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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. Confusion - confabulation - ophthalmoplegia - ataxia.

2. Administer to a symptomatic patient to diagnose myasthenia gravis.
Edrophonium
Pseudomonas
Angina - ST- segment changes on ECG - or ? BP
Rate control - rhythm conversion - and anticoagulation

3. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Erythema multiforme
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision - making capacity
Pityriasis versicolor

4. Relative risk?
Subdural hematoma
The IR of a disease in a population exposed to a particular factor
ETEC
S. aureus

5. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
HIDA scan
Conflict of interest
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis

6. First step in the management of a patient with acute GI bleed.
Type I (distal) RTA
Establish the ABCs
Nephrogenic diabetes insipidus (DI)
HIDA scan

7. Identify key organisms causing diarrhea:
Giardia
Iron deficiency anemia
Chronic granulomatous disease
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed

8. Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Suspect ankylosing spondylitis. Check HLA- B27
Kegel exercises - estrogen - pessaries for stress incontinence
Benzodiazepines
Confounding variable

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

10. Galactorrhea - impotence - menstrual dysfunction - and ? libido.
OCPs - danazol - GnRH agonists
Patient on dopamine antagonist
Fluid restriction - demeclocycline
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella

11. 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 _____.
Rubella
No. Parental consent is not necessary for the medical treatment of pregnant minors
Confounding variable
Obstructive pulmonary disease (e.g. - asthma)

12. A patient presents with signs of hypocalcemia - high phosphorus - and low PTH.
Excessive EtOH
Check for ? ICP; look for papilledema
Hypoparathyroidism
Seventy percent if the stenosis is symptomatic

13. 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.

14. Appropriate diagnostic test?
Mycoplasma
Pharmacologic stress test (e.g. - dobutamine echo)
Duchenne muscular dystrophy
Parvovirus B19

15. 1
Contact dermatitis
Placental abruption and placenta previa
Chronic lymphocytic leukemia (CLL)
1

16. Causes of exudative effusion.
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Factitious disorder (Munchausen syndrome)
a - antagonists (phentolamine and phenoxybenzamine)
ETEC

17. Identify key organisms causing diarrhea:
Displacement
Respiratory alkalosis
Campylobacter
Continuous - painful vaginal bleeding

18. PFT showing ? FEV1/FVC.
Protamine
Obstructive pulmonary disease (e.g. - asthma)
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Anion gap acidosis and 1

19. A 15-year - old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
Glanzmann's thrombasthenia
Pseudomonas
No. Parental consent is not necessary for the medical treatment of pregnant minors
Mallory- Weiss

20. A young patient with a family history of sudden death collapses and dies while exercising.
Small cell lung cancer (SCLC)
Stasis - hypercoagulability - endothelial damage
Trauma; the second most common is berry aneurysm
Hypertrophic cardiomyopathy

21. Causes of hypoxemia.
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Pityriasis rosea
Rate control with carotid massasge or other vagal stimulation
Psoriasis

22. Lab values suggestive of menopause.
Rett's disorder
CML
Neuroleptic malignant syndrome
? serum FSH

23. The most common type of nephrolithiasis.
AP chest - AP/lateral C- spine - AP pelvis
Reaction formation
Rate control - rhythm conversion - and anticoagulation
Calcium oxalate

24. Macrocytic - megaloblastic anemia without neurologic symptoms.
Folate deficiency
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Low - voltage - diffuse ST- segment elevation

25. Describe a test that consistently gives identical results - but the results are wrong.
High reliability - low validity
Fluids and antibiotics
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Lesions of 1

26. A homeless child is small for his age and has peeling skin and a swollen belly.
Kwashiorkor (protein malnutrition)
Femoral hernia
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
a - antagonists (phentolamine and phenoxybenzamine)

27. The most common histology of bladder cancer.
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Rate control with carotid massasge or other vagal stimulation
Transitional cell carcinoma

28. The most common cause of hypothyroidism.

29. 'Stuck - on' appearance.
Higher incidence
Trauma; the second most common is berry aneurysm
Seborrheic keratosis
Malingering

30. Treatment for mild - persistent asthma.
Inhaled Beta- agonists and inhaled corticosteroids
Herpes simplex
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Huntington's disease

31. Treatment for bacterial vaginosis.
Rubella
Hypovolemic shock
Oral or topical metronidazole
Colposcopy and endocervical curettage

32. Key side effects of atypical antipsychotics.
Stasis - hypercoagulability - endothelial damage
Type IV (distal) RTA
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Weight gain - type 2 DM - QT prolongation

33. Symptoms of placental abruption.
Continuous - painful vaginal bleeding
Never
1
Headache

34. Shortest AP diameter of the pelvis.
Septic or anaphylactic shock
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Absence seizures
MS

35. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
Septic or anaphylactic shock
Haemophilus ducreyi
CML
Parkland formula

36. 'Dewdrop on a rose petal.'
Lesions of 1
Wait - surgical resection - radiation and/or androgen suppression
MAOIs
Panic disorder

37. Treatment of SIADH?
Avascular necrosis
Stasis - hypercoagulability - endothelial damage
Fluid restriction - demeclocycline
Lesch - Nyhan syndrome (purine salvage problem with

38. Four causes of microcytic anemia.
Biliary tract obstruction
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
SSRIs
TICS

39. A 24-year - old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Bacterial meningitis
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Pseudomonas

40. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Seventy percent if the stenosis is symptomatic
Uremic syndrome seen in patients with renal failure
Postinfectious glomerulonephritis
Uterine atony

41. Acceptable urine output in a stable patient.
30 cc/hour
Psoriasis
Displacement
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states

42. Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV- positive patient At what CD4 count? Mycobacterium avium - intracellulare (MAI) prophylaxis?
Guillain - Barr
Mycoplasma
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Conflict of interest

43. Typical antibiotics for group B streptococcus (GBS) prophylaxis.
'Chocolate cysts -' powder burns
SCLC
IV penicillin or ampicillin
Pemphigus vulgaris

44. Treatment of central DI.
Administration of DDAVP ? serum osmolality and free water restriction
Uterine atony
Osteoarthritis
Neurofibromatosis 1

45. Microcytic anemia with ? serum iron - ? ferritin - and ? TIBC.
Nitroprusside
Sporothrix schenckii
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Iron deficiency anemia

46. The most likely cause of acute lower GI bleed in patients > 40 years old.
Diverticulosis
Low - voltage - diffuse ST- segment elevation
They can mask symptoms of hypoglycemia
A patient's family cannot require that a doctor withhold information from the patient

47. Four signs and symptoms of streptococcal pharyngitis.
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus

48. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
ARDS
Avascular necrosis
Pregnant women. Treat this group aggressively because of potential complications
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed

49. Flat - topped papules.
Lichen planus
HBV - DTaP - Hib - IPV - PCV
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Calcium oxalate

50. Microcytic anemia with ? serum iron - ? total iron - binding capacity (TIBC) - and normal or ? ferritin.
Bullous pemphigoid
Anemia of chronic disease
Excessive EtOH
Neither