Practice Test 11 - USMLE Step 2
20 questions. Answer them in any order, then submit to see your score and every explanation.
- A 24-year-old wants long-term contraception. She has migraine with aura and is taking topiramate. No smoking. BP 116/74. Pregnancy test negative. She wants the most effective method with minimal user action. Which contraceptive method is most suitable for this patient?
- Patient A is a 25-year-old woman four weeks postpartum with depression who is started on sertraline. She asks about safety while breastfeeding. She has no other medical problems, and the infant is healthy and gaining weight. Which advice should be given to the patient regarding postpartum recovery?
- A 7-year-old boy falls from a tree onto his outstretched hand. Radiographs show an angulated mid-shaft greenstick fracture of the radius with 20° dorsal angulation and an intact ulna. Optimal treatment?
- What is the most likely diagnosis?
- In addition to activating the massive transfusion protocol, what is the most appropriate initial fluid for resuscitation?
- Which of the following is the most immediate priority in this patient's management?
- Which of the following is the most appropriate immediate intervention?
- A 13-year-old girl presents with a painful swollen left wrist after a fall. Radiograph shows a nondisplaced distal radius fracture. During the exam, you notice multiple healing bruises on her back. When questioned privately, she admits that her mother often hits her with a belt but begs you not to tell anyone. Which of the following is the physician's most appropriate response?
- A 60-year-old woman with rheumatoid arthritis presents with dry cough and progressive dyspnea. CXR shows reticular opacities; SpO2 falls with exertion. Potential causes of hypoxemia include ILD, PE, pneumonia, and HF. What diagnostic test should be performed next?
- A 59-year-old woman undergoes total knee arthroplasty. She receives neuraxial anesthesia and postoperative prophylactic enoxaparin 40 mg s.c. daily. On postoperative day 4 her hemoglobin has fallen from 12.4 to 9.2 g/dL, heart rate is 96/min, BP 118/72 mm Hg. The operative dressing is dry, and the patient is asymptomatic. What is the most appropriate next step?
- Which of the following is the most appropriate next step in management?
- Which of the following is the most likely cause of this patient's persistent unresponsiveness?
- A 46-year-old man fractures his humeral shaft in a fall. Examination reveals wrist drop and numbness over the dorsal hand. Radial pulses are normal. What management step is indicated now?
- This patient's profound hypoxemia is best explained by which of the following pathophysiologic mechanisms?
- A 65-year-old man has been unable to pass flatus or stool since his open abdominal aortic aneurysm repair 4 days ago. He reports mild abdominal discomfort and nausea. Vitals are normal. Abdomen is distended but non-tender; high-pitched bowel sounds are absent. Upright abdominal radiograph shows diffusely dilated small and large bowel loops without air-fluid levels and no transition point. Which of the following is the next best step in management?
- Which of the following is the most appropriate initial management for this patient?
- In addition to referral to a gynecologic oncologist, which of the following is the most appropriate next step in the evaluation of this patient?
- Targeting a hemoglobin level greater than 11.5 g/dL with an ESA in this patient population has been associated with an increased risk of which of the following?
- Which of the following is the most likely diagnosis?
- Which of the following is the most appropriate immediate management for this patient?