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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. The mainstay of Parkinson's therapy.
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
? Ca2+ - ? K- - ? phosphate - ? uric acid
Mycoplasma
Levodopa/carbidopa

2. A condition associated with red 'currant - jelly' stools.
They can mask symptoms of hypoglycemia
Intussusception
Nephrotic syndrome
Contact dermatitis

3. CSF findings:
Aseptic (viral) meningitis
Bullous pemphigoid
Intussusception
Huntington's disease

4. Rhomboid - shaped - positively birefringent crystals on joint fluid aspirate.
Reaction formation
TICS
Immediate cardioversion
Pseudogout

5. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
Huntington's disease
Threatened abortion
Endometriosis
Pheochromocytoma

6. Anemia associated with absent radii and thumbs - diffuse hyperpigmentation - caf

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7. Life - threatening muscle rigidity - fever - and rhabdomyolysis.
Squamous cell carcinoma
Immediate needle thoracostomy
Neuroleptic malignant syndrome
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins

8. The most common 1
Nephrolithiasis
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Multiple myeloma
Seborrheic dermatitis. Treat with antifungals

9. Iris - like target lesions.
Erythema multiforme
Trauma; the second most common is berry aneurysm
IV penicillin or ampicillin
Polymyalgia rheumatica

10. Complication of scaphoid fracture.
CHF - shock - and altered mental status
Klebsiella
RSV bronchiolitis
Avascular necrosis

11. Name the defense mechanism:
Flumazenil
Pityriasis versicolor
Isolation
Cardiogenic shock

12. Four signs and symptoms of streptococcal pharyngitis.
Femoral hernia
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Number of deaths per 1000 population

13. Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
Weight loss and OCPs
Wait - surgical resection - radiation and/or androgen suppression
Headache
Inevitable abortion

14. What % lesion is an indication for carotid endarterectomy?
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Murphy's sign - seen in acute cholecystitis
Weight loss and OCPs
Seventy percent if the stenosis is symptomatic

15. The most common organism in burn - related infections.
Avascular necrosis
Huntington's disease
Pseudomonas
TICS

16. Treatment for TTP.
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Nephrolithiasis

17. Odds ratio?
Seborrheic dermatitis. Treat with antifungals
Radiation
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Hypertrophic cardiomyopathy

18. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Oral or topical metronidazole
Malignancy and hyperparathyroidism
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Normal

19. The most common inherited cause of hypercoagulability.
V/Q scan
Factor V Leiden mutation
Frotteurism (a paraphilia)
Ulcerative colitis

20. Appropriate diagnostic test?
Pharmacologic stress test (e.g. - dobutamine echo)
Anorexia
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Incidence and prevalence

21. A patient presents with recent PID with RUQ pain.
Prevalence
Consider Fitz - Hugh - Curtis syndrome
Low - voltage - diffuse ST- segment elevation
Diverticulosis

22. Classic ECG finding in atrial flutter.

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23. Red plaques with silvery- white scales and sharp margins.
Phototherapy (mild) or exchange transfusion (severe)
Osteoarthritis
Psoriasis
Benzodiazepines

24. A 17-year - old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Conversion disorder
Frotteurism (a paraphilia)
Distal radius (Colles' fracture)

25. Honey- crusted lesions.
High reliability - low validity
Impetigo
Non - Hodgkin's lymphoma
Basal cell carcinoma

26. Treatment for malignant hypertension.
< 7.0
Nitroprusside
S. aureus
ALS

27. A 'blueberry muffin' rash is characteristic of what congenital infection?
Bruton's X- linked agammaglobulinemia
Confounding variable
Rubella
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

28. Extraintestinal manifestations of IBD.
Higher incidence
Hypokalemia
SIADH due to stress
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1

29. Trauma series.
Excessive EtOH
AP chest - AP/lateral C- spine - AP pelvis
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
50 cc/hour

30. Identify key organisms causing diarrhea:
Cardiogenic shock
Lichen sclerosus
Phencyclidine hydrochloride (PCP) intoxication
Salmonella

31. A 24-year - old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
Anorexia
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Treat existing heart failure and replace the tricuspid valve
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension

32. Ring - enhancing brain lesion on CT with seizures
Taenia solium (cysticercosis)
50 cc/hour
? serum FSH
Choriocarcinoma

33. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
Wegener's granulomatosis and Goodpasture's syndrome
Wait - surgical resection - radiation and/or androgen suppression
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Lead - time bias

34. Cohort study
ARDS
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Incidence and prevalence
Coarctation of the aorta

35. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Administration of DDAVP ? serum osmolality and free water restriction
Nephritic syndrome
OCPs

36. Treatment of tension pneumothorax.
Cellulitis
Immediate needle thoracostomy
Type IV (distal) RTA
Prerenal

37. Not contraindications to vaccination.
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Colposcopy and endocervical curettage
Check for ? ICP; look for papilledema
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity

38. Risk factors for cholelithiasis.
Identify cause; pressors (e.g. - dobutamine)
Fat - female - fertile - forty - flatulent
Klebsiella
Diphenhydramine or epinephrine 1:1000

39. Findings in 3
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Small cell lung cancer (SCLC)
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Clomiphene citrate

40. The coagulation parameter affected by warfarin.
Nephrolithiasis
PT
Check for ? ICP; look for papilledema
Cellulitis

41. Bilious emesis within hours after the first feeding.
Duodenal atresia
Hypoxia and hypocarbia
Glomerulonephritis/nephritic syndrome
Iron overload; use deferoxamine

42. Treatment for postpartum hemorrhage.
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Uterine massage; if that fails - give oxytocin
Glomerulonephritis/nephritic syndrome
DI

43. Treatment for Guillain - Barr
IVIG or plasmapheresis
Lung - breast - skin (melanoma) - kidney - GI tract
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Respiratory alkalosis

44. RTA associated with abnormal HCO3 - and rickets.
Out
Type II (proximal) RTA
High reliability - low validity
IV benzodiazepine

45. Identify key organisms causing diarrhea:
Toxoplasma gondii
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Guillain - Barr
S. aureus

46. Test to rule out urethral injury.
Trichomonas vaginitis
Conflict of interest
50 cc/hour
Retrograde cystourethrogram

47. Key side effects of atypical antipsychotics.
Chronic lymphocytic leukemia (CLL)
Prinzmetal's angina
Intussusception
Weight gain - type 2 DM - QT prolongation

48. Identify key organisms causing diarrhea:
Endometrial or estrogen receptor - breast cancer
Clostridium difficile
Normal
Wegener's granulomatosis and Goodpasture's syndrome

49. A 15-year - old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
No. Parental consent is not necessary for the medical treatment of pregnant minors
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
IVIG or plasmapheresis

50. Honeycomb pattern on CXR. Diagnosis? Treatment?
Identify cause; pressors (e.g. - dobutamine)
Coarctation of the aorta
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Lung - breast - skin (melanoma) - kidney - GI tract