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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. Precipitants of hemolytic crisis in patients with G6PD deficiency.
Protamine
Pityriasis rosea
Sulfonamides - antimalarial drugs - fava beans
Folate deficiency
2. Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
Hypertension - bradycardia - and abnormal respirations
Fat - female - fertile - forty - flatulent
Suspect ankylosing spondylitis. Check HLA- B27
Squamous cell carcinoma
3. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Stasis - hypercoagulability - endothelial damage
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Murphy's sign - seen in acute cholecystitis
4. CSF findings:
Usually resolves spontaneously; may require IVIG and/or corticosteroids
S. aureus or S. epidermidis.
High TSH - low T4 - antimicrosomal antibodies
Bacterial meningitis
5. An eight -year - old boy presents with hemarthrosis and ? PTT with normal PT and bleeding time. Diagnosis? Treatment?
Type II (proximal) RTA
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Respiratory alkalosis
Fanconi's anemia
6. A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Check for ? ICP; look for papilledema
Neuroblastoma
Depersonalization disorder
7. How to distinguish polycythemia vera from 2
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Coarctation of the aorta
Asherman's syndrome
Conflict of interest
8. Type of ARF in a patient with FeNa < 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
Sheehan's syndrome (postpartum pituitary necrosis)
Prerenal
A patient with chest trauma who was previously stable suddenly dies
9. A fall in systolic BP of > 10 mmHg with inspiration.
Pulsus paradoxus (seen in cardiac tamponade)
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
No. Parental consent is not necessary for the medical treatment of pregnant minors
Anorexia
10. 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?
11. Eosinophils in urine sediment.
MAOIs
Displacement
Allergic interstitial nephritis
Guillain - Barr
12. A patient has ? vaginal discharge and petechial patches in the upper vagina and cervix.
Allergic interstitial nephritis
Continuous positive airway pressure
Trichomonas vaginitis
Number of live births per 1000 women 15-44 years of age
13. Involuntary commitment or isolation for medical treatment may be undertaken For what reason?
Toxoplasma gondii
Kl
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Choriocarcinoma
14. A painful - recurrent vesicular eruption of mucocutaneous surfaces.
Ultrasound
Bladder rupture or urethral injury
Rubella
Herpes simplex
15. Flat - topped papules.
Administration of DDAVP ? serum osmolality and free water restriction
Type II (proximal) RTA
Lichen planus
Radiation
16. Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
Respiratory alkalosis
ARDS
Chronic lymphocytic leukemia (CLL)
Lung - breast - skin (melanoma) - kidney - GI tract
17. Name the organism:
Number of deaths from birth to 28 days per 1000 live births
Legionella pneumonia
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Klebsiella
18. Identify key organisms causing diarrhea:
Neurofibromatosis 1
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
? serum FSH
Vibrio - HAV
19. Auer rods on blood smear.
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Acute myelogenous leukemia (AML)
DM - SLE - and amyloidosis
Malingering
20. Treatment for Guillain - Barr
Usually resolves spontaneously; may require IVIG and/or corticosteroids
IVIG or plasmapheresis
Retinoic acid
Menometrorrhagia
21. Name the defense mechanism:
Levodopa/carbidopa
Regression
Cirrhosis - CHF - nephritic syndrome
Diverticulosis
22. Criteria for exudative effusion.
Acne vulgaris
Aseptic (viral) meningitis
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Nephrolithiasis
23. Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Suspect ankylosing spondylitis. Check HLA- B27
Trichomonas vaginitis
Subdural hematoma
24. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
A patient's family cannot require that a doctor withhold information from the patient
Hypertrophic cardiomyopathy
Sarcoidosis
Contact dermatitis
25. Name the defense mechanism:
Reye's syndrome
Spinal stenosis
Reaction formation
Diamond - Blackfan anemia
26. An autosomal - recessive disorder with a defect in the GPIIbIIIa platelet receptor and ? platelet aggregation.
27. An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
Alopecia areata (autoimmune process)
BP > 140/90 on three separate occasions two weeks apart
Exercise stress treadmill with ECG
Febrile seizures (roseola infantum)
28. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Kegel exercises - estrogen - pessaries for stress incontinence
Lobular carcinoma in situ
The IR of a disease in a population exposed to a particular factor
29. Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
Absence seizures
Bacterial meningitis
Nephrotic syndrome
IV benzodiazepine
30. ECG findings suggesting MI.
Iron deficiency anemia
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Check for ? ICP; look for papilledema
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
31. Meningitis in neonates. Causes? Treatment?
CML
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Lichen sclerosus
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
32. Side effects of corticosteroids.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Lesions of 1
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
1
33. PFT showing ? FEV1/FVC.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
ETEC
Restrictive pulmonary disease
Clostridium difficile
34. Name the organism:
Cluster headache
Pseudomonas
Trauma - alcohol withdrawal - brain tumor
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
35. Classic physical findings for endocarditis.
36. Postnatal mortality?
Number of deaths from 28 days to one year per 1000 live births
Anemia of chronic disease
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Hypotension and bradycardia
37. Treatment for SVC syndrome.
Hodgkin's lymphoma
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Nephrotic syndrome
Radiation
38. Inflammatory disease of the colon with ? risk of colon cancer.
Ulcerative colitis
Dissociative fugue
Regresses after menopause
Retrograde cystourethrogram
39. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Identify cause; fluid and blood repletion
Observational bias
Neisseria meningitidis
40. Associated with Propionibacterium acnes and changes in androgen levels.
Acne vulgaris
Restrictive pulmonary disease
Consider Fitz - Hugh - Curtis syndrome
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
41. Perinatal mortality?
42. The 6 P's of ischemia due to peripheral vascular disease.
OCPs - danazol - GnRH agonists
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
PT
OCPs
43. Relative risk?
IgA nephropathy (Berger's disease)
Low - voltage - diffuse ST- segment elevation
Benzodiazepines
The IR of a disease in a population exposed to a particular factor
44. Infant mortality?
High reliability - low validity
Patent ductus arteriosus (PDA)
Sensitivity
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
45. A doctor refers a patient for an MRI at a facility he/she owns.
Graves' disease
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Conflict of interest
Weight gain - type 2 DM - QT prolongation
46. 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?
Anemia of chronic disease
Hashimoto's thyroiditis
Lyme disease - Ixodes tick - doxycycline
AP chest - AP/lateral C- spine - AP pelvis
47. ? risk of what infection with silicosis?
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Osteoarthritis
Ophthalmologic exam - CT - and MRI
Mycobacterium tuberculosis
48. 'Stones - bones - groans - psychiatric overtones.'
Rate control - rhythm conversion - and anticoagulation
Stasis - hypercoagulability - endothelial damage
Signs and symptoms of hypercalcemia
O2 - analgesia - hydration - and - if severe - transfusion
49. Vaccinations at a six- month well - child visit.
HBV - DTaP - Hib - IPV - PCV
Osgood - Schlatter disease
Higher prevalence
Continuous - painful vaginal bleeding
50. The most common histology of bladder cancer.
Tardive dyskinesia. ? or discontinue haloperidol and consider another antipsychotic (e.g. - risperidone - clozapine)
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Anorexia
Transitional cell carcinoma