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. Name the organism:
Salmonella
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
No. Parental consent is not necessary for the medical treatment of pregnant minors


2. The number of true positives divided by the number of patients with the disease is _____.
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Acute pancreatitis
Bacillus cereus
Sensitivity


3. Side effects of corticosteroids.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Anion gap acidosis and 1
Hypocalcemia


4. 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)
Avascular necrosis
Endometrial or estrogen receptor - breast cancer
Taenia solium (cysticercosis)


5. Hematuria - hypertension - and oliguria.
A patient's family cannot require that a doctor withhold information from the patient
Type II (proximal) RTA
Nephritic syndrome
Diamond - Blackfan anemia


6. Identify key organisms causing diarrhea:
Osteogenesis imperfecta
Salmonella
Lesch - Nyhan syndrome (purine salvage problem with
Coarctation of the aorta


7. Neonatal mortality?
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Number of deaths from birth to 28 days per 1000 live births
Ampulla of the oviduct
Pentad of TTP


8. ECG findings suggesting MI.
Dantrolene or bromocriptine
Hypertrophic cardiomyopathy
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Wegener's granulomatosis and Goodpasture's syndrome


9. A 'blueberry muffin' rash is characteristic of what congenital infection?
Seventy percent if the stenosis is symptomatic
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Naloxone
Rubella


10. Four signs and symptoms of streptococcal pharyngitis.
46 -XX
Endometrial or estrogen receptor - breast cancer
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Obstructive pulmonary disease (e.g. - asthma)


11. Treatment for opioid overdose.
Phencyclidine hydrochloride (PCP) intoxication
Naloxone
Uremic syndrome seen in patients with renal failure
Femoral hernia


12. The most common cause of hypothyroidism.


13. Identify key organisms causing diarrhea:
Vibrio - HAV
Actinomyces israelii
Non - Hodgkin's lymphoma
Kwashiorkor (protein malnutrition)


14. Cause of neonatal RDS.
Inhaled Beta- agonists and inhaled corticosteroids
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Surfactant deficiency
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)


15. Four causes of microcytic anemia.
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
TICS
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Betamethasone or dexamethasone


16. 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.
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Seventy percent if the stenosis is symptomatic
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Avascular necrosis


17. 'Dewdrop on a rose petal.'
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Lesions of 1
Conduct disorder
Ampulla of the oviduct


18. Difference between Mallory- Weiss and Boerhaave tears.
Anorexia
Weight loss and OCPs
Mallory- Weiss
Placental abruption and placenta previa


19. Reynolds' pentad.


20. Sensitive tests have few false negatives and are used to rule _____ a disease.
Retrograde cystourethrogram
Actinomyces israelii
Hashimoto's thyroiditis
Out


21. Presents with a herald patch - Christmas - tree pattern.
Guillain - Barr
Pityriasis rosea
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Conversion disorder


22. Acceptable urine output in a trauma patient.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Pseudomonas
Broca's aphasia. Frontal lobe - left MCA distribution
50 cc/hour


23. Acute - phase treatment for Kawasaki disease.
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
Hypotension and bradycardia
Pheochromocytoma


24. The most common 1
Multiple myeloma
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Absence seizures
A patient's family cannot require that a doctor withhold information from the patient


25. What is the immunodeficiency?
Non - Hodgkin's lymphoma
CML
Wiskott - Aldrich syndrome
Esophageal atresia with distal TEF (85%). Unable to pass NG tube


26. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Septic or anaphylactic shock
Type I (distal) RTA
Paget's disease
Hypoxia and hypocarbia


27. Appropriate diagnostic test?
Hypernatremia
Pharmacologic stress test (e.g. - dobutamine echo)
Type I (distal) RTA
Hypoxia and hypocarbia


28. Risk factors for cholelithiasis.
Parvovirus B19
CA-125 and transvaginal ultrasound
Fat - female - fertile - forty - flatulent
Type I (distal) RTA


29. Complication of overly rapid correction of hyponatremia.
Asherman's syndrome
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Central pontine myelinolysis


30. A 55-year - old obese patient presents with dirty - velvety patches on the back of the neck.
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Excessive EtOH
Renal cell carcinoma (RCC)
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes


31. When should a vaginal exam be performed with suspected placenta previa?
Sarcoidosis
Squamous cell carcinoma
Never
Administration of DDAVP ? serum osmolality and free water restriction


32. PFT showing ? FEV1/FVC.
Restrictive pulmonary disease
Suspect ankylosing spondylitis. Check HLA- B27
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Basal cell carcinoma


33. Name the organism:
Biliary tract obstruction
< 7.0
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Pseudomonas


34. A 55-year - old man presents with irritative and obstructive urinary symptoms. Treatment options?
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Mycobacterium tuberculosis
Glomerulonephritis/nephritic syndrome
Wernicke's encephalopathy due to a deficiency of thiamine


35. Findings in 3
Lichen sclerosus
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Hashimoto's thyroiditis
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements


36. Combined UMN and LMN disorder.
Identify cause; fluid and blood repletion
Emergent laparotomy to repair perforated viscus - likely stomach
ALS
Sheehan's syndrome (postpartum pituitary necrosis)


37. Treatment for bacterial vaginosis.
Levodopa/carbidopa
Subarachnoid hemorrhage (SAH)
Oral or topical metronidazole
Wrist drop - loss of thumb abduction


38. Treatment of DKA.
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Fluids and antibiotics
Pemphigus vulgaris
Amoxicillin


39. Pure RBC aplasia.
Diamond - Blackfan anemia
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Small cell lung cancer (SCLC)


40. The diagnostic test for pulmonary embolism.
Nitroprusside
V/Q scan
Headache
Malingering


41. Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
Nephrotic syndrome
TICS
Lobular carcinoma in situ
CHF - shock - and altered mental status


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


43. 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
S. aureus
Radiation
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)


44. The most frequent presentation of intracranial neoplasm.
Headache
Duchenne muscular dystrophy
Incidence and prevalence
Conduct disorder


45. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Rubella
Acute myelogenous leukemia (AML)
Kegel exercises - estrogen - pessaries for stress incontinence
Wrist drop - loss of thumb abduction


46. Characteristics of 2


47. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Acne vulgaris
Reye's syndrome
INH - penicillamine - hydralazine - procainamide
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine


48. Identify key organisms causing diarrhea:
Chronic granulomatous disease
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Angina is new - is worsening - or occurs at rest
Klebsiella


49. Treatment for mild - persistent asthma.
Neither
Inhaled Beta- agonists and inhaled corticosteroids
Inevitable abortion
M3


50. Typical antibiotics for group B streptococcus (GBS) prophylaxis.
Pityriasis versicolor
Hypocalcemia
IV penicillin or ampicillin
Contact dermatitis