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. Treatment for mild - persistent asthma.
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Bacterial meningitis
Trichomonas vaginitis
Inhaled Beta- agonists and inhaled corticosteroids


2. Eight surgically correctable causes of hypertension.

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3. A son asks that his mother not be told about her recently discovered cancer.

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4. Endocarditis prophylaxis regimens.
Oral surgery
Niacin
Taenia solium (cysticercosis)
Femoral hernia


5. A 17-year - old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Conversion disorder
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Colposcopy and endocervical curettage
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed


6. A young patient with a family history of sudden death collapses and dies while exercising.
Alopecia areata (autoimmune process)
Hypertrophic cardiomyopathy
Patent ductus arteriosus (PDA)
Neisseria meningitidis


7. The coagulation parameter affected by warfarin.
Colposcopy and endocervical curettage
PT
Sulfonamides - antimalarial drugs - fava beans
< 7.0


8. The most common type of nephrolithiasis.
Subdural hematoma
Biliary tract obstruction
RSV bronchiolitis
Calcium oxalate


9. Hyperphagia - hypersexuality - hyperorality - and hyperdocility.
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Kl
Number of live births per 1000 women 15-44 years of age


10. The 6 P's of ischemia due to peripheral vascular disease.
High TSH - low T4 - antimicrosomal antibodies
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Mallory- Weiss
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs


11. The first test to perform when a woman presents with amenorrhea.
Beta- hCG; the most common cause of amenorrhea is pregnancy
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Intraductal papilloma


12. What is the immunodeficiency?
Bacterial meningitis
Continuous positive airway pressure
Amoxicillin
Wiskott - Aldrich syndrome


13. Perinatal mortality?

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14. Diagnostic test for hereditary spherocytosis.
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Asymmetry - border irregularity - color variation - large diameter
Osmotic fragility test


15. Iris - like target lesions.
Haemophilus ducreyi
Lyme disease - Ixodes tick - doxycycline
Subdural hematoma
Erythema multiforme


16. In which patients do you initiate colorectal cancer screening early?
Conduct disorder
Asymmetry - border irregularity - color variation - large diameter
AP chest - AP/lateral C- spine - AP pelvis
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


17. Side effects of corticosteroids.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Impetigo
Inhaled Beta- agonists and inhaled corticosteroids


18. Signs of neurogenic shock.
Beta- blockers - Ca2+ channel blockers - TCAs
Seborrheic dermatitis. Treat with antifungals
RSV bronchiolitis
Hypotension and bradycardia


19. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Number of deaths from 28 days to one year per 1000 live births
Pityriasis versicolor
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Rate control with carotid massasge or other vagal stimulation


20. A neonate has meconium ileus.

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21. Causes of drug - induced SLE.
IV benzodiazepine
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
IV hydration and loop diuretics (furosemide)
INH - penicillamine - hydralazine - procainamide


22. The most common pituitary tumor. Treatment?
Lichen planus
Factor V Leiden mutation
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
No. Parental consent is not necessary for the medical treatment of pregnant minors


23. Classic physical findings for endocarditis.

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24. CSF findings:
Number of live births per 1000 population
Clostridium difficile
Anticoagulation - rate control - cardioversion
Bacterial meningitis


25. 'Stuck - on' appearance.
Seborrheic keratosis
Pulsus paradoxus (seen in cardiac tamponade)
Wait - surgical resection - radiation and/or androgen suppression
Bacillus cereus


26. 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
Treat immediately. Consent is implied in emergency situations
Septic or anaphylactic shock
OCP and barrier contraception


27. Medication to avoid in patients with a history of alcohol withdrawal seizures.
Neuroleptics
'Sawtooth' P waves
All - compartment fasciotomy for suspected compartment syndrome
RSV bronchiolitis


28. Four signs and symptoms of streptococcal pharyngitis.
Rett's disorder
Panic disorder
Stasis - hypercoagulability - endothelial damage
Fever - pharyngeal erythema - tonsillar exudate - lack of cough


29. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Regression
Osteogenesis imperfecta
Anemia - thrombocytopenia - and acute renal failure


30. Causes of hypoxemia.
Cluster headache
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Emergent laparotomy to repair perforated viscus - likely stomach


31. Key side effects of atypical antipsychotics.
Taenia solium (cysticercosis)
Partial mole
Prinzmetal's angina
Weight gain - type 2 DM - QT prolongation


32. Presence of red cell casts in urine sediment.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Pseudomonas
Glomerulonephritis/nephritic syndrome
Dantrolene or bromocriptine


33. Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
Third - degree heart block
Fluids and antibiotics
Isolation
Osteoarthritis


34. 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.
Levodopa/carbidopa
Mallory- Weiss
Polymyalgia rheumatica
Fatigue and impending respiratory failure


35. Electrolyte changes in tumor lysis syndrome.
? Ca2+ - ? K- - ? phosphate - ? uric acid
Selective IgA deficiency
Uterine atony
7-10 days


36. Name the organism:
Actinic keratosis
Pasteurella multocida
Haemophilus ducreyi
Febrile seizures (roseola infantum)


37. Virchow's triad.
Contact dermatitis
Stasis - hypercoagulability - endothelial damage
Retinoic acid
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes


38. What is the immunodeficiency?
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Chronic granulomatous disease
Pulsus paradoxus (seen in cardiac tamponade)
Avascular necrosis


39. Red plaques with silvery- white scales and sharp margins.
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Fatigue and impending respiratory failure
Psoriasis
Menometrorrhagia


40. PFT showing ? FEV1/FVC.
A patient's family cannot require that a doctor withhold information from the patient
Aseptic (viral) meningitis
Nephritic syndrome
Restrictive pulmonary disease


41. A 30-year - old woman has unpredictable urine loss. Examination is normal. Medical options?
SSRIs
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Precocious puberty


42. Risk factors for DVT.

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43. Acid - base disturbance commonly seen in pregnant women.
Rubella
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Pemphigus vulgaris
Respiratory alkalosis


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

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45. A young patient has angina at rest with ST- segment elevation. Cardiac enzymes are normal.

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46. Identify key organisms causing diarrhea:
HBV immunoglobulin
Factor V Leiden mutation
Campylobacter
Lesion of 1


47. Joints in the hand affected in rheumatoid arthritis.
Vibrio - HAV
Dissociative fugue
Hypertrophic cardiomyopathy
MCP and PIP joints; DIP joints are spared


48. Cannon 'a' waves.
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Prinzmetal's angina
Third - degree heart block
Nephrolithiasis


49. Characteristics of 2

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50. A violent patient has vertical and horizontal nystagmus.
S. aureus
Prinzmetal's angina
Respiratory alkalosis
Phencyclidine hydrochloride (PCP) intoxication