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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. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Number of live births per 1000 population
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Uterine massage; if that fails - give oxytocin
Treat existing heart failure and replace the tricuspid valve

2. A patient presents with pain on passive movement - pallor - poikilothermia - paresthesias - paralysis - and pulselessness. Treatment?
Mycobacterium tuberculosis
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Conversion disorder
All - compartment fasciotomy for suspected compartment syndrome

3. Radiographic evidence of aortic disruption or dissection.
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
? protein intake - lactulose - neomycin
Lung - breast - skin (melanoma) - kidney - GI tract
Number of deaths from 20 weeks' gestation to birth per 1000 total births

4. Side effects of corticosteroids.
Lichen planus
Amoxicillin
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies

5. A five - month - old girl has ? head growth - truncal dyscoordination - and ? social interaction.

6. T- wave flattening and U waves.
Allergic interstitial nephritis
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Hypokalemia
Clostridium difficile

7. A patient with a history of lithium use presents with copious amounts of dilute urine.
Edrophonium
Crohn's disease
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Nephrogenic diabetes insipidus (DI)

8. A crescent - shaped hyperdensity on CT that does not cross the midline.
Type II (proximal) RTA
Treat immediately. Consent is implied in emergency situations
Diamond - Blackfan anemia
Subdural hematoma

9. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
? Ca2+ - ? K- - ? phosphate - ? uric acid
Herpes simplex
Hashimoto's thyroiditis

10. Unilateral - severe periorbital headache with tearing and conjunctival erythema.
Precocious puberty
Renal cell carcinoma (RCC)
Cluster headache
Membranous glomerulonephritis

11. Odds ratio?
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
Klebsiella
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism

12. Treatment for ventricular fibrillation.
Panic disorder
Reye's syndrome
Type I (distal) RTA
Immediate cardioversion

13. A significant cause of morbidity in thalassemia patients. Treatment?
Abdominal ultrasound and CT
Iron overload; use deferoxamine
Hypertension - bradycardia - and abnormal respirations
Wernicke's encephalopathy due to a deficiency of thiamine

14. Non - small cell lung cancer (NSCLC) associated with hypercalcemia.
Excessive EtOH
Choriocarcinoma
Squamous cell carcinoma
Angina is new - is worsening - or occurs at rest

15. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Calcium oxalate
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Angina is new - is worsening - or occurs at rest
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer

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.
Identify cause; fluid and blood repletion
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Hodgkin's lymphoma
Alopecia areata (autoimmune process)

17. Inspiratory arrest during palpation of the RUQ.

18. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
< 7.0
Postinfectious glomerulonephritis
Dissociative fugue
S. aureus or S. epidermidis.

19. A 14-year - old girl presents with prolonged bleeding after dental surgery and with menses - normal PT - normal or ? PTT - and ? bleeding time. Diagnosis? Treatment?

20. Involuntary psychiatric hospitalization can be undertaken for which three reasons?
Klebsiella
AP chest - AP/lateral C- spine - AP pelvis
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1

21. Identify key organisms causing diarrhea:
S. aureus
MAOIs
Varicella zoster
V/Q scan

22. A 13-year - old male has a history of theft - vandalism - and violence toward family pets.
Conduct disorder
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Biliary tract obstruction
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination

23. The most common cause of bloody nipple discharge.
Menometrorrhagia
Conversion disorder
Intraductal papilloma
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse

24. Gout - self - mutilation - and choreoathetosis.
HGPRTase deficiency)
Contact dermatitis
1
Ampulla of the oviduct

25. Indications for medical treatment of ectopic pregnancy.

26. Honeycomb pattern on CXR. Diagnosis? Treatment?
Ophthalmologic exam - CT - and MRI
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Regresses after menopause
Mycoplasma

27. Auer rods on blood smear.
Acute myelogenous leukemia (AML)
IV penicillin or ampicillin
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Pseudomonas

28. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Aseptic (viral) meningitis
Pheochromocytoma
Hypertrophic cardiomyopathy
Neuroleptics

29. ECG findings suggesting MI.
1
Paget's disease
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Actinic keratosis

30. Classic physical findings for endocarditis.

31. ? risk of what infection with silicosis?
Retinoic acid
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Mycobacterium tuberculosis
Duchenne muscular dystrophy

32. Name the organism:
Alport's syndrome
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
DI
Klebsiella

33. Medications and viruses that ? aplastic anemia.
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Regression
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
Calcium oxalate

34. A burn patient presents with cherry- red flushed skin and coma. SaO2 is normal - but carboxyhemoglobin is elevated. Treatment?
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Huntington's disease
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Salmonella

35. Presents with a herald patch - Christmas - tree pattern.
Rett's disorder
Hashimoto's thyroiditis
Polymyalgia rheumatica
Pityriasis rosea

36. Name the organism:
Glomerulonephritis/nephritic syndrome
Actinomyces israelii
Pasteurella multocida
1

37. 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?
Absence seizures
? protein intake - lactulose - neomycin
Lyme disease - Ixodes tick - doxycycline
Hypoparathyroidism

38. Name the defense mechanism:
Depersonalization disorder
Ultrasound
Reaction formation
Retrograde cystourethrogram

39. Bilious emesis within hours after the first feeding.
Hashimoto's thyroiditis
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
Number of live births per 1000 women 15-44 years of age
Duodenal atresia

40. Relative risk?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
The IR of a disease in a population exposed to a particular factor
Number of deaths from 28 days to one year per 1000 live births
Herpes simplex

41. Drugs that slow AV node transmission.
Beta- blockers - digoxin - calcium channel blockers
Threatened abortion
Restrictive pulmonary disease
Clomiphene citrate

42. Low urine specific gravity in the presence of high serum osmolality.
Prevalence
Actinic keratosis
DI
Immediate needle thoracostomy

43. Lung cancer associated with SIADH.
Establish the ABCs
Kwashiorkor (protein malnutrition)
Small cell lung cancer (SCLC)
Hypotension - distant heart sounds - and JVD

44. CSF findings:
Abdominal ultrasound and CT
OCPs - danazol - GnRH agonists
Aseptic (viral) meningitis
Cirrhosis - CHF - nephritic syndrome

45. Glomerulonephritis with deafness.

46. A man unexpectedly flies across the country - takes a new name - and has no memory of his prior life.
Small cell lung cancer (SCLC)
Dissociative fugue
Trauma - alcohol withdrawal - brain tumor
Intussusception

47. Name the organism:
Ampulla of the oviduct
Haemophilus ducreyi
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Hypovolemic shock

48. Type of ARF in a patient with FeNa < 1%.
O2 - analgesia - hydration - and - if severe - transfusion
Out
Prerenal
Vibrio - HAV

49. Contraceptive methods that protect against PID.
RCC or other erythropoietin - producing tumor; evaluate with CT scan
OCP and barrier contraception
Fluids and antibiotics
Beta- hCG; the most common cause of amenorrhea is pregnancy

50. A neonate has meconium ileus.