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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. Microcytic anemia with ? serum iron - ? ferritin - and ? TIBC.
Dressler's syndrome: fever - pericarditis - ? ESR
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Cerebral berry aneurysms (AD PCKD)
Iron deficiency anemia

2. Acid - base disorder in pulmonary embolism.
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Hypoxia and hypocarbia

3. Identify key organisms causing diarrhea:
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
ETEC
Higher prevalence
ARDS

4. Treatment of AF.
Rate control - rhythm conversion - and anticoagulation
Betamethasone or dexamethasone
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Polymyalgia rheumatica

5. A 20-year - old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?
Higher prevalence
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
CA-125 and transvaginal ultrasound
Cerebral berry aneurysms (AD PCKD)

6. Presents with a herald patch - Christmas - tree pattern.
Pityriasis rosea
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Fat - female - fertile - forty - flatulent
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones

7. First step in the management of a patient with acute GI bleed.
Antipsychotics (neuroleptic malignant syndrome)
Pityriasis rosea
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Establish the ABCs

8. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Kegel exercises - estrogen - pessaries for stress incontinence
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Infection - cancer - and autoimmune disease
Type IV (distal) RTA

9. Side effects of corticosteroids.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Lesions of 1
Malingering
DM - SLE - and amyloidosis

10. Eight surgically correctable causes of hypertension.

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11. Type of ARF in a patient with FeNa < 1%.
Spinal stenosis
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Prerenal
Fever - pharyngeal erythema - tonsillar exudate - lack of cough

12. A 17-year - old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Pharmacologic stress test (e.g. - dobutamine echo)
Conversion disorder
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism

13. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
Pseudogout
Yersinia
1
HIDA scan

14. What should always be done prior to LP?
Check for ? ICP; look for papilledema
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Colposcopy and endocervical curettage
B12 deficiency

15. The 6 P's of ischemia due to peripheral vascular disease.
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Duchenne muscular dystrophy
Identify cause; pressors (e.g. - dobutamine)

16. Exophthalmos - pretibial myxedema - and ? TSH.

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17. Criteria for exudative effusion.
Nephritic syndrome
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Factitious disorder (Munchausen syndrome)

18. Caf
Cellulitis
Establish the ABCs
Neurofibromatosis 1
Parainfluenza virus type 1

19. Trauma series.
AP chest - AP/lateral C- spine - AP pelvis
1
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Niacin

20. Testicular cancer associated with Beta- hCG - AFP.
Central pontine myelinolysis
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
E. coli O157:H7
Choriocarcinoma

21. Neonatal mortality?
Number of deaths from birth to 28 days per 1000 live births
Low - voltage - diffuse ST- segment elevation
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Iron deficiency anemia

22. Administer to a symptomatic patient to diagnose myasthenia gravis.
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Metformin
Edrophonium
Ampulla of the oviduct

23. Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
Allergic interstitial nephritis
Immediate needle thoracostomy
Regression
Spinal stenosis

24. Aplastic crisis in sickle cell disease.
Uremic syndrome seen in patients with renal failure
Hypovolemic shock
Parvovirus B19
Nephrolithiasis

25. Typical antibiotics for group B streptococcus (GBS) prophylaxis.
Malignancy and hyperparathyroidism
Hypertrophic cardiomyopathy
Murphy's sign - seen in acute cholecystitis
IV penicillin or ampicillin

26. Identify key organisms causing diarrhea:
Biliary tract obstruction
Broca's aphasia. Frontal lobe - left MCA distribution
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Clostridium difficile

27. AML subtype associated with DIC.
Excessive EtOH
Beta- blockers - digoxin - calcium channel blockers
Displacement
M3

28. The most common cause of SAH.
Trauma; the second most common is berry aneurysm
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Graves' disease
Uterine atony

29. The most common 1
Selective IgA deficiency
105 bacteria/mL
Sporothrix schenckii
Rate control with carotid massasge or other vagal stimulation

30. The most common form of glomerulonephritis.

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31. A 25-year - old African - American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
O2 - analgesia - hydration - and - if severe - transfusion
Patent ductus arteriosus (PDA)
Stasis - hypercoagulability - endothelial damage
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

32. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Basal cell carcinoma
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Toxoplasma gondii
Prevalence

33. Rigidity and stiffness that progress to choreiform movements - accompanied by moodiness and altered behavior.

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34. Ring - enhancing brain lesion on CT with seizures
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Sarcoidosis
Taenia solium (cysticercosis)
Giardia

35. Cross - sectional survey
Osteogenesis imperfecta
Pseudomonas
Prevalence
Nephrotic syndrome

36. An agent that reverses the effects of heparin.
Protamine
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Hypoxia and hypocarbia

37. Signs of air embolism.
A patient's family cannot require that a doctor withhold information from the patient
A patient with chest trauma who was previously stable suddenly dies
MS
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing

38. What % lesion is an indication for carotid endarterectomy?
Lung - breast - skin (melanoma) - kidney - GI tract
Seventy percent if the stenosis is symptomatic
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Pentad of TTP

39. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Mallory- Weiss
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Malingering
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

40. Name the organism:
Emergent laparotomy to repair perforated viscus - likely stomach
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Haemophilus ducreyi
Depersonalization disorder

41. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
Hypotension and bradycardia
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Threatened abortion
Osgood - Schlatter disease

42. The most common cancer in men and the most common cause of death from cancer in men.
Klebsiella
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Bacillus cereus
Treat immediately. Consent is implied in emergency situations

43. First - line treatment for moderate hypercalcemia.
IV hydration and loop diuretics (furosemide)
Inevitable abortion
Kwashiorkor (protein malnutrition)
Salmonella

44. Defect in an X- linked syndrome with mental retardation -
Lesch - Nyhan syndrome (purine salvage problem with
Wiskott - Aldrich syndrome
Lesions of 1
B12 deficiency

45. Proteinuria - hypoalbuminemia - hyperlipidemia - hyperlipiduria - edema.
Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first - degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
Nephrotic syndrome
DM - SLE - and amyloidosis

46. Infant mortality?
Coarctation of the aorta
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Anemia of chronic disease
Hashimoto's thyroiditis

47. Low urine specific gravity in the presence of high serum osmolality.
Vibrio - HAV
Nephritic syndrome
Lesion of 1
DI

48. CSF findings:
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Osteoarthritis
Aseptic (viral) meningitis
Excessive EtOH

49. CSF findings:
Squamous cell carcinoma
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
MS
Excessive EtOH

50. Non - small cell lung cancer (NSCLC) associated with hypercalcemia.
Squamous cell carcinoma
Duodenal atresia
Prerenal
Retrograde cystourethrogram