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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. Medical treatment for hepatic encephalopathy.
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Colposcopy and endocervical curettage
? protein intake - lactulose - neomycin
Hypoparathyroidism

2. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
Regresses after menopause
Hypovolemic shock
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Sheehan's syndrome (postpartum pituitary necrosis)

3. Epidemics such as influenza
Higher prevalence
Neurofibromatosis 1
Higher incidence
MS

4. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Restrictive pulmonary disease
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Duchenne muscular dystrophy
Normal

5. After a minor fender bender - a man wears a neck brace and requests permanent disability.
Nephrotic syndrome
Coccidioidomycosis. Amphotericin B
Malingering
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations

6. Risk factors for DVT.

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7. Glomerulonephritis with hemoptysis.

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8. Shortest AP diameter of the pelvis.
Malingering
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Iatrogenic steroid administration. The second most common cause is Cushing's disease

9. Four characteristics of a nevus suggestive of melanoma.
Asymmetry - border irregularity - color variation - large diameter
Patent ductus arteriosus (PDA)
Menometrorrhagia
Chronic granulomatous disease

10. Fertility rate?
Wiskott - Aldrich syndrome
Number of live births per 1000 women 15-44 years of age
Type I (distal) RTA
Number of live births per 1000 population

11. The most common inherited hemolytic anemia.
Trauma - alcohol withdrawal - brain tumor
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Hereditary spherocytosis
Squamous cell carcinoma

12. Unopposed estrogen is contraindicated in which cancers?
Hypoparathyroidism
Absence seizures
Endometrial or estrogen receptor - breast cancer
Pseudomonas

13. Heinz bodies?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Nephritic syndrome
Choriocarcinoma
a - antagonists (phentolamine and phenoxybenzamine)

14. Diagnostic test for hereditary spherocytosis.
Elevated ICP - RBCs - xanthochromia
Nephrogenic diabetes insipidus (DI)
Parvovirus B19
Osmotic fragility test

15. Laparoscopic findings in endometriosis.

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16. Hyperphagia - hypersexuality - hyperorality - and hyperdocility.
Reaction formation
Number of deaths from 28 days to one year per 1000 live births
Type II (proximal) RTA
Kl

17. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Pregnant women. Treat this group aggressively because of potential complications
Neuroblastoma
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Trauma - alcohol withdrawal - brain tumor

18. Treatment for neuroleptic malignant syndrome.
Lesions of 1
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Dantrolene or bromocriptine

19. The most common pituitary tumor. Treatment?
Aseptic (viral) meningitis
Suspect retinoblastoma
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
RSV bronchiolitis

20. Relative risk?
Reaction formation
Neuroblastoma
The IR of a disease in a population exposed to a particular factor
Hypertrophic cardiomyopathy

21. Difference between Mallory- Weiss and Boerhaave tears.
Treat existing heart failure and replace the tricuspid valve
Oral or topical metronidazole
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Mallory- Weiss

22. Meningitis in infants. Causes? Treatment?
Stasis - hypercoagulability - endothelial damage
Endometriosis
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Hyperkalemia

23. True or false: Once patients sign a statement giving consent - they must continue treatment.
E. coli O157:H7
Prinzmetal's angina
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
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

24. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Distal radius (Colles' fracture)
Treat immediately. Consent is implied in emergency situations

25. Treatment for AML M3.
Retinoic acid
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Uremic syndrome seen in patients with renal failure
Klebsiella

26. The most common histology of bladder cancer.
Partial mole
Diphenhydramine or epinephrine 1:1000
Transitional cell carcinoma
The IR of a disease in a population exposed to a particular factor

27. The most common cause of postpartum hemorrhage.
Panic disorder
Hyperkalemia
M3
Uterine atony

28. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
B12 deficiency
< 7.0
Lead - time bias
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma

29. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Oral surgery
Kegel exercises - estrogen - pessaries for stress incontinence
< 7.0
Diverticulosis

30. Virus associated with aplastic anemia in patients with sickle cell anemia.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Haemophilus ducreyi
Parvovirus B19
Threatened abortion

31. Pure RBC aplasia.
Rate control with carotid massasge or other vagal stimulation
Suspect ankylosing spondylitis. Check HLA- B27
Varicella zoster
Diamond - Blackfan anemia

32. Microcytic anemia with ? serum iron - ? total iron - binding capacity (TIBC) - and normal or ? ferritin.
Lung - breast - skin (melanoma) - kidney - GI tract
Anemia of chronic disease
Uterine atony
Broca's aphasia. Frontal lobe - left MCA distribution

33. Name the organism:
Hypoparathyroidism
Toxoplasma gondii
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Nitroprusside

34. The most common form of nephritic syndrome.
Membranous glomerulonephritis
CA-125 and transvaginal ultrasound
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Anemia - thrombocytopenia - and acute renal failure

35. The diagnostic test for pulmonary embolism.
V/Q scan
Bladder rupture or urethral injury
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
Surfactant deficiency

36. Salicylate ingestion ? In What type of acid - base disorder?
Pheochromocytoma
Osteogenesis imperfecta
Anion gap acidosis and 1
Number of deaths per 1000 population

37. Asplenic patients are particularly susceptible to these organisms.
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Treat immediately. Consent is implied in emergency situations
Wait - surgical resection - radiation and/or androgen suppression
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)

38. Neutropenic nadir postchemotherapy.
Lung - breast - skin (melanoma) - kidney - GI tract
7-10 days
Uremic syndrome seen in patients with renal failure
Hypotension - distant heart sounds - and JVD

39. A crescent - shaped hyperdensity on CT that does not cross the midline.
Angina is new - is worsening - or occurs at rest
Hyperkalemia
Subdural hematoma
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. Treatment of hypovolemic shock.
Wiskott - Aldrich syndrome
Osgood - Schlatter disease
Precocious puberty
Identify cause; fluid and blood repletion

41. Tests to rule out shaken baby syndrome.
Hyperkalemia
Suspect retinoblastoma
Ophthalmologic exam - CT - and MRI
Clomiphene citrate

42. Difference between a cohort and a case - control study.
Diverticulosis
S. aureus or S. epidermidis.
Displacement
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

43. Causes of transudative effusion.
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Incidence and prevalence
Lichen planus
Lung - breast - skin (melanoma) - kidney - GI tract

44. Testicular cancer associated with Beta- hCG - AFP.
Highly sensitive for TB
Choriocarcinoma
Suspect retinoblastoma
Partial mole

45. Treatment for acetaminophen overdose.
N- acetylcysteine
? serum FSH
Nephritic syndrome
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy

46. Test to rule out urethral injury.
High TSH - low T4 - antimicrosomal antibodies
Retrograde cystourethrogram
Parainfluenza virus type 1
Number of deaths from 28 days to one year per 1000 live births

47. Ring - enhancing brain lesion on CT with seizures
Ulcerative colitis
Surfactant deficiency
Bacillus cereus
Taenia solium (cysticercosis)

48. Beck's triad for cardiac tamponade.
IV penicillin or ampicillin
Hypotension - distant heart sounds - and JVD
SIADH due to stress
Hypokalemia

49. Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
Glomerulonephritis/nephritic syndrome
Intraductal papilloma
Retinoic acid
Squamous cell carcinoma

50. Combined UMN and LMN disorder.
ALS
Salmonella
INH - penicillamine - hydralazine - procainamide
Patient on dopamine antagonist