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. Medications and viruses that ? aplastic anemia.
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Seventy percent if the stenosis is symptomatic
CML
Stasis - hypercoagulability - endothelial damage


2. Chronic diseases such as SLE
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Seventy percent if the stenosis is symptomatic
Uterine atony
Higher prevalence


3. The most common cause of Cushing's syndrome.

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4. 'Stuck - on' appearance.
Seborrheic keratosis
Salmonella
30 cc/hour
Osgood - Schlatter disease


5. Treatment for benzodiazepine overdose.
Renal cell carcinoma (RCC)
Flumazenil
Continuous positive airway pressure
HBV immunoglobulin


6. Red plaques with silvery- white scales and sharp margins.
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Psoriasis
Conduct disorder
ACEI


7. Treatment for SVC syndrome.
All - compartment fasciotomy for suspected compartment syndrome
Niacin
Radiation
Osgood - Schlatter disease


8. Term for heavy bleeding during and between menstrual periods.
Hashimoto's thyroiditis
Klebsiella
Menometrorrhagia
Iatrogenic steroid administration. The second most common cause is Cushing's disease


9. What % lesion is an indication for carotid endarterectomy?
MAOIs
Bladder rupture or urethral injury
Seventy percent if the stenosis is symptomatic
Diamond - Blackfan anemia


10. Describe a test that consistently gives identical results - but the results are wrong.
Partial mole
High reliability - low validity
Fluid restriction - demeclocycline
Taenia solium (cysticercosis)


11. What should always be done prior to LP?
Vibrio - HAV
Neuroleptic malignant syndrome
Kegel exercises - estrogen - pessaries for stress incontinence
Check for ? ICP; look for papilledema


12. Risk factors for DVT.

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13. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
Campylobacter
HIDA scan
Sheehan's syndrome (postpartum pituitary necrosis)
Febrile seizures (roseola infantum)


14. The most common cause of hypothyroidism.

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15. Nontender abdominal mass associated with elevated VMA and HVA.
Naloxone
ARDS
Neuroblastoma
Squamous cell carcinoma


16. Treatment of central DI.
Administration of DDAVP ? serum osmolality and free water restriction
Graves' disease
Pregnant women. Treat this group aggressively because of potential complications
Displacement


17. Vaccinations at a six- month well - child visit.
Femoral hernia
HBV - DTaP - Hib - IPV - PCV
Coccidioidomycosis. Amphotericin B
Neisseria meningitidis


18. Maternal mortality?
HBV - DTaP - Hib - IPV - PCV
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
1
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help


19. A condition associated with red 'currant - jelly' stools.
Nephritic syndrome
Chronic granulomatous disease
IV hydration and loop diuretics (furosemide)
Intussusception


20. Treatment for TTP.
Parkland formula
< 7.0
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Bacterial meningitis


21. Type of ARF in a patient with FeNa < 1%.
Prerenal
Squamous cell carcinoma
Pulsus paradoxus (seen in cardiac tamponade)
CF or Hirschsprung's disease


22. The most common pituitary tumor. Treatment?
Glanzmann's thrombasthenia
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Acne vulgaris
Nephrotic syndrome


23. Thrombotic thrombocytopenic purpura (TTP) pentad?
Uterine massage; if that fails - give oxytocin
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Pentad of TTP
Treat because the disease represents an immediate threat to the child's life. Then seek a court order


24. Amenorrhea - bradycardia - and abnormal body image in a young female.
Wait - surgical resection - radiation and/or androgen suppression
Avascular necrosis
Retinoic acid
Anorexia


25. A woman who was abused as a child frequently feels outside of or detached from her body.
Displacement
They can mask symptoms of hypoglycemia
Depersonalization disorder
Incidence and prevalence


26. The most frequent presentation of intracranial neoplasm.
Choriocarcinoma
Lichen planus
Herpes simplex
Headache


27. Treatment for bacterial vaginosis.
Oral or topical metronidazole
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Pasteurella multocida
Trauma - alcohol withdrawal - brain tumor


28. A 49-year - old male presents with acute - onset flank pain and hematuria.
46 -XX
Nephrolithiasis
False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision - making capacity
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations


29. Treatment of DKA.
'Chocolate cysts -' powder burns
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Number of live births per 1000 women 15-44 years of age


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

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31. First - line treatment for moderate hypercalcemia.
IV hydration and loop diuretics (furosemide)
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Restrictive pulmonary disease
Central pontine myelinolysis


32. A 'blueberry muffin' rash is characteristic of what congenital infection?
1
Oral surgery
Isolation
Rubella


33. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Basal cell carcinoma
MCP and PIP joints; DIP joints are spared
Wiskott - Aldrich syndrome
Number of deaths from birth to 28 days per 1000 live births


34. A patient presents with pain on passive movement - pallor - poikilothermia - paresthesias - paralysis - and pulselessness. Treatment?
Neither
All - compartment fasciotomy for suspected compartment syndrome
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
Hereditary spherocytosis


35. Chvostek's and Trousseau's signs.
Beta- blockers - digoxin - calcium channel blockers
Hypocalcemia
HIDA scan
Spinal stenosis


36. PFT showing ? FEV1/FVC.
Restrictive pulmonary disease
Murphy's sign - seen in acute cholecystitis
Ophthalmologic exam - CT - and MRI
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)


37. Microcytic anemia with ? serum iron - ? total iron - binding capacity (TIBC) - and normal or ? ferritin.
Anemia of chronic disease
Niacin
Hashimoto's thyroiditis
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV


38. Antidepressants associated with hypertensive crisis.
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
MAOIs
Membranous glomerulonephritis
Biliary tract obstruction


39. 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)
Conflict of interest
Lung - breast - skin (melanoma) - kidney - GI tract
Fatigue and impending respiratory failure


40. Identify key organisms causing diarrhea:
Giardia
ARDS
Cellulitis
Diphenhydramine or epinephrine 1:1000


41. Name the organism:
Pasteurella multocida
Regression
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Radiation


42. Side effects of corticosteroids.
Pulsus paradoxus (seen in cardiac tamponade)
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Self - limited - painless vaginal bleeding
Pseudomonas


43. The mainstay of Parkinson's therapy.
Levodopa/carbidopa
Polymyalgia rheumatica
S. aureus or S. epidermidis.
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity


44. Name the organism:
Toxoplasma gondii
Wrist drop - loss of thumb abduction
Acute myelogenous leukemia (AML)
46 -XX


45. Fetal mortality?

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46. Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Anticoagulation - rate control - cardioversion
Squamous cell carcinoma
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity


47. The most common cancer in men and the most common cause of death from cancer in men.
Aseptic (viral) meningitis
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Kegel exercises - estrogen - pessaries for stress incontinence


48. Name the defense mechanism:
? Ca2+ - ? K- - ? phosphate - ? uric acid
Reaction formation
Squamous cell carcinoma
Dressler's syndrome: fever - pericarditis - ? ESR


49. Aplastic crisis in sickle cell disease.
Pharmacologic stress test (e.g. - dobutamine echo)
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Iron deficiency anemia
Parvovirus B19


50. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Normal
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies