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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. Bone is fractured in fall on outstretched hand.

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2. Charcot's triad.
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Nephrotic syndrome
Retrograde cystourethrogram
Uterine atony

3. Acceptable urine output in a trauma patient.
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
50 cc/hour
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Salmonella

4. Name the organism:
Cerebral berry aneurysms (AD PCKD)
OCPs - danazol - GnRH agonists
Vibrio - HAV
Klebsiella

5. The most common inherited hemolytic anemia.
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
CA-125 and transvaginal ultrasound
Hereditary spherocytosis
Iron deficiency anemia

6. A 35-year - old male has recurrent episodes of palpitations - diaphoresis - and fear of going crazy.
Panic disorder
Erythema multiforme
Regression
O2 - analgesia - hydration - and - if severe - transfusion

7. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Postinfectious glomerulonephritis
Broca's aphasia. Frontal lobe - left MCA distribution
Menometrorrhagia
Varicella zoster

8. Unilateral - severe periorbital headache with tearing and conjunctival erythema.
Patient on dopamine antagonist
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Cluster headache
Parvovirus B19

9. A fall in systolic BP of > 10 mmHg with inspiration.
Factitious disorder (Munchausen syndrome)
Pulsus paradoxus (seen in cardiac tamponade)
Oral or topical metronidazole
Benzodiazepines

10. Treatment for acute coronary syndrome.
Substance abuse
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
All - compartment fasciotomy for suspected compartment syndrome
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin

11. 'Dewdrop on a rose petal.'
Lesions of 1
Septic or anaphylactic shock
Abdominal ultrasound and CT
68% - 95.5% - 99.7%

12. Classic ECG finding in atrial flutter.

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13. Rigidity and stiffness that progress to choreiform movements - accompanied by moodiness and altered behavior.

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14. RTA associated with aldosterone defect.
Menometrorrhagia
Frotteurism (a paraphilia)
Cirrhosis - CHF - nephritic syndrome
Type IV (distal) RTA

15. Name the organism:
Hypertrophic cardiomyopathy
Type II (proximal) RTA
Haemophilus ducreyi
Clostridium difficile

16. After a minor fender bender - a man wears a neck brace and requests permanent disability.
Uremic syndrome seen in patients with renal failure
Consider Fitz - Hugh - Curtis syndrome
Malingering
Lung - breast - skin (melanoma) - kidney - GI tract

17. Symptoms of placental abruption.
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
Continuous - painful vaginal bleeding
HIDA scan
Number of live births per 1000 population

18. A newborn female has continuous 'machinery murmur.'
Postinfectious glomerulonephritis
Patent ductus arteriosus (PDA)
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones

19. Shortest AP diameter of the pelvis.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Menometrorrhagia
CA-125 and transvaginal ultrasound
Lesion of 1

20. Chronic diseases such as SLE
Endometriosis
Contact dermatitis
Higher prevalence
Crohn's disease

21. Medical options for endometriosis.
Type II (proximal) RTA
Angina - ST- segment changes on ECG - or ? BP
OCPs - danazol - GnRH agonists
Precocious puberty

22. 'Stuck - on' appearance.
Rate control with carotid massasge or other vagal stimulation
Osgood - Schlatter disease
Seborrheic keratosis
Consider Fitz - Hugh - Curtis syndrome

23. Attributable risk?
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Ophthalmologic exam - CT - and MRI

24. Identify key organisms causing diarrhea:
Legionella pneumonia
Clostridium difficile
Coccidioidomycosis. Amphotericin B
Varicella zoster

25. A 20-year - old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?
Naloxone
Cerebral berry aneurysms (AD PCKD)
Glanzmann's thrombasthenia
IV penicillin or ampicillin

26. When can a physician refuse to continue treating a patient on the grounds of futility?
Ophthalmologic exam - CT - and MRI
Bruton's X- linked agammaglobulinemia
When there is no rationale for treatment - maximal intervention is failing - a given intervention has already failed - and treatment will not achieve the goals of care
INH - penicillamine - hydralazine - procainamide

27. Neutropenic nadir postchemotherapy.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Bullous pemphigoid
7-10 days
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)

28. A patient presents with recent PID with RUQ pain.
PT
Number of deaths from birth to 28 days per 1000 live births
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Consider Fitz - Hugh - Curtis syndrome

29. 1
Placental abruption and placenta previa
PT
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Self - limited - painless vaginal bleeding

30. The most common 1
Multiple myeloma
Duodenal atresia
MCP and PIP joints; DIP joints are spared
Obstructive pulmonary disease (e.g. - asthma)

31. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
Phototherapy (mild) or exchange transfusion (severe)
Elevated ICP - RBCs - xanthochromia
ARDS
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7

32. Key side effects of atypical antipsychotics.
Uterine atony
Respiratory alkalosis
Weight gain - type 2 DM - QT prolongation
Highly sensitive for TB

33. A patient presents with signs of hypocalcemia - high phosphorus - and low PTH.
Glomerulonephritis/nephritic syndrome
Hypoparathyroidism
? Ca2+ - ? K- - ? phosphate - ? uric acid
Seventy percent if the stenosis is symptomatic

34. Identify key organisms causing diarrhea:
Hodgkin's lymphoma
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
Edrophonium
E. coli O157:H7

35. Bilious emesis within hours after the first feeding.
Conversion disorder
Asherman's syndrome
Lichen planus
Duodenal atresia

36. The most common causes of hypercalcemia.
Contact dermatitis
Malignancy and hyperparathyroidism
Conversion disorder
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed

37. 'Doughy skin.'
Osgood - Schlatter disease
68% - 95.5% - 99.7%
BP > 140/90 on three separate occasions two weeks apart
Hypernatremia

38. How to diagnose and follow a leiomyoma.
Ultrasound
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Vibrio - HAV

39. Name the organism:
Streptococcus pneumoniae
Malingering
'Sawtooth' P waves
'Chocolate cysts -' powder burns

40. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
HIDA scan
Higher prevalence
E. coli O157:H7
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful

41. Presence of red cell casts in urine sediment.
Glomerulonephritis/nephritic syndrome
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Clomiphene citrate
Basal cell carcinoma

42. Indications for surgical repair of abdominal aortic aneurysm.
Sulfonamides - antimalarial drugs - fava beans
High TSH - low T4 - antimicrosomal antibodies
Hypocalcemia
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured

43. The most common 1
Pregnant women. Treat this group aggressively because of potential complications
Selective IgA deficiency
Stasis - hypercoagulability - endothelial damage
Substance abuse

44. Identify key organisms causing diarrhea:
Seborrheic keratosis
Giardia
Actinic keratosis
Hypernatremia

45. Test to rule out urethral injury.
Oral or topical metronidazole
Retrograde cystourethrogram
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Number of deaths from 20 weeks' gestation to birth per 1000 total births

46. Premalignant lesion from sun exposure that can ? squamous cell carcinoma.
Actinic keratosis
Lichen sclerosus
Erythema multiforme
Betamethasone or dexamethasone

47. Vaccinations at a six- month well - child visit.
Parvovirus B19
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
HBV - DTaP - Hib - IPV - PCV
Retrograde cystourethrogram

48. Relative risk?
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
The IR of a disease in a population exposed to a particular factor
Lesion of 1
Psoriasis

49. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Osteogenesis imperfecta
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Squamous cell carcinoma
RSV bronchiolitis

50. First step in the management of a patient with acute GI bleed.
Hypernatremia
Wait - surgical resection - radiation and/or androgen suppression
Establish the ABCs
Surfactant deficiency