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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. Amenorrhea - bradycardia - and abnormal body image in a young female.
Sheehan's syndrome (postpartum pituitary necrosis)
Campylobacter
Crohn's disease
Anorexia

2. Acid - base disorder in pulmonary embolism.
Neisseria meningitidis
Infection - febrile seizures - trauma - idiopathic
SIADH due to stress
Hypoxia and hypocarbia

3. Infant mortality?
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
50 cc/hour
Prevalence
Klebsiella

4. Virus associated with aplastic anemia in patients with sickle cell anemia.
Colposcopy and endocervical curettage
Parvovirus B19
Beta- blockers - Ca2+ channel blockers - TCAs
Campylobacter

5. A middle - aged man presents with acute - onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis - and how did he get it? Treatment?
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Hashimoto's thyroiditis
Lyme disease - Ixodes tick - doxycycline
Pseudomonas

6. Nikolsky's sign.
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Bullous pemphigoid
MCP and PIP joints; DIP joints are spared
Pregnant women. Treat this group aggressively because of potential complications

7. Reed - Sternberg cells

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8. Medication given to accelerate fetal lung maturity.
Betamethasone or dexamethasone
Absence seizures
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Dressler's syndrome: fever - pericarditis - ? ESR

9. Treatment of SIADH?
Lung - breast - skin (melanoma) - kidney - GI tract
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Fluid restriction - demeclocycline
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse

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

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11. A 55-year - old man is diagnosed with prostate cancer. Treatment options?
Elevated ICP - RBCs - xanthochromia
Wait - surgical resection - radiation and/or androgen suppression
Sensitivity
Seborrheic dermatitis. Treat with antifungals

12. Aplastic crisis in sickle cell disease.
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Parvovirus B19
Streptococcus pneumoniae
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

13. Case - control study
Pregnant women. Treat this group aggressively because of potential complications
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Neither
Klebsiella

14. A 55-year - old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram - negative rods. What is the diagnosis?
Lung - breast - skin (melanoma) - kidney - GI tract
Cardiogenic shock
Paget's disease
Legionella pneumonia

15. Medications and viruses that ? aplastic anemia.
Neither
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Hypokalemia

16. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Surfactant deficiency
Identify cause; fluid and blood repletion
Contact dermatitis

17. Involuntary commitment or isolation for medical treatment may be undertaken For what reason?
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
ALS
Angina is new - is worsening - or occurs at rest
Salmonella

18. CSF findings with SAH.
Contact dermatitis
Retinoic acid
Elevated ICP - RBCs - xanthochromia
Lichen planus

19. Red plaques with silvery- white scales and sharp margins.
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Mycoplasma
Psoriasis
1

20. Honeycomb pattern on CXR. Diagnosis? Treatment?
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Neurofibromatosis 1
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Inevitable abortion

21. Ring - enhancing brain lesion on CT with seizures
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Beta- blockers - digoxin - calcium channel blockers
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Taenia solium (cysticercosis)

22. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Esophageal atresia with distal TEF (85%). Unable to pass NG tube

23. In which patients do you initiate colorectal cancer screening early?
Type II (proximal) RTA
The IR of a disease in a population exposed to a particular factor
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
Broca's aphasia. Frontal lobe - left MCA distribution

24. Name the organism:
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Bruton's X- linked agammaglobulinemia
Haemophilus ducreyi
Hypoxia and hypocarbia

25. Antidepressants associated with hypertensive crisis.
Pasteurella multocida
Clomiphene citrate
MAOIs
IgA nephropathy (Berger's disease)

26. Treatment for acute coronary syndrome.
Retinoic acid
Endometrial biopsy
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
TICS

27. Signs of neurogenic shock.
Hypotension and bradycardia
RSV bronchiolitis
Herpes simplex
Cirrhosis - CHF - nephritic syndrome

28. The most common cause of SAH.
Suspect retinoblastoma
Trauma; the second most common is berry aneurysm
Alopecia areata (autoimmune process)
Hashimoto's thyroiditis

29. Confusion - confabulation - ophthalmoplegia - ataxia.

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30. Perinatal mortality?

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31. Indications for surgical repair of abdominal aortic aneurysm.
1
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Central pontine myelinolysis
Pseudomonas

32. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Osteogenesis imperfecta
Immediate cardioversion
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Spinal stenosis

33. Testicular cancer associated with Beta- hCG - AFP.
Femoral hernia
Suspect ankylosing spondylitis. Check HLA- B27
Choriocarcinoma
Psoriasis

34. Test to rule out urethral injury.
Retrograde cystourethrogram
Mallory- Weiss
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Fluid restriction - demeclocycline

35. Associated with Propionibacterium acnes and changes in androgen levels.
Levodopa/carbidopa
Pheochromocytoma
Diphenhydramine or epinephrine 1:1000
Acne vulgaris

36. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Diverticulosis
Non - Hodgkin's lymphoma
Normal
Squamous cell carcinoma

37. Cross - sectional survey
RSV bronchiolitis
PT
Immediate cardioversion
Prevalence

38. A patient presents with weakness - nausea - vomiting - weight loss - and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
Nephritic syndrome
1
Hypertrophic cardiomyopathy
ALS

39. Treatment of cardiogenic shock.
Identify cause; pressors (e.g. - dobutamine)
CF or Hirschsprung's disease
Third - degree heart block
Metformin

40. The most common inherited hemolytic anemia.
Pheochromocytoma
Patient on dopamine antagonist
Menometrorrhagia
Hereditary spherocytosis

41. What is the metabolic syndrome?
Exercise stress treadmill with ECG
Rate control - rhythm conversion - and anticoagulation
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states

42. Supportive treatment for ARDS.
Continuous positive airway pressure
Endometrial biopsy
CHF - shock - and altered mental status
Ampulla of the oviduct

43. Four causes of microcytic anemia.
Distal radius (Colles' fracture)
Femoral hernia
Dissociative fugue
TICS

44. Side effects of corticosteroids.
Bullous pemphigoid
Phototherapy (mild) or exchange transfusion (severe)
Rett's disorder
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies

45. Therapy for polycystic ovarian syndrome.
Weight loss and OCPs
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Hypertension - bradycardia - and abnormal respirations
IV penicillin or ampicillin

46. Charcot's triad.
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
SCLC
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
E. coli O157:H7

47. Mortality rate?
Number of deaths per 1000 population
Continuous - painful vaginal bleeding
Phencyclidine hydrochloride (PCP) intoxication
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer

48. First - line treatment for otitis media.
Continuous - painful vaginal bleeding
Seminoma
Amoxicillin
Osteoarthritis

49. Nontender abdominal mass associated with elevated VMA and HVA.
S. aureus or S. epidermidis.
Nephritic syndrome
Streptococcus pneumoniae
Neuroblastoma

50. Causes of transudative effusion.
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Allergic interstitial nephritis
Huntington's disease
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots