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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. Causes of hypoxemia.
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
BP > 140/90 on three separate occasions two weeks apart
Neuroblastoma
Niacin

2. Inflammatory disease of the colon with ? risk of colon cancer.
Varicella zoster
Levodopa/carbidopa
Ulcerative colitis
Intussusception

3. Hyperphagia - hypersexuality - hyperorality - and hyperdocility.
Kl
Basal cell carcinoma
Low - voltage - diffuse ST- segment elevation
TICS

4. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
Isolation
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Nephrotic syndrome
RCC or other erythropoietin - producing tumor; evaluate with CT scan

5. Diagnostic test for hypertrophic cardiomyopathy.
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
Seborrheic keratosis
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant

6. Proteinuria - hypoalbuminemia - hyperlipidemia - hyperlipiduria - edema.
Naloxone
Suspect ankylosing spondylitis. Check HLA- B27
CF or Hirschsprung's disease
Nephrotic syndrome

7. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
The IR of a disease in a population exposed to a particular factor
68% - 95.5% - 99.7%
False. Withdrawing and withholding life are the same from an ethical standpoint
Pseudomonas

8. Medication to avoid in patients with a history of alcohol withdrawal seizures.
CML
E. coli O157:H7
Toxoplasma gondii
Neuroleptics

9. A 13-year - old male has a history of theft - vandalism - and violence toward family pets.
Conduct disorder
Nephrotic syndrome
Headache
Diamond - Blackfan anemia

10. Classic ultrasound and gross appearance of complete hydatidiform mole.

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11. CSF findings:
Fluid restriction - demeclocycline
Guillain - Barr
Neisseria meningitidis
Subarachnoid hemorrhage (SAH)

12. Medication used to induce ovulation.
INH - penicillamine - hydralazine - procainamide
DI
Clomiphene citrate
Identify cause; pressors (e.g. - dobutamine)

13. What is the immunodeficiency?

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14. The most common histology of bladder cancer.
30 cc/hour
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Transitional cell carcinoma
Amoxicillin

15. Lung cancer highly related to cigarette exposure.
Prinzmetal's angina
SCLC
Agranulocytosis
Alopecia areata (autoimmune process)

16. T- wave flattening and U waves.
Prinzmetal's angina
AP chest - AP/lateral C- spine - AP pelvis
Asymmetry - border irregularity - color variation - large diameter
Hypokalemia

17. The 6 P's of ischemia due to peripheral vascular disease.
V/Q scan
Antipsychotics (neuroleptic malignant syndrome)
Reaction formation
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia

18. Chromosomal pattern of a complete mole.
Hyperkalemia
Streptococcus pneumoniae
1
46 -XX

19. Endocarditis prophylaxis regimens.
Seventy percent if the stenosis is symptomatic
Edrophonium
Oral surgery
Number of live births per 1000 population

20. PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific?
Out
BP > 140/90 on three separate occasions two weeks apart
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Highly sensitive for TB

21. Four signs and symptoms of streptococcal pharyngitis.
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Seminoma
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Phototherapy (mild) or exchange transfusion (severe)

22. A 49-year - old male presents with acute - onset flank pain and hematuria.
Betamethasone or dexamethasone
Agranulocytosis
Lyme disease - Ixodes tick - doxycycline
Nephrolithiasis

23. Identify key organisms causing diarrhea:
30 cc/hour
Clomiphene citrate
Yersinia
Selective IgA deficiency

24. The three most common causes of fever of unknown origin (FUO).
Hypoxia and hypocarbia
Infection - cancer - and autoimmune disease
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Asymmetry - border irregularity - color variation - large diameter

25. A 30-year - old woman has unpredictable urine loss. Examination is normal. Medical options?
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.

26. The number of bacterial culture on a clean - catch specimen to diagnose a UTI.
Osteogenesis imperfecta
S. aureus
Parainfluenza virus type 1
105 bacteria/mL

27. Drowsiness - asterixis - nausea - and a pericardial friction rub.
IgA nephropathy (Berger's disease)
Herpes simplex
Uremic syndrome seen in patients with renal failure
Reaction formation

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

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29. The most common inherited cause of hypercoagulability.
OCPs - danazol - GnRH agonists
Factor V Leiden mutation
Multiple myeloma
Anticoagulation - rate control - cardioversion

30. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Kegel exercises - estrogen - pessaries for stress incontinence
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies

31. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Third - degree heart block
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
HIDA scan
Contact dermatitis

32. Lab findings in Hashimoto's thyroiditis.
Fluids and antibiotics
High TSH - low T4 - antimicrosomal antibodies
Murphy's sign - seen in acute cholecystitis
Aseptic (viral) meningitis

33. Treatment for TTP.
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Nephritic syndrome
Signs and symptoms of hypercalcemia
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

34. Evaluation of a pulsatile abdominal mass and bruit.
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Abdominal ultrasound and CT
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis

35. Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow - up evaluation?
Hereditary spherocytosis
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Colposcopy and endocervical curettage
Graves' disease

36. Bone is fractured in fall on outstretched hand.

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37. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Treat immediately. Consent is implied in emergency situations
Postinfectious glomerulonephritis
Broca's aphasia. Frontal lobe - left MCA distribution
Colposcopy and endocervical curettage

38. Flat - topped papules.
Patent ductus arteriosus (PDA)
MCP and PIP joints; DIP joints are spared
Lichen planus
Pseudomonas

39. Name the defense mechanism:
Chronic granulomatous disease
Isolation
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
S. aureus or S. epidermidis.

40. Lab values suggestive of menopause.
Check for ? ICP; look for papilledema
? serum FSH
Sarcoidosis
Actinic keratosis

41. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
30 cc/hour
Frotteurism (a paraphilia)
Bruton's X- linked agammaglobulinemia

42. Treatment of DKA.
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Choriocarcinoma
? serum FSH

43. Virchow's triad.
Murphy's sign - seen in acute cholecystitis
Number of deaths from birth to 28 days per 1000 live births
Stasis - hypercoagulability - endothelial damage
Third - degree heart block

44. What should always be done prior to LP?
Check for ? ICP; look for papilledema
Threatened abortion
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Iron overload; use deferoxamine

45. Natural history of a leiomyoma.
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Cellulitis
Regresses after menopause
DM - SLE - and amyloidosis

46. Honeycomb pattern on CXR. Diagnosis? Treatment?
Neisseria meningitidis
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Infection - cancer - and autoimmune disease
Bullous pemphigoid

47. The most common cause of postpartum hemorrhage.
Seborrheic keratosis
Uterine atony
Endometrial biopsy
Flumazenil

48. Precipitants of hemolytic crisis in patients with G6PD deficiency.
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Sulfonamides - antimalarial drugs - fava beans
Oral surgery
Phototherapy (mild) or exchange transfusion (severe)

49. What is the immunodeficiency?
Nephritic syndrome
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
SCLC
Wiskott - Aldrich syndrome

50. Name the defense mechanism:
Ophthalmologic exam - CT - and MRI
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Displacement
Patent ductus arteriosus (PDA)