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. The most common cause of hypothyroidism.

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2. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
E. coli O157:H7
Lobular carcinoma in situ
Absence seizures


3. Gout - self - mutilation - and choreoathetosis.
Trichomonas vaginitis
Choriocarcinoma
HGPRTase deficiency)
Type IV (distal) RTA


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

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5. Term for heavy bleeding during and between menstrual periods.
Pseudomonas
Sulfonamides - antimalarial drugs - fava beans
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Menometrorrhagia


6. Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
Immediate needle thoracostomy
CML
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Usually resolves spontaneously; may require IVIG and/or corticosteroids


7. Name the organism:
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Pseudomonas
Check for ? ICP; look for papilledema


8. Classic causes of drug - induced hepatitis.
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Hypocalcemia
ALS
a - antagonists (phentolamine and phenoxybenzamine)


9. Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
Kwashiorkor (protein malnutrition)
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
Number of live births per 1000 population
Osteoarthritis


10. RTA associated with aldosterone defect.
Squamous cell carcinoma
Erythema multiforme
Type IV (distal) RTA
Angina - ST- segment changes on ECG - or ? BP


11. First - line medication for status epilepticus.
Nephrotic syndrome
PT
IV benzodiazepine
Seminoma


12. The most common cause of hypertension in young men.
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
ETEC
Excessive EtOH
Emergent laparotomy to repair perforated viscus - likely stomach


13. Name the organism:
Check for ? ICP; look for papilledema
Salmonella
Lesions of 1
Agranulocytosis


14. Treatment for malignant hypertension.
Nitroprusside
Consider Fitz - Hugh - Curtis syndrome
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones


15. PFT showing ? FEV1/FVC.
Sporothrix schenckii
Angina - ST- segment changes on ECG - or ? BP
Restrictive pulmonary disease
Cluster headache


16. A newborn female has continuous 'machinery murmur.'
Amoxicillin
Patent ductus arteriosus (PDA)
HBV immunoglobulin
Malignancy and hyperparathyroidism


17. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
Dantrolene or bromocriptine
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Inevitable abortion
1


18. A violent patient has vertical and horizontal nystagmus.
Phencyclidine hydrochloride (PCP) intoxication
Subarachnoid hemorrhage (SAH)
Bladder rupture or urethral injury
Weight loss and OCPs


19. A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Threatened abortion
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Glanzmann's thrombasthenia
1


20. Radiographic indications for surgery in patients with acute abdomen.
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Osteogenesis imperfecta
ETEC
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)


21. Name the defense mechanism:
Weight loss and OCPs
Bladder rupture or urethral injury
Isolation
Lyme disease - Ixodes tick - doxycycline


22. 'Cradle cap.'
Seborrheic dermatitis. Treat with antifungals
Haemophilus ducreyi
a - antagonists (phentolamine and phenoxybenzamine)
Retrograde cystourethrogram


23. Infection of small airways with epidemics in winter and spring.
RSV bronchiolitis
Glanzmann's thrombasthenia
Glomerulonephritis/nephritic syndrome
Multiple myeloma


24. Chromosomal pattern of a complete mole.
1
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Neuroleptics
46 -XX


25. Treatment for TTP.
They can mask symptoms of hypoglycemia
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Partial mole
Rate control with carotid massasge or other vagal stimulation


26. Treatment of DKA.
Chronic lymphocytic leukemia (CLL)
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements


27. Treatment for bacterial vaginosis.
Incidence and prevalence
Malingering
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Oral or topical metronidazole


28. Common symptoms associated with silent MIs.
Bacillus cereus
Absence seizures
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
CHF - shock - and altered mental status


29. A crescent - shaped hyperdensity on CT that does not cross the midline.
Threatened abortion
Patent ductus arteriosus (PDA)
Subdural hematoma
Pseudogout


30. Infant mortality?
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
? serum FSH
Lobular carcinoma in situ
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis


31. Causes of transudative effusion.
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Osmotic fragility test
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Squamous cell carcinoma


32. Lab findings in Hashimoto's thyroiditis.
Kl
High TSH - low T4 - antimicrosomal antibodies
Type I (distal) RTA
Alopecia areata (autoimmune process)


33. The most common cause of SAH.
Trauma; the second most common is berry aneurysm
Pemphigus vulgaris
Neuroleptics
Murphy's sign - seen in acute cholecystitis


34. True or false: Withdrawing life - sustaining care is ethically distinct from withholding sustaining care.
Ultrasound
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
False. Withdrawing and withholding life are the same from an ethical standpoint
Osmotic fragility test


35. Name the organism:
7-10 days
Nephrogenic diabetes insipidus (DI)
Actinomyces israelii
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births


36. Reynolds' pentad.

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37. After a minor fender bender - a man wears a neck brace and requests permanent disability.
Hodgkin's lymphoma
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Malingering
Cardiogenic shock


38. The most serious side effect of clozapine.
Abdominal ultrasound and CT
Agranulocytosis
Number of live births per 1000 women 15-44 years of age
Neither


39. A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
E. coli O157:H7
Alport's syndrome


40. Cold agglutinins.
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Glomerulonephritis/nephritic syndrome
Type II (proximal) RTA
Mycoplasma


41. The diagnostic test for pulmonary embolism.
Suspect ankylosing spondylitis. Check HLA- B27
V/Q scan
Incidence and prevalence
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births


42. Bone is fractured in fall on outstretched hand.

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43. Three systemic diseases ? nephrotic syndrome.
DM - SLE - and amyloidosis
Hodgkin's lymphoma
Renal cell carcinoma (RCC)
Confounding variable


44. Risk factors for pyelonephritis.
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Bullous pemphigoid
Taenia solium (cysticercosis)
Alport's syndrome


45. The most common form of glomerulonephritis.

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46. The most frequent presentation of intracranial neoplasm.
Neurofibromatosis 1
Headache
Mycobacterium tuberculosis
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births


47. Treatment for benzodiazepine overdose.
Flumazenil
Patent ductus arteriosus (PDA)
Graves' disease
Mycoplasma


48. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Hypertension - bradycardia - and abnormal respirations
M3
Cerebral berry aneurysms (AD PCKD)
Frotteurism (a paraphilia)


49. Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
B12 deficiency
Pemphigus vulgaris
Spinal stenosis


50. Nontender abdominal mass associated with elevated VMA and HVA.
Coccidioidomycosis. Amphotericin B
Actinic keratosis
Neuroblastoma
Nephritic syndrome