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Test your basic knowledge |
USMLE Step 2
Start Test
Study First
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. Associated with Propionibacterium acnes and changes in androgen levels.
Acne vulgaris
Lichen sclerosus
Multiple myeloma
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
2. Exophthalmos - pretibial myxedema - and ? TSH.
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3. The most common type of nephrolithiasis.
Trichomonas vaginitis
Calcium oxalate
Acute pancreatitis
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
4. Rhomboid - shaped - positively birefringent crystals on joint fluid aspirate.
Pseudogout
Nephritic syndrome
Lyme disease - Ixodes tick - doxycycline
Out
5. A patient presents with recent PID with RUQ pain.
Fluids and antibiotics
Graves' disease
Lobular carcinoma in situ
Consider Fitz - Hugh - Curtis syndrome
6. Treatment for benzodiazepine overdose.
Dressler's syndrome: fever - pericarditis - ? ESR
Flumazenil
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
SIADH due to stress
7. Shortest AP diameter of the pelvis.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Higher incidence
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
8. True or false: Withdrawing life - sustaining care is ethically distinct from withholding sustaining care.
The IR of a disease in a population exposed to a particular factor
Elevated ICP - RBCs - xanthochromia
False. Withdrawing and withholding life are the same from an ethical standpoint
Erythema multiforme
9. How to distinguish polycythemia vera from 2
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Sheehan's syndrome (postpartum pituitary necrosis)
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Bruton's X- linked agammaglobulinemia
10. Chronic diseases such as SLE
Neurofibromatosis 1
Higher prevalence
Angina - ST- segment changes on ECG - or ? BP
105 bacteria/mL
11. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Acute myelogenous leukemia (AML)
Contact dermatitis
Salmonella
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
12. A 25-year - old African - American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
Fluids and antibiotics
Giardia
1
O2 - analgesia - hydration - and - if severe - transfusion
13. Antidepressants associated with hypertensive crisis.
IV hydration and loop diuretics (furosemide)
Acne vulgaris
MAOIs
Ampulla of the oviduct
14. A five - month - old girl has ? head growth - truncal dyscoordination - and ? social interaction.
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15. Name the organism:
Pseudomonas
Legionella pneumonia
Duodenal atresia
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
16. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
Never
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Biliary tract obstruction
Threatened abortion
17. Class of drugs that may cause syndrome of muscle rigidity - hyperthermia - autonomic instability - and extrapyramidal symptoms.
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Alport's syndrome
Antipsychotics (neuroleptic malignant syndrome)
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
18. Complication of overly rapid correction of hyponatremia.
E. coli O157:H7
Fatigue and impending respiratory failure
Central pontine myelinolysis
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
19. Risk factors for pyelonephritis.
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Erythema multiforme
BP > 140/90 on three separate occasions two weeks apart
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
20. Lab findings in Hashimoto's thyroiditis.
High TSH - low T4 - antimicrosomal antibodies
Identify cause; pressors (e.g. - dobutamine)
Beta- blockers - Ca2+ channel blockers - TCAs
Conduct disorder
21. Appropriate diagnostic test?
Asymmetry - border irregularity - color variation - large diameter
Sulfonamides - antimalarial drugs - fava beans
V/Q scan
Exercise stress treadmill with ECG
22. First step in the management of a patient with acute GI bleed.
Establish the ABCs
Substance abuse
Osgood - Schlatter disease
Acute pancreatitis
23. Virchow's triad.
Seborrheic dermatitis. Treat with antifungals
Prerenal
Stasis - hypercoagulability - endothelial damage
Benzodiazepines
24. Auer rods on blood smear.
Acute myelogenous leukemia (AML)
Neisseria meningitidis
Parkinson's disease
Placental abruption and placenta previa
25. The 6 P's of ischemia due to peripheral vascular disease.
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Clomiphene citrate
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Parainfluenza virus type 1
26. + Nikolsky's sign.
Pemphigus vulgaris
Coarctation of the aorta
Cerebral berry aneurysms (AD PCKD)
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
27. The most common pituitary tumor. Treatment?
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Nephrotic syndrome
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
28. Defect in an X- linked syndrome with mental retardation -
Lesch - Nyhan syndrome (purine salvage problem with
Hodgkin's lymphoma
Hypertrophic cardiomyopathy
Iatrogenic steroid administration. The second most common cause is Cushing's disease
29. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Osgood - Schlatter disease
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Duchenne muscular dystrophy
Wegener's granulomatosis and Goodpasture's syndrome
30. Treatment for DTs.
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Benzodiazepines
Crohn's disease
Subarachnoid hemorrhage (SAH)
31. The most common causes of hypercalcemia.
Malignancy and hyperparathyroidism
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Actinic keratosis
Ophthalmologic exam - CT - and MRI
32. Treatment for acute coronary syndrome.
Cerebral berry aneurysms (AD PCKD)
Rate control with carotid massasge or other vagal stimulation
Dissociative fugue
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
33. What is the immunodeficiency?
Paget's disease
Renal cell carcinoma (RCC)
High TSH - low T4 - antimicrosomal antibodies
Chronic granulomatous disease
34. Endocarditis prophylaxis regimens.
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
No. Parental consent is not necessary for the medical treatment of pregnant minors
Oral surgery
Angina is new - is worsening - or occurs at rest
35. Name the organism:
Actinomyces israelii
Sulfonamides - antimalarial drugs - fava beans
Chronic lymphocytic leukemia (CLL)
Colposcopy and endocervical curettage
36. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
Seborrheic keratosis
'Chocolate cysts -' powder burns
Diphenhydramine or epinephrine 1:1000
RCC or other erythropoietin - producing tumor; evaluate with CT scan
37. Sensitive tests have few false negatives and are used to rule _____ a disease.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Graves' disease
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Out
38. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Number of live births per 1000 women 15-44 years of age
Normal
Stasis - hypercoagulability - endothelial damage
Spinal stenosis
39. Treatment for neuroleptic malignant syndrome.
Dantrolene or bromocriptine
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Osgood - Schlatter disease
Kwashiorkor (protein malnutrition)
40. Identify key organisms causing diarrhea:
Parkinson's disease
Elevated ICP - RBCs - xanthochromia
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Lesions of 1
41. Treatment of DKA.
SIADH due to stress
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Femoral hernia
Conflict of interest
42. Medications and viruses that ? aplastic anemia.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Partial mole
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Factor V Leiden mutation
43. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
ARDS
Lichen planus
1
Anion gap acidosis and 1
44. RTA associated with aldosterone defect.
Type IV (distal) RTA
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Conduct disorder
Seminoma
45. Inflammatory disease of the colon with ? risk of colon cancer.
Sarcoidosis
Ulcerative colitis
Pulsus paradoxus (seen in cardiac tamponade)
Lesion of 1
46. The most common cause of hypertension in young women.
Ophthalmologic exam - CT - and MRI
OCPs
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Number of deaths from 20 weeks' gestation to birth per 1000 total births
47. Cause of amenorrhea with normal prolactin - no response to estrogen - progesterone challenge - and a history of D&C.
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48. Hematuria - flank pain - and palpable flank mass.
'Chocolate cysts -' powder burns
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Regression
Renal cell carcinoma (RCC)
49. A young patient has angina at rest with ST- segment elevation. Cardiac enzymes are normal.
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50. Odds ratio?
Endometriosis
Cirrhosis - CHF - nephritic syndrome
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
HBV immunoglobulin