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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. Difference between Mallory- Weiss and Boerhaave tears.
Retinoic acid
Mallory- Weiss
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Femoral hernia

2. Hypercholesterolemia treatment that ? flushing and pruritus.
Panic disorder
Niacin
Diphenhydramine or epinephrine 1:1000
Flumazenil

3. Findings in 3
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Contact dermatitis
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid

4. A 'blueberry muffin' rash is characteristic of what congenital infection?
1
Klebsiella
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
Rubella

5. Classic causes of drug - induced hepatitis.
Coccidioidomycosis. Amphotericin B
Check for ? ICP; look for papilledema
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Pityriasis rosea

6. A doctor refers a patient for an MRI at a facility he/she owns.
Hodgkin's lymphoma
Conflict of interest
SCLC
MCP and PIP joints; DIP joints are spared

7. 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 _____.
Membranous glomerulonephritis
Pentad of TTP
Confounding variable
Renal cell carcinoma (RCC)

8. 'Stuck - on' appearance.
Parainfluenza virus type 1
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Seborrheic keratosis
Rubella

9. Therapy for polycystic ovarian syndrome.
A patient with chest trauma who was previously stable suddenly dies
Panic disorder
Sulfonamides - antimalarial drugs - fava beans
Weight loss and OCPs

10. A 55-year - old patient presents with acute 'broken speech.' What type of aphasia? What lobe and vascular distribution?

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11. Blood in the urethral meatus or high - riding prostate.
IV penicillin or ampicillin
Bladder rupture or urethral injury
Highly sensitive for TB
Varicella zoster

12. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
SIADH due to stress
Polymyalgia rheumatica
Glanzmann's thrombasthenia
Postinfectious glomerulonephritis

13. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Number of deaths from birth to 28 days per 1000 live births
Hypotension - distant heart sounds - and JVD
Patient on dopamine antagonist

14. Macrocytic - megaloblastic anemia without neurologic symptoms.
Absence seizures
Sensitivity
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
Folate deficiency

15. A 55-year - old man is diagnosed with prostate cancer. Treatment options?
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Headache
Placental abruption and placenta previa
Wait - surgical resection - radiation and/or androgen suppression

16. Aplastic crisis in sickle cell disease.
Parvovirus B19
Septic or anaphylactic shock
Infection - cancer - and autoimmune disease
Headache

17. Tanner stage 3 in a six-year - old female.
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Precocious puberty
Suspect retinoblastoma
Exercise stress treadmill with ECG

18. Combined UMN and LMN disorder.
ALS
Phototherapy (mild) or exchange transfusion (severe)
Endometrial biopsy
CA-125 and transvaginal ultrasound

19. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Iron deficiency anemia
Osteogenesis imperfecta
Type I (distal) RTA

20. After a minor fender bender - a man wears a neck brace and requests permanent disability.
RSV bronchiolitis
Central pontine myelinolysis
Malingering
CHF - shock - and altered mental status

21. Beck's triad for cardiac tamponade.
Sheehan's syndrome (postpartum pituitary necrosis)
Hypotension - distant heart sounds - and JVD
Hereditary spherocytosis
Hypoxia and hypocarbia

22. Hematuria - hypertension - and oliguria.
Varicella zoster
Parainfluenza virus type 1
Nephritic syndrome
Partial mole

23. Treatment for opioid overdose.
Obstructive pulmonary disease (e.g. - asthma)
Bacterial meningitis
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Naloxone

24. Symptoms of placental abruption.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Continuous - painful vaginal bleeding
Fanconi's anemia
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis

25. Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Alopecia areata (autoimmune process)
Ultrasound
Sulfonamides - antimalarial drugs - fava beans
Suspect ankylosing spondylitis. Check HLA- B27

26. Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow - up evaluation?
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Coarctation of the aorta
Colposcopy and endocervical curettage
Consider Fitz - Hugh - Curtis syndrome

27. When should a vaginal exam be performed with suspected placenta previa?
Never
Kwashiorkor (protein malnutrition)
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Calcium oxalate

28. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
B12 deficiency
Threatened abortion
Hodgkin's lymphoma
Seventy percent if the stenosis is symptomatic

29. A late - life - threatening complication of chronic myelogenous leukemia (CML).
Depersonalization disorder
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Higher prevalence
Headache

30. 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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31. Annual screening for women with a strong family history of ovarian cancer.
Acute myelogenous leukemia (AML)
Lesion of 1
Herpes simplex
CA-125 and transvaginal ultrasound

32. A patient presents with signs of hypocalcemia - high phosphorus - and low PTH.
Type II (proximal) RTA
Absence seizures
Hypoparathyroidism
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones

33. Unopposed estrogen is contraindicated in which cancers?
Actinic keratosis
Uremic syndrome seen in patients with renal failure
Endometrial or estrogen receptor - breast cancer
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)

34. Four characteristics of a nevus suggestive of melanoma.
Dantrolene or bromocriptine
Asymmetry - border irregularity - color variation - large diameter
Factor V Leiden mutation
Endometrial biopsy

35. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
Pentad of TTP
CML
High TSH - low T4 - antimicrosomal antibodies
Pemphigus vulgaris

36. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
SSRIs
1
Actinic keratosis
RCC or other erythropoietin - producing tumor; evaluate with CT scan

37. Cohort study
Cohort studies can be used to calculate relative risk (RR) - incidence - and/or odds ratio (OR). Case - control studies can be used to calculate an OR
Phencyclidine hydrochloride (PCP) intoxication
Sporothrix schenckii
Incidence and prevalence

38. Treatment of SIADH?
Diamond - Blackfan anemia
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Type II (proximal) RTA
Fluid restriction - demeclocycline

39. An antidiabetic agent associated with lactic acidosis.
Metformin
CML
Hypoparathyroidism
Usually resolves spontaneously; may require IVIG and/or corticosteroids

40. The most common causes of dementia.

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41. Identify key organisms causing diarrhea:
Lung - breast - skin (melanoma) - kidney - GI tract
Erythema multiforme
Osteogenesis imperfecta
Campylobacter

42. Signs suggesting radial nerve damage with humeral fracture.
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Restrictive pulmonary disease
Wrist drop - loss of thumb abduction
Bullous pemphigoid

43. True or false: Once patients sign a statement giving consent - they must continue treatment.
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Mycobacterium tuberculosis
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

44. Name the defense mechanism:
Spinal stenosis
Regresses after menopause
Reaction formation
'Chocolate cysts -' powder burns

45. The most common cause of hypertension in young men.
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Stasis - hypercoagulability - endothelial damage
Cohort studies can be used to calculate relative risk (RR) - incidence - and/or odds ratio (OR). Case - control studies can be used to calculate an OR
Excessive EtOH

46. Medical treatment for hepatic encephalopathy.
a - antagonists (phentolamine and phenoxybenzamine)
Oral or topical metronidazole
Chronic granulomatous disease
? protein intake - lactulose - neomycin

47. Signs of neurogenic shock.
Cellulitis
Coarctation of the aorta
Hypotension and bradycardia
Contact dermatitis

48. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Angina - ST- segment changes on ECG - or ? BP
Cardiogenic shock
Squamous cell carcinoma
Kegel exercises - estrogen - pessaries for stress incontinence

49. The number of true positives divided by the number of patients with the disease is _____.
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
? protein intake - lactulose - neomycin
Sensitivity
Factor V Leiden mutation

50. First - line pharmacotherapy for depression.
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
CHF - shock - and altered mental status
All - compartment fasciotomy for suspected compartment syndrome
SSRIs