USMLE-Rx Step 2 Practice Q's

USMLE-Rx Step 2 Qmax Challenge #21707

5

Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 48-year-old man presents to his primary physician complaining of “acne” on his face. It first appeared 2 months ago and has not responded to an “acne soap” he bought. He recently started using a new shaving cream. The rash is slightly pruritic and is located on his nasal bridge, nasolabial folds, and top lip. The lesions are erythematous with some slight yellowish flaking, particularly over his lip with no evidence of telangiectasias or pustules.

Which of the following is the most optimal management?

A. Discontinuation of shaving cream use
B. Low-potency (1%) hydrocortisone cream
C. Topical emollients
D. Topical metronidazole
E. Topical mupirocin ointment

———————–

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This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

USMLE-Rx Step 2 Qmax Challenge #21702

8

Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 4-year-old girl is brought by her mother to the pediatrician because of a rash. She had a fever and headache yesterday, and this morning broke out in a rash on her torso. The lesions are erythematous macules and vesicles in different stages, distributed diffusely over her trunk but most prominent on her left upper chest and right flank. A diagnosis of chickenpox is made. Of note, there is a 16-year-old sibling in the household who has not been vaccinated and has never had chickenpox.

Which of the following interventions is best indicated for healthy but susceptible household contacts?

A. Administration of intravenous acyclovir to the patient
B. Administration of oral acyclovir to the patient and household contacts
C. Administration of vaccine and intramuscular varicella zoster immunoglobulin to household contacts
D. Administration of varicella vaccine to household contacts
E. No prophylaxis is necessary for household contacts

———————–

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This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

USMLE-Rx Step 2 Qmax Challenge #21685

7

Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 47-year-old man is brought unconscious to the emergency department by fire and rescue personnel after being rescued from a house fire. No medical history is available. His heart rate is 110/min, respiratory rate is 12/min, blood pressure is 115/70 mm Hg, and oxygen saturation is 99% on 2 L oxygen via nonrebreather face mask. Physical examination reveals second-degree burns on most of his trunk and upper arms and first-degree burns on his face, constituting approximately 15% body surface area. His nasal alae are singed. Cardiovascular examination is notable for a regular rhythm and capillary refill

Which of the following is the most appropriate first step in management?

A. Continue oxygen via nonrebreather mask and monitor closely
B. Initiate hyperbaric oxygen therapy
C. Intubate and deliver 100% oxygen via endotracheal tube
D. Obtain ECG and initiate continuous cardiovascular monitoring
E. Place two large-bore intravenous lines and start intravenous fluids

———————–

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This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

USMLE-Rx Step 2 Qmax Challenge #21681

2

Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 16-year-old girl presents to her pediatrician complaining of “acne” on her face and chest for the past 4 months. She does not take any medications, and her family history is significant for a brother with acne that is treated with isotretinoin. Her mother has told her to stop eating so much pizza, but it is her favorite food and she has found this difficult. On physical examination she has erythematous papules, comedones, and pustules present predominantly on her forehead, chin, and cheeks, but also scattered on her chest and shoulders. Scarring is present on her chin and cheeks. A diagnosis of moderate acne vulgaris is made, and topical treatment with tretinoin and benzoyl peroxide is initiated. After 12 weeks of compliant treatment she has no improvement in symptoms.

Which of the following is the most appropriate next step in therapy?

A. Continue topical therapy and discuss dietary modification
B. Continue topical therapy and initiate oral tetracycline
C. Continue topical therapy and initiate treatment with isotretinoin
D. Continue topical therapy and reassess in 4 weeks
E. Discontinue topical therapy and initiate oral contraceptive therapy (containing estrogen)

———————–

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This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

USMLE-Rx Step 2 Qmax Challenge #21665

7

Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 37-year-old woman is admitted to the hospital with hypernatremia. The woman was recently diagnosed with Langerhans cell histiocytosis after a skin biopsy of a raised, pruritic purple lesion in her axilla that was refractory to treatment with topical steroids. The woman states that she feels fine, and denies any confusion. She admits to polyuria, polydipsia, and persistent thirst. On physical examination the patient is awake, alert, and oriented. She is afebrile and has a blood pressure of 120/80 mm Hg, heart rate of 70/min, and respiratory rate of 16/min. Results of cardiac and pulmonary examinations are normal, with clear breath sounds throughout. The above-mentioned axillary lesions are noted. Laboratory tests show:

Na+: 155 mEq/L
K+: 4.2 mEq/L
Cl-: 120 mEq/L
HCO3-: 25 mEq/L
Blood urea nitrogen: 22 mg/dL
Creatinine: 1.0 mg/dL

The patient’s urine osmolality is 100 mOsm/kg (normal: 50-1200 mOsm/kg).

The medication used to chronically treat diabetes insipidus in this patient also has what effect?

A. Binds reversibly to the 30S ribosomal subunit
B. Decreases plasma factor VIII
C. Increases von Willebrand factor
D. Inhibits platelet adhesion
E. Prevents some hypertension-related cardiovascular outcomes
F. Stabilizes mood

———————–

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This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

USMLE-Rx Step 2 Qmax Challenge #21662

8

Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 60-year-old man presents to his primary care physician with the chief complaints of fatigue and unintentional weight loss over the past few months. He has noted blood in his urine, but never brought it to a physician’s attention because it was never painful. Over the past 2 weeks, he has also developed a nonproductive cough. On physical examination the man is cachectic with temporal wasting. He has a palpable, irregularly shaped mass that is located just above the pubic symphysis to the left of the midline. Digital rectal examination reveals a normal prostate and guaiac-negative stool. Urinalysis is positive for blood. CT scans of the chest, abdomen, and pelvis show a large tumor in the bladder and several suspicious-looking pelvic and cervical lymph nodes. X-ray of the chest reveals four 1-cm lesions in the man’s left lung. He undergoes a cystoscopy and a 4-cm mass is seen on the left superior aspect of the bladder. A biopsy reveals transitional cell carcinoma.

Which treatment is most appropriate for this man’s disease?

A. Hospice
B. Intravesicular bacille Calmette-Guérin and systemic chemotherapy
C. Pelvic exenteration and systemic chemotherapy
D. Systemic chemotherapy
E. Transurethral resection of the bladder tumor, pelvic radiation, and systemic chemotherapy

———————–

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This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

USMLE-Rx Step 2 Qmax Challenge #21656

6

Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).

A 5-year-old boy is brought to the pediatrician because of persistent hypercalciuria discovered on routine urinalysis. The boy has a history of renal stones and Ehlers-Danlos syndrome. His family history is notable for a sister, 22 years old, who was diagnosed with Ehlers-Danlos syndrome as a child. The boy is examined and is in no distress. He is in the 5th percentile for height and the 10th percentile for weight. His respiratory rate is 30/min, heart rate is 100/min, and blood pressure is 110/70 mm Hg. The boy has a soft late-systolic murmur that is heard best at the apex. His lungs are clear and abdomen is soft. His lower extremities are notable for laxity of his knee joint. Laboratory studies show:

Na+: 140 mEq/L
K+: 2.6 mEq/L
Cl-: 119 mEq/L
HCO3-: 9 mEq/L
Blood urea nitrogen: 8 mg/L
Creatinine: 0.5 mg/L

Arterial blood gas analysis reveals a pH of 7.2.
What is the most appropriate treatment for this boy’s renal disorder?

A. Acetazolamide
B. Ammonium chloride
C. Potassium citrate
D. Sodium polystyrene sulfonate
E. Vitamin D

———————–

Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

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