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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. 'Cradle cap.'
Edrophonium
Seborrheic dermatitis. Treat with antifungals
Chronic granulomatous disease
Diphenhydramine or epinephrine 1:1000

2. What should always be done prior to LP?
Psoriasis
Check for ? ICP; look for papilledema
Cellulitis
Mycoplasma

3. Heinz bodies?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Ophthalmologic exam - CT - and MRI
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)

4. The coagulation parameter affected by warfarin.
'Sawtooth' P waves
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
PT
Patent ductus arteriosus (PDA)

5. Tanner stage 3 in a six-year - old female.
Lead - time bias
Intraductal papilloma
Precocious puberty
105 bacteria/mL

6. Epidemics such as influenza
MAOIs
Sarcoidosis
Uterine massage; if that fails - give oxytocin
Higher incidence

7. AML subtype associated with DIC.
M3
Wrist drop - loss of thumb abduction
Trauma; the second most common is berry aneurysm
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin

8. Combined UMN and LMN disorder.
Treat existing heart failure and replace the tricuspid valve
ALS
Endometrial or estrogen receptor - breast cancer
False. Withdrawing and withholding life are the same from an ethical standpoint

9. Sentinel loop on AXR.
Acute pancreatitis
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Yersinia
Patient on dopamine antagonist

10. A newborn female has continuous 'machinery murmur.'
Patent ductus arteriosus (PDA)
Neither
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Incidence and prevalence

11. The most common histology of bladder cancer.
Transitional cell carcinoma
Selective IgA deficiency
Weight gain - type 2 DM - QT prolongation
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis

12. ? CO - ? PCWP - ? PVR.
Pemphigus vulgaris
Phototherapy (mild) or exchange transfusion (severe)
Cardiogenic shock
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves

13. Treatment for mild - persistent asthma.
Bacillus cereus
Salmonella
Inhaled Beta- agonists and inhaled corticosteroids
Basal cell carcinoma

14. The most common cause of postpartum hemorrhage.
Uterine atony
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Consider Fitz - Hugh - Curtis syndrome
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)

15. In which patients do you initiate colorectal cancer screening early?
Bullous pemphigoid
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
Herpes simplex
CHF - shock - and altered mental status

16. 'Stones - bones - groans - psychiatric overtones.'
Pemphigus vulgaris
Hypotension - distant heart sounds - and JVD
Signs and symptoms of hypercalcemia
Biliary tract obstruction

17. The most common organism in burn - related infections.
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Postinfectious glomerulonephritis
IV hydration and loop diuretics (furosemide)
Pseudomonas

18. Treatment for TTP.
MAOIs
Ophthalmologic exam - CT - and MRI
Establish the ABCs
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs

19. A two - month - old presents with nonbilious projectile emesis. What are the appropriate steps in management?
Giardia
Osmotic fragility test
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Conduct disorder

20. The most common causes of dementia.

21. Infant mortality?
Surfactant deficiency
CML
Weight gain - type 2 DM - QT prolongation
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)

22. Laparoscopic findings in endometriosis.

23. Drowsiness - asterixis - nausea - and a pericardial friction rub.
Uremic syndrome seen in patients with renal failure
Giardia
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
DI

24. Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?
Kl
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin

25. Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
Inevitable abortion
Patent ductus arteriosus (PDA)
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction

26. Characteristics of 2

27. Identify key organisms causing diarrhea:
Alzheimer's and multi - infarct
Hypotension and bradycardia
Hyperkalemia
Vibrio - HAV

28. Caf
Neurofibromatosis 1
Actinomyces israelii
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Asherman's syndrome

29. The first test to perform when a woman presents with amenorrhea.
Patent ductus arteriosus (PDA)
Rett's disorder
Beta- hCG; the most common cause of amenorrhea is pregnancy
'Sawtooth' P waves

30. Method of calculating fluid repletion in burn patients.
HIDA scan
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Parkland formula
Dissociative fugue

31. Honey- crusted lesions.
Impetigo
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Wrist drop - loss of thumb abduction

32. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
IV hydration and loop diuretics (furosemide)
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)

33. Classic ECG finding in atrial flutter.

34. Name the organism:
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Intraductal papilloma
Pasteurella multocida
Higher incidence

35. Presence of red cell casts in urine sediment.
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Glomerulonephritis/nephritic syndrome
Hypocalcemia
Suspect ankylosing spondylitis. Check HLA- B27

36. Acid - base disorder in pulmonary embolism.
Trauma; the second most common is berry aneurysm
Hypoxia and hypocarbia
Beta- blockers - digoxin - calcium channel blockers
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones

37. The most common cause of female infertility.
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Endometriosis
Fatigue and impending respiratory failure
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline

38. A neonate has meconium ileus.

39. A homeless child is small for his age and has peeling skin and a swollen belly.
TICS
Anion gap acidosis and 1
Duodenal atresia
Kwashiorkor (protein malnutrition)

40. A young patient with a family history of sudden death collapses and dies while exercising.
ALS
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Hypertrophic cardiomyopathy

41. Shortest AP diameter of the pelvis.
O2 - analgesia - hydration - and - if severe - transfusion
Distal radius (Colles' fracture)
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Malingering

42. A 55-year - old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram - negative rods. What is the diagnosis?
Anticoagulation - rate control - cardioversion
Prevalence
Legionella pneumonia
Clomiphene citrate

43. Medical treatment for IBD.
OCP and barrier contraception
Asymmetry - border irregularity - color variation - large diameter
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations

44. Proteinuria - hypoalbuminemia - hyperlipidemia - hyperlipiduria - edema.
Nephrotic syndrome
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Neuroleptic malignant syndrome
46 -XX

45. Joints in the hand affected in rheumatoid arthritis.
Sheehan's syndrome (postpartum pituitary necrosis)
IgA nephropathy (Berger's disease)
MCP and PIP joints; DIP joints are spared
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves

46. Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
Displacement
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Spinal stenosis
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis

47. An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
Low - voltage - diffuse ST- segment elevation
Febrile seizures (roseola infantum)
Isolation
Immediate cardioversion

48. A patient presents with recent PID with RUQ pain.
Neither
Wrist drop - loss of thumb abduction
Consider Fitz - Hugh - Curtis syndrome
B12 deficiency

49. Three systemic diseases ? nephrotic syndrome.
Cirrhosis - CHF - nephritic syndrome
DM - SLE - and amyloidosis
105 bacteria/mL
Pheochromocytoma

50. Definition of hypertension.
Streptococcus pneumoniae
BP > 140/90 on three separate occasions two weeks apart
Dressler's syndrome: fever - pericarditis - ? ESR
Colposcopy and endocervical curettage