bromocriptine
Basal cell carcinoma
Infection - cancer - and autoimmune disease

36. Acceptable urine output in a stable patient.
Crohn's disease
Protamine
30 cc/hour
Rett's disorder

37. May be seen in children who are accused of inattention in class and confused with ADHD.
Absence seizures
Small cell lung cancer (SCLC)
Iron deficiency anemia
Substance abuse

38. A 49-year - old male presents with acute - onset flank pain and hematuria.
Displacement
Iron overload; use deferoxamine
Nephrolithiasis
46 -XX

39. Antihypertensive for a diabetic patient with proteinuria.
Rett's disorder
ACEI
Obstructive pulmonary disease (e.g. - asthma)
RCC or other erythropoietin - producing tumor; evaluate with CT scan

40. Gout - self - mutilation - and choreoathetosis.
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
A patient with chest trauma who was previously stable suddenly dies
Angina - ST- segment changes on ECG - or ? BP
HGPRTase deficiency)

41. The most common cause of Cushing's syndrome.

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42. Chromosomal pattern of a complete mole.
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Threatened abortion
46 -XX
Rate control - rhythm conversion - and anticoagulation

43. Treatment of central DI.
Administration of DDAVP ? serum osmolality and free water restriction
Asymmetry - border irregularity - color variation - large diameter
Sheehan's syndrome (postpartum pituitary necrosis)
Colposcopy and endocervical curettage

44. Blood in the urethral meatus or high - riding prostate.
Streptococcus pneumoniae
Prevalence
Bladder rupture or urethral injury
Asymmetry - border irregularity - color variation - large diameter

45. Treatment for neuroleptic malignant syndrome.
Hypernatremia
Acute mania. Start a mood stabilizer (e.g. - lithium)
Treat existing heart failure and replace the tricuspid valve
Dantrolene or bromocriptine

46. Cannon 'a' waves.
Third - degree heart block
Aseptic (viral) meningitis
IV hydration and loop diuretics (furosemide)
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy

47. A patient presents with weakness - nausea - vomiting - weight loss - and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
Rate control with carotid massasge or other vagal stimulation
Pharmacologic stress test (e.g. - dobutamine echo)
1
ETEC

48. Treatment for mild - persistent asthma.
Patient on dopamine antagonist
Bladder rupture or urethral injury
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Inhaled Beta- agonists and inhaled corticosteroids

49. Relative risk?
The IR of a disease in a population exposed to a particular factor
Establish the ABCs
Observational bias
OCP and barrier contraception

50. CSF findings:
Subarachnoid hemorrhage (SAH)
Squamous cell carcinoma
Choriocarcinoma
Type II (proximal) RTA