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Practice Test 3 - USMLE Step 2

20 questions. Answer them in any order, then submit to see your score and every explanation.

  1. Which of the following is the most appropriate next step in management?
  2. Which of the following is the most appropriate initial diagnostic test to order in this setting?
  3. What is the most appropriate next step in management?
  4. 6 hours after thyroidectomy, 43F has neck swelling, stridor, HR 120, O2 88%; incision tense. Most appropriate initial treatment?
  5. A 58-year-old woman with hypertension and CKD stage 3 takes lisinopril and spironolactone. She presents with progressive muscle weakness and palpitations for 2 hours. BP 148/86, HR 54. ECG shows peaked T waves and QRS widening. Labs:
    TestResult
    ABGpH 7.36, PaCO2 40 mm Hg, HCO3− 22 mEq/L
    Na+138 mEq/L
    K+7.2 mEq/L
    Cl−104 mEq/L
    BUN/Cr44/2.6 mg/dL
    Glucose118 mg/dL
    Time-sensitive context: telemetry shows intermittent runs of ventricular ectopy. Differential includes medication effect vs hemolysis vs acidosis. Management steps being considered: - Stabilize myocardium - Shift potassium intracellularly - Remove potassium from body - Stop offending agents Which of the following is the most appropriate initial treatment for this electrolyte imbalance?
  6. Which of the following is the most likely diagnosis?
  7. Which of the following is the most appropriate next step in the management of this patient's anemia?
  8. Which of the following is the most appropriate primary management strategy for her arthritis?
  9. Which of the following is the most appropriate next step in management?
  10. A 26-year-old woman has had near-daily dull bitemporal headaches for 3 months. She originally had episodic tension-type headaches and began taking over-the-counter ibuprofen 600 mg up to 3 times daily; she now awakens with headache each morning. Neurologic examination is normal. Which of the following is the most likely diagnosis?
  11. A 35-year-old woman with childhood rheumatic fever has progressive dyspnea on exertion and occasional hemoptysis. Exam: loud S1, opening snap followed by diastolic rumble at apex. Echo shows mitral valve area 1.0 cm² and enlarged LA. Which complication is most likely?
  12. What is the most likely karyotype in this patient?
  13. Which of the following is the most appropriate management?
  14. Which of the following medications should be avoided in this patient?
  15. Which of the following is the single greatest modifiable risk factor for the development of obstructive sleep apnea in this patient?
  16. What is the most likely diagnosis?
  17. Which of the following is the most common cause of primary nephrotic syndrome in this patient's demographic?
  18. What is the most appropriate initial management?
  19. This patient's presentation is most consistent with which of the following neurodegenerative syndromes?
  20. Which of the following is the most appropriate next step in management?

Practice tests