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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. Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Threatened abortion
Malingering
Identify cause; pressors (e.g. - dobutamine)

2. What is the immunodeficiency?

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3. The most common histology of bladder cancer.
Conduct disorder
Femoral hernia
Transitional cell carcinoma
Prinzmetal's angina

4. Cannon 'a' waves.
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
SCLC
ARDS
Third - degree heart block

5. First - line medication for status epilepticus.
Hypernatremia
IV benzodiazepine
Diverticulosis
Conduct disorder

6. A patient presents with signs of hypocalcemia - high phosphorus - and low PTH.
Excessive EtOH
Pentad of TTP
Hypoparathyroidism
Elevated ICP - RBCs - xanthochromia

7. Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
ALS
Spinal stenosis
Bruton's X- linked agammaglobulinemia
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin

8. Treatment for Guillain - Barr
Treat existing heart failure and replace the tricuspid valve
Bacillus cereus
Klebsiella
IVIG or plasmapheresis

9. A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
Parkland formula
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Ulcerative colitis
Herpes simplex

10. A patient presents with recent PID with RUQ pain.
IVIG or plasmapheresis
Anemia of chronic disease
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Consider Fitz - Hugh - Curtis syndrome

11. Heinz bodies?
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Glanzmann's thrombasthenia
Parainfluenza virus type 1
Actinic keratosis

12. Not contraindications to vaccination.
Flumazenil
Rett's disorder
Acne vulgaris
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity

13. Symptoms of placenta previa.
Non - Hodgkin's lymphoma
Headache
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Self - limited - painless vaginal bleeding

14. Treatment for AML M3.
Diamond - Blackfan anemia
'Sawtooth' P waves
CA-125 and transvaginal ultrasound
Retinoic acid

15. Lab values suggestive of menopause.
Lesions of 1
? serum FSH
Incidence and prevalence
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'

16. Classic physical findings for endocarditis.

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17. Amenorrhea - bradycardia - and abnormal body image in a young female.
Partial mole
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
M3
Anorexia

18. A patient with a history of lithium use presents with copious amounts of dilute urine.
Nephrogenic diabetes insipidus (DI)
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Seventy percent if the stenosis is symptomatic
Postinfectious glomerulonephritis

19. Post - HBV exposure treatment.
HBV immunoglobulin
Treat existing heart failure and replace the tricuspid valve
Number of deaths from birth to 28 days per 1000 live births
Duchenne muscular dystrophy

20. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
Asymmetry - border irregularity - color variation - large diameter
Lead - time bias
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Bullous pemphigoid

21. A burn patient presents with cherry- red flushed skin and coma. SaO2 is normal - but carboxyhemoglobin is elevated. Treatment?
Lesions of 1
Absence seizures
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Regresses after menopause

22. AML subtype associated with DIC.
Spinal stenosis
Vibrio - HAV
Cluster headache
M3

23. Medication to avoid in patients with a history of alcohol withdrawal seizures.
Neuroleptics
Angina - ST- segment changes on ECG - or ? BP
1
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin

24. Medical treatment for hepatic encephalopathy.
Osteoarthritis
Emergent laparotomy to repair perforated viscus - likely stomach
Kwashiorkor (protein malnutrition)
? protein intake - lactulose - neomycin

25. Hyperphagia - hypersexuality - hyperorality - and hyperdocility.
Kl
Abdominal ultrasound and CT
Parainfluenza virus type 1
Cardiomegaly - prominent pulmonary vessels - Kerley B lines - 'bat's - wing' appearance of hilar shadows - and perivascular and peribronchial cuffing

26. Causes of exudative effusion.
Crohn's disease
Lobular carcinoma in situ
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Type II (proximal) RTA

27. Cross - sectional survey
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Salmonella
Prevalence
Broca's aphasia. Frontal lobe - left MCA distribution

28. 'Stuck - on' appearance.
Placental abruption and placenta previa
Seborrheic keratosis
Septic or anaphylactic shock
Parainfluenza virus type 1

29. Cohort study
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
A patient with chest trauma who was previously stable suddenly dies
Mycobacterium tuberculosis
Incidence and prevalence

30. A congenital heart disease that cause 2
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Coarctation of the aorta
Selective IgA deficiency
Slipped capital femoral epiphyses. AP and frog - leg lateral view

31. Hematuria - flank pain - and palpable flank mass.
Patient on dopamine antagonist
TICS
Renal cell carcinoma (RCC)
SSRIs

32. Prophylactic treatment for migraine.
M3
Erythema multiforme
Beta- blockers - Ca2+ channel blockers - TCAs
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6

33. Treatment of AF.
Rate control - rhythm conversion - and anticoagulation
Actinomyces israelii
Sporothrix schenckii
Parkinson's disease

34. Low urine specific gravity in the presence of high serum osmolality.
DI
Highly sensitive for TB
Febrile seizures (roseola infantum)
No. Parental consent is not necessary for the medical treatment of pregnant minors

35. Treatment of DKA.
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Pseudogout
Colposcopy and endocervical curettage

36. Postnatal mortality?
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Number of deaths from 28 days to one year per 1000 live births
Duodenal atresia
Arthralgias - migratory polyarthropathies - Bell's palsy - myocarditis

37. The most common cause of Cushing's syndrome.

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38. A significant cause of morbidity in thalassemia patients. Treatment?
Restrictive pulmonary disease
Iron overload; use deferoxamine
Central pontine myelinolysis
Confounding variable

39. Name the organism:
Actinic keratosis
Central pontine myelinolysis
Pseudomonas
Transitional cell carcinoma

40. Bias introduced into a study when a clinician is aware of the patient's treatment type.
Beta- blockers - digoxin - calcium channel blockers
IgA nephropathy (Berger's disease)
Observational bias
Lesch - Nyhan syndrome (purine salvage problem with

41. The most common pituitary tumor. Treatment?
Subarachnoid hemorrhage (SAH)
Lichen planus
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Cirrhosis - CHF - nephritic syndrome

42. CSF findings:
Subarachnoid hemorrhage (SAH)
Mycobacterium tuberculosis
MS
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

43. Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow - up evaluation?
Kl
Colposcopy and endocervical curettage
Panic disorder
Elevated ICP - RBCs - xanthochromia

44. Neutropenic nadir postchemotherapy.
Cutaneous anthrax. Treat with penicillin G or ciprofloxacin
Osteoarthritis
O2 - analgesia - hydration - and - if severe - transfusion
7-10 days

45. The most common pathogen causing croup.
Type IV (distal) RTA
Selective IgA deficiency
Parainfluenza virus type 1
Sporothrix schenckii

46. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Fatigue and impending respiratory failure
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Hyperkalemia
Number of deaths from birth to 28 days per 1000 live births

47. Acute - phase treatment for Kawasaki disease.
Seborrheic keratosis
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Substance abuse

48. A homeless child is small for his age and has peeling skin and a swollen belly.
Kwashiorkor (protein malnutrition)
Slipped capital femoral epiphyses. AP and frog - leg lateral view
'Sawtooth' P waves
Number of deaths from 28 days to one year per 1000 live births

49. True or false: Withdrawing life - sustaining care is ethically distinct from withholding sustaining care.
Osteogenesis imperfecta
Diphenhydramine or epinephrine 1:1000
False. Withdrawing and withholding life are the same from an ethical standpoint
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine

50. Bone is fractured in fall on outstretched hand.

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