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Test your basic knowledge |
USMLE Step 2
Start Test
Study First
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. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Diamond - Blackfan anemia
Pulsus paradoxus (seen in cardiac tamponade)
Type I (distal) RTA
Signs and symptoms of hypercalcemia
2. Medication used to induce ovulation.
Lesch - Nyhan syndrome (purine salvage problem with
M3
Clomiphene citrate
Subdural hematoma
3. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Small cell lung cancer (SCLC)
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Acute myelogenous leukemia (AML)
4. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
Actinic keratosis
CML
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Glomerulonephritis/nephritic syndrome
5. Reynolds' pentad.
6. Chronic diseases such as SLE
Higher prevalence
Salmonella
Avascular necrosis
Pseudogout
7. Unopposed estrogen is contraindicated in which cancers?
Endometrial or estrogen receptor - breast cancer
OCPs - danazol - GnRH agonists
Infection - febrile seizures - trauma - idiopathic
Legionella pneumonia
8. A 55-year - old patient presents with acute 'broken speech.' What type of aphasia? What lobe and vascular distribution?
9. 'Stuck - on' appearance.
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
Seborrheic keratosis
Never
Immediate cardioversion
10. Cause of neonatal RDS.
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Surfactant deficiency
Clomiphene citrate
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
11. Heinz bodies?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Obstructive pulmonary disease (e.g. - asthma)
Cirrhosis - CHF - nephritic syndrome
Slipped capital femoral epiphyses. AP and frog - leg lateral view
12. First - line treatment for moderate hypercalcemia.
Avascular necrosis
Nephrotic syndrome
IV hydration and loop diuretics (furosemide)
Transitional cell carcinoma
13. After a minor fender bender - a man wears a neck brace and requests permanent disability.
No. Parental consent is not necessary for the medical treatment of pregnant minors
S. aureus or S. epidermidis.
Malingering
Nephritic syndrome
14. Eight surgically correctable causes of hypertension.
15. A 20-year - old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?
Cerebral berry aneurysms (AD PCKD)
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Taenia solium (cysticercosis)
Distal radius (Colles' fracture)
16. In which patients do you initiate colorectal cancer screening early?
Trauma; the second most common is berry aneurysm
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
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
Rubella
17. Honeycomb pattern on CXR. Diagnosis? Treatment?
Obstructive pulmonary disease (e.g. - asthma)
Campylobacter
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Choriocarcinoma
18. Treatment of tension pneumothorax.
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Alzheimer's and multi - infarct
Neuroleptics
Immediate needle thoracostomy
19. Criteria for exudative effusion.
Anion gap acidosis and 1
Postinfectious glomerulonephritis
Hypotension - distant heart sounds - and JVD
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
20. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Diverticulosis
Postinfectious glomerulonephritis
Glomerulonephritis/nephritic syndrome
21. Nikolsky's sign.
Type I (distal) RTA
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Bullous pemphigoid
Antipsychotics (neuroleptic malignant syndrome)
22. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Acute pancreatitis
Contact dermatitis
OCPs
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones
23. Aplastic crisis in sickle cell disease.
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
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
Parvovirus B19
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
24. Identify key organisms causing diarrhea:
Bladder rupture or urethral injury
E. coli O157:H7
Nephritic syndrome
Number of deaths from birth to 28 days per 1000 live births
25. Tanner stage 3 in a six-year - old female.
Precocious puberty
Elevated ICP - RBCs - xanthochromia
? serum FSH
Number of deaths from 28 days to one year per 1000 live births
26. Treatment for ventricular fibrillation.
Threatened abortion
RCC or other erythropoietin - producing tumor; evaluate with CT scan
S. aureus
Immediate cardioversion
27. CSF findings:
Protamine
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Aseptic (viral) meningitis
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
28. A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Polymyalgia rheumatica
Nephritic syndrome
Pentad of TTP
29. Medical treatment for IBD.
Number of live births per 1000 population
Number of deaths from birth to 28 days per 1000 live births
Bullous pemphigoid
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
30. Treatment for neuroleptic malignant syndrome.
Prevalence
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Asymmetry - border irregularity - color variation - large diameter
Dantrolene or bromocriptine
31. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Membranous glomerulonephritis
Frotteurism (a paraphilia)
Anion gap acidosis and 1
Restrictive pulmonary disease
32. Sensitive tests have few false negatives and are used to rule _____ a disease.
Coccidioidomycosis. Amphotericin B
INH - penicillamine - hydralazine - procainamide
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Out
33. Treatment for acetaminophen overdose.
Rate control - rhythm conversion - and anticoagulation
HBV immunoglobulin
N- acetylcysteine
Nephrotic syndrome
34. Medications and viruses that ? aplastic anemia.
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Mycobacterium tuberculosis
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Oral or topical metronidazole
35. Rigidity and stiffness with resting tremor and masked facies.
36. A patient with a history of lithium use presents with copious amounts of dilute urine.
Nephrogenic diabetes insipidus (DI)
Flumazenil
? protein intake - lactulose - neomycin
Basal cell carcinoma
37. Cold agglutinins.
Bladder rupture or urethral injury
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Abdominal ultrasound and CT
Mycoplasma
38. Glomerulonephritis with hemoptysis.
39. Fetal mortality?
40. Risk factors for pyelonephritis.
Uremic syndrome seen in patients with renal failure
Anemia - thrombocytopenia - and acute renal failure
Metformin
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
41. Hematuria - flank pain - and palpable flank mass.
? Ca2+ - ? K- - ? phosphate - ? uric acid
Pemphigus vulgaris
Allergic interstitial nephritis
Renal cell carcinoma (RCC)
42. The most common pituitary tumor. Treatment?
MS
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
PT
43. Identify key organisms causing diarrhea:
Klebsiella
Vibrio - HAV
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Distal radius (Colles' fracture)
44. What is the immunodeficiency?
Naloxone
Salmonella
Nitroprusside
Wiskott - Aldrich syndrome
45. Sentinel loop on AXR.
Out
Lesch - Nyhan syndrome (purine salvage problem with
The IR of a disease in a population exposed to a particular factor
Acute pancreatitis
46. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Highly sensitive for TB
Type I (distal) RTA
Treat immediately. Consent is implied in emergency situations
Lobular carcinoma in situ
47. Contraceptive methods that protect against PID.
Edrophonium
Diphenhydramine or epinephrine 1:1000
Hypotension - distant heart sounds - and JVD
OCP and barrier contraception
48. An autosomal - recessive disorder with a defect in the GPIIbIIIa platelet receptor and ? platelet aggregation.
49. Precipitants of hemolytic crisis in patients with G6PD deficiency.
Type II (proximal) RTA
Sulfonamides - antimalarial drugs - fava beans
Trauma; the second most common is berry aneurysm
DM - SLE - and amyloidosis
50. Honey- crusted lesions.
Trichomonas vaginitis
Impetigo
RSV bronchiolitis
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'