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. Difference between Mallory- Weiss and Boerhaave tears.
Stasis - hypercoagulability - endothelial damage
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Hypotension and bradycardia
Mallory- Weiss


2. A patient fails to lactate after an emergency C- section with marked blood loss.

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3. Hematuria - hypertension - and oliguria.
Rett's disorder
Parvovirus B19
Nephritic syndrome
TICS


4. The most common histology of bladder cancer.
Type II (proximal) RTA
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Reaction formation
Transitional cell carcinoma


5. Test to rule out urethral injury.
Anemia of chronic disease
Retrograde cystourethrogram
Pseudomonas
DI


6. What is the immunodeficiency?
Central pontine myelinolysis
Pasteurella multocida
Chronic granulomatous disease
Oral or topical metronidazole


7. Albuminocytologic dissociation.
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
A patient's family cannot require that a doctor withhold information from the patient
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Guillain - Barr


8. Treatment of hypovolemic shock.
Hypoxia and hypocarbia
Iron deficiency anemia
Dantrolene or bromocriptine
Identify cause; fluid and blood repletion


9. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Consider Fitz - Hugh - Curtis syndrome
Basal cell carcinoma
Number of deaths from birth to 28 days per 1000 live births
Osgood - Schlatter disease


10. Treatment for acute coronary syndrome.
Hypoxia and hypocarbia
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Klebsiella
OCP and barrier contraception


11. Signs of air embolism.
A patient with chest trauma who was previously stable suddenly dies
Cirrhosis - CHF - nephritic syndrome
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Fatigue and impending respiratory failure


12. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Contact dermatitis
Infection - febrile seizures - trauma - idiopathic
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing


13. Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
Spinal stenosis
Higher prevalence
Hypokalemia
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin


14. Case - control study
Hypotension and bradycardia
Neither
The IR of a disease in a population exposed to a particular factor
Wiskott - Aldrich syndrome


15. A fall in systolic BP of > 10 mmHg with inspiration.
Factor V Leiden mutation
Pulsus paradoxus (seen in cardiac tamponade)
Rate control - rhythm conversion - and anticoagulation
Self - limited - painless vaginal bleeding


16. Chronic diseases such as SLE
Edrophonium
Higher prevalence
Osteoarthritis
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states


17. Galactorrhea - impotence - menstrual dysfunction - and ? libido.
Patient on dopamine antagonist
Identify cause; pressors (e.g. - dobutamine)
Acne vulgaris
Isolation


18. Name the defense mechanism:
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Consider Fitz - Hugh - Curtis syndrome
Displacement
Treat because the disease represents an immediate threat to the child's life. Then seek a court order


19. The most common cancer in men and the most common cause of death from cancer in men.
Number of deaths from birth to 28 days per 1000 live births
Wait - surgical resection - radiation and/or androgen suppression
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Prerenal


20. Name the organism:
Legionella pneumonia
E. coli O157:H7
Seminoma
Pseudomonas


21. Symptoms of placenta previa.
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Self - limited - painless vaginal bleeding
Reye's syndrome
30 cc/hour


22. Perinatal mortality?

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23. Causes of hypoxemia.
Dressler's syndrome: fever - pericarditis - ? ESR
Klebsiella
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch


24. An 11-year - old obese - African - American boy presents with sudden onset of limp. Diagnosis? Workup?
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Substance abuse
MAOIs
Hypernatremia


25. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Anorexia
Lung - breast - skin (melanoma) - kidney - GI tract
IVIG or plasmapheresis
Duchenne muscular dystrophy


26. Charcot's triad.
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Paget's disease
Ulcerative colitis
Pseudomonas


27. First - line treatment for otitis media.
Amoxicillin
Identify cause; fluid and blood repletion
They can mask symptoms of hypoglycemia
Klebsiella


28. Acceptable urine output in a trauma patient.
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
50 cc/hour
Highly sensitive for TB
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed


29. First - line medication for status epilepticus.
Out
Squamous cell carcinoma
IV benzodiazepine
Angina - ST- segment changes on ECG - or ? BP


30. A 24-year - old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
Inevitable abortion
SIADH due to stress
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Anion gap acidosis and 1


31. Pure RBC aplasia.
Avascular necrosis
Diamond - Blackfan anemia
Hyperkalemia
Higher incidence


32. A postoperative patient with significant pain presents with hyponatremia and normal volume status.
Check for ? ICP; look for papilledema
SIADH due to stress
Identify cause; pressors (e.g. - dobutamine)
Anemia of chronic disease


33. Postnatal mortality?
Inhaled Beta- agonists and inhaled corticosteroids
Number of deaths from 28 days to one year per 1000 live births
Lichen planus
Cerebral berry aneurysms (AD PCKD)


34. How to diagnose and follow a leiomyoma.
Non - Hodgkin's lymphoma
Ultrasound
Basal cell carcinoma
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy


35. The number of bacterial culture on a clean - catch specimen to diagnose a UTI.
Osteogenesis imperfecta
Frotteurism (a paraphilia)
IV penicillin or ampicillin
105 bacteria/mL


36. Four causes of microcytic anemia.
46 -XX
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Crohn's disease
TICS


37. Low urine specific gravity in the presence of high serum osmolality.
DI
Clostridium difficile
No. Parental consent is not necessary for the medical treatment of pregnant minors
Patent ductus arteriosus (PDA)


38. Identify key organisms causing diarrhea:
Obstructive pulmonary disease (e.g. - asthma)
Observational bias
Identify cause; fluid and blood repletion
Vibrio - HAV


39. Medical treatment for hepatic encephalopathy.
M3
Pseudomonas
? protein intake - lactulose - neomycin
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides


40. The diagnostic test for pulmonary embolism.
Asymmetry - border irregularity - color variation - large diameter
V/Q scan
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
ALS


41. The most common cause of SAH.
Varicella zoster
Trauma; the second most common is berry aneurysm
Identify cause; pressors (e.g. - dobutamine)
Inhaled Beta- agonists and inhaled corticosteroids


42. A neonate has meconium ileus.

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43. 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?
Osgood - Schlatter disease
Trauma; the second most common is berry aneurysm
Legionella pneumonia
Parvovirus B19


44. The most common pathogen causing croup.
Parainfluenza virus type 1
Taenia solium (cysticercosis)
The IR of a disease in a population exposed to a particular factor
Osteogenesis imperfecta


45. Gout - self - mutilation - and choreoathetosis.
Anemia - thrombocytopenia - and acute renal failure
HGPRTase deficiency)
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
ACEI


46. A 'blueberry muffin' rash is characteristic of what congenital infection?
Actinic keratosis
Rubella
Intussusception
Sporothrix schenckii


47. The most serious side effect of clozapine.
Parainfluenza virus type 1
Agranulocytosis
They can mask symptoms of hypoglycemia
Depersonalization disorder


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

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49. A four -year - old child presents with oliguria - petechiae - and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
Parvovirus B19
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Alzheimer's and multi - infarct
Febrile seizures (roseola infantum)


50. A son asks that his mother not be told about her recently discovered cancer.

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