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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. Associated with Propionibacterium acnes and changes in androgen levels.
Acne vulgaris
Lichen sclerosus
Multiple myeloma
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7

2. Exophthalmos - pretibial myxedema - and ? TSH.

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3. The most common type of nephrolithiasis.
Trichomonas vaginitis
Calcium oxalate
Acute pancreatitis
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.

4. Rhomboid - shaped - positively birefringent crystals on joint fluid aspirate.
Pseudogout
Nephritic syndrome
Lyme disease - Ixodes tick - doxycycline
Out

5. A patient presents with recent PID with RUQ pain.
Fluids and antibiotics
Graves' disease
Lobular carcinoma in situ
Consider Fitz - Hugh - Curtis syndrome

6. Treatment for benzodiazepine overdose.
Dressler's syndrome: fever - pericarditis - ? ESR
Flumazenil
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
SIADH due to stress

7. Shortest AP diameter of the pelvis.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Higher incidence
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

8. True or false: Withdrawing life - sustaining care is ethically distinct from withholding sustaining care.
The IR of a disease in a population exposed to a particular factor
Elevated ICP - RBCs - xanthochromia
False. Withdrawing and withholding life are the same from an ethical standpoint
Erythema multiforme

9. How to distinguish polycythemia vera from 2
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Sheehan's syndrome (postpartum pituitary necrosis)
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Bruton's X- linked agammaglobulinemia

10. Chronic diseases such as SLE
Neurofibromatosis 1
Higher prevalence
Angina - ST- segment changes on ECG - or ? BP
105 bacteria/mL

11. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Acute myelogenous leukemia (AML)
Contact dermatitis
Salmonella
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured

12. A 25-year - old African - American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
Fluids and antibiotics
Giardia
1
O2 - analgesia - hydration - and - if severe - transfusion

13. Antidepressants associated with hypertensive crisis.
IV hydration and loop diuretics (furosemide)
Acne vulgaris
MAOIs
Ampulla of the oviduct

14. A five - month - old girl has ? head growth - truncal dyscoordination - and ? social interaction.

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15. Name the organism:
Pseudomonas
Legionella pneumonia
Duodenal atresia
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones

16. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
Never
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Biliary tract obstruction
Threatened abortion

17. Class of drugs that may cause syndrome of muscle rigidity - hyperthermia - autonomic instability - and extrapyramidal symptoms.
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Alport's syndrome
Antipsychotics (neuroleptic malignant syndrome)
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.

18. Complication of overly rapid correction of hyponatremia.
E. coli O157:H7
Fatigue and impending respiratory failure
Central pontine myelinolysis
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid

19. Risk factors for pyelonephritis.
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Erythema multiforme
BP > 140/90 on three separate occasions two weeks apart
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin

20. Lab findings in Hashimoto's thyroiditis.
High TSH - low T4 - antimicrosomal antibodies
Identify cause; pressors (e.g. - dobutamine)
Beta- blockers - Ca2+ channel blockers - TCAs
Conduct disorder

21. Appropriate diagnostic test?
Asymmetry - border irregularity - color variation - large diameter
Sulfonamides - antimalarial drugs - fava beans
V/Q scan
Exercise stress treadmill with ECG

22. First step in the management of a patient with acute GI bleed.
Establish the ABCs
Substance abuse
Osgood - Schlatter disease
Acute pancreatitis

23. Virchow's triad.
Seborrheic dermatitis. Treat with antifungals
Prerenal
Stasis - hypercoagulability - endothelial damage
Benzodiazepines

24. Auer rods on blood smear.
Acute myelogenous leukemia (AML)
Neisseria meningitidis
Parkinson's disease
Placental abruption and placenta previa

25. The 6 P's of ischemia due to peripheral vascular disease.
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Clomiphene citrate
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Parainfluenza virus type 1

26. + Nikolsky's sign.
Pemphigus vulgaris
Coarctation of the aorta
Cerebral berry aneurysms (AD PCKD)
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states

27. The most common pituitary tumor. Treatment?
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Nephrotic syndrome
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism

28. Defect in an X- linked syndrome with mental retardation -
Lesch - Nyhan syndrome (purine salvage problem with
Hodgkin's lymphoma
Hypertrophic cardiomyopathy
Iatrogenic steroid administration. The second most common cause is Cushing's disease

29. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Osgood - Schlatter disease
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Duchenne muscular dystrophy
Wegener's granulomatosis and Goodpasture's syndrome

30. Treatment for DTs.
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Benzodiazepines
Crohn's disease
Subarachnoid hemorrhage (SAH)

31. The most common causes of hypercalcemia.
Malignancy and hyperparathyroidism
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Actinic keratosis
Ophthalmologic exam - CT - and MRI

32. Treatment for acute coronary syndrome.
Cerebral berry aneurysms (AD PCKD)
Rate control with carotid massasge or other vagal stimulation
Dissociative fugue
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin

33. What is the immunodeficiency?
Paget's disease
Renal cell carcinoma (RCC)
High TSH - low T4 - antimicrosomal antibodies
Chronic granulomatous disease

34. Endocarditis prophylaxis regimens.
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
No. Parental consent is not necessary for the medical treatment of pregnant minors
Oral surgery
Angina is new - is worsening - or occurs at rest

35. Name the organism:
Actinomyces israelii
Sulfonamides - antimalarial drugs - fava beans
Chronic lymphocytic leukemia (CLL)
Colposcopy and endocervical curettage

36. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
Seborrheic keratosis
'Chocolate cysts -' powder burns
Diphenhydramine or epinephrine 1:1000
RCC or other erythropoietin - producing tumor; evaluate with CT scan

37. Sensitive tests have few false negatives and are used to rule _____ a disease.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Graves' disease
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Out

38. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Number of live births per 1000 women 15-44 years of age
Normal
Stasis - hypercoagulability - endothelial damage
Spinal stenosis

39. Treatment for neuroleptic malignant syndrome.
Dantrolene or bromocriptine
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Osgood - Schlatter disease
Kwashiorkor (protein malnutrition)

40. Identify key organisms causing diarrhea:
Parkinson's disease
Elevated ICP - RBCs - xanthochromia
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Lesions of 1

41. Treatment of DKA.
SIADH due to stress
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Femoral hernia
Conflict of interest

42. Medications and viruses that ? aplastic anemia.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Partial mole
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Factor V Leiden mutation

43. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
ARDS
Lichen planus
1
Anion gap acidosis and 1

44. RTA associated with aldosterone defect.
Type IV (distal) RTA
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Conduct disorder
Seminoma

45. Inflammatory disease of the colon with ? risk of colon cancer.
Sarcoidosis
Ulcerative colitis
Pulsus paradoxus (seen in cardiac tamponade)
Lesion of 1

46. The most common cause of hypertension in young women.
Ophthalmologic exam - CT - and MRI
OCPs
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Number of deaths from 20 weeks' gestation to birth per 1000 total births

47. Cause of amenorrhea with normal prolactin - no response to estrogen - progesterone challenge - and a history of D&C.

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48. Hematuria - flank pain - and palpable flank mass.
'Chocolate cysts -' powder burns
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Regression
Renal cell carcinoma (RCC)

49. A young patient has angina at rest with ST- segment elevation. Cardiac enzymes are normal.

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50. Odds ratio?
Endometriosis
Cirrhosis - CHF - nephritic syndrome
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
HBV immunoglobulin