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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. A condition associated with red 'currant - jelly' stools.
Rate control - rhythm conversion - and anticoagulation
Pityriasis rosea
Intussusception
SCLC

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

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3. Reynolds' pentad.

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4. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Dantrolene or bromocriptine
Squamous cell carcinoma
Regression
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

5. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
S. aureus
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Pheochromocytoma
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy

6. Auer rods on blood smear.
Sulfonamides - antimalarial drugs - fava beans
All - compartment fasciotomy for suspected compartment syndrome
Acne vulgaris
Acute myelogenous leukemia (AML)

7. A four -year - old child presents with oliguria - petechiae - and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
V/Q scan
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
MCP and PIP joints; DIP joints are spared
IV benzodiazepine

8. Thrombotic thrombocytopenic purpura (TTP) pentad?
Membranous glomerulonephritis
Huntington's disease
Check for ? ICP; look for papilledema
Pentad of TTP

9. Treatment for TTP.
Guillain - Barr
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Allergic interstitial nephritis
Esophageal atresia with distal TEF (85%). Unable to pass NG tube

10. Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
Osteoarthritis
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Distal radius (Colles' fracture)

11. What is the metabolic syndrome?
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Clomiphene citrate
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

12. The mainstay of Parkinson's therapy.
Levodopa/carbidopa
Sulfonamides - antimalarial drugs - fava beans
Reaction formation
Hypoparathyroidism

13. First - line treatment for moderate hypercalcemia.
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
IV hydration and loop diuretics (furosemide)
Factitious disorder (Munchausen syndrome)
ARDS

14. Risk factors for pyelonephritis.
Seborrheic keratosis
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Pseudomonas
? serum FSH

15. 'Dewdrop on a rose petal.'
O2 - analgesia - hydration - and - if severe - transfusion
Mycobacterium tuberculosis
Lesions of 1
Type IV (distal) RTA

16. Identify key organisms causing diarrhea:
Endometrial or estrogen receptor - breast cancer
Yersinia
Seminoma
Iatrogenic steroid administration. The second most common cause is Cushing's disease

17. Characteristics of 2

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18. Treatment of septic shock.
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Fluids and antibiotics
Levodopa/carbidopa
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination

19. An agent that reverses the effects of heparin.
Uterine atony
Ulcerative colitis
Depersonalization disorder
Protamine

20. Treatment of central DI.
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Nephrotic syndrome
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Administration of DDAVP ? serum osmolality and free water restriction

21. + Nikolsky's sign.
HGPRTase deficiency)
Pemphigus vulgaris
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Iron overload; use deferoxamine

22. Shortest AP diameter of the pelvis.
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
High reliability - low validity

23. Definition of unstable angina.
Fluid restriction - demeclocycline
Angina is new - is worsening - or occurs at rest
Higher prevalence
Esophageal atresia with distal TEF (85%). Unable to pass NG tube

24. PFT showing ? FEV1/FVC.
S. aureus
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Restrictive pulmonary disease
Pityriasis versicolor

25. The most common causes of hypercalcemia.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Malignancy and hyperparathyroidism
Hypertension - bradycardia - and abnormal respirations
Intraductal papilloma

26. The most common cause of female infertility.
Hypotension - distant heart sounds - and JVD
Taenia solium (cysticercosis)
Endometriosis
Infection - cancer - and autoimmune disease

27. Albuminocytologic dissociation.
Endometrial or estrogen receptor - breast cancer
Lichen sclerosus
Oral surgery
Guillain - Barr

28. Conditions in which confidentiality must be overridden.
Basal cell carcinoma
Parkland formula
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Immediate needle thoracostomy

29. A 'blueberry muffin' rash is characteristic of what congenital infection?
Rubella
Identify cause; pressors (e.g. - dobutamine)
Menometrorrhagia
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.

30. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Pityriasis versicolor
Mycobacterium tuberculosis
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Incidence and prevalence

31. A significant cause of morbidity in thalassemia patients. Treatment?
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Number of deaths from birth to 28 days per 1000 live births
Iron overload; use deferoxamine
Frotteurism (a paraphilia)

32. Endocarditis prophylaxis regimens.
Diverticulosis
Acute mania. Start a mood stabilizer (e.g. - lithium)
Oral surgery
Obstructive pulmonary disease (e.g. - asthma)

33. A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?
S. aureus or S. epidermidis.
Osgood - Schlatter disease
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Duchenne muscular dystrophy

34. Maternal mortality?
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Pityriasis rosea
Displacement

35. Type of ARF in a patient with FeNa < 1%.
Lead - time bias
Prerenal
Placental abruption and placenta previa
Rate control with carotid massasge or other vagal stimulation

36. 'Cradle cap.'
Acute myelogenous leukemia (AML)
Fanconi's anemia
Seborrheic dermatitis. Treat with antifungals
Psoriasis

37. Signs suggesting radial nerve damage with humeral fracture.
Wrist drop - loss of thumb abduction
Yersinia
Femoral hernia
Number of deaths per 1000 population

38. Treatment for opioid overdose.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Headache
Naloxone
Acute myelogenous leukemia (AML)

39. May be seen in children who are accused of inattention in class and confused with ADHD.
Panic disorder
Nephrogenic diabetes insipidus (DI)
Bruton's X- linked agammaglobulinemia
Absence seizures

40. The diagnostic test for pulmonary embolism.
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
V/Q scan
Hodgkin's lymphoma
INH - penicillamine - hydralazine - procainamide

41. Attributable risk?
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Cardiogenic shock
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs

42. Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Niacin
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Glanzmann's thrombasthenia
Suspect ankylosing spondylitis. Check HLA- B27

43. CSF findings:
Signs and symptoms of hypercalcemia
Acute pancreatitis
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Bacterial meningitis

44. Presents with a herald patch - Christmas - tree pattern.
Trauma - alcohol withdrawal - brain tumor
Betamethasone or dexamethasone
Pityriasis rosea
Iron overload; use deferoxamine

45. An eight -year - old boy presents with hemarthrosis and ? PTT with normal PT and bleeding time. Diagnosis? Treatment?
1
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
46 -XX

46. The most common 1
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
'Sawtooth' P waves
IgA nephropathy (Berger's disease)
Lung - breast - skin (melanoma) - kidney - GI tract

47. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Basal cell carcinoma
Biliary tract obstruction
Folate deficiency
Klebsiella

48. A patient with a history of lithium use presents with copious amounts of dilute urine.
Salmonella
Acute myelogenous leukemia (AML)
Factor V Leiden mutation
Nephrogenic diabetes insipidus (DI)

49. Microcytic anemia with ? serum iron - ? total iron - binding capacity (TIBC) - and normal or ? ferritin.
Contact dermatitis
Anemia of chronic disease
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Amoxicillin

50. The most common causes of dementia.

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