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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. 'Stones - bones - groans - psychiatric overtones.'
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Lung - breast - skin (melanoma) - kidney - GI tract
Signs and symptoms of hypercalcemia
Bladder rupture or urethral injury

2. Relative risk?
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
The IR of a disease in a population exposed to a particular factor
Hypokalemia
Streptococcus pneumoniae

3. Bone is fractured in fall on outstretched hand.

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4. Vaccinations at a six- month well - child visit.
HBV - DTaP - Hib - IPV - PCV
Cardiogenic shock
O2 - analgesia - hydration - and - if severe - transfusion
Elevated ICP - RBCs - xanthochromia

5. ECG findings suggesting MI.
HGPRTase deficiency)
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Alport's syndrome
Radiation

6. Name the defense mechanism:
Type IV (distal) RTA
Displacement
Beta- hCG; the most common cause of amenorrhea is pregnancy
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine

7. An autosomal - recessive disorder with a defect in the GPIIbIIIa platelet receptor and ? platelet aggregation.

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8. Treatment for Guillain - Barr
Number of live births per 1000 women 15-44 years of age
Lesions of 1
Levodopa/carbidopa
IVIG or plasmapheresis

9. Inflammatory disease of the colon with ? risk of colon cancer.
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
S. aureus or S. epidermidis.
Ulcerative colitis
HIDA scan

10. Name the organism:
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Pasteurella multocida
Pseudomonas
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis

11. An active 13-year - old boy has anterior knee pain. Diagnosis?
Osgood - Schlatter disease
Alopecia areata (autoimmune process)
Hypotension and bradycardia
Third - degree heart block

12. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Graves' disease
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Edrophonium
Parainfluenza virus type 1

13. Annual screening for women with a strong family history of ovarian cancer.
CA-125 and transvaginal ultrasound
M3
Continuous - painful vaginal bleeding
Bullous pemphigoid

14. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
Placental abruption and placenta previa
Transitional cell carcinoma
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Cerebral berry aneurysms (AD PCKD)

15. Treatment for atrial fibrillation.
Anticoagulation - rate control - cardioversion
Selective IgA deficiency
Alopecia areata (autoimmune process)
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

16. Findings in 3
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Wait - surgical resection - radiation and/or androgen suppression
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Herpes simplex

17. Breast malignancy presenting as itching - burning - and erosion of the nipple.

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18. When can a physician refuse to continue treating a patient on the grounds of futility?
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
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Infection - cancer - and autoimmune disease
Nephrolithiasis

19. Treatment of SIADH?
Fluid restriction - demeclocycline
Out
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Intussusception

20. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Type IV (distal) RTA
Osgood - Schlatter disease
Kegel exercises - estrogen - pessaries for stress incontinence
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin

21. Goal hemoglobin A1c for a patient with DM.
Seminoma
Endometrial biopsy
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
< 7.0

22. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
68% - 95.5% - 99.7%
Obstructive pulmonary disease (e.g. - asthma)
Retinoic acid
Angina - ST- segment changes on ECG - or ? BP

23. A 40-year - old obese female with elevated alkaline phosphatase - elevated bilirubin - pruritus - dark urine - and clay- colored stools.
Contact dermatitis
Biliary tract obstruction
Anemia of chronic disease
A patient with chest trauma who was previously stable suddenly dies

24. Why are Beta- blockers contraindicated in diabetics?
Partial mole
They can mask symptoms of hypoglycemia
Seborrheic dermatitis. Treat with antifungals
Duodenal atresia

25. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Pityriasis rosea
Distal radius (Colles' fracture)
Seborrheic dermatitis. Treat with antifungals
Pheochromocytoma

26. Presence of red cell casts in urine sediment.
Glomerulonephritis/nephritic syndrome
IV penicillin or ampicillin
Hereditary spherocytosis
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)

27. A patient presents with recent PID with RUQ pain.
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Self - limited - painless vaginal bleeding
Headache
Consider Fitz - Hugh - Curtis syndrome

28. Identify key organisms causing diarrhea:
Pseudogout
E. coli O157:H7
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs

29. The most common organism in burn - related infections.
Pseudomonas
Chronic lymphocytic leukemia (CLL)
DI
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin

30. Treatment for SVC syndrome.
Actinomyces israelii
Seborrheic keratosis
Pharmacologic stress test (e.g. - dobutamine echo)
Radiation

31. A doctor refers a patient for an MRI at a facility he/she owns.
Choriocarcinoma
Absence seizures
Conflict of interest
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

32. Arthritis - conjunctivitis - and urethritis in young men. Associated organisms?

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33. Supportive treatment for ARDS.
Malingering
Continuous positive airway pressure
IV benzodiazepine
Obstructive pulmonary disease (e.g. - asthma)

34. A patient has ? vaginal discharge and petechial patches in the upper vagina and cervix.
Trichomonas vaginitis
Signs and symptoms of hypercalcemia
7-10 days
Aseptic (viral) meningitis

35. Dermatomal distribution.
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
CML
Neither
Varicella zoster

36. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
HIDA scan
Signs and symptoms of hypercalcemia
Calcium oxalate
Anemia of chronic disease

37. Differential of hypervolemic hyponatremia.
Cirrhosis - CHF - nephritic syndrome
Bruton's X- linked agammaglobulinemia
N- acetylcysteine
Anemia of chronic disease

38. A patient with a history of lithium use presents with copious amounts of dilute urine.
Mallory- Weiss
Nephrogenic diabetes insipidus (DI)
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
Yersinia

39. What is the immunodeficiency?
TICS
M3
Chronic granulomatous disease
Hypocalcemia

40. Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
Inevitable abortion
Bacillus cereus
Suspect retinoblastoma
N- acetylcysteine

41. Albuminocytologic dissociation.
Neisseria meningitidis
CA-125 and transvaginal ultrasound
Guillain - Barr
Seborrheic keratosis

42. The most common type of testicular cancer.
Seminoma
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Lichen planus
Malignancy and hyperparathyroidism

43. Side effects of corticosteroids.
Isolation
Bullous pemphigoid
ARDS
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies

44. Treatment for mild and severe unconjugated hyperbilirubinemia.
Phototherapy (mild) or exchange transfusion (severe)
? protein intake - lactulose - neomycin
Murphy's sign - seen in acute cholecystitis
Elevated ICP - RBCs - xanthochromia

45. Signs of active ischemia during stress testing.
Pityriasis versicolor
Prevalence
IV benzodiazepine
Angina - ST- segment changes on ECG - or ? BP

46. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Nephritic syndrome
ARDS
a - antagonists (phentolamine and phenoxybenzamine)

47. Sensitive tests have few false negatives and are used to rule _____ a disease.
OCP and barrier contraception
Kwashiorkor (protein malnutrition)
Out
Guillain - Barr

48. The most common pituitary tumor. Treatment?
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
RSV bronchiolitis
Duodenal atresia
Osteoarthritis

49. Which healthy population is susceptible to UTIs?
Acute myelogenous leukemia (AML)
Lung - breast - skin (melanoma) - kidney - GI tract
Pregnant women. Treat this group aggressively because of potential complications
Beta- blockers - digoxin - calcium channel blockers

50. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Klebsiella
Postinfectious glomerulonephritis
Kegel exercises - estrogen - pessaries for stress incontinence
Diphenhydramine or epinephrine 1:1000