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. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
Endometrial biopsy
Hypovolemic shock
Anticoagulation - rate control - cardioversion
Diphenhydramine or epinephrine 1:1000


2. Low urine specific gravity in the presence of high serum osmolality.
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Neisseria meningitidis
Acne vulgaris
DI


3. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Nephrolithiasis
Pheochromocytoma
Anorexia
Benzodiazepines


4. Unilateral - severe periorbital headache with tearing and conjunctival erythema.
N- acetylcysteine
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Cluster headache
Administration of DDAVP ? serum osmolality and free water restriction


5. If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status - then socioeconomic status is a _____.
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Third - degree heart block
Confounding variable
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy


6. Causes of hypoxemia.
Fluid restriction - demeclocycline
Acne vulgaris
Check for ? ICP; look for papilledema
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch


7. Causes of transudative effusion.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Anion gap acidosis and 1
Parainfluenza virus type 1


8. Arthritis - conjunctivitis - and urethritis in young men. Associated organisms?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


9. Associated with Propionibacterium acnes and changes in androgen levels.
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Febrile seizures (roseola infantum)
Acne vulgaris
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin


10. Treatment for TTP.
Precocious puberty
Abdominal ultrasound and CT
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms


11. A neonate has meconium ileus.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


12. Blood in the urethral meatus or high - riding prostate.
Precocious puberty
Mallory- Weiss
Bladder rupture or urethral injury
Iron overload; use deferoxamine


13. A condition associated with red 'currant - jelly' stools.
Klebsiella
Continuous positive airway pressure
Intussusception
Pityriasis rosea


14. Treatment for bacterial vaginosis.
Oral or topical metronidazole
No. Parental consent is not necessary for the medical treatment of pregnant minors
A patient's family cannot require that a doctor withhold information from the patient
N- acetylcysteine


15. Meningitis in neonates. Causes? Treatment?
Wiskott - Aldrich syndrome
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
DI
Hypocalcemia


16. Cohort study
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Pityriasis versicolor
Multiple myeloma
Incidence and prevalence


17. A patient continues to use cocaine after being in jail - losing his job - and not paying child support.
Substance abuse
Immediate cardioversion
Mycoplasma
Uremic syndrome seen in patients with renal failure


18. Number needed to treat?
Fluid restriction - demeclocycline
They can mask symptoms of hypoglycemia
Campylobacter
1


19. Which healthy population is susceptible to UTIs?
Cluster headache
Pregnant women. Treat this group aggressively because of potential complications
OCPs
Respiratory alkalosis


20. Name the defense mechanism:
Depersonalization disorder
HBV immunoglobulin
Isolation
Niacin


21. Life - threatening muscle rigidity - fever - and rhabdomyolysis.
Neuroleptic malignant syndrome
Betamethasone or dexamethasone
CA-125 and transvaginal ultrasound
Agranulocytosis


22. After a minor fender bender - a man wears a neck brace and requests permanent disability.
Benzodiazepines
Malingering
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer


23. Risk factors for pyelonephritis.
High TSH - low T4 - antimicrosomal antibodies
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Frotteurism (a paraphilia)


24. Indications for surgical repair of abdominal aortic aneurysm.
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
IgA nephropathy (Berger's disease)
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Impetigo


25. Epidemics such as influenza
Higher incidence
Bacillus cereus
Parkinson's disease
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin


26. Administer to a symptomatic patient to diagnose myasthenia gravis.
Headache
Osteogenesis imperfecta
Edrophonium
IVIG or plasmapheresis


27. Signs of neurogenic shock.
Agranulocytosis
Identify cause; pressors (e.g. - dobutamine)
Hypotension and bradycardia
Calcium oxalate


28. A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
OCPs - danazol - GnRH agonists
Number of deaths per 1000 population
Parkland formula


29. A 55-year - old patient presents with acute 'broken speech.' What type of aphasia? What lobe and vascular distribution?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


30. Which of the following are ? in DIC: fibrin split products - D- dimer - fibrinogen - platelets - and hematocrit.
Incidence and prevalence
Uterine atony
S. aureus or S. epidermidis.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.


31. Lung cancer highly related to cigarette exposure.
Hypokalemia
SCLC
Impetigo
Legionella pneumonia


32. A significant cause of morbidity in thalassemia patients. Treatment?
Lead - time bias
Selective IgA deficiency
Iron overload; use deferoxamine
Pulsus paradoxus (seen in cardiac tamponade)


33. A child has loss of red light reflex. Diagnosis?
Impetigo
Neuroleptic malignant syndrome
ARDS
Suspect retinoblastoma


34. Treatment for opioid overdose.
Identify cause; pressors (e.g. - dobutamine)
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Naloxone
Osgood - Schlatter disease


35. Name the organism:
Inevitable abortion
Pseudomonas
Kwashiorkor (protein malnutrition)
< 7.0


36. Complication of overly rapid correction of hyponatremia.
Confounding variable
Central pontine myelinolysis
Trauma; the second most common is berry aneurysm
Parvovirus B19


37. CSF findings:
TICS
Bacterial meningitis
They can mask symptoms of hypoglycemia
Glanzmann's thrombasthenia


38. 'Doughy skin.'
Hypernatremia
Neither
Factitious disorder (Munchausen syndrome)
Bullous pemphigoid


39. Why are Beta- blockers contraindicated in diabetics?
Bladder rupture or urethral injury
Levodopa/carbidopa
Asymmetry - border irregularity - color variation - large diameter
They can mask symptoms of hypoglycemia


40. Classic CXR findings for pulmonary edema.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


41. Hypercholesterolemia treatment that ? flushing and pruritus.
Niacin
Neuroleptics
Anemia of chronic disease
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia


42. Trauma series.
AP chest - AP/lateral C- spine - AP pelvis
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
? protein intake - lactulose - neomycin
CA-125 and transvaginal ultrasound


43. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
? protein intake - lactulose - neomycin
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid


44. Identify key organisms causing diarrhea:
Salmonella
Reaction formation
Weight gain - type 2 DM - QT prolongation
Parainfluenza virus type 1


45. Gout - self - mutilation - and choreoathetosis.
HGPRTase deficiency)
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Iron deficiency anemia
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline


46. Treatment for atrial fibrillation.
Hypocalcemia
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
IV hydration and loop diuretics (furosemide)
Anticoagulation - rate control - cardioversion


47. Anemia associated with absent radii and thumbs - diffuse hyperpigmentation - caf

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


48. 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?
Hypokalemia
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Highly sensitive for TB
Klebsiella


49. Lab findings in Hashimoto's thyroiditis.
Kegel exercises - estrogen - pessaries for stress incontinence
Diphenhydramine or epinephrine 1:1000
High TSH - low T4 - antimicrosomal antibodies
'Sawtooth' P waves


50. Relative risk?
Endometrial or estrogen receptor - breast cancer
The IR of a disease in a population exposed to a particular factor
Hypernatremia
Bacillus cereus