Test your basic knowledge |

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. Reed - Sternberg cells

2. Fetal mortality?

3. Four characteristics of a nevus suggestive of melanoma.
Trichomonas vaginitis
Reye's syndrome
Asymmetry - border irregularity - color variation - large diameter
Fanconi's anemia

4. What is the immunodeficiency?

5. Hematuria - hypertension - and oliguria.
1
Rett's disorder
Nephritic syndrome
50 cc/hour

6. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Guillain - Barr
Phencyclidine hydrochloride (PCP) intoxication
Basal cell carcinoma
Herpes simplex

7. A 55-year - old obese patient presents with dirty - velvety patches on the back of the neck.
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Toxoplasma gondii
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes

8. The most common form of glomerulonephritis.

9. Annual screening for women with a strong family history of ovarian cancer.
Rubella
CA-125 and transvaginal ultrasound
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
Nephrogenic diabetes insipidus (DI)

10. Presence of red cell casts in urine sediment.
Fluids and antibiotics
Kl
Glomerulonephritis/nephritic syndrome
Neuroblastoma

11. Lung cancer associated with SIADH.
Small cell lung cancer (SCLC)
OCPs
Membranous glomerulonephritis
Seborrheic keratosis

12. Radiographic indications for surgery in patients with acute abdomen.
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
CML
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Administration of DDAVP ? serum osmolality and free water restriction

13. Class of drugs that may cause syndrome of muscle rigidity - hyperthermia - autonomic instability - and extrapyramidal symptoms.
Wiskott - Aldrich syndrome
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Alport's syndrome
Antipsychotics (neuroleptic malignant syndrome)

14. 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
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Headache
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides

15. Supportive treatment for ARDS.
Pemphigus vulgaris
Duchenne muscular dystrophy
Lesch - Nyhan syndrome (purine salvage problem with
Continuous positive airway pressure

16. Treatment of DKA.
Seventy percent if the stenosis is symptomatic
Postinfectious glomerulonephritis
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy

17. Flat - topped papules.
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Pseudomonas
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Lichen planus

18. Why are Beta- blockers contraindicated in diabetics?
Number of live births per 1000 women 15-44 years of age
Immediate needle thoracostomy
Type IV (distal) RTA
They can mask symptoms of hypoglycemia

19. A middle - aged man presents with acute - onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis - and how did he get it? Treatment?
Reye's syndrome
Lyme disease - Ixodes tick - doxycycline
Hodgkin's lymphoma
Hypotension and bradycardia

20. Autoimmune complication occurring 2-4 weeks post - MI.

21. An antidiabetic agent associated with lactic acidosis.
Metformin
Nephritic syndrome
Duchenne muscular dystrophy
Mallory- Weiss

22. Low urine specific gravity in the presence of high serum osmolality.
Anemia - thrombocytopenia - and acute renal failure
Lichen sclerosus
DI
Crohn's disease

23. Fertility rate?
Number of live births per 1000 women 15-44 years of age
Neurofibromatosis 1
? Ca2+ - ? K- - ? phosphate - ? uric acid
Number of deaths per 1000 population

24. Virchow's triad.
Cirrhosis - CHF - nephritic syndrome
Huntington's disease
Stasis - hypercoagulability - endothelial damage
Coarctation of the aorta

25. Meningitis in neonates. Causes? Treatment?
1
Biliary tract obstruction
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
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

26. A six-year - old girl presents with a port - wine stain in the V2 distribution as well as with mental retardation - seizures - and leptomeningeal angioma.
Graves' disease
Nephrotic syndrome
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Benzodiazepines

27. PFT showing ? FEV1/FVC.
Duchenne muscular dystrophy
Obstructive pulmonary disease (e.g. - asthma)
Wait - surgical resection - radiation and/or androgen suppression
Nephrolithiasis

28. An 80-year - old man presents with fatigue - lymphadenopathy - splenomegaly - and isolated lymphocytosis. Suspected diagnosis?
Neurofibromatosis 1
Restrictive pulmonary disease
Chronic lymphocytic leukemia (CLL)
Hypoparathyroidism

29. What is the immunodeficiency?
Chronic granulomatous disease
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
MS
Endometrial biopsy

30. Bone is fractured in fall on outstretched hand.

31. Nontender abdominal mass associated with elevated VMA and HVA.
Number of live births per 1000 women 15-44 years of age
Neuroblastoma
Retrograde cystourethrogram
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)

32. The most common cancer in men and the most common cause of death from cancer in men.
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
< 7.0
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Rubella

33. A two - month - old presents with nonbilious projectile emesis. What are the appropriate steps in management?
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Squamous cell carcinoma

34. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
RCC or other erythropoietin - producing tumor; evaluate with CT scan
1
Selective IgA deficiency
CF or Hirschsprung's disease

35. ? CO - ? PCWP - ? PVR.
Ultrasound
Septic or anaphylactic shock
1
A patient's family cannot require that a doctor withhold information from the patient

36. A 17-year - old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Nephritic syndrome
IgA nephropathy (Berger's disease)
Conversion disorder
Sporothrix schenckii

37. Chromosomal pattern of a complete mole.
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
46 -XX
Obstructive pulmonary disease (e.g. - asthma)
Selective IgA deficiency

38. A 25-year - old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.

39. Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV- positive patient At what CD4 count? Mycobacterium avium - intracellulare (MAI) prophylaxis?
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Parvovirus B19
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Coarctation of the aorta

40. In which patients do you initiate colorectal cancer screening early?
Continuous positive airway pressure
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
Out
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination

41. First - line pharmacotherapy for depression.
Administration of DDAVP ? serum osmolality and free water restriction
Colposcopy and endocervical curettage
SSRIs
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant

42. Medical treatment for hepatic encephalopathy.
AP chest - AP/lateral C- spine - AP pelvis
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
? protein intake - lactulose - neomycin
Distal radius (Colles' fracture)

43. 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)
Murphy's sign - seen in acute cholecystitis
Subdural hematoma
Febrile seizures (roseola infantum)

44. Neonatal mortality?
Number of deaths from birth to 28 days per 1000 live births
Number of live births per 1000 population
IV penicillin or ampicillin
Hypernatremia

45. Complication of overly rapid correction of hyponatremia.
Bullous pemphigoid
Dressler's syndrome: fever - pericarditis - ? ESR
Central pontine myelinolysis
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

46. Cohort study
Incidence and prevalence
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Continuous positive airway pressure
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline

47. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Choriocarcinoma
Observational bias
Asherman's syndrome
Aseptic (viral) meningitis

48. Name the organism:
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Iron overload; use deferoxamine
Pasteurella multocida
Ulcerative colitis

49. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
68% - 95.5% - 99.7%
Parvovirus B19

50. The most common 1
Anion gap acidosis and 1
Huntington's disease
Confounding variable
Multiple myeloma