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. Name the organism:
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Lesion of 1
Toxoplasma gondii
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies


2. A crescent - shaped hyperdensity on CT that does not cross the midline.
Pemphigus vulgaris
Aseptic (viral) meningitis
Osteogenesis imperfecta
Subdural hematoma


3. Relative risk?
Hypertension - bradycardia - and abnormal respirations
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Frotteurism (a paraphilia)
The IR of a disease in a population exposed to a particular factor


4. A febrile patient with a history of diabetes presents with a red - swollen - painful lower extremity.
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Toxoplasma gondii
Central pontine myelinolysis
Cellulitis


5. Differential of hypervolemic hyponatremia.
Femoral hernia
Panic disorder
RSV bronchiolitis
Cirrhosis - CHF - nephritic syndrome


6. Post - HBV exposure treatment.
HBV immunoglobulin
Infection - febrile seizures - trauma - idiopathic
Oral surgery
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe


7. Characteristics of 2

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8. What is the immunodeficiency?
Nephrotic syndrome
Chronic granulomatous disease
Menometrorrhagia
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe


9. Combined UMN and LMN disorder.
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Lyme disease - Ixodes tick - doxycycline
ALS
Pheochromocytoma


10. The most common form of nephritic syndrome.
HBV immunoglobulin
Membranous glomerulonephritis
Anemia of chronic disease
OCP and barrier contraception


11. Cannon 'a' waves.
OCPs - danazol - GnRH agonists
Third - degree heart block
Prinzmetal's angina
Asherman's syndrome


12. The coagulation parameter affected by warfarin.
105 bacteria/mL
PT
Regression
Osteogenesis imperfecta


13. 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 _____.
Fluid restriction - demeclocycline
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
Confounding variable
Treat existing heart failure and replace the tricuspid valve


14. + Nikolsky's sign.
HBV immunoglobulin
Toxoplasma gondii
Pemphigus vulgaris
CML


15. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Surfactant deficiency
46 -XX
Postinfectious glomerulonephritis
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis


16. Test to rule out urethral injury.
Phototherapy (mild) or exchange transfusion (severe)
Precocious puberty
Retrograde cystourethrogram
Pheochromocytoma


17. Albuminocytologic dissociation.
MS
Guillain - Barr
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
IV hydration and loop diuretics (furosemide)


18. A 10-year - old child presents in status epilepticus - but her parents refuse treatment on religious grounds.

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19. Non - small cell lung cancer (NSCLC) associated with hypercalcemia.
Varicella zoster
M3
Postinfectious glomerulonephritis
Squamous cell carcinoma


20. Name the organism:
Regresses after menopause
Klebsiella
Oral surgery
Self - limited - painless vaginal bleeding


21. The most common cause of postpartum hemorrhage.
Uterine atony
OCPs
S. aureus
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella


22. A significant cause of morbidity in thalassemia patients. Treatment?
Iron overload; use deferoxamine
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Check for ? ICP; look for papilledema
Neuroleptics


23. Antihypertensive for a diabetic patient with proteinuria.
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
ACEI
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Dressler's syndrome: fever - pericarditis - ? ESR


24. Lab values suggestive of menopause.
Displacement
? serum FSH
Hypoparathyroidism
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births


25. Acceptable urine output in a trauma patient.
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
50 cc/hour


26. The most common cause of seizures in young adults (18-35 years).
Trauma - alcohol withdrawal - brain tumor
Nephrotic syndrome
Ophthalmologic exam - CT - and MRI
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)


27. Class of drugs that may cause syndrome of muscle rigidity - hyperthermia - autonomic instability - and extrapyramidal symptoms.
Antipsychotics (neuroleptic malignant syndrome)
Seborrheic dermatitis. Treat with antifungals
Oral or topical metronidazole
Coarctation of the aorta


28. Treatment for Guillain - Barr
B12 deficiency
IVIG or plasmapheresis
Yersinia
Fluid restriction - demeclocycline


29. Classic ECG finding in atrial flutter.

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30. The most common cause of bloody nipple discharge.
Calcium oxalate
Intraductal papilloma
Inhaled Beta- agonists and inhaled corticosteroids
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis


31. PFT showing ? FEV1/FVC.
Uremic syndrome seen in patients with renal failure
Obstructive pulmonary disease (e.g. - asthma)
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Identify cause; fluid and blood repletion


32. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Crohn's disease
Displacement
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Pheochromocytoma


33. Premalignant lesion from sun exposure that can ? squamous cell carcinoma.
Actinic keratosis
MAOIs
Small cell lung cancer (SCLC)
Phencyclidine hydrochloride (PCP) intoxication


34. Salicylate ingestion ? In What type of acid - base disorder?
Anion gap acidosis and 1
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
Subarachnoid hemorrhage (SAH)
A patient's family cannot require that a doctor withhold information from the patient


35. Neonatal mortality?
Number of deaths from birth to 28 days per 1000 live births
Pseudomonas
Squamous cell carcinoma
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)


36. A condition associated with red 'currant - jelly' stools.
Rubella
Intussusception
Cellulitis
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)


37. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Conduct disorder
Neuroleptic malignant syndrome
Observational bias


38. The most serious side effect of clozapine.
Endometrial or estrogen receptor - breast cancer
Transitional cell carcinoma
Agranulocytosis
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant


39. Presence of red cell casts in urine sediment.
Duchenne muscular dystrophy
Basal cell carcinoma
Fluids and antibiotics
Glomerulonephritis/nephritic syndrome


40. A painful - recurrent vesicular eruption of mucocutaneous surfaces.
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Herpes simplex
Wegener's granulomatosis and Goodpasture's 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


41. A 'blueberry muffin' rash is characteristic of what congenital infection?
Lead - time bias
Endometrial or estrogen receptor - breast cancer
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Rubella


42. Honeycomb pattern on CXR. Diagnosis? Treatment?
Administration of DDAVP ? serum osmolality and free water restriction
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Number of deaths from 20 weeks' gestation to birth per 1000 total births
Oral or topical metronidazole


43. Common symptoms associated with silent MIs.
Prevalence
CHF - shock - and altered mental status
68% - 95.5% - 99.7%
Nephrolithiasis


44. Classic CXR findings for pulmonary edema.

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45. Lab findings in Hashimoto's thyroiditis.
Hypovolemic shock
High TSH - low T4 - antimicrosomal antibodies
Yersinia
Pentad of TTP


46. An autosomal - recessive disorder with a defect in the GPIIbIIIa platelet receptor and ? platelet aggregation.

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47. Evaluation of a pulsatile abdominal mass and bruit.
Highly sensitive for TB
Reaction formation
Campylobacter
Abdominal ultrasound and CT


48. Electrolyte changes in tumor lysis syndrome.
Sarcoidosis
? Ca2+ - ? K- - ? phosphate - ? uric acid
Nephrolithiasis
Factitious disorder (Munchausen syndrome)


49. How to diagnose and follow a leiomyoma.
Suspect retinoblastoma
Ultrasound
Sporothrix schenckii
OCP and barrier contraception


50. Diagnostic test for hereditary spherocytosis.
Parvovirus B19
Osmotic fragility test
Observational bias
Hashimoto's thyroiditis