Practice Test 7 - USMLE Step 2
20 questions. Answer them in any order, then submit to see your score and every explanation.
- Which of the following types of shock most likely explains this patient's presentation?
- What is the most appropriate recommendation for this patient?
- History: A 40-year-old woman presents with heavy menstrual bleeding and bulk symptoms from fibroids. She has completed childbearing and desires uterine preservation. She is adherent to iron therapy but remains symptomatic. Presenting issue: She reports pelvic pressure, urinary frequency, and anemia-related fatigue. Exam shows a 14-week-size irregular uterus. Diagnostics: Hgb 9.6 g/dL. Transvaginal US shows multiple intramural and submucosal fibroids. Considerations: She asks about a minimally invasive option with shorter recovery than surgery. Which of the following is the most appropriate next step in management?
- Which of the following is the most appropriate initial pharmacologic treatment for this child?
- Which of the following antibiotic regimens provides the most appropriate empiric coverage for this patient?
- Which of the following is the most appropriate surgical management?
- A previously healthy 13-year-old boy presents with photophobia, fever, and vomiting. Examination shows neck stiffness and petechial rash on the lower extremities. Blood pressure is 90/58 mm Hg, heart rate 130/min. After fluid resuscitation and collection of blood cultures, which of the following is the best next step?
- A 30-year-old woman has 6 months of alternating diarrhea and constipation with crampy pain relieved by defecation; high stress; exam and CBC normal. Most likely diagnosis?
- Which diagnostic test should be obtained next to confirm the suspected diagnosis?
- What is the most likely diagnosis?
- According to current guidelines, which of the following is the most appropriate next step for this patient?
- A 70-year-old woman with obesity hypoventilation syndrome presents with lethargy and dyspnea. ABG shows pH 7.29, PaCO2 62 mm Hg, PaO2 58 mm Hg. Potential causes of hypoxemia include hypoventilation, PE, pneumonia, and HF. Which of the following is the best initial treatment?
- Which of the following is the most appropriate advice for the parents?
- What is the most appropriate initial step in management?
- In addition to receiving Rho(D) immune globulin for any episode of vaginal bleeding, when should this patient be scheduled to routinely receive prophylactic Rho(D) immune globulin?
- A 70-year-old woman with HFrEF (EF 30%) presents with dyspnea, fatigue, and edema after dietary indiscretion. Exam: JVD, rales, S3. BP 138/82. Labs: BNP 1700 pg/mL; troponin negative; sodium 128 mEq/L. CXR shows pulmonary edema. Echo shows EF 30%. She is alert and not hypotensive. Which lifestyle modification should be recommended to this patient to reduce future decompensations?
- Which of the following is the most appropriate strategy for his perioperative pain management?
- Which of the following is the most appropriate management for this patient?
- This patient's condition results from a genetic defect affecting the synthesis of which of the following proteins?
- Which of the following is the most appropriate next step regarding nutritional support for this patient?