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. Why are Beta- blockers contraindicated in diabetics?
Lichen sclerosus
105 bacteria/mL
They can mask symptoms of hypoglycemia
Membranous glomerulonephritis


2. Difference between a cohort and a case - control study.
High TSH - low T4 - antimicrosomal antibodies
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
1
ACEI


3. Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
CA-125 and transvaginal ultrasound
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Osteoarthritis
Fatigue and impending respiratory failure


4. Life - threatening muscle rigidity - fever - and rhabdomyolysis.
Number of deaths from 28 days to one year per 1000 live births
Neuroleptic malignant syndrome
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
MAOIs


5. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Suspect retinoblastoma
Selective IgA deficiency
Partial mole
Treat existing heart failure and replace the tricuspid valve


6. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
PT
Conduct disorder
Pityriasis versicolor
Crohn's disease


7. In which patients do you initiate colorectal cancer screening early?
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Hypertrophic cardiomyopathy
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
Erythema multiforme


8. Inflammation and epithelial thinning of the anogenital area - predominantly in postmenopausal women.
Paget's disease
Actinomyces israelii
Lichen sclerosus
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births


9. What is the metabolic syndrome?
Cellulitis
DI
Allergic interstitial nephritis
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states


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

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


11. Treatment for atrial fibrillation.
Number of live births per 1000 population
Anticoagulation - rate control - cardioversion
BP > 140/90 on three separate occasions two weeks apart
Allergic interstitial nephritis


12. Antihypertensive for a diabetic patient with proteinuria.
ACEI
Uremic syndrome seen in patients with renal failure
Agranulocytosis
46 -XX


13. Treatment for mild and severe unconjugated hyperbilirubinemia.
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Varicella zoster
Phototherapy (mild) or exchange transfusion (severe)
Frotteurism (a paraphilia)


14. Elevated erythropoietin level - elevated hematocrit - and normal O2 saturation suggest?
Parvovirus B19
Parainfluenza virus type 1
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Number of deaths per 1000 population


15. Identify key organisms causing diarrhea:
Taenia solium (cysticercosis)
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Rubella
Surfactant deficiency


16. Signs of air embolism.
Sporothrix schenckii
105 bacteria/mL
All - compartment fasciotomy for suspected compartment syndrome
A patient with chest trauma who was previously stable suddenly dies


17. Case - control study
Neither
Anemia - thrombocytopenia - and acute renal failure
Diphenhydramine or epinephrine 1:1000
Lichen planus


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?
Inevitable abortion
Normal
Asymmetry - border irregularity - color variation - large diameter
Retinoic acid


19. Tests to rule out shaken baby syndrome.
Seborrheic dermatitis. Treat with antifungals
Psoriasis
Ophthalmologic exam - CT - and MRI
Graves' disease


20. Infection of small airways with epidemics in winter and spring.
RSV bronchiolitis
Nephrotic syndrome
Kwashiorkor (protein malnutrition)
Respiratory alkalosis


21. Odds ratio?
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Prinzmetal's angina
Crohn's disease
Broca's aphasia. Frontal lobe - left MCA distribution


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

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


23. Beck's triad for cardiac tamponade.
Hypotension - distant heart sounds - and JVD
Number of deaths from birth to 28 days per 1000 live births
1
Elevated ICP - RBCs - xanthochromia


24. Treatment for opioid overdose.
Taenia solium (cysticercosis)
Colposcopy and endocervical curettage
Prevalence
Naloxone


25. Treatment for DTs.
Benzodiazepines
N- acetylcysteine
Usually resolves spontaneously; may require IVIG and/or corticosteroids
CA-125 and transvaginal ultrasound


26. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Duchenne muscular dystrophy
Neuroleptics
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Asherman's syndrome


27. Definition of hypertension.
Coccidioidomycosis. Amphotericin B
Suspect ankylosing spondylitis. Check HLA- B27
Alopecia areata (autoimmune process)
BP > 140/90 on three separate occasions two weeks apart


28. Complication of scaphoid fracture.
Surfactant deficiency
No. Parental consent is not necessary for the medical treatment of pregnant minors
Lyme disease - Ixodes tick - doxycycline
Avascular necrosis


29. A 30-year - old woman has unpredictable urine loss. Examination is normal. Medical options?
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
'Chocolate cysts -' powder burns
Endometrial biopsy
Anemia - thrombocytopenia - and acute renal failure


30. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Kegel exercises - estrogen - pessaries for stress incontinence
Check for ? ICP; look for papilledema
Hyperkalemia
Alopecia areata (autoimmune process)


31. Ring - enhancing brain lesion on CT with seizures
Taenia solium (cysticercosis)
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
Uterine massage; if that fails - give oxytocin
Selective IgA deficiency


32. First - line treatment for moderate hypercalcemia.
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Type II (proximal) RTA
ACEI
IV hydration and loop diuretics (furosemide)


33. A young patient has angina at rest with ST- segment elevation. Cardiac enzymes are normal.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


34. Annual screening for women with a strong family history of ovarian cancer.
Calcium oxalate
Administration of DDAVP ? serum osmolality and free water restriction
Panic disorder
CA-125 and transvaginal ultrasound


35. Name the organism:
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Pasteurella multocida
Osmotic fragility test
Acute myelogenous leukemia (AML)


36. Therapy for polycystic ovarian syndrome.
Patient on dopamine antagonist
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Dissociative fugue
Weight loss and OCPs


37. Endocarditis prophylaxis regimens.
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Weight loss and OCPs
Oral surgery
Neisseria meningitidis


38. The most common cause of hypothyroidism.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


39. Indications for medical treatment of ectopic pregnancy.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


40. Maternal mortality?
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
MAOIs
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing
Seborrheic dermatitis. Treat with antifungals


41. Treatment of tension pneumothorax.
Actinic keratosis
Threatened abortion
Identify cause; fluid and blood repletion
Immediate needle thoracostomy


42. Eight surgically correctable causes of hypertension.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


43. A painful - recurrent vesicular eruption of mucocutaneous surfaces.
Herpes simplex
68% - 95.5% - 99.7%
Iron deficiency anemia
Treat because the disease represents an immediate threat to the child's life. Then seek a court order


44. Chronic diseases such as SLE
Higher prevalence
ARDS
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Trauma; the second most common is berry aneurysm


45. A 55-year - old obese patient presents with dirty - velvety patches on the back of the neck.
'Sawtooth' P waves
The IR of a disease in a population exposed to a particular factor
Hypotension - distant heart sounds - and JVD
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes


46. Four causes of microcytic anemia.
MCP and PIP joints; DIP joints are spared
TICS
Diphenhydramine or epinephrine 1:1000
Stasis - hypercoagulability - endothelial damage


47. Meningitis in infants. Causes? Treatment?
Respiratory alkalosis
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Endometrial biopsy
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin


48. Lab values suggestive of menopause.
Naloxone
? serum FSH
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
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


49. Medical treatment for IBD.
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Hypertension - bradycardia - and abnormal respirations
Endometriosis
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity


50. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
Threatened abortion
Impetigo
Lesions of 1
Seborrheic dermatitis. Treat with antifungals