Test your basic knowledge |

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. Treatment for AML M3.
Retinoic acid
Ampulla of the oviduct
Precocious puberty
Immediate needle thoracostomy

2. Conditions in which confidentiality must be overridden.
Osgood - Schlatter disease
Bruton's X- linked agammaglobulinemia
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Suspect ankylosing spondylitis. Check HLA- B27

3. Identify key organisms causing diarrhea:
HGPRTase deficiency)
Colposcopy and endocervical curettage
ETEC
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity

4. A two - month - old presents with nonbilious projectile emesis. What are the appropriate steps in management?
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Exercise stress treadmill with ECG

5. Drugs that slow AV node transmission.
HBV immunoglobulin
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
CA-125 and transvaginal ultrasound
Beta- blockers - digoxin - calcium channel blockers

6. Unopposed estrogen is contraindicated in which cancers?
Endometrial or estrogen receptor - breast cancer
Hodgkin's lymphoma
Naloxone
Depersonalization disorder

7. Hematuria - hypertension - and oliguria.
Varicella zoster
Nephritic syndrome
Glomerulonephritis/nephritic syndrome
Pseudomonas

8. Indications for surgical repair of abdominal aortic aneurysm.
Excessive EtOH
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Hypotension and bradycardia
Inhaled Beta- agonists and inhaled corticosteroids

9. Treatment for postpartum hemorrhage.
Uterine massage; if that fails - give oxytocin
Substance abuse
Obstructive pulmonary disease (e.g. - asthma)
Lead - time bias

10. Identify key organisms causing diarrhea:
Elevated ICP - RBCs - xanthochromia
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Check for ? ICP; look for papilledema
Yersinia

11. Fetal mortality?

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

12. Causes of drug - induced SLE.
INH - penicillamine - hydralazine - procainamide
Mallory- Weiss
Observational bias
Higher incidence

13. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Establish the ABCs
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Parkinson's disease

14. Low urine specific gravity in the presence of high serum osmolality.
DI
Pemphigus vulgaris
HGPRTase deficiency)
Neuroleptics

15. A fall in systolic BP of > 10 mmHg with inspiration.
Dressler's syndrome: fever - pericarditis - ? ESR
Aseptic (viral) meningitis
105 bacteria/mL
Pulsus paradoxus (seen in cardiac tamponade)

16. A 30-year - old woman has unpredictable urine loss. Examination is normal. Medical options?
? serum FSH
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Wiskott - Aldrich syndrome
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.

17. Sensitive tests have few false negatives and are used to rule _____ a disease.
Out
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Patient on dopamine antagonist
Bacillus cereus

18. The most common form of nephritic syndrome.
Phototherapy (mild) or exchange transfusion (severe)
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
Bacterial meningitis
Membranous glomerulonephritis

19. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Trichomonas vaginitis
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
B12 deficiency
Infection - cancer - and autoimmune disease

20. CSF findings:
Infection - cancer - and autoimmune disease
Murphy's sign - seen in acute cholecystitis
Aseptic (viral) 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

21. A 15-year - old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
Third - degree heart block
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
Retinoic acid

22. Treatment of DKA.
Isolation
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Kl
Seventy percent if the stenosis is symptomatic

23. Albuminocytologic dissociation.
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
HBV - DTaP - Hib - IPV - PCV
Niacin
Guillain - Barr

24. Name the organism:
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
1
Isolation
Toxoplasma gondii

25. Identify key organisms causing diarrhea:
Patent ductus arteriosus (PDA)
Isolation
Giardia
ALS

26. Characteristics favoring carcinoma in an isolated pulmonary nodule.
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Malignancy and hyperparathyroidism
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)

27. Erythema migrans.
Cluster headache
Substance abuse
Lesion of 1
CHF - shock - and altered mental status

28. Test to rule out urethral injury.
? Ca2+ - ? K- - ? phosphate - ? uric acid
Uterine massage; if that fails - give oxytocin
Toxoplasma gondii
Retrograde cystourethrogram

29. The most common cancer in men and the most common cause of death from cancer in men.
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Asherman's syndrome
Membranous glomerulonephritis
Amoxicillin

30. Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Suspect ankylosing spondylitis. Check HLA- B27
7-10 days
Hyperkalemia
Hereditary spherocytosis

31. Maternal mortality?
Klebsiella
RSV bronchiolitis
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births

32. Which of the following are ? in DIC: fibrin split products - D- dimer - fibrinogen - platelets - and hematocrit.
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Diverticulosis
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.

33. Risk factors for cholelithiasis.
Hypotension - distant heart sounds - and JVD
Fat - female - fertile - forty - flatulent
Hypertension - bradycardia - and abnormal respirations
Precocious puberty

34. Identify key organisms causing diarrhea:
Sensitivity
Clostridium difficile
Broca's aphasia. Frontal lobe - left MCA distribution
Salmonella

35. Shortest AP diameter of the pelvis.
Amoxicillin
Allergic interstitial nephritis
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Protamine

36. Medical options for endometriosis.
Panic disorder
OCPs - danazol - GnRH agonists
Restrictive pulmonary disease
Weight loss and OCPs

37. CSF findings:
Uremic syndrome seen in patients with renal failure
Bacterial meningitis
Hypovolemic shock
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.

38. A patient from California or Arizona presents with fever - malaise - cough - and night sweats. Diagnosis? Treatment?
Coccidioidomycosis. Amphotericin B
Anemia - thrombocytopenia - and acute renal failure
Crohn's disease
Obstructive pulmonary disease (e.g. - asthma)

39. A condition associated with red 'currant - jelly' stools.
Intussusception
1
Avascular necrosis
Neisseria meningitidis

40. Caf
Fluids and antibiotics
Giardia
Uremic syndrome seen in patients with renal failure
Neurofibromatosis 1

41. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Flumazenil
Rett's disorder
Kegel exercises - estrogen - pessaries for stress incontinence
Pheochromocytoma

42. Autoimmune complication occurring 2-4 weeks post - MI.

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

43. Treatment for acute coronary syndrome.
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
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Pityriasis rosea

44. A child has loss of red light reflex. Diagnosis?
Suspect retinoblastoma
Neurofibromatosis 1
Cardiogenic shock
Fanconi's anemia

45. Red plaques with silvery- white scales and sharp margins.
Antipsychotics (neuroleptic malignant syndrome)
CF or Hirschsprung's disease
Psoriasis
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)

46. Typical antibiotics for group B streptococcus (GBS) prophylaxis.
Wrist drop - loss of thumb abduction
High TSH - low T4 - antimicrosomal antibodies
DM - SLE - and amyloidosis
IV penicillin or ampicillin

47. Should a - or Beta- antagonists be used first in treating pheochromocytoma?
Edrophonium
Septic or anaphylactic shock
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
a - antagonists (phentolamine and phenoxybenzamine)

48. Treatment for DTs.
Membranous glomerulonephritis
Consider Fitz - Hugh - Curtis syndrome
Benzodiazepines
RCC or other erythropoietin - producing tumor; evaluate with CT scan

49. The most common inherited hemolytic anemia.
Hereditary spherocytosis
Cerebral berry aneurysms (AD PCKD)
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
Edrophonium

50. Attributable risk?
Septic or anaphylactic shock
Duchenne muscular dystrophy
Metformin
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed