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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. An eight -year - old boy presents with hemarthrosis and ? PTT with normal PT and bleeding time. Diagnosis? Treatment?
The IR of a disease in a population exposed to a particular factor
Murphy's sign - seen in acute cholecystitis
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Folate deficiency

2. Medication to avoid in patients with a history of alcohol withdrawal seizures.
Transitional cell carcinoma
Neuroleptics
Trauma; the second most common is berry aneurysm
PT

3. Conditions in which confidentiality must be overridden.
Cohort studies can be used to calculate relative risk (RR) - incidence - and/or odds ratio (OR). Case - control studies can be used to calculate an OR
ARDS
Sporothrix schenckii
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse

4. Name the organism:
Partial mole
Wait - surgical resection - radiation and/or androgen suppression
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Klebsiella

5. A patient presents with pain on passive movement - pallor - poikilothermia - paresthesias - paralysis - and pulselessness. Treatment?
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Type IV (distal) RTA
All - compartment fasciotomy for suspected compartment syndrome
Guillain - Barr

6. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Osteogenesis imperfecta
Amoxicillin
Flumazenil
No. Parental consent is not necessary for the medical treatment of pregnant minors

7. 'Stones - bones - groans - psychiatric overtones.'
Pemphigus vulgaris
BP > 140/90 on three separate occasions two weeks apart
Angina - ST- segment changes on ECG - or ? BP
Signs and symptoms of hypercalcemia

8. Differential of hypervolemic hyponatremia.
Osteogenesis imperfecta
Cirrhosis - CHF - nephritic syndrome
Clomiphene citrate
N- acetylcysteine

9. Hyperphagia - hypersexuality - hyperorality - and hyperdocility.
Kl
Weight gain - type 2 DM - QT prolongation
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Osteogenesis imperfecta

10. Fertility rate?
Seborrheic dermatitis. Treat with antifungals
Anemia - thrombocytopenia - and acute renal failure
Obstructive pulmonary disease (e.g. - asthma)
Number of live births per 1000 women 15-44 years of age

11. Key side effects of atypical antipsychotics.
Iron deficiency anemia
Wait - surgical resection - radiation and/or androgen suppression
Weight gain - type 2 DM - QT prolongation
Actinomyces israelii

12. CSF findings:
Subarachnoid hemorrhage (SAH)
Trichomonas vaginitis
Absence seizures
Observational bias

13. Glomerulonephritis with hemoptysis.

14. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Postinfectious glomerulonephritis
Frotteurism (a paraphilia)
HBV - DTaP - Hib - IPV - PCV
Femoral hernia

15. When should a vaginal exam be performed with suspected placenta previa?
Renal cell carcinoma (RCC)
Oral or topical metronidazole
Never
Reaction formation

16. The most common pathogen causing croup.
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Parainfluenza virus type 1
Nephrolithiasis
Lyme disease - Ixodes tick - doxycycline

17. Acute - phase treatment for Kawasaki disease.
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Guillain - Barr
Signs and symptoms of hypercalcemia
Alopecia areata (autoimmune process)

18. A four -year - old child presents with oliguria - petechiae - and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
Febrile seizures (roseola infantum)
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Intraductal papilloma
Emergent laparotomy to repair perforated viscus - likely stomach

19. Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
Prerenal
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Inevitable abortion
Placental abruption and placenta previa

20. Drugs that slow AV node transmission.
Beta- blockers - digoxin - calcium channel blockers
Hypotension and bradycardia
Infection - cancer - and autoimmune disease
Never

21. Identify key organisms causing diarrhea:
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
ETEC
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Clomiphene citrate

22. A first - born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Prevalence
Frotteurism (a paraphilia)
S. aureus or S. epidermidis.
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction

23. Treatment of AF.
RSV bronchiolitis
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Femoral hernia
Rate control - rhythm conversion - and anticoagulation

24. Relative risk?
The IR of a disease in a population exposed to a particular factor
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Clostridium difficile
INH - penicillamine - hydralazine - procainamide

25. Describe a test that consistently gives identical results - but the results are wrong.
High reliability - low validity
Protamine
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Klebsiella

26. Case - control study
Ultrasound
Rett's disorder
Parainfluenza virus type 1
Neither

27. Three systemic diseases ? nephrotic syndrome.
Klebsiella
Postinfectious glomerulonephritis
DM - SLE - and amyloidosis
Membranous glomerulonephritis

28. The most common cause of postpartum hemorrhage.
Sulfonamides - antimalarial drugs - fava beans
Uterine atony
Kl
Colposcopy and endocervical curettage

29. Treatment for acetaminophen overdose.
N- acetylcysteine
Hypernatremia
Cirrhosis - CHF - nephritic syndrome
Seborrheic dermatitis. Treat with antifungals

30. Radiographic evidence of aortic disruption or dissection.
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
When there is no rationale for treatment - maximal intervention is failing - a given intervention has already failed - and treatment will not achieve the goals of care
A patient with chest trauma who was previously stable suddenly dies

31. Acid - base disturbance commonly seen in pregnant women.
Respiratory alkalosis
AP chest - AP/lateral C- spine - AP pelvis
Precocious puberty
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)

32. A patient presents with weakness - nausea - vomiting - weight loss - and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
Varicella zoster
O2 - analgesia - hydration - and - if severe - transfusion
Prinzmetal's angina
1

33. Treatment of supraventricular tachycardia (SVT).
Rate control with carotid massasge or other vagal stimulation
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Weight loss and OCPs
Klebsiella

34. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Treat immediately. Consent is implied in emergency situations
Conflict of interest
Type I (distal) RTA
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension

35. Treatment for mild - persistent asthma.
Inhaled Beta- agonists and inhaled corticosteroids
Metformin
Pheochromocytoma
Pseudomonas

36. Red plaques with silvery- white scales and sharp margins.
Psoriasis
Sensitivity
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Iatrogenic steroid administration. The second most common cause is Cushing's disease

37. Difference between a cohort and a case - control study.
V/Q scan
Cellulitis
Hashimoto's thyroiditis
Cohort studies can be used to calculate relative risk (RR) - incidence - and/or odds ratio (OR). Case - control studies can be used to calculate an OR

38. Maternal mortality?
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Lead - time bias
High TSH - low T4 - antimicrosomal antibodies
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension

39. Common symptoms associated with silent MIs.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
CHF - shock - and altered mental status

40. How to diagnose and follow a leiomyoma.
Respiratory alkalosis
Neuroleptics
Ultrasound
Colposcopy and endocervical curettage

41. Antihypertensive for a diabetic patient with proteinuria.
Lichen sclerosus
Kwashiorkor (protein malnutrition)
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
ACEI

42. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
Sensitivity
Exercise stress treadmill with ECG
Ophthalmologic exam - CT - and MRI
RCC or other erythropoietin - producing tumor; evaluate with CT scan

43. A 15-year - old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
O2 - analgesia - hydration - and - if severe - transfusion
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
No. Parental consent is not necessary for the medical treatment of pregnant minors

44. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Osteogenesis imperfecta
Anemia - thrombocytopenia - and acute renal failure
Esophageal atresia with distal TEF (85%). Unable to pass NG tube

45. The 6 P's of ischemia due to peripheral vascular disease.
Parkland formula
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Cohort studies can be used to calculate relative risk (RR) - incidence - and/or odds ratio (OR). Case - control studies can be used to calculate an OR
Sulfonamides - antimalarial drugs - fava beans

46. Microcytic anemia with ? serum iron - ? ferritin - and ? TIBC.
Iron deficiency anemia
Paget's disease
Pityriasis versicolor
S. aureus or S. epidermidis.

47. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
1
DM - SLE - and amyloidosis
Low - voltage - diffuse ST- segment elevation

48. Complication of scaphoid fracture.
CML
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Osteogenesis imperfecta
Avascular necrosis

49. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Parvovirus B19
Nitroprusside
IgA nephropathy (Berger's disease)
Postinfectious glomerulonephritis

50. Macrocytic - megaloblastic anemia without neurologic symptoms.
Iron overload; use deferoxamine
Regresses after menopause
Folate deficiency
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe