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. Signs suggesting radial nerve damage with humeral fracture.
Infection - febrile seizures - trauma - idiopathic
Inevitable abortion
Cardiogenic shock
Wrist drop - loss of thumb abduction


2. Auer rods on blood smear.
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Acute myelogenous leukemia (AML)
Small cell lung cancer (SCLC)
1


3. The number of true positives divided by the number of patients with the disease is _____.
SIADH due to stress
Sensitivity
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Seminoma


4. Glomerulonephritis with hemoptysis.

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5. A 10-year - old boy presents with fever - weight loss - and night sweats. Examination shows anterior mediastinal mass. Suspected diagnosis?

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6. Drowsiness - asterixis - nausea - and a pericardial friction rub.
Bacterial meningitis
HBV - DTaP - Hib - IPV - PCV
Uremic syndrome seen in patients with renal failure
Bacillus cereus


7. Natural history of a leiomyoma.
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Regresses after menopause
Cerebral berry aneurysms (AD PCKD)
Anemia of chronic disease


8. Characteristics of 2

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9. Maternal mortality?
Osgood - Schlatter disease
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Nephritic syndrome
Slipped capital femoral epiphyses. AP and frog - leg lateral view


10. When should a vaginal exam be performed with suspected placenta previa?
Number of live births per 1000 women 15-44 years of age
Toxoplasma gondii
Rate control with carotid massasge or other vagal stimulation
Never


11. Method of calculating fluid repletion in burn patients.
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Neither
Parkland formula


12. Identify key organisms causing diarrhea:
Fluids and antibiotics
Phencyclidine hydrochloride (PCP) intoxication
Beta- hCG; the most common cause of amenorrhea is pregnancy
E. coli O157:H7


13. Acute - phase treatment for Kawasaki disease.
Absence seizures
Folate deficiency
Membranous glomerulonephritis
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms


14. Tanner stage 3 in a six-year - old female.
Asherman's syndrome
Niacin
Precocious puberty
Malignancy and hyperparathyroidism


15. Perinatal mortality?

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16. 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?

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17. The most serious side effect of clozapine.
Hypotension and bradycardia
Agranulocytosis
Highly sensitive for TB
Alzheimer's and multi - infarct


18. Presents with a herald patch - Christmas - tree pattern.
Diverticulosis
Pityriasis rosea
Sensitivity
Nitroprusside


19. A 16-year - old presents with an annular patch of alopecia with broken - off - stubby hairs.
Wiskott - Aldrich syndrome
? protein intake - lactulose - neomycin
Low - voltage - diffuse ST- segment elevation
Alopecia areata (autoimmune process)


20. Signs of neurogenic shock.
Ampulla of the oviduct
Kegel exercises - estrogen - pessaries for stress incontinence
Hypotension and bradycardia
Lesion of 1


21. The number of bacterial culture on a clean - catch specimen to diagnose a UTI.
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Acute pancreatitis
105 bacteria/mL


22. Salicylate ingestion ? In What type of acid - base disorder?
Huntington's disease
Reaction formation
Chronic lymphocytic leukemia (CLL)
Anion gap acidosis and 1


23. Autoimmune complication occurring 2-4 weeks post - MI.

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24. Treatment for ventricular fibrillation.
TICS
Actinic keratosis
Immediate cardioversion
Ulcerative colitis


25. Post - HBV exposure treatment.
Campylobacter
Anemia - thrombocytopenia - and acute renal failure
HBV immunoglobulin
Suspect retinoblastoma


26. Treatment for Guillain - Barr
Incidence and prevalence
IVIG or plasmapheresis
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Excessive EtOH


27. A violent patient has vertical and horizontal nystagmus.
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Phencyclidine hydrochloride (PCP) intoxication
Glomerulonephritis/nephritic syndrome
Wiskott - Aldrich syndrome


28. Cause of neonatal RDS.
Actinic keratosis
Chronic lymphocytic leukemia (CLL)
Surfactant deficiency
Obstructive pulmonary disease (e.g. - asthma)


29. Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?
Benzodiazepines
Endometrial or estrogen receptor - breast cancer
Weight gain - type 2 DM - QT prolongation
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin


30. A child has loss of red light reflex. Diagnosis?
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Suspect retinoblastoma
Restrictive pulmonary disease
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy


31. Radiographic evidence of aortic disruption or dissection.
Mallory- Weiss
Wait - surgical resection - radiation and/or androgen suppression
Continuous - painful vaginal bleeding
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus


32. Symptoms of placenta previa.
Clostridium difficile
Self - limited - painless vaginal bleeding
Consider Fitz - Hugh - Curtis syndrome
105 bacteria/mL


33. Identify key organisms causing diarrhea:
Clostridium difficile
Naloxone
Continuous positive airway pressure
Isolation


34. Treatment of central DI.
Reye's syndrome
Administration of DDAVP ? serum osmolality and free water restriction
Nephritic syndrome
Hypoxia and hypocarbia


35. Treatment for TTP.
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Distal radius (Colles' fracture)
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
SSRIs


36. Chronic diseases such as SLE
Exercise stress treadmill with ECG
Impetigo
Immediate needle thoracostomy
Higher prevalence


37. Inflammatory disease of the colon with ? risk of colon cancer.
Ulcerative colitis
Allergic interstitial nephritis
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Continuous - painful vaginal bleeding


38. A patient fails to lactate after an emergency C- section with marked blood loss.

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39. Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV- positive patient At what CD4 count? Mycobacterium avium - intracellulare (MAI) prophylaxis?
OCP and barrier contraception
ACEI
RCC or other erythropoietin - producing tumor; evaluate with CT scan
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)


40. The diagnostic test for pulmonary embolism.
Inevitable abortion
Suspect retinoblastoma
V/Q scan
Hypoxia and hypocarbia


41. Four causes of microcytic anemia.
Patent ductus arteriosus (PDA)
Infection - cancer - and autoimmune disease
TICS
HGPRTase deficiency)


42. Goal hemoglobin A1c for a patient with DM.
Endometriosis
Coccidioidomycosis. Amphotericin B
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
< 7.0


43. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Pemphigus vulgaris
Hypertrophic cardiomyopathy
Streptococcus pneumoniae
Pityriasis versicolor


44. Identify key organisms causing diarrhea:
Giardia
IgA nephropathy (Berger's disease)
Pseudomonas
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves


45. A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Type IV (distal) RTA
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Isolation
Murphy's sign - seen in acute cholecystitis


46. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Trauma; the second most common is berry aneurysm
Treat existing heart failure and replace the tricuspid valve
Giardia
Nephritic syndrome


47. Classic ECG finding in atrial flutter.

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48. Treatment for neuroleptic malignant syndrome.
OCPs
Dantrolene or bromocriptine
Squamous cell carcinoma
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)


49. Trauma series.
Administration of DDAVP ? serum osmolality and free water restriction
a - antagonists (phentolamine and phenoxybenzamine)
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
AP chest - AP/lateral C- spine - AP pelvis


50. Test to rule out urethral injury.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Retrograde cystourethrogram
Continuous positive airway pressure
TICS