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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. Infection of small airways with epidemics in winter and spring.
Benzodiazepines
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Radiation
RSV bronchiolitis

2. Causes of transudative effusion.
SIADH due to stress
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Emergent laparotomy to repair perforated viscus - likely stomach
Fanconi's anemia

3. Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
Prevalence
Menometrorrhagia
Osteoarthritis
Lead - time bias

4. 'Dewdrop on a rose petal.'
Inevitable abortion
Lesions of 1
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
S. aureus

5. A patient continues to use cocaine after being in jail - losing his job - and not paying child support.
Substance abuse
Alopecia areata (autoimmune process)
Sheehan's syndrome (postpartum pituitary necrosis)
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant

6. Treatment of SIADH?
Fluid restriction - demeclocycline
Surfactant deficiency
Intraductal papilloma
Neurofibromatosis 1

7. Blood in the urethral meatus or high - riding prostate.
Bladder rupture or urethral injury
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Parvovirus B19

8. Sudden onset of mental status changes - emesis - and liver dysfunction after taking aspirin.

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9. Nontender abdominal mass associated with elevated VMA and HVA.
Neuroblastoma
Rubella
Pseudomonas
Paget's disease

10. Evaluation of a pulsatile abdominal mass and bruit.
HIDA scan
Abdominal ultrasound and CT
Wegener's granulomatosis and Goodpasture's syndrome
Seborrheic dermatitis. Treat with antifungals

11. Epidemics such as influenza
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Higher incidence
Beta- blockers - digoxin - calcium channel blockers
Endometriosis

12. Honey- crusted lesions.
Impetigo
Osteogenesis imperfecta
'Chocolate cysts -' powder burns
Acute pancreatitis

13. Diagnostic test for hypertrophic cardiomyopathy.
AP chest - AP/lateral C- spine - AP pelvis
Bacterial meningitis
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
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)

14. Classic causes of drug - induced hepatitis.
Cellulitis
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Campylobacter
Neisseria meningitidis

15. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
ARDS
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin

16. A condition associated with red 'currant - jelly' stools.
Klebsiella
Hodgkin's lymphoma
HIDA scan
Intussusception

17. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
Hypoxia and hypocarbia
Conduct disorder
Seminoma
68% - 95.5% - 99.7%

18. A significant cause of morbidity in thalassemia patients. Treatment?
AP chest - AP/lateral C- spine - AP pelvis
CF or Hirschsprung's disease
Clomiphene citrate
Iron overload; use deferoxamine

19. Signs of active ischemia during stress testing.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Lichen sclerosus
Angina - ST- segment changes on ECG - or ? BP
Dantrolene or bromocriptine

20. Nonpainful chancre.
E. coli O157:H7
Hypokalemia
1
Choriocarcinoma

21. A 55-year - old patient presents with acute 'broken speech.' What type of aphasia? What lobe and vascular distribution?

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22. Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
Usually resolves spontaneously; may require IVIG and/or corticosteroids
MAOIs
Continuous - painful vaginal bleeding
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1

23. A first - born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Haemophilus ducreyi
Crohn's disease
Bladder rupture or urethral injury
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction

24. Risk factors for pyelonephritis.
Wegener's granulomatosis and Goodpasture's syndrome
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides

25. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
Type IV (distal) RTA
Suspect retinoblastoma
Hypovolemic shock
CA-125 and transvaginal ultrasound

26. Heinz bodies?
Nephrolithiasis
CA-125 and transvaginal ultrasound
ARDS
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy

27. HUS triad?
RSV bronchiolitis
Prerenal
Uterine atony
Anemia - thrombocytopenia - and acute renal failure

28. Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
E. coli O157:H7
Frotteurism (a paraphilia)
Nephrotic syndrome
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline

29. Antibiotics with teratogenic effects.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Lesch - Nyhan syndrome (purine salvage problem with
Malingering
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms

30. A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Naloxone
Incidence and prevalence
RSV bronchiolitis
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)

31. Identify key organisms causing diarrhea:
Parkinson's disease
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
ETEC
Psoriasis

32. Signs of ? ICP (Cushing's triad).
A patient with chest trauma who was previously stable suddenly dies
Hypertension - bradycardia - and abnormal respirations
B12 deficiency
Surfactant deficiency

33. ? CO - ? PCWP - ? PVR.
ARDS
AP chest - AP/lateral C- spine - AP pelvis
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Cardiogenic shock

34. The most common location for an ectopic pregnancy.
SSRIs
OCPs - danazol - GnRH agonists
Ampulla of the oviduct
Diamond - Blackfan anemia

35. Honeycomb pattern on CXR. Diagnosis? Treatment?
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Oral surgery
Intraductal papilloma
Endometriosis

36. Contraceptive methods that protect against PID.
Rubella
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Bruton's X- linked agammaglobulinemia
OCP and barrier contraception

37. Testicular cancer associated with Beta- hCG - AFP.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Choriocarcinoma
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus

38. Low urine specific gravity in the presence of high serum osmolality.
DI
Rubella
Angina - ST- segment changes on ECG - or ? BP
Third - degree heart block

39. Classic CXR findings for pulmonary edema.

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40. Class of drugs that may cause syndrome of muscle rigidity - hyperthermia - autonomic instability - and extrapyramidal symptoms.
Antipsychotics (neuroleptic malignant syndrome)
Metformin
Membranous glomerulonephritis
E. coli O157:H7

41. Identify key organisms causing diarrhea:
Bacillus cereus
SCLC
CML
Lichen sclerosus

42. An agent that reverses the effects of heparin.
Infection - cancer - and autoimmune disease
Oral surgery
Protamine
Angina - ST- segment changes on ECG - or ? BP

43. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
Lead - time bias
Parvovirus B19
1
Conduct disorder

44. Signs of neurogenic shock.
Central pontine myelinolysis
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
Hypotension and bradycardia
Hypoparathyroidism

45. 'Stones - bones - groans - psychiatric overtones.'
Fatigue and impending respiratory failure
Salmonella
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Signs and symptoms of hypercalcemia

46. Sensitive tests have few false negatives and are used to rule _____ a disease.
N- acetylcysteine
SIADH due to stress
Out
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)

47. The number of bacterial culture on a clean - catch specimen to diagnose a UTI.
Anorexia
105 bacteria/mL
Pityriasis rosea
Postinfectious glomerulonephritis

48. Eight surgically correctable causes of hypertension.

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49. Name the organism:
Parkland formula
Streptococcus pneumoniae
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Contact dermatitis

50. Cold agglutinins.
Duchenne muscular dystrophy
Mycoplasma
Third - degree heart block
Klebsiella