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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. Sentinel loop on AXR.
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
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
Acute pancreatitis
Psoriasis

2. Salicylate ingestion ? In What type of acid - base disorder?
Pregnant women. Treat this group aggressively because of potential complications
Anion gap acidosis and 1
Mycoplasma
Osteoarthritis

3. Key side effects of atypical antipsychotics.
Weight gain - type 2 DM - QT prolongation
Surfactant deficiency
ARDS
Femoral hernia

4. Characteristics favoring carcinoma in an isolated pulmonary nodule.
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
S. aureus
Hypertrophic cardiomyopathy
Number of deaths from 20 weeks' gestation to birth per 1000 total births

5. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
Observational bias
68% - 95.5% - 99.7%
Nephritic syndrome
Vibrio - HAV

6. ECG findings suggesting MI.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Parkinson's disease
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
DM - SLE - and amyloidosis

7. Administer to a symptomatic patient to diagnose myasthenia gravis.
Pemphigus vulgaris
Edrophonium
Displacement
Pseudogout

8. Molar pregnancy containing fetal tissue.
Conduct disorder
Partial mole
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Polymyalgia rheumatica

9. An antidiabetic agent associated with lactic acidosis.
Metformin
Cerebral berry aneurysms (AD PCKD)
Aseptic (viral) meningitis
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy

10. PFT showing ? FEV1/FVC.
MCP and PIP joints; DIP joints are spared
Obstructive pulmonary disease (e.g. - asthma)
Conduct disorder
Flumazenil

11. 'Doughy skin.'
Hypernatremia
SIADH due to stress
Lobular carcinoma in situ
Wernicke's encephalopathy due to a deficiency of thiamine

12. True or false: Withdrawing life - sustaining care is ethically distinct from withholding sustaining care.
Distal radius (Colles' fracture)
Uterine massage; if that fails - give oxytocin
Bladder rupture or urethral injury
False. Withdrawing and withholding life are the same from an ethical standpoint

13. Name the organism:
Hypertension - bradycardia - and abnormal respirations
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Neisseria meningitidis
Anion gap acidosis and 1

14. Hernia with highest risk of incarceration
Femoral hernia
Fanconi's anemia
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Sensitivity

15. Honey- crusted lesions.
Rubella
Neuroleptic malignant syndrome
Number of deaths per 1000 population
Impetigo

16. A 24-year - old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Pityriasis versicolor
Nephrotic syndrome
Conflict of interest

17. Describe a test that consistently gives identical results - but the results are wrong.
Bladder rupture or urethral injury
Ultrasound
High reliability - low validity
Legionella pneumonia

18. CSF findings:
Subarachnoid hemorrhage (SAH)
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Edrophonium
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline

19. Vaccinations at a six- month well - child visit.
HBV - DTaP - Hib - IPV - PCV
Femoral hernia
Rate control with carotid massasge or other vagal stimulation
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)

20. Macrocytic - megaloblastic anemia without neurologic symptoms.
Check for ? ICP; look for papilledema
Folate deficiency
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Edrophonium

21. Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Neither
Number of live births per 1000 women 15-44 years of age
HBV immunoglobulin

22. Rhomboid - shaped - positively birefringent crystals on joint fluid aspirate.
Pseudogout
Neither
Contact dermatitis
Betamethasone or dexamethasone

23. Fetal mortality?

24. A first - born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Nephrotic syndrome
Vibrio - HAV
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction

25. When can a physician refuse to continue treating a patient on the grounds of futility?
M3
When there is no rationale for treatment - maximal intervention is failing - a given intervention has already failed - and treatment will not achieve the goals of care
Colposcopy and endocervical curettage
50 cc/hour

26. HUS triad?
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Anemia - thrombocytopenia - and acute renal failure
DI
Uterine massage; if that fails - give oxytocin

27. Cause of neonatal RDS.
Lesion of 1
Surfactant deficiency
Avascular necrosis
Neuroleptics

28. Arthritis - conjunctivitis - and urethritis in young men. Associated organisms?

29. Life - threatening muscle rigidity - fever - and rhabdomyolysis.
Actinomyces israelii
Neuroleptic malignant syndrome
Benzodiazepines
Third - degree heart block

30. Name the organism:
Klebsiella
Observational bias
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
The IR of a disease in a population exposed to a particular factor

31. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
Respiratory alkalosis
V/Q scan
TICS
1

32. Treatment of SIADH?
Femoral hernia
Wrist drop - loss of thumb abduction
Hypotension and bradycardia
Fluid restriction - demeclocycline

33. Case - control study
? Ca2+ - ? K- - ? phosphate - ? uric acid
Avascular necrosis
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Neither

34. Name the defense mechanism:
Osteogenesis imperfecta
Displacement
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
IV hydration and loop diuretics (furosemide)

35. Hematuria - hypertension - and oliguria.
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Confounding variable
Betamethasone or dexamethasone
Nephritic syndrome

36. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
IV benzodiazepine
Basal cell carcinoma
Rate control with carotid massasge or other vagal stimulation

37. Criteria for exudative effusion.
Diamond - Blackfan anemia
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
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

38. Laparoscopic findings in endometriosis.

39. First step in the management of a patient with acute GI bleed.
Levodopa/carbidopa
Establish the ABCs
Never
Prerenal

40. Differential of hypervolemic hyponatremia.
Cirrhosis - CHF - nephritic syndrome
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
No. Parental consent is not necessary for the medical treatment of pregnant minors
Pityriasis versicolor

41. A patient with a history of lithium use presents with copious amounts of dilute urine.
Nephrogenic diabetes insipidus (DI)
Factitious disorder (Munchausen syndrome)
Membranous glomerulonephritis
Angina - ST- segment changes on ECG - or ? BP

42. A patient presents with weakness - nausea - vomiting - weight loss - and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
Wernicke's encephalopathy due to a deficiency of thiamine
1
Never
Sarcoidosis

43. A patient presents with pain on passive movement - pallor - poikilothermia - paresthesias - paralysis - and pulselessness. Treatment?
All - compartment fasciotomy for suspected compartment syndrome
Number of deaths from 28 days to one year per 1000 live births
Bacillus cereus
Salmonella

44. AML subtype associated with DIC.
ETEC
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
M3
Higher prevalence

45. A two - month - old presents with nonbilious projectile emesis. What are the appropriate steps in management?
Cirrhosis - CHF - nephritic syndrome
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Sporothrix schenckii
Huntington's disease

46. Rigidity and stiffness with resting tremor and masked facies.

47. Cohort study
PT
Neuroleptics
? protein intake - lactulose - neomycin
Incidence and prevalence

48. Sensitive tests have few false negatives and are used to rule _____ a disease.
Consider Fitz - Hugh - Curtis syndrome
Surfactant deficiency
Out
Folate deficiency

49. Testicular cancer associated with Beta- hCG - AFP.
Coccidioidomycosis. Amphotericin B
Choriocarcinoma
Anemia of chronic disease
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline

50. Treatment of AF.
Anorexia
Rate control - rhythm conversion - and anticoagulation
RSV bronchiolitis
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1