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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 most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Lesch - Nyhan syndrome (purine salvage problem with
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
Basal cell carcinoma

2. Heinz bodies?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
ARDS
Naloxone
Glanzmann's thrombasthenia

3. Case - control study
Neither
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Membranous glomerulonephritis

4. Definition of hypertension.
CML
BP > 140/90 on three separate occasions two weeks apart
Femoral hernia
Glomerulonephritis/nephritic syndrome

5. Acid - base disturbance commonly seen in pregnant women.
Hashimoto's thyroiditis
Out
Respiratory alkalosis
Antipsychotics (neuroleptic malignant syndrome)

6. HUS triad?
Suspect retinoblastoma
Lichen sclerosus
Absence seizures
Anemia - thrombocytopenia - and acute renal failure

7. ? CO - ? PCWP - ? PVR.
Amoxicillin
Paget's disease
Septic or anaphylactic shock
Erythema multiforme

8. Caf
The IR of a disease in a population exposed to a particular factor
Exercise stress treadmill with ECG
Neurofibromatosis 1
Colposcopy and endocervical curettage

9. Treatment for benzodiazepine overdose.
Flumazenil
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
OCP and barrier contraception
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots

10. A neonate has meconium ileus.

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11. Name the organism:
M3
Contact dermatitis
Salmonella
Pseudomonas

12. Treatment of DKA.
Pharmacologic stress test (e.g. - dobutamine echo)
Sulfonamides - antimalarial drugs - fava beans
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Seminoma

13. What should always be done prior to LP?
Type II (proximal) RTA
Check for ? ICP; look for papilledema
No. Parental consent is not necessary for the medical treatment of pregnant minors
Small cell lung cancer (SCLC)

14. Electrolyte changes in tumor lysis syndrome.
Hypotension - distant heart sounds - and JVD
Actinic keratosis
? Ca2+ - ? K- - ? phosphate - ? uric acid
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies

15. A 50-year - old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?

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16. The most common cancer in men and the most common cause of death from cancer in men.
Pityriasis rosea
IV penicillin or ampicillin
Absence seizures
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths

17. Which healthy population is susceptible to UTIs?
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Impetigo
Higher prevalence
Pregnant women. Treat this group aggressively because of potential complications

18. Low urine specific gravity in the presence of high serum osmolality.
Postinfectious glomerulonephritis
Distal radius (Colles' fracture)
Fluid restriction - demeclocycline
DI

19. A significant cause of morbidity in thalassemia patients. Treatment?
Anion gap acidosis and 1
Osmotic fragility test
Varicella zoster
Iron overload; use deferoxamine

20. Symptoms of placental abruption.
Continuous - painful vaginal bleeding
Sensitivity
PT
Streptococcus pneumoniae

21. Maternal mortality?
Lung - breast - skin (melanoma) - kidney - GI tract
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Cerebral berry aneurysms (AD PCKD)
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births

22. The most common inherited hemolytic anemia.
Lichen planus
Hereditary spherocytosis
High reliability - low validity
Klebsiella

23. Nonpainful chancre.
1
Biliary tract obstruction
Hashimoto's thyroiditis
E. coli O157:H7

24. Eight surgically correctable causes of hypertension.

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25. The most common causes of hypercalcemia.
AP chest - AP/lateral C- spine - AP pelvis
Confounding variable
Obstructive pulmonary disease (e.g. - asthma)
Malignancy and hyperparathyroidism

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

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27. A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?
S. aureus or S. epidermidis.
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Pharmacologic stress test (e.g. - dobutamine echo)

28. AML subtype associated with DIC.
Suspect retinoblastoma
M3
Osmotic fragility test
Alzheimer's and multi - infarct

29. 1
Placental abruption and placenta previa
Type I (distal) RTA
Actinic keratosis
False. Withdrawing and withholding life are the same from an ethical standpoint

30. Treatment for mild and severe unconjugated hyperbilirubinemia.
TICS
30 cc/hour
Legionella pneumonia
Phototherapy (mild) or exchange transfusion (severe)

31. Meningitis in neonates. Causes? Treatment?
Benzodiazepines
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Colposcopy and endocervical curettage
IV hydration and loop diuretics (furosemide)

32. CSF findings:
Pityriasis rosea
Angina is new - is worsening - or occurs at rest
Subarachnoid hemorrhage (SAH)
Anemia - thrombocytopenia - and acute renal failure

33. A postoperative patient with significant pain presents with hyponatremia and normal volume status.
SIADH due to stress
O2 - analgesia - hydration - and - if severe - transfusion
105 bacteria/mL
Pseudomonas

34. Lab values suggestive of menopause.
Trichomonas vaginitis
Calcium oxalate
Radiation
? serum FSH

35. The most common histology of bladder cancer.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Reaction formation
Transitional cell carcinoma
Asymmetry - border irregularity - color variation - large diameter

36. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Frotteurism (a paraphilia)
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Check for ? ICP; look for papilledema
Uterine atony

37. Risk factors for cholelithiasis.
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Fat - female - fertile - forty - flatulent
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Hyperkalemia

38. Test to rule out urethral injury.
TICS
Retrograde cystourethrogram
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Parainfluenza virus type 1

39. Cold agglutinins.
Mycoplasma
Klebsiella
CML
a - antagonists (phentolamine and phenoxybenzamine)

40. Not contraindications to vaccination.
Infection - cancer - and autoimmune disease
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Chronic lymphocytic leukemia (CLL)
ETEC

41. A 55-year - old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram - negative rods. What is the diagnosis?
Chronic lymphocytic leukemia (CLL)
Legionella pneumonia
Wiskott - Aldrich syndrome
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy

42. Method of calculating fluid repletion in burn patients.
Parkland formula
CHF - shock - and altered mental status
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
Consider Fitz - Hugh - Curtis syndrome

43. Name the organism:
? serum FSH
Acute myelogenous leukemia (AML)
Neisseria meningitidis
Parkinson's disease

44. Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
Continuous positive airway pressure
Squamous cell carcinoma
Wiskott - Aldrich syndrome
Incidence and prevalence

45. Treatment for TTP.
Pentad of TTP
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Uremic syndrome seen in patients with renal failure
Pulsus paradoxus (seen in cardiac tamponade)

46. First - line treatment for moderate hypercalcemia.
Parainfluenza virus type 1
CF or Hirschsprung's disease
IV hydration and loop diuretics (furosemide)
M3

47. Key side effects of atypical antipsychotics.
Rett's disorder
Weight gain - type 2 DM - QT prolongation
Pregnant women. Treat this group aggressively because of potential complications
Pulsus paradoxus (seen in cardiac tamponade)

48. A patient presents with signs of hypocalcemia - high phosphorus - and low PTH.
Hypoparathyroidism
Cirrhosis - CHF - nephritic syndrome
Patent ductus arteriosus (PDA)
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity

49. The first test to perform when a woman presents with amenorrhea.
S. aureus or S. epidermidis.
Beta- hCG; the most common cause of amenorrhea is pregnancy
Immediate needle thoracostomy
Acute mania. Start a mood stabilizer (e.g. - lithium)

50. Sentinel loop on AXR.
Membranous glomerulonephritis
Acute pancreatitis
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Usually resolves spontaneously; may require IVIG and/or corticosteroids