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. Low urine specific gravity in the presence of high serum osmolality.
Seborrheic dermatitis. Treat with antifungals
Hodgkin's lymphoma
DI
PT


2. A man unexpectedly flies across the country - takes a new name - and has no memory of his prior life.
Hypokalemia
Dissociative fugue
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Spinal stenosis


3. RTA associated with abnormal HCO3 - and rickets.
Pregnant women. Treat this group aggressively because of potential complications
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Type II (proximal) RTA
Pseudomonas


4. Name the organism:
Acute pancreatitis
Actinomyces israelii
Self - limited - painless vaginal bleeding
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch


5. Maternal mortality?
ARDS
High TSH - low T4 - antimicrosomal antibodies
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Osteogenesis imperfecta


6. Dermatomal distribution.
Varicella zoster
Regresses after menopause
7-10 days
Hypoxia and hypocarbia


7. Rigidity and stiffness with resting tremor and masked facies.

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8. The coagulation parameter affected by warfarin.
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
PT
Coccidioidomycosis. Amphotericin B
Alport's syndrome


9. The mainstay of Parkinson's therapy.
A patient with chest trauma who was previously stable suddenly dies
High TSH - low T4 - antimicrosomal antibodies
Levodopa/carbidopa
Higher incidence


10. Differential of hypervolemic hyponatremia.
Cirrhosis - CHF - nephritic syndrome
Coccidioidomycosis. Amphotericin B
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Lichen sclerosus


11. Patient presents with sudden onset of severe - diffuse abdominal pain. Exam reveals peritoneal signs and AXR reveals free air under the diaphragm. Management?
Suspect retinoblastoma
Emergent laparotomy to repair perforated viscus - likely stomach
Guillain - Barr
MS


12. Medication used to induce ovulation.
Incidence and prevalence
Clomiphene citrate
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy


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

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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?
Osteogenesis imperfecta
Suspect retinoblastoma
Levodopa/carbidopa
Legionella pneumonia


15. Treatment for Guillain - Barr
Pasteurella multocida
IVIG or plasmapheresis
Edrophonium
Uremic syndrome seen in patients with renal failure


16. Treatment of central DI.
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Administration of DDAVP ? serum osmolality and free water restriction
Alzheimer's and multi - infarct
Malingering


17. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Radiation
Regresses after menopause
Osteogenesis imperfecta
'Chocolate cysts -' powder burns


18. Amenorrhea - bradycardia - and abnormal body image in a young female.
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Protamine
Legionella pneumonia
Anorexia


19. Characteristics of 2

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20. The most common histology of bladder cancer.
Suspect ankylosing spondylitis. Check HLA- B27
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Transitional cell carcinoma
Iron overload; use deferoxamine


21. Aplastic crisis in sickle cell disease.
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Parvovirus B19
Septic or anaphylactic shock
Cellulitis


22. Meningitis in neonates. Causes? Treatment?
Intraductal papilloma
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Seminoma
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


23. Proteinuria - hypoalbuminemia - hyperlipidemia - hyperlipiduria - edema.
Placental abruption and placenta previa
Nephrotic syndrome
Beta- blockers - Ca2+ channel blockers - TCAs
Pulsus paradoxus (seen in cardiac tamponade)


24. CSF findings:
Subarachnoid hemorrhage (SAH)
Never
S. aureus or S. epidermidis.
46 -XX


25. An elderly female presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ? ESR.
Polymyalgia rheumatica
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Lichen sclerosus
Rate control with carotid massasge or other vagal stimulation


26. Cross - sectional survey
Nitroprusside
Prevalence
Yersinia
Headache


27. Identify key organisms causing diarrhea:
Squamous cell carcinoma
Hypoxia and hypocarbia
Intussusception
Vibrio - HAV


28. The most common location for an ectopic pregnancy.
Ampulla of the oviduct
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Slipped capital femoral epiphyses. AP and frog - leg lateral view
OCP and barrier contraception


29. 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 _____.
Confounding variable
BP > 140/90 on three separate occasions two weeks apart
Hypotension - distant heart sounds - and JVD
Lichen sclerosus


30. Identify key organisms causing diarrhea:
IV penicillin or ampicillin
Clostridium difficile
ALS
Guillain - Barr


31. Glomerulonephritis with deafness.

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32. Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
Osteoarthritis
Continuous - painful vaginal bleeding
Prerenal
Actinic keratosis


33. A 14-year - old girl presents with prolonged bleeding after dental surgery and with menses - normal PT - normal or ? PTT - and ? bleeding time. Diagnosis? Treatment?

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34. Inspiratory arrest during palpation of the RUQ.

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

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36. PFT showing ? FEV1/FVC.
Asymmetry - border irregularity - color variation - large diameter
Angina is new - is worsening - or occurs at rest
Endometriosis
Obstructive pulmonary disease (e.g. - asthma)


37. Four characteristics of a nevus suggestive of melanoma.
Crohn's disease
Asymmetry - border irregularity - color variation - large diameter
Rubella
HGPRTase deficiency)


38. The most common cause of postpartum hemorrhage.
Depersonalization disorder
Uterine atony
Ophthalmologic exam - CT - and MRI
OCPs


39. Chvostek's and Trousseau's signs.
M3
Hypocalcemia
DM - SLE - and amyloidosis
Postinfectious glomerulonephritis


40. Reynolds' pentad.

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41. Chromosomal pattern of a complete mole.
All - compartment fasciotomy for suspected compartment syndrome
46 -XX
Pityriasis rosea
Febrile seizures (roseola infantum)


42. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
MAOIs
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
Regresses after menopause
CML


43. Appropriate diagnostic test?
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Pharmacologic stress test (e.g. - dobutamine echo)
RSV bronchiolitis
Asymmetry - border irregularity - color variation - large diameter


44. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Postinfectious glomerulonephritis
Endometrial biopsy
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Broca's aphasia. Frontal lobe - left MCA distribution


45. Cold agglutinins.
S. aureus or S. epidermidis.
Mycoplasma
Fat - female - fertile - forty - flatulent
Higher prevalence


46. Name the organism:
Streptococcus pneumoniae
HBV immunoglobulin
Uterine massage; if that fails - give oxytocin
Pheochromocytoma


47. Name the defense mechanism:
No. Parental consent is not necessary for the medical treatment of pregnant minors
M3
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Reaction formation


48. Perinatal mortality?

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49. Treatment for benzodiazepine overdose.
They can mask symptoms of hypoglycemia
Diamond - Blackfan anemia
Flumazenil
MS


50. What is the immunodeficiency?
Chronic granulomatous disease
Bruton's X- linked agammaglobulinemia
Lichen sclerosus
Endometriosis