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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. Identify key organisms causing diarrhea:
Respiratory alkalosis
The IR of a disease in a population exposed to a particular factor
Seventy percent if the stenosis is symptomatic
S. aureus

2. Mortality rate?
IV hydration and loop diuretics (furosemide)
Asherman's syndrome
Inevitable abortion
Number of deaths per 1000 population

3. Causes of drug - induced SLE.
Multiple myeloma
Legionella pneumonia
Avascular necrosis
INH - penicillamine - hydralazine - procainamide

4. Characteristics favoring carcinoma in an isolated pulmonary nodule.
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
High reliability - low validity
CA-125 and transvaginal ultrasound
Malingering

5. Medical options for endometriosis.
Paget's disease
Absence seizures
OCPs - danazol - GnRH agonists
SCLC

6. Cause of neonatal RDS.
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Surfactant deficiency
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)

7. Classic ECG findings in pericarditis.
Cardiogenic shock
Wait - surgical resection - radiation and/or androgen suppression
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Low - voltage - diffuse ST- segment elevation

8. Treatment for bacterial vaginosis.
Oral or topical metronidazole
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Factitious disorder (Munchausen syndrome)
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins

9. Name the defense mechanism:
Retrograde cystourethrogram
Isolation
Intraductal papilloma
Angina is new - is worsening - or occurs at rest

10. AML subtype associated with DIC.
Absence seizures
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
M3
Bacillus cereus

11. Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
Nephrotic syndrome
Pseudomonas
Regression
Hypokalemia

12. Name the organism:
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Actinomyces israelii
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Panic disorder

13. Identify key organisms causing diarrhea:
Glanzmann's thrombasthenia
SCLC
1
Yersinia

14. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Basal cell carcinoma
Depersonalization disorder
ETEC
Iron deficiency anemia

15. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Endometrial biopsy
Immediate cardioversion
Squamous cell carcinoma
Frotteurism (a paraphilia)

16. Treatment of SIADH?
Fluid restriction - demeclocycline
PT
Salmonella
Subarachnoid hemorrhage (SAH)

17. Tanner stage 3 in a six-year - old female.
Beta- hCG; the most common cause of amenorrhea is pregnancy
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Precocious puberty
IV penicillin or ampicillin

18. 'Cradle cap.'
RSV bronchiolitis
Seborrheic dermatitis. Treat with antifungals
B12 deficiency
Endometriosis

19. True or false: Once patients sign a statement giving consent - they must continue treatment.
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
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
False. Withdrawing and withholding life are the same from an ethical standpoint

20. Treatment for acute coronary syndrome.
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Lesions of 1
SIADH due to stress
A patient's family cannot require that a doctor withhold information from the patient

21. Appropriate diagnostic test?
Treat existing heart failure and replace the tricuspid valve
Immediate cardioversion
Factor V Leiden mutation
Pharmacologic stress test (e.g. - dobutamine echo)

22. The first test to perform when a woman presents with amenorrhea.
Respiratory alkalosis
Beta- hCG; the most common cause of amenorrhea is pregnancy
Conversion disorder
Pheochromocytoma

23. RTA associated with abnormal HCO3 - and rickets.
Emergent laparotomy to repair perforated viscus - likely stomach
Type II (proximal) RTA
Femoral hernia
IV hydration and loop diuretics (furosemide)

24. 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
Yersinia
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Never

25. Treatment for neuroleptic malignant syndrome.
Prevalence
N- acetylcysteine
Dantrolene or bromocriptine
PT

26. First - line treatment for otitis media.
OCPs - danazol - GnRH agonists
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Amoxicillin
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus

27. Cohort study
Incidence and prevalence
Broca's aphasia. Frontal lobe - left MCA distribution
Reye's syndrome
Duchenne muscular dystrophy

28. Normalizing PCO2 in a patient having an asthma exacerbation may indicate?
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Angina is new - is worsening - or occurs at rest
Fatigue and impending respiratory failure

29. Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
Anion gap acidosis and 1
Reaction formation
IV benzodiazepine
Inevitable abortion

30. Precipitants of hemolytic crisis in patients with G6PD deficiency.
Infection - cancer - and autoimmune disease
Sulfonamides - antimalarial drugs - fava beans
Kl
CA-125 and transvaginal ultrasound

31. A 16-year - old presents with an annular patch of alopecia with broken - off - stubby hairs.
Alopecia areata (autoimmune process)
Asymmetry - border irregularity - color variation - large diameter
Taenia solium (cysticercosis)
Fluid restriction - demeclocycline

32. Medical treatment for hepatic encephalopathy.
? protein intake - lactulose - neomycin
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Type IV (distal) RTA
HBV - DTaP - Hib - IPV - PCV

33. Meningitis in infants. Causes? Treatment?
Radiation
Metformin
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
DI

34. Peaked T waves and widened QRS.
S. aureus
Prinzmetal's angina
Hyperkalemia
Uterine massage; if that fails - give oxytocin

35. Goal hemoglobin A1c for a patient with DM.
< 7.0
CA-125 and transvaginal ultrasound
Incidence and prevalence
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones

36. PFT showing ? FEV1/FVC.
Restrictive pulmonary disease
Septic or anaphylactic shock
Kl
MCP and PIP joints; DIP joints are spared

37. Aplastic crisis in sickle cell disease.
Parvovirus B19
MCP and PIP joints; DIP joints are spared
Sulfonamides - antimalarial drugs - fava beans
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms

38. Not contraindications to vaccination.
Conversion disorder
Factitious disorder (Munchausen syndrome)
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity

39. Name the organism:
Toxoplasma gondii
A patient with chest trauma who was previously stable suddenly dies
Number of deaths per 1000 population
Transitional cell carcinoma

40. Treatment for DTs.
Seminoma
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Infection - cancer - and autoimmune disease
Benzodiazepines

41. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
Agranulocytosis
Haemophilus ducreyi
HIDA scan
Uremic syndrome seen in patients with renal failure

42. Hematuria - hypertension - and oliguria.
Wernicke's encephalopathy due to a deficiency of thiamine
Nephritic syndrome
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Pulsus paradoxus (seen in cardiac tamponade)

43. The most common cause of hypertension in young men.
Excessive EtOH
Absence seizures
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
30 cc/hour

44. Drugs that slow AV node transmission.
Beta- blockers - digoxin - calcium channel blockers
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate
Neisseria meningitidis
RSV bronchiolitis

45. Cold agglutinins.
Mycoplasma
Higher incidence
Huntington's disease
Varicella zoster

46. Lung cancer highly related to cigarette exposure.
Folate deficiency
SCLC
Febrile seizures (roseola infantum)
Rate control with carotid massasge or other vagal stimulation

47. Hypercholesterolemia treatment that ? flushing and pruritus.
Actinic keratosis
SIADH due to stress
Immediate cardioversion
Niacin

48. The number of bacterial culture on a clean - catch specimen to diagnose a UTI.
Frotteurism (a paraphilia)
105 bacteria/mL
Graves' disease
Continuous - painful vaginal bleeding

49. A patient presents with pain on passive movement - pallor - poikilothermia - paresthesias - paralysis - and pulselessness. Treatment?
Prerenal
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states
All - compartment fasciotomy for suspected compartment syndrome
O2 - analgesia - hydration - and - if severe - transfusion

50. Complication of overly rapid correction of hyponatremia.
Hypocalcemia
Salmonella
Central pontine myelinolysis
PT