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. A 13-year - old male has a history of theft - vandalism - and violence toward family pets.
Conduct disorder
Continuous positive airway pressure
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Crohn's disease


2. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Frotteurism (a paraphilia)
Fluid restriction - demeclocycline
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Pseudomonas


3. Perinatal mortality?

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4. Antihypertensive for a diabetic patient with proteinuria.
Beta- hCG; the most common cause of amenorrhea is pregnancy
IgA nephropathy (Berger's disease)
ACEI
Number of deaths from 28 days to one year per 1000 live births


5. Treatment for malignant hypertension.
Uterine atony
Nitroprusside
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Bruton's X- linked agammaglobulinemia


6. Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
< 7.0
Inevitable abortion
Wegener's granulomatosis and Goodpasture's syndrome
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin


7. Treatment for AML M3.
Regresses after menopause
Protamine
Mycobacterium tuberculosis
Retinoic acid


8. A young patient with a family history of sudden death collapses and dies while exercising.
Selective IgA deficiency
Ulcerative colitis
Calcium oxalate
Hypertrophic cardiomyopathy


9. The most common inherited hemolytic anemia.
Hereditary spherocytosis
DM - SLE - and amyloidosis
Haemophilus ducreyi
Varicella zoster


10. Identify key organisms causing diarrhea:
AP chest - AP/lateral C- spine - AP pelvis
ETEC
Number of live births per 1000 women 15-44 years of age
IV hydration and loop diuretics (furosemide)


11. Normalizing PCO2 in a patient having an asthma exacerbation may indicate?
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Administration of DDAVP ? serum osmolality and free water restriction
Fatigue and impending respiratory failure
Number of deaths from 28 days to one year per 1000 live births


12. Sentinel loop on AXR.
Anticoagulation - rate control - cardioversion
Kl
Acute pancreatitis
AP chest - AP/lateral C- spine - AP pelvis


13. How to diagnose and follow a leiomyoma.
Ultrasound
Higher prevalence
Membranous glomerulonephritis
Neuroleptic malignant syndrome


14. The most common cause of bloody nipple discharge.
MCP and PIP joints; DIP joints are spared
Out
Betamethasone or dexamethasone
Intraductal papilloma


15. Risk factors for DVT.

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16. Low urine specific gravity in the presence of high serum osmolality.
DI
Cirrhosis - CHF - nephritic syndrome
OCPs
Asherman's syndrome


17. Virchow's triad.
Benzodiazepines
Stasis - hypercoagulability - endothelial damage
Bacterial meningitis
Levodopa/carbidopa


18. The most common form of nephritic syndrome.
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Anion gap acidosis and 1
Infection - febrile seizures - trauma - idiopathic
Membranous glomerulonephritis


19. Trauma series.
Hypotension and bradycardia
AP chest - AP/lateral C- spine - AP pelvis
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Hereditary spherocytosis


20. Iris - like target lesions.
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
? Ca2+ - ? K- - ? phosphate - ? uric acid
Placental abruption and placenta previa
Erythema multiforme


21. Nikolsky's sign.
IV hydration and loop diuretics (furosemide)
Lobular carcinoma in situ
Bullous pemphigoid
ETEC


22. An elderly female presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ? ESR.
Polymyalgia rheumatica
Weight gain - type 2 DM - QT prolongation
Wrist drop - loss of thumb abduction
Hypernatremia


23. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Lobular carcinoma in situ
High reliability - low validity
Beta- hCG; the most common cause of amenorrhea is pregnancy


24. Unopposed estrogen is contraindicated in which cancers?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Alport's syndrome
Rett's disorder
Endometrial or estrogen receptor - breast cancer


25. A man unexpectedly flies across the country - takes a new name - and has no memory of his prior life.
Iron deficiency anemia
Dissociative fugue
Choriocarcinoma
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV


26. A 40-year - old obese female with elevated alkaline phosphatase - elevated bilirubin - pruritus - dark urine - and clay- colored stools.
Anion gap acidosis and 1
Uterine massage; if that fails - give oxytocin
Spinal stenosis
Biliary tract obstruction


27. The most common causes of dementia.

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28. Differential of hypervolemic hyponatremia.
Treat existing heart failure and replace the tricuspid valve
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Cirrhosis - CHF - nephritic syndrome
Selective IgA deficiency


29. Classic ECG findings in pericarditis.
Aseptic (viral) meningitis
Asherman's syndrome
Calcium oxalate
Low - voltage - diffuse ST- segment elevation


30. Treatment for acute coronary syndrome.
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
Coarctation of the aorta
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Chronic lymphocytic leukemia (CLL)


31. Natural history of a leiomyoma.
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Regresses after menopause
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Taenia solium (cysticercosis)


32. Classic physical findings for endocarditis.

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33. Complication of scaphoid fracture.
ACEI
Haemophilus ducreyi
Avascular necrosis
Choriocarcinoma


34. The mainstay of Parkinson's therapy.
Klebsiella
They can mask symptoms of hypoglycemia
Pulsus paradoxus (seen in cardiac tamponade)
Levodopa/carbidopa


35. A patient presents with signs of hypocalcemia - high phosphorus - and low PTH.
Incidence and prevalence
? serum FSH
MAOIs
Hypoparathyroidism


36. 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.
Huntington's disease
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
BP > 140/90 on three separate occasions two weeks apart
46 -XX


37. How to distinguish polycythemia vera from 2
Endometrial or estrogen receptor - breast cancer
Choriocarcinoma
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
ACEI


38. Infant mortality?
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Seborrheic dermatitis. Treat with antifungals
Asymmetry - border irregularity - color variation - large diameter
Endometrial or estrogen receptor - breast cancer


39. Maternal mortality?
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
A patient's family cannot require that a doctor withhold information from the patient
Anion gap acidosis and 1
Endometrial or estrogen receptor - breast cancer


40. Molar pregnancy containing fetal tissue.
Trauma - alcohol withdrawal - brain tumor
Colposcopy and endocervical curettage
Malignancy and hyperparathyroidism
Partial mole


41. RTA associated with aldosterone defect.
Type IV (distal) RTA
Lichen sclerosus
Self - limited - painless vaginal bleeding
Chronic granulomatous disease


42. 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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43. Reynolds' pentad.

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44. A congenital heart disease that cause 2
Mycoplasma
Parkinson's disease
Coarctation of the aorta
Allergic interstitial nephritis


45. Treatment of central DI.
Naloxone
Administration of DDAVP ? serum osmolality and free water restriction
Malignancy and hyperparathyroidism
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed


46. The most common type of testicular cancer.
ALS
Hypoparathyroidism
Seminoma
BP > 140/90 on three separate occasions two weeks apart


47. Identify key organisms causing diarrhea:
Hypocalcemia
Administration of DDAVP ? serum osmolality and free water restriction
Giardia
Hypertrophic cardiomyopathy


48. If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status - then socioeconomic status is a _____.
Seminoma
Confounding variable
Broca's aphasia. Frontal lobe - left MCA distribution
Duodenal atresia


49. Appropriate diagnostic test?
Parvovirus B19
Pharmacologic stress test (e.g. - dobutamine echo)
a - antagonists (phentolamine and phenoxybenzamine)
Intraductal papilloma


50. Proteinuria - hypoalbuminemia - hyperlipidemia - hyperlipiduria - edema.
Mycobacterium tuberculosis
Nephrotic syndrome
Endometrial or estrogen receptor - breast cancer
Neisseria meningitidis