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Test your basic knowledge |
USMLE Step 2
Start Test
Study First
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 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Parvovirus B19
'Sawtooth' P waves
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Pseudomonas
2. Identify key organisms causing diarrhea:
Salmonella
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Cerebral berry aneurysms (AD PCKD)
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
3. CSF findings with SAH.
Elevated ICP - RBCs - xanthochromia
? serum FSH
Excessive EtOH
PT
4. What should always be done prior to LP?
HGPRTase deficiency)
Check for ? ICP; look for papilledema
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Number of deaths from birth to 28 days per 1000 live births
5. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Frotteurism (a paraphilia)
Neisseria meningitidis
Amoxicillin
Wiskott - Aldrich syndrome
6. After a minor fender bender - a man wears a neck brace and requests permanent disability.
Malingering
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Diphenhydramine or epinephrine 1:1000
Prerenal
7. Proteinuria - hypoalbuminemia - hyperlipidemia - hyperlipiduria - edema.
Never
Nephrotic syndrome
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Conduct disorder
8. Nonpainful chancre.
Panic disorder
Salmonella
1
Subdural hematoma
9. Prophylactic treatment for migraine.
Nephrogenic diabetes insipidus (DI)
Guillain - Barr
Clostridium difficile
Beta- blockers - Ca2+ channel blockers - TCAs
10. The most common histology of bladder cancer.
Hodgkin's lymphoma
Transitional cell carcinoma
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Dantrolene or bromocriptine
11. The most common cause of seizures in young adults (18-35 years).
Neuroleptic malignant syndrome
DI
Trauma - alcohol withdrawal - brain tumor
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
12. Inflammation and epithelial thinning of the anogenital area - predominantly in postmenopausal women.
Lichen sclerosus
Huntington's disease
Low - voltage - diffuse ST- segment elevation
Cirrhosis - CHF - nephritic syndrome
13. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Graves' disease
Multiple myeloma
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
14. Perinatal mortality?
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15. Cause of amenorrhea with normal prolactin - no response to estrogen - progesterone challenge - and a history of D&C.
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16. Arthritis - conjunctivitis - and urethritis in young men. Associated organisms?
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17. A patient continues to use cocaine after being in jail - losing his job - and not paying child support.
Headache
Weight loss and OCPs
Substance abuse
Alport's syndrome
18. A 55-year - old obese patient presents with dirty - velvety patches on the back of the neck.
MAOIs
Clomiphene citrate
SCLC
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
19. Electrolyte changes in tumor lysis syndrome.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Fat - female - fertile - forty - flatulent
? Ca2+ - ? K- - ? phosphate - ? uric acid
Spinal stenosis
20. A 49-year - old male presents with acute - onset flank pain and hematuria.
Diphenhydramine or epinephrine 1:1000
Reaction formation
Nephrolithiasis
Bacillus cereus
21. The coagulation parameter affected by warfarin.
PT
ACEI
Infection - febrile seizures - trauma - idiopathic
Ophthalmologic exam - CT - and MRI
22. Name the organism:
Sporothrix schenckii
Osteoarthritis
Acute mania. Start a mood stabilizer (e.g. - lithium)
Confounding variable
23. Which of the following are ? in DIC: fibrin split products - D- dimer - fibrinogen - platelets - and hematocrit.
Menometrorrhagia
Acne vulgaris
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
'Sawtooth' P waves
24. Case - control study
1
Sarcoidosis
False. Withdrawing and withholding life are the same from an ethical standpoint
Neither
25. Sensitive tests have few false negatives and are used to rule _____ a disease.
Hashimoto's thyroiditis
Out
Inhaled Beta- agonists and inhaled corticosteroids
Asymmetry - border irregularity - color variation - large diameter
26. Identify key organisms causing diarrhea:
Giardia
a - antagonists (phentolamine and phenoxybenzamine)
Ophthalmologic exam - CT - and MRI
Patent ductus arteriosus (PDA)
27. Which healthy population is susceptible to UTIs?
Hashimoto's thyroiditis
B12 deficiency
Hypovolemic shock
Pregnant women. Treat this group aggressively because of potential complications
28. Dyspnea - lateral hilar lymphodenopathy on CXR - noncaseating granulomas - increased ACE - and hypercalcemia.
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Parkland formula
Displacement
Sarcoidosis
29. The most common inherited hemolytic anemia.
Hereditary spherocytosis
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
30. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Rate control - rhythm conversion - and anticoagulation
Dissociative fugue
Parvovirus B19
Observational bias
31. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Type I (distal) RTA
OCP and barrier contraception
Benzodiazepines
Chronic granulomatous disease
32. A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
Chronic lymphocytic leukemia (CLL)
Pityriasis versicolor
Lead - time bias
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
33. A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Selective IgA deficiency
Continuous positive airway pressure
Hyperkalemia
34. Name the organism:
Salmonella
The IR of a disease in a population exposed to a particular factor
Lichen planus
Anticoagulation - rate control - cardioversion
35. What is the immunodeficiency?
Clostridium difficile
Choriocarcinoma
Neuroleptic malignant syndrome
Chronic granulomatous disease
36. Acid - base disturbance commonly seen in pregnant women.
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Respiratory alkalosis
Anion gap acidosis and 1
37. 'Stuck - on' appearance.
Regresses after menopause
Coarctation of the aorta
Neuroleptic malignant syndrome
Seborrheic keratosis
38. Radiographic indications for surgery in patients with acute abdomen.
Transitional cell carcinoma
Klebsiella
Pregnant women. Treat this group aggressively because of potential complications
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
39. True or false: Once patients sign a statement giving consent - they must continue treatment.
Continuous - painful vaginal bleeding
Treat immediately. Consent is implied in emergency situations
Type II (proximal) RTA
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
40. Appropriate diagnostic test?
OCPs
Exercise stress treadmill with ECG
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Wiskott - Aldrich syndrome
41. In which patients do you initiate colorectal cancer screening early?
MS
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
Pemphigus vulgaris
1
42. What % lesion is an indication for carotid endarterectomy?
V/Q scan
Seventy percent if the stenosis is symptomatic
Hypertension - bradycardia - and abnormal respirations
Anion gap acidosis and 1
43. A patient with a history of lithium use presents with copious amounts of dilute urine.
Hypernatremia
Inhaled Beta- agonists and inhaled corticosteroids
Fluid restriction - demeclocycline
Nephrogenic diabetes insipidus (DI)
44. Differential of hypervolemic hyponatremia.
Displacement
Cirrhosis - CHF - nephritic syndrome
Pityriasis versicolor
CML
45. Glomerulonephritis with deafness.
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46. Three systemic diseases ? nephrotic syndrome.
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Lesch - Nyhan syndrome (purine salvage problem with
Elevated ICP - RBCs - xanthochromia
DM - SLE - and amyloidosis
47. Cause of neonatal RDS.
Surfactant deficiency
Polymyalgia rheumatica
Broca's aphasia. Frontal lobe - left MCA distribution
IgA nephropathy (Berger's disease)
48. Name the organism:
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
ETEC
Pseudomonas
Usually resolves spontaneously; may require IVIG and/or corticosteroids
49. A 55-year - old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram - negative rods. What is the diagnosis?
Legionella pneumonia
Anion gap acidosis and 1
S. aureus or S. epidermidis.
O2 - analgesia - hydration - and - if severe - transfusion
50. Defect in an X- linked syndrome with mental retardation -
Lyme disease - Ixodes tick - doxycycline
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Lesch - Nyhan syndrome (purine salvage problem with
Uterine atony
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