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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. Mortality rate?
Cellulitis
Number of deaths per 1000 population
Confounding variable
1

2. AML subtype associated with DIC.
Emergent laparotomy to repair perforated viscus - likely stomach
Betamethasone or dexamethasone
M3
Anion gap acidosis and 1

3. Pure RBC aplasia.
Oral surgery
Diamond - Blackfan anemia
? protein intake - lactulose - neomycin
Sarcoidosis

4. The most common cause of Cushing's syndrome.

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5. Treatment for opioid overdose.
Consider Fitz - Hugh - Curtis syndrome
DM - SLE - and amyloidosis
Acute myelogenous leukemia (AML)
Naloxone

6. Treatment for mild - persistent asthma.
Inhaled Beta- agonists and inhaled corticosteroids
1
B12 deficiency
'Sawtooth' P waves

7. RTA associated with aldosterone defect.
False. Withdrawing and withholding life are the same from an ethical standpoint
Lobular carcinoma in situ
Amoxicillin
Type IV (distal) RTA

8. Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
Placental abruption and placenta previa
IV hydration and loop diuretics (furosemide)
Squamous cell carcinoma
Klebsiella

9. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Sheehan's syndrome (postpartum pituitary necrosis)
Contact dermatitis
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
1

10. Not contraindications to vaccination.
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Fat - female - fertile - forty - flatulent
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Intussusception

11. Identify key organisms causing diarrhea:
< 7.0
Bacillus cereus
SSRIs
Duodenal atresia

12. Life - threatening muscle rigidity - fever - and rhabdomyolysis.
Administration of DDAVP ? serum osmolality and free water restriction
Prevalence
Neuroleptic malignant syndrome
HGPRTase deficiency)

13. Electrolyte changes in tumor lysis syndrome.
MAOIs
Continuous positive airway pressure
? Ca2+ - ? K- - ? phosphate - ? uric acid
Weight loss and OCPs

14. Four characteristics of a nevus suggestive of melanoma.
Retrograde cystourethrogram
Rate control with carotid massasge or other vagal stimulation
Asymmetry - border irregularity - color variation - large diameter
Intussusception

15. Identify key organisms causing diarrhea:
68% - 95.5% - 99.7%
Vibrio - HAV
Osmotic fragility test
Higher incidence

16. When should a vaginal exam be performed with suspected placenta previa?
Never
Acute pancreatitis
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Anticoagulation - rate control - cardioversion

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

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18. What is the immunodeficiency?
Chronic granulomatous disease
Trichomonas vaginitis
Establish the ABCs
Wiskott - Aldrich syndrome

19. Precipitants of hemolytic crisis in patients with G6PD deficiency.
Treat existing heart failure and replace the tricuspid valve
OCPs
Reaction formation
Sulfonamides - antimalarial drugs - fava beans

20. When can a physician refuse to continue treating a patient on the grounds of futility?
Yersinia
IV hydration and loop diuretics (furosemide)
Angina is new - is worsening - or occurs at rest
When there is no rationale for treatment - maximal intervention is failing - a given intervention has already failed - and treatment will not achieve the goals of care

21. A child has loss of red light reflex. Diagnosis?
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
Suspect retinoblastoma
Central pontine myelinolysis
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs

22. First - line treatment for otitis media.
Duchenne muscular dystrophy
Menometrorrhagia
Amoxicillin
Taenia solium (cysticercosis)

23. Epidemics such as influenza
Herpes simplex
Bladder rupture or urethral injury
Hypocalcemia
Higher incidence

24. Treatment of supraventricular tachycardia (SVT).
Regresses after menopause
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Incidence and prevalence
Rate control with carotid massasge or other vagal stimulation

25. Salicylate ingestion ? In What type of acid - base disorder?
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Anion gap acidosis and 1

26. Postnatal mortality?
Number of deaths from 28 days to one year per 1000 live births
Factor V Leiden mutation
Graves' disease
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant

27. The most serious side effect of clozapine.
Pasteurella multocida
Agranulocytosis
Fat - female - fertile - forty - flatulent
Hypotension - distant heart sounds - and JVD

28. What is the metabolic syndrome?
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Observational bias
Sensitivity

29. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
Angina - ST- segment changes on ECG - or ? BP
HIDA scan
Infection - cancer - and autoimmune disease
Regresses after menopause

30. Annual screening for women with a strong family history of ovarian cancer.
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
CA-125 and transvaginal ultrasound
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Neither

31. A patient hasn't slept for days - lost $20 -000 gambling - is agitated - and has pressured speech. Diagnosis? Treatment?
Higher incidence
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Abdominal ultrasound and CT
Acute mania. Start a mood stabilizer (e.g. - lithium)

32. Treatment for malignant hypertension.
Hypocalcemia
Nitroprusside
Pseudomonas
Neuroleptics

33. Treatment for acute coronary syndrome.
Sarcoidosis
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
Neuroblastoma

34. A doctor refers a patient for an MRI at a facility he/she owns.
No. Parental consent is not necessary for the medical treatment of pregnant minors
Conflict of interest
CA-125 and transvaginal ultrasound
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'

35. May be seen in children who are accused of inattention in class and confused with ADHD.
A patient with chest trauma who was previously stable suddenly dies
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
When there is no rationale for treatment - maximal intervention is failing - a given intervention has already failed - and treatment will not achieve the goals of care
Absence seizures

36. Involuntary commitment or isolation for medical treatment may be undertaken For what reason?
Treat existing heart failure and replace the tricuspid valve
Crohn's disease
Panic disorder
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)

37. Patient presents with sudden onset of severe - diffuse abdominal pain. Exam reveals peritoneal signs and AXR reveals free air under the diaphragm. Management?
Emergent laparotomy to repair perforated viscus - likely stomach
Respiratory alkalosis
Panic disorder
Number of deaths from 28 days to one year per 1000 live births

38. 'Doughy skin.'
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Hypernatremia
Sporothrix schenckii
Number of deaths from birth to 28 days per 1000 live births

39. Infant mortality?
Conduct disorder
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Bruton's X- linked agammaglobulinemia
Basal cell carcinoma

40. A fall in systolic BP of > 10 mmHg with inspiration.
S. aureus
Wegener's granulomatosis and Goodpasture's syndrome
Bruton's X- linked agammaglobulinemia
Pulsus paradoxus (seen in cardiac tamponade)

41. Name the organism:
DI
Klebsiella
Actinomyces israelii
Pregnant women. Treat this group aggressively because of potential complications

42. Treatment of anaphylactic shock.
Subarachnoid hemorrhage (SAH)
Type II (proximal) RTA
Diphenhydramine or epinephrine 1:1000
Establish the ABCs

43. Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?
Radiation
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Pityriasis versicolor
Anticoagulation - rate control - cardioversion

44. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Postinfectious glomerulonephritis
Ampulla of the oviduct
Rate control with carotid massasge or other vagal stimulation
Small cell lung cancer (SCLC)

45. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Iron deficiency anemia
Lobular carcinoma in situ
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Membranous glomerulonephritis

46. CSF findings:
MS
'Chocolate cysts -' powder burns
? Ca2+ - ? K- - ? phosphate - ? uric acid
Non - Hodgkin's lymphoma

47. Causes of hypoxemia.
OCPs
Parkinson's disease
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Threatened abortion

48. Symptoms of placenta previa.
Sensitivity
Self - limited - painless vaginal bleeding
Diamond - Blackfan anemia
Signs and symptoms of hypercalcemia

49. A significant cause of morbidity in thalassemia patients. Treatment?
Klebsiella
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Iron overload; use deferoxamine
Renal cell carcinoma (RCC)

50. A 55-year - old man has sudden - excruciating first MTP joint pain after a night of drinking red wine. Diagnosis - workup - and chronic treatment?
B12 deficiency
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Pemphigus vulgaris
Hypotension - distant heart sounds - and JVD