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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. Not contraindications to vaccination.
Third - degree heart block
Aseptic (viral) meningitis
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
ALS

2. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Bacterial meningitis
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Kegel exercises - estrogen - pessaries for stress incontinence
Neuroleptics

3. Cold agglutinins.
Anemia of chronic disease
Conflict of interest
CA-125 and transvaginal ultrasound
Mycoplasma

4. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
Broca's aphasia. Frontal lobe - left MCA distribution
68% - 95.5% - 99.7%
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
1

5. Vaccinations at a six- month well - child visit.
Panic disorder
Seborrheic dermatitis. Treat with antifungals
HBV - DTaP - Hib - IPV - PCV
Yersinia

6. The first test to perform when a woman presents with amenorrhea.
Patent ductus arteriosus (PDA)
Substance abuse
Beta- hCG; the most common cause of amenorrhea is pregnancy
Fatigue and impending respiratory failure

7. The most serious side effect of clozapine.
Inhaled Beta- agonists and inhaled corticosteroids
N- acetylcysteine
Iron deficiency anemia
Agranulocytosis

8. An 80-year - old man presents with fatigue - lymphadenopathy - splenomegaly - and isolated lymphocytosis. Suspected diagnosis?
Vibrio - HAV
Dantrolene or bromocriptine
Chronic lymphocytic leukemia (CLL)
Subarachnoid hemorrhage (SAH)

9. Tanner stage 3 in a six-year - old female.
Polymyalgia rheumatica
Kwashiorkor (protein malnutrition)
Precocious puberty
Suspect ankylosing spondylitis. Check HLA- B27

10. Pure RBC aplasia.
Subarachnoid hemorrhage (SAH)
A patient's family cannot require that a doctor withhold information from the patient
Diamond - Blackfan anemia
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs

11. Trauma series.
Coccidioidomycosis. Amphotericin B
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
AP chest - AP/lateral C- spine - AP pelvis
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism

12. The most common causes of hypercalcemia.
Sulfonamides - antimalarial drugs - fava beans
Folate deficiency
Malignancy and hyperparathyroidism
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths

13. Term for heavy bleeding during and between menstrual periods.
Fluid restriction - demeclocycline
Menometrorrhagia
RSV bronchiolitis
Establish the ABCs

14. Unilateral - severe periorbital headache with tearing and conjunctival erythema.
Retrograde cystourethrogram
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Cluster headache
Elevated ICP - RBCs - xanthochromia

15. A crescent - shaped hyperdensity on CT that does not cross the midline.
Seminoma
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Subdural hematoma
Levodopa/carbidopa

16. A patient presents with recent PID with RUQ pain.
Lesion of 1
Consider Fitz - Hugh - Curtis syndrome
Erythema multiforme
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements

17. Infection of small airways with epidemics in winter and spring.
SSRIs
Graves' disease
RSV bronchiolitis
Patent ductus arteriosus (PDA)

18. True or false: Once patients sign a statement giving consent - they must continue treatment.
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Retrograde cystourethrogram
'Chocolate cysts -' powder burns
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

19. Difference between a cohort and a case - control study.
Fatigue and impending respiratory failure
Hodgkin's lymphoma
Kl
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

20. Treatment for neuroleptic malignant syndrome.
Dantrolene or bromocriptine
Hypovolemic shock
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Clomiphene citrate

21. 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?
Number of live births per 1000 population
Oral surgery
IV hydration and loop diuretics (furosemide)
Lyme disease - Ixodes tick - doxycycline

22. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Seventy percent if the stenosis is symptomatic
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

23. Virchow's triad.
Lobular carcinoma in situ
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Stasis - hypercoagulability - endothelial damage
Klebsiella

24. Macrocytic - megaloblastic anemia with neurologic symptoms.
Aseptic (viral) meningitis
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
B12 deficiency
Hypernatremia

25. Identify key organisms causing diarrhea:
E. coli O157:H7
Salmonella
Postinfectious glomerulonephritis
Basal cell carcinoma

26. Odds ratio?
Varicella zoster
Respiratory alkalosis
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Parvovirus B19

27. Hyperphagia - hypersexuality - hyperorality - and hyperdocility.
Pregnant women. Treat this group aggressively because of potential complications
Kl
Alport's syndrome
Distal radius (Colles' fracture)

28. Microcytic anemia with ? serum iron - ? ferritin - and ? TIBC.
105 bacteria/mL
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
Hypokalemia
Iron deficiency anemia

29. Cross - sectional survey
Excessive EtOH
Actinomyces israelii
Wrist drop - loss of thumb abduction
Prevalence

30. Shortest AP diameter of the pelvis.
OCPs
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
BP > 140/90 on three separate occasions two weeks apart
Postinfectious glomerulonephritis

31. Lung cancer highly related to cigarette exposure.
Lobular carcinoma in situ
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Nephrolithiasis
SCLC

32. Contraceptive methods that protect against PID.
Immediate needle thoracostomy
Lesion of 1
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
OCP and barrier contraception

33. May be seen in children who are accused of inattention in class and confused with ADHD.
Endometrial biopsy
Establish the ABCs
Uterine atony
Absence seizures

34. Treatment for SVC syndrome.
Glomerulonephritis/nephritic syndrome
Radiation
? Ca2+ - ? K- - ? phosphate - ? uric acid
Iron overload; use deferoxamine

35. Nontender abdominal mass associated with elevated VMA and HVA.
Neuroblastoma
Mallory- Weiss
Lesion of 1
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)

36. Glomerulonephritis with hemoptysis.

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37. Medical treatment for IBD.
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Clomiphene citrate
'Sawtooth' P waves
Hypoparathyroidism

38. A 55-year - old man presents with irritative and obstructive urinary symptoms. Treatment options?
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Intussusception

39. Thrombotic thrombocytopenic purpura (TTP) pentad?
Radiation
DM - SLE - and amyloidosis
Pentad of TTP
Naloxone

40. Normalizing PCO2 in a patient having an asthma exacerbation may indicate?
Treat immediately. Consent is implied in emergency situations
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Fatigue and impending respiratory failure
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)

41. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Seborrheic keratosis
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones

42. The three most common causes of fever of unknown origin (FUO).
Infection - cancer - and autoimmune disease
MAOIs
Small cell lung cancer (SCLC)
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths

43. Rigidity and stiffness that progress to choreiform movements - accompanied by moodiness and altered behavior.

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44. T- wave flattening and U waves.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Incidence and prevalence
Hypokalemia

45. Microcytic anemia with ? serum iron - ? total iron - binding capacity (TIBC) - and normal or ? ferritin.
N- acetylcysteine
Anemia of chronic disease
Factitious disorder (Munchausen syndrome)
The IR of a disease in a population exposed to a particular factor

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

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47. Identify key organisms causing diarrhea:
ETEC
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Immediate cardioversion
? serum FSH

48. Three systemic diseases ? nephrotic syndrome.
Febrile seizures (roseola infantum)
DM - SLE - and amyloidosis
Postinfectious glomerulonephritis
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins

49. Name the organism:
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Pseudomonas
Uterine atony
Anemia of chronic disease

50. Acceptable urine output in a stable patient.
Excessive EtOH
7-10 days
Rubella
30 cc/hour