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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. Meningitis in neonates. Causes? Treatment?
Diamond - Blackfan anemia
PT
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Parainfluenza virus type 1
2. How to diagnose and follow a leiomyoma.
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Ultrasound
Higher prevalence
Clomiphene citrate
3. What % lesion is an indication for carotid endarterectomy?
Seventy percent if the stenosis is symptomatic
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Acute myelogenous leukemia (AML)
Intussusception
4. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Alopecia areata (autoimmune process)
Weight gain - type 2 DM - QT prolongation
Salmonella
5. Symptoms of placental abruption.
HIDA scan
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
Continuous - painful vaginal bleeding
Bullous pemphigoid
6. HUS triad?
Rubella
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Anemia - thrombocytopenia - and acute renal failure
Bacillus cereus
7. The most common type of nephrolithiasis.
Endometriosis
Hodgkin's lymphoma
Calcium oxalate
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
8. Cross - sectional survey
Prevalence
CA-125 and transvaginal ultrasound
RSV bronchiolitis
Lung - breast - skin (melanoma) - kidney - GI tract
9. A condition associated with red 'currant - jelly' stools.
Subdural hematoma
Intussusception
Distal radius (Colles' fracture)
Diverticulosis
10. Fertility rate?
Factor V Leiden mutation
Neuroblastoma
Duchenne muscular dystrophy
Number of live births per 1000 women 15-44 years of age
11. Identify key organisms causing diarrhea:
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Vibrio - HAV
105 bacteria/mL
N- acetylcysteine
12. Medical treatment for hepatic encephalopathy.
? protein intake - lactulose - neomycin
Neurofibromatosis 1
Intussusception
Pentad of TTP
13. The most common cause of female infertility.
DM - SLE - and amyloidosis
Endometriosis
Amoxicillin
Hashimoto's thyroiditis
14. Confusion - confabulation - ophthalmoplegia - ataxia.
15. A homeless child is small for his age and has peeling skin and a swollen belly.
Edrophonium
Kwashiorkor (protein malnutrition)
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Anemia of chronic disease
16. Drowsiness - asterixis - nausea - and a pericardial friction rub.
Uremic syndrome seen in patients with renal failure
Metformin
Sulfonamides - antimalarial drugs - fava beans
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
17. Goal hemoglobin A1c for a patient with DM.
Usually resolves spontaneously; may require IVIG and/or corticosteroids
< 7.0
Ophthalmologic exam - CT - and MRI
Basal cell carcinoma
18. 1
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Obstructive pulmonary disease (e.g. - asthma)
Placental abruption and placenta previa
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
19. A middle - aged man presents with acute - onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis - and how did he get it? Treatment?
Out
Lyme disease - Ixodes tick - doxycycline
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
20. Medication to avoid in patients with a history of alcohol withdrawal seizures.
Prerenal
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Neuroleptics
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
21. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Restrictive pulmonary disease
Phencyclidine hydrochloride (PCP) intoxication
1
Frotteurism (a paraphilia)
22. Treatment for malignant hypertension.
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Acute mania. Start a mood stabilizer (e.g. - lithium)
Immediate cardioversion
Nitroprusside
23. A young patient with a family history of sudden death collapses and dies while exercising.
Hypertrophic cardiomyopathy
Coccidioidomycosis. Amphotericin B
Graves' disease
Folate deficiency
24. Definition of unstable angina.
MAOIs
False. Withdrawing and withholding life are the same from an ethical standpoint
Angina is new - is worsening - or occurs at rest
Pityriasis versicolor
25. Cannon 'a' waves.
Third - degree heart block
Threatened abortion
Rate control with carotid massasge or other vagal stimulation
? serum FSH
26. First - line medication for status epilepticus.
CA-125 and transvaginal ultrasound
Infection - febrile seizures - trauma - idiopathic
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
IV benzodiazepine
27. Tests to rule out shaken baby syndrome.
SIADH due to stress
Ophthalmologic exam - CT - and MRI
MAOIs
Check for ? ICP; look for papilledema
28. Postnatal mortality?
Osteogenesis imperfecta
MAOIs
Number of deaths from 28 days to one year per 1000 live births
Mallory- Weiss
29. Complication of scaphoid fracture.
Wait - surgical resection - radiation and/or androgen suppression
Partial mole
Avascular necrosis
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
30. A 55-year - old man presents with irritative and obstructive urinary symptoms. Treatment options?
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Ultrasound
Endometriosis
Rett's disorder
31. Arthritis - conjunctivitis - and urethritis in young men. Associated organisms?
32. Cause of amenorrhea with normal prolactin - no response to estrogen - progesterone challenge - and a history of D&C.
33. Heinz bodies?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Oral or topical metronidazole
Immediate cardioversion
Hyperkalemia
34. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
S. aureus
Protamine
Hypovolemic shock
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
35. A patient with a history of lithium use presents with copious amounts of dilute urine.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Nephrogenic diabetes insipidus (DI)
Subdural hematoma
Contact dermatitis
36. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
CML
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7
Lesion of 1
37. A 40-year - old obese female with elevated alkaline phosphatase - elevated bilirubin - pruritus - dark urine - and clay- colored stools.
Ophthalmologic exam - CT - and MRI
Amoxicillin
Biliary tract obstruction
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
38. Four signs and symptoms of streptococcal pharyngitis.
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Alzheimer's and multi - infarct
Rett's disorder
Central pontine myelinolysis
39. Should a - or Beta- antagonists be used first in treating pheochromocytoma?
a - antagonists (phentolamine and phenoxybenzamine)
Beta- blockers - Ca2+ channel blockers - TCAs
Ulcerative colitis
Lesch - Nyhan syndrome (purine salvage problem with
40. Glomerulonephritis with hemoptysis.
41. CSF findings with SAH.
105 bacteria/mL
Sarcoidosis
Panic disorder
Elevated ICP - RBCs - xanthochromia
42. Radiographic indications for surgery in patients with acute abdomen.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Isolation
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Pseudomonas
43. Which of the following are ? in DIC: fibrin split products - D- dimer - fibrinogen - platelets - and hematocrit.
Giardia
Hypovolemic shock
Diphenhydramine or epinephrine 1:1000
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
44. Unilateral - severe periorbital headache with tearing and conjunctival erythema.
Parkland formula
Cluster headache
IgA nephropathy (Berger's disease)
Fanconi's anemia
45. An 11-year - old obese - African - American boy presents with sudden onset of limp. Diagnosis? Workup?
Suspect retinoblastoma
SCLC
Continuous - painful vaginal bleeding
Slipped capital femoral epiphyses. AP and frog - leg lateral view
46. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Hereditary spherocytosis
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Suspect ankylosing spondylitis. Check HLA- B27
Duodenal atresia
47. Name the organism:
Acute pancreatitis
Fanconi's anemia
Trauma; the second most common is berry aneurysm
Actinomyces israelii
48. A woman who was abused as a child frequently feels outside of or detached from her body.
Depersonalization disorder
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Prevalence
Sulfonamides - antimalarial drugs - fava beans
49. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Threatened abortion
IgA nephropathy (Berger's disease)
1
50. Findings in 3
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Duchenne muscular dystrophy
Identify cause; pressors (e.g. - dobutamine)