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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. A 15-year - old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
Cirrhosis - CHF - nephritic syndrome
Hereditary spherocytosis
Sarcoidosis
No. Parental consent is not necessary for the medical treatment of pregnant minors

2. First - line treatment for otitis media.
Malingering
Amoxicillin
Oral surgery
High TSH - low T4 - antimicrosomal antibodies

3. A young patient with a family history of sudden death collapses and dies while exercising.
Cirrhosis - CHF - nephritic syndrome
Hypertrophic cardiomyopathy
Beta- hCG; the most common cause of amenorrhea is pregnancy
Osgood - Schlatter disease

4. Erythema migrans.
Prerenal
Herpes simplex
Lesion of 1
SSRIs

5. CSF findings:
Subarachnoid hemorrhage (SAH)
Paget's disease
Duodenal atresia
Rett's disorder

6. ? CO - ? PCWP - ? PVR.
Cardiogenic shock
M3
Acne vulgaris
Esophageal atresia with distal TEF (85%). Unable to pass NG tube

7. What is the metabolic syndrome?
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Pityriasis versicolor
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Glanzmann's thrombasthenia

8. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Restrictive pulmonary disease
Contact dermatitis
Number of live births per 1000 women 15-44 years of age
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.

9. Treatment for SVC syndrome.
Obstructive pulmonary disease (e.g. - asthma)
Fatigue and impending respiratory failure
Radiation
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation

10. First step in the management of a patient with acute GI bleed.
Alopecia areata (autoimmune process)
Salmonella
IV hydration and loop diuretics (furosemide)
Establish the ABCs

11. Treatment for atrial fibrillation.
Fluids and antibiotics
Alopecia areata (autoimmune process)
Colposcopy and endocervical curettage
Anticoagulation - rate control - cardioversion

12. Postnatal mortality?
Regression
Coccidioidomycosis. Amphotericin B
Number of deaths from 28 days to one year per 1000 live births
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements

13. The most common cause of SAH.
Pseudomonas
Normal
Asherman's syndrome
Trauma; the second most common is berry aneurysm

14. Term for heavy bleeding during and between menstrual periods.
Menometrorrhagia
Neuroleptic malignant syndrome
Mycobacterium tuberculosis
Number of deaths from 28 days to one year per 1000 live births

15. Method of calculating fluid repletion in burn patients.
IV benzodiazepine
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Parkland formula

16. Name the organism:
Parainfluenza virus type 1
ALS
Displacement
Sporothrix schenckii

17. Hypercholesterolemia treatment that ? flushing and pruritus.
Phencyclidine hydrochloride (PCP) intoxication
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Niacin

18. Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
Lesion of 1
Parvovirus B19
Rate control - rhythm conversion - and anticoagulation
Usually resolves spontaneously; may require IVIG and/or corticosteroids

19. Treatment of SIADH?
Fluid restriction - demeclocycline
E. coli O157:H7
1
Renal cell carcinoma (RCC)

20. Treatment for ventricular fibrillation.
Biliary tract obstruction
Elevated ICP - RBCs - xanthochromia
ARDS
Immediate cardioversion

21. A patient has ? vaginal discharge and petechial patches in the upper vagina and cervix.
Exercise stress treadmill with ECG
Trichomonas vaginitis
Pseudomonas
Clomiphene citrate

22. Drugs that slow AV node transmission.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Amoxicillin
Beta- blockers - digoxin - calcium channel blockers
105 bacteria/mL

23. Acid - base disorder in pulmonary embolism.
Rett's disorder
Hypoxia and hypocarbia
Regresses after menopause
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)

24. May be seen in children who are accused of inattention in class and confused with ADHD.
Absence seizures
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
IV penicillin or ampicillin
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones

25. Risk factors for pyelonephritis.
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Streptococcus pneumoniae
Antipsychotics (neuroleptic malignant syndrome)
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones

26. A patient continues to use cocaine after being in jail - losing his job - and not paying child support.
HGPRTase deficiency)
Substance abuse
Surfactant deficiency
Osgood - Schlatter disease

27. Name the defense mechanism:
Regression
Fluid restriction - demeclocycline
Coarctation of the aorta
Consider Fitz - Hugh - Curtis syndrome

28. Radiographic evidence of aortic disruption or dissection.
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Salmonella
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Murphy's sign - seen in acute cholecystitis

29. Name the organism:
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
TICS
Pseudomonas
Consider Fitz - Hugh - Curtis syndrome

30. Neonatal mortality?
The IR of a disease in a population exposed to a particular factor
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Colposcopy and endocervical curettage
Number of deaths from birth to 28 days per 1000 live births

31. A doctor refers a patient for an MRI at a facility he/she owns.
INH - penicillamine - hydralazine - procainamide
Fatigue and impending respiratory failure
Conflict of interest
False. Withdrawing and withholding life are the same from an ethical standpoint

32. Classic ultrasound and gross appearance of complete hydatidiform mole.

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33. Inflammatory disease of the colon with ? risk of colon cancer.
Ulcerative colitis
Ultrasound
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Glanzmann's thrombasthenia

34. A 25-year - old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.

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35. Signs of air embolism.
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Wegener's granulomatosis and Goodpasture's syndrome
A patient with chest trauma who was previously stable suddenly dies
Oral or topical metronidazole

36. Lab findings in Hashimoto's thyroiditis.
Febrile seizures (roseola infantum)
High TSH - low T4 - antimicrosomal antibodies
Number of deaths per 1000 population
Diverticulosis

37. Autoimmune complication occurring 2-4 weeks post - MI.

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38. CSF findings:
Anticoagulation - rate control - cardioversion
Femoral hernia
Squamous cell carcinoma
MS

39. Common symptoms associated with silent MIs.
7-10 days
Conduct disorder
'Chocolate cysts -' powder burns
CHF - shock - and altered mental status

40. Natural history of a leiomyoma.
Ultrasound
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
Higher prevalence
Regresses after menopause

41. Radiographic indications for surgery in patients with acute abdomen.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Establish the ABCs
Pityriasis rosea

42. The most common type of nephrolithiasis.
Calcium oxalate
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Anemia - thrombocytopenia - and acute renal failure
Elevated ICP - RBCs - xanthochromia

43. Microcytic anemia with ? serum iron - ? ferritin - and ? TIBC.
Oral or topical metronidazole
Iron overload; use deferoxamine
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Iron deficiency anemia

44. Charcot's triad.
Pseudogout
AP chest - AP/lateral C- spine - AP pelvis
Elevated ICP - RBCs - xanthochromia
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis

45. An agent that reverses the effects of heparin.
Wiskott - Aldrich syndrome
Protamine
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Hereditary spherocytosis

46. Premalignant lesion from sun exposure that can ? squamous cell carcinoma.
Rubella
Patient on dopamine antagonist
Cerebral berry aneurysms (AD PCKD)
Actinic keratosis

47. A woman who was abused as a child frequently feels outside of or detached from her body.
Type IV (distal) RTA
Depersonalization disorder
Beta- blockers - digoxin - calcium channel blockers
ACEI

48. A 25-year - old African - American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Lyme disease - Ixodes tick - doxycycline
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
O2 - analgesia - hydration - and - if severe - transfusion

49. 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?
Naloxone
Highly sensitive for TB
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Subarachnoid hemorrhage (SAH)

50. CSF findings:
CHF - shock - and altered mental status
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Bacterial meningitis
No. Parental consent is not necessary for the medical treatment of pregnant minors