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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 frequent presentation of intracranial neoplasm.
Central pontine myelinolysis
Squamous cell carcinoma
Sheehan's syndrome (postpartum pituitary necrosis)
Headache

2. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Type I (distal) RTA
Nephrotic syndrome
Taenia solium (cysticercosis)
Observational bias

3. Treatment of supraventricular tachycardia (SVT).
Trauma - alcohol withdrawal - brain tumor
Rate control with carotid massasge or other vagal stimulation
Parvovirus B19
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin

4. Characteristics favoring carcinoma in an isolated pulmonary nodule.
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Biliary tract obstruction
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed

5. Treatment for malignant hypertension.
Varicella zoster
Nitroprusside
Type I (distal) RTA
Iatrogenic steroid administration. The second most common cause is Cushing's disease

6. The most common form of nephritic syndrome.
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Number of live births per 1000 women 15-44 years of age
Hereditary spherocytosis
Membranous glomerulonephritis

7. Premalignant lesion from sun exposure that can ? squamous cell carcinoma.
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Bacillus cereus
Actinic keratosis
Intussusception

8. Treatment of hypovolemic shock.
Absence seizures
Ophthalmologic exam - CT - and MRI
Identify cause; fluid and blood repletion
Hashimoto's thyroiditis

9. Difference between a cohort and a case - control study.
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
Neurofibromatosis 1
1
Conflict of interest

10. Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
Ultrasound
Nephrotic syndrome
Depersonalization disorder
Bladder rupture or urethral injury

11. CSF findings:
Prerenal
Bacterial meningitis
Ampulla of the oviduct
Depersonalization disorder

12. CSF findings:
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Aseptic (viral) meningitis
E. coli O157:H7
Folate deficiency

13. The most common cause of female infertility.
Anemia - thrombocytopenia - and acute renal failure
Nephrotic syndrome
HBV - DTaP - Hib - IPV - PCV
Endometriosis

14. Rigidity and stiffness that progress to choreiform movements - accompanied by moodiness and altered behavior.

15. Maternal mortality?
Parkland formula
Type II (proximal) RTA
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Selective IgA deficiency

16. Chvostek's and Trousseau's signs.
They can mask symptoms of hypoglycemia
Neuroleptic malignant syndrome
Calcium oxalate
Hypocalcemia

17. A 10-year - old child presents in status epilepticus - but her parents refuse treatment on religious grounds.

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?
Protamine
Normal
Bullous pemphigoid
Non - Hodgkin's lymphoma

19. Erythema migrans.
Lesion of 1
Subarachnoid hemorrhage (SAH)
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)

20. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Murphy's sign - seen in acute cholecystitis
Squamous cell carcinoma
Basal cell carcinoma
IVIG or plasmapheresis

21. Cannon 'a' waves.
Parkinson's disease
Acute pancreatitis
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Third - degree heart block

22. Gout - self - mutilation - and choreoathetosis.
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Number of deaths from 28 days to one year per 1000 live births
HGPRTase deficiency)
Sarcoidosis

23. Appropriate diagnostic test?
Conversion disorder
Rate control - rhythm conversion - and anticoagulation
MS
Pharmacologic stress test (e.g. - dobutamine echo)

24. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Actinic keratosis
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
'Chocolate cysts -' powder burns
Rubella

25. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Bacillus cereus
Sturge - Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia

26. Treatment for atrial fibrillation.
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Hypokalemia
Anticoagulation - rate control - cardioversion
Hypocalcemia

27. An 11-year - old obese - African - American boy presents with sudden onset of limp. Diagnosis? Workup?
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Nitroprusside
Beta- blockers - digoxin - calcium channel blockers
Osteogenesis imperfecta

28. CSF findings:
Graves' disease
Conflict of interest
Hypoxia and hypocarbia
Subarachnoid hemorrhage (SAH)

29. Which of the following are ? in DIC: fibrin split products - D- dimer - fibrinogen - platelets - and hematocrit.
N- acetylcysteine
Coarctation of the aorta
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia

30. When can a physician refuse to continue treating a patient on the grounds of futility?
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
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
Phototherapy (mild) or exchange transfusion (severe)
Frotteurism (a paraphilia)

31. Treatment for acute coronary syndrome.
BP > 140/90 on three separate occasions two weeks apart
Nitroprusside
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism

32. Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Niacin
Spinal stenosis
Conflict of interest

33. A neonate has meconium ileus.

34. Macrocytic - megaloblastic anemia with neurologic symptoms.
Endometriosis
B12 deficiency
Polymyalgia rheumatica
Sulfonamides - antimalarial drugs - fava beans

35. Extraintestinal manifestations of IBD.
Legionella pneumonia
Taenia solium (cysticercosis)
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Prevalence

36. Defect in an X- linked syndrome with mental retardation -
Fatigue and impending respiratory failure
Nephrotic syndrome
Lesch - Nyhan syndrome (purine salvage problem with
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism

37. The most common cause of hypertension in young men.
Reye's syndrome
Beta- hCG; the most common cause of amenorrhea is pregnancy
Ophthalmologic exam - CT - and MRI
Excessive EtOH

38. A patient complains of headache - weakness - and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia - hypokalemia - and metabolic alkalosis.
Beta- blockers - Ca2+ channel blockers - TCAs
Stasis - endothelial injury and hypercoagulability (Virchow's triad)
1
Pseudomonas

39. Contraceptive methods that protect against PID.
S. aureus or S. epidermidis.
Protamine
Antipsychotics (neuroleptic malignant syndrome)
OCP and barrier contraception

40. Treatment for SVC syndrome.
Radiation
Avascular necrosis
Naloxone
Factitious disorder (Munchausen syndrome)

41. Inflammation and epithelial thinning of the anogenital area - predominantly in postmenopausal women.
Pseudomonas
Actinomyces israelii
Lichen sclerosus
Campylobacter

42. The coagulation parameter affected by warfarin.
Clomiphene citrate
PT
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis

43. Meningitis in neonates. Causes? Treatment?
Nephrotic syndrome
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Pregnant women. Treat this group aggressively because of potential complications

44. Supportive treatment for ARDS.
Excessive EtOH
Hypertension - bradycardia - and abnormal respirations
Continuous positive airway pressure
Low - voltage - diffuse ST- segment elevation

45. Glomerulonephritis with deafness.

46. Cross - sectional survey
Low - voltage - diffuse ST- segment elevation
Prevalence
Iron deficiency anemia
Selective IgA deficiency

47. Case - control study
Stasis - hypercoagulability - endothelial damage
Neither
Sheehan's syndrome (postpartum pituitary necrosis)
Surfactant deficiency

48. The most serious side effect of clozapine.
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Emergent laparotomy to repair perforated viscus - likely stomach
Agranulocytosis

49. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Lead - time bias
Reaction formation
Regresses after menopause
Treat immediately. Consent is implied in emergency situations

50. Name the organism:
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Beta- blockers - Ca2+ channel blockers - TCAs
Pseudomonas
Substance abuse