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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. 1
TICS
Pregnant women. Treat this group aggressively because of potential complications
Placental abruption and placenta previa
SIADH due to stress

2. Identify key organisms causing diarrhea:
Bacillus cereus
CHF - shock - and altered mental status
A patient with chest trauma who was previously stable suddenly dies
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs

3. Supportive treatment for ARDS.
Continuous positive airway pressure
Rubella
Betamethasone or dexamethasone
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe

4. Name the organism:
Haemophilus ducreyi
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Acute pancreatitis
Kl

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

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6. A patient presents with weakness - nausea - vomiting - weight loss - and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
? serum FSH
Continuous positive airway pressure
Radiation
1

7. Name the organism:
Kegel exercises - estrogen - pessaries for stress incontinence
Phototherapy (mild) or exchange transfusion (severe)
The IR of a disease in a population exposed to a particular factor
Streptococcus pneumoniae

8. Treatment of AF.
Retinoic acid
Rate control - rhythm conversion - and anticoagulation
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Infection - febrile seizures - trauma - idiopathic

9. Name the organism:
Actinomyces israelii
Rate control with carotid massasge or other vagal stimulation
Diamond - Blackfan anemia
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'

10. The most common type of nephrolithiasis.
Calcium oxalate
SCLC
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
IV penicillin or ampicillin

11. The most common form of nephritic syndrome.
Membranous glomerulonephritis
O2 - analgesia - hydration - and - if severe - transfusion
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
CF or Hirschsprung's disease

12. Treatment for malignant hypertension.
Nitroprusside
E. coli O157:H7
Neuroblastoma
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid

13. A 55-year - old patient presents with acute 'broken speech.' What type of aphasia? What lobe and vascular distribution?

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14. First - line treatment for moderate hypercalcemia.
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Pemphigus vulgaris
IV hydration and loop diuretics (furosemide)
Acute myelogenous leukemia (AML)

15. Treatment of supraventricular tachycardia (SVT).
Rate control with carotid massasge or other vagal stimulation
Pseudogout
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
'Chocolate cysts -' powder burns

16. First - line pharmacotherapy for depression.
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
SSRIs
Uterine atony
Chronic lymphocytic leukemia (CLL)

17. 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?
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
'Sawtooth' P waves
Legionella pneumonia
Retrograde cystourethrogram

18. Antihypertensive for a diabetic patient with proteinuria.
a - antagonists (phentolamine and phenoxybenzamine)
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
ACEI
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid

19. Caf
Conversion disorder
Squamous cell carcinoma
Neurofibromatosis 1
Lichen planus

20. Differential of hypervolemic hyponatremia.
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
HIDA scan
Lichen planus
Cirrhosis - CHF - nephritic syndrome

21. A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
? protein intake - lactulose - neomycin
Broca's aphasia. Frontal lobe - left MCA distribution
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Clostridium difficile

22. ? CO - ? PCWP - ? PVR.
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Bladder rupture or urethral injury
Exercise stress treadmill with ECG
Septic or anaphylactic shock

23. Treatment for postpartum hemorrhage.
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
Varicella zoster
Uterine massage; if that fails - give oxytocin
A patient's family cannot require that a doctor withhold information from the patient

24. ? CO - ? PCWP - ? PVR.
Edrophonium
OCP and barrier contraception
Cardiogenic shock
Pityriasis versicolor

25. Medications and viruses that ? aplastic anemia.
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Type II (proximal) RTA
A patient's family cannot require that a doctor withhold information from the patient

26. An agent that reverses the effects of heparin.
Protamine
Polymyalgia rheumatica
False. Withdrawing and withholding life are the same from an ethical standpoint
Coccidioidomycosis. Amphotericin B

27. The most common 1
Squamous cell carcinoma
Agranulocytosis
Femoral hernia
Multiple myeloma

28. An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
CHF - shock - and altered mental status
Fat - female - fertile - forty - flatulent
PT
Febrile seizures (roseola infantum)

29. 'Stuck - on' appearance.
Benzodiazepines
Seborrheic keratosis
Sheehan's syndrome (postpartum pituitary necrosis)
DI

30. Salicylate ingestion ? In What type of acid - base disorder?
1
Diverticulosis
Anion gap acidosis and 1
Femoral hernia

31. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Conversion disorder
Parkland formula
Threatened abortion

32. The number of true positives divided by the number of patients with the disease is _____.
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Beta- hCG; the most common cause of amenorrhea is pregnancy
Sensitivity

33. Radiographic evidence of aortic disruption or dissection.
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus

34. Acid - base disorder in pulmonary embolism.
Osgood - Schlatter disease
Hypoxia and hypocarbia
Neisseria meningitidis
ALS

35. Diagnostic test for hereditary spherocytosis.
Osmotic fragility test
Sarcoidosis
1
Higher prevalence

36. Findings in 3
Biliary tract obstruction
Chronic lymphocytic leukemia (CLL)
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms

37. What is the immunodeficiency?
Wiskott - Aldrich syndrome
Phototherapy (mild) or exchange transfusion (severe)
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Respiratory alkalosis

38. The number of bacterial culture on a clean - catch specimen to diagnose a UTI.
105 bacteria/mL
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
SIADH due to stress

39. Causes of drug - induced SLE.
Normal
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Distal radius (Colles' fracture)
INH - penicillamine - hydralazine - procainamide

40. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Administration of DDAVP ? serum osmolality and free water restriction
Number of deaths from 28 days to one year per 1000 live births
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine

41. Treatment of septic shock.
Bullous pemphigoid
Infection - cancer - and autoimmune disease
Fluids and antibiotics
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)

42. Inspiratory arrest during palpation of the RUQ.

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43. Chronic diseases such as SLE
Higher prevalence
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Phencyclidine hydrochloride (PCP) intoxication
Sensitivity

44. Identify key organisms causing diarrhea:
Check for ? ICP; look for papilledema
Naloxone
S. aureus
30 cc/hour

45. + Nikolsky's sign.
Toxoplasma gondii
Pemphigus vulgaris
Suspect retinoblastoma
Pheochromocytoma

46. Chromosomal pattern of a complete mole.
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Pseudomonas
46 -XX

47. Treatment for bacterial vaginosis.
Oral or topical metronidazole
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Alzheimer's and multi - infarct
Hypokalemia

48. Difference between a cohort and a case - control study.
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
Campylobacter
PT
Lesions of 1

49. The most likely cause of acute lower GI bleed in patients > 40 years old.
Beta- hCG; the most common cause of amenorrhea is pregnancy
Diverticulosis
Beta- blockers - Ca2+ channel blockers - TCAs
Hypoparathyroidism

50. Shortest AP diameter of the pelvis.
MS
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination