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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. Symptoms of placental abruption.
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
Febrile seizures (roseola infantum)
Benzodiazepines
Continuous - painful vaginal bleeding
2. Rigidity and stiffness with resting tremor and masked facies.
3. Lung cancer associated with SIADH.
Incidence and prevalence
Regression
Type II (proximal) RTA
Small cell lung cancer (SCLC)
4. Treatment for ventricular fibrillation.
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
Parkland formula
Immediate cardioversion
CML
5. ? CO - ? PCWP - ? PVR.
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Septic or anaphylactic shock
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations
Kegel exercises - estrogen - pessaries for stress incontinence
6. Sudden onset of mental status changes - emesis - and liver dysfunction after taking aspirin.
7. Classic CXR findings for pulmonary edema.
8. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Osteogenesis imperfecta
Type II (proximal) RTA
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Surfactant deficiency
9. A 55-year - old obese patient presents with dirty - velvety patches on the back of the neck.
Fanconi's anemia
Huntington's disease
Wegener's granulomatosis and Goodpasture's syndrome
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
10. PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific?
Patent ductus arteriosus (PDA)
Mycobacterium tuberculosis
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Highly sensitive for TB
11. Signs of ? ICP (Cushing's triad).
Hypertension - bradycardia - and abnormal respirations
Transitional cell carcinoma
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Iron overload; use deferoxamine
12. Meningitis in neonates. Causes? Treatment?
Pseudomonas
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Osmotic fragility test
13. Causes of transudative effusion.
Kegel exercises - estrogen - pessaries for stress incontinence
Seborrheic dermatitis. Treat with antifungals
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
1
14. Causes of hypoxemia.
Beta- blockers - digoxin - calcium channel blockers
Endometrial or estrogen receptor - breast cancer
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
15. What is the immunodeficiency?
16. Common symptoms associated with silent MIs.
Factor V Leiden mutation
CHF - shock - and altered mental status
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Intussusception
17. Rhomboid - shaped - positively birefringent crystals on joint fluid aspirate.
Pseudogout
MS
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
105 bacteria/mL
18. Pure RBC aplasia.
Cellulitis
Spinal stenosis
Diphenhydramine or epinephrine 1:1000
Diamond - Blackfan anemia
19. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
Anemia of chronic disease
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella
Cluster headache
1
20. Flat - topped papules.
Lichen planus
All - compartment fasciotomy for suspected compartment syndrome
Avascular necrosis
Kwashiorkor (protein malnutrition)
21. The first test to perform when a woman presents with amenorrhea.
Anorexia
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
Beta- hCG; the most common cause of amenorrhea is pregnancy
Conversion disorder
22. A postoperative patient with significant pain presents with hyponatremia and normal volume status.
Diphenhydramine or epinephrine 1:1000
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
SIADH due to stress
Anticoagulation - rate control - cardioversion
23. Four causes of microcytic anemia.
Trauma; the second most common is berry aneurysm
TICS
Giardia
Amoxicillin
24. The most common inherited cause of hypercoagulability.
Neuroblastoma
Paget's disease
Anion gap acidosis and 1
Factor V Leiden mutation
25. Inflammation and epithelial thinning of the anogenital area - predominantly in postmenopausal women.
1
Lichen sclerosus
Pseudomonas
ETEC
26. Differential of hypervolemic hyponatremia.
Cirrhosis - CHF - nephritic syndrome
Spinal stenosis
Highly sensitive for TB
Duodenal atresia
27. A significant cause of morbidity in thalassemia patients. Treatment?
Iron overload; use deferoxamine
The IR of a disease in a population exposed to a particular factor
Psoriasis
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
28. Which of the following are ? in DIC: fibrin split products - D- dimer - fibrinogen - platelets - and hematocrit.
Multiple myeloma
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Graves' disease
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
29. Classic ultrasound and gross appearance of complete hydatidiform mole.
30. Gout - self - mutilation - and choreoathetosis.
Cardiogenic shock
Aseptic (viral) meningitis
HGPRTase deficiency)
Yersinia
31. Identify key organisms causing diarrhea:
Surfactant deficiency
Immediate cardioversion
Headache
Yersinia
32. The diagnostic test for pulmonary embolism.
Angina is new - is worsening - or occurs at rest
V/Q scan
46 -XX
Legionella pneumonia
33. How to diagnose and follow a leiomyoma.
Menometrorrhagia
Seborrheic dermatitis. Treat with antifungals
Ultrasound
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
34. Natural history of a leiomyoma.
Nephrogenic diabetes insipidus (DI)
Regresses after menopause
Trichomonas vaginitis
Mycoplasma
35. 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
Parkinson's disease
IV hydration and loop diuretics (furosemide)
36. Treatment for Guillain - Barr
Subarachnoid hemorrhage (SAH)
IVIG or plasmapheresis
Osmotic fragility test
1
37. The most common 1
50 cc/hour
Multiple myeloma
Lung - breast - skin (melanoma) - kidney - GI tract
Higher prevalence
38. Birth rate?
Hashimoto's thyroiditis
Patent ductus arteriosus (PDA)
They can mask symptoms of hypoglycemia
Number of live births per 1000 population
39. The most common location for an ectopic pregnancy.
Ampulla of the oviduct
ALS
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Hypoxia and hypocarbia
40. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
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
Kl
Pityriasis versicolor
Dissociative fugue
41. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis
Treat immediately. Consent is implied in emergency situations
Coarctation of the aorta
Retrograde cystourethrogram
42. Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?
Guillain - Barr
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
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Number of deaths from 20 weeks' gestation to birth per 1000 total births
43. Cause of amenorrhea with normal prolactin - no response to estrogen - progesterone challenge - and a history of D&C.
44. Identify key organisms causing diarrhea:
E. coli O157:H7
Anemia of chronic disease
Regression
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
45. Treatment of AF.
Trauma - alcohol withdrawal - brain tumor
Acute mania. Start a mood stabilizer (e.g. - lithium)
Rate control - rhythm conversion - and anticoagulation
Trauma; the second most common is berry aneurysm
46. Postnatal mortality?
Number of deaths from 28 days to one year per 1000 live births
Uterine atony
BP > 140/90 on three separate occasions two weeks apart
Folate deficiency
47. The most common cause of hypertension in young women.
IgA nephropathy (Berger's disease)
High reliability - low validity
Selective IgA deficiency
OCPs
48. Caf
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Neurofibromatosis 1
Surfactant deficiency
IV penicillin or ampicillin
49. Name the organism:
SIADH due to stress
Protamine
Streptococcus pneumoniae
Clomiphene citrate
50. Presence of red cell casts in urine sediment.
Glomerulonephritis/nephritic syndrome
Bullous pemphigoid
No. Parental consent is not necessary for the medical treatment of pregnant minors
OCPs