USMLE-Rx Step 2 Practice Q's

USMLE-Rx Step 2 Qmax Challenge #21454

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USMLE-Rx Step 2 Qmax Challenge #21454A 24-year-old man presents to his physician because of back pain that has become more severe over the past several months. He describes the pain as dull and localizes it to his lower back and gluteus muscles bilaterally. He notes feeling very stiff in the morning, but the stiffness improves with activity. He also notes the pain often awakens him during the night and does not go away until he gets out of bed and walks around for a while. On physical examination his lungs are clear to auscultation bilaterally, but he seems to have diminished air entry due to impaired chest wall expansion. Palpation of the sacral spine and hip joints causes pain. He cannot fully flex or extend at the hips. He also has limited hip abduction. X-ray of the spine is shown in the image.

Which of the following is the patient at risk for developing?

A. Anterior uveitis
B. Gastroesophageal reflux disease
C. Malar rash
D. Mitral stenosis
E. Pleuritis

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USMLE-Rx Step 2 Qmax Challenge #21423

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USMLE-Rx Step 2 Qmax Challenge #21423A 32-year-old man is found to have a solitary, firm mass in the thyroid on routine physical examination. He has no complaints and the remainder of his physical examination is unremarkable. Family history is significant for an uncle who died of thyroid cancer at age 40 years. A biopsy of the thyroid stained with Congo red is shown in the image.

What further study should be done in this patient?

A. Barium swallow
B. Measurement of serum insulin-like growth factor-1
C. Measurement of urinary metanephrine levels
D. MRI of the brain
E. Renal biopsy

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This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

USMLE-Rx Step 2 Qmax Challenge #21296

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USMLE-Rx Step 2 Qmax Challenge #21296An 82-year-old man with hypertension, hypercholesterolemia, and chronic obstructive pulmonary disease presents to the emergency department with severe back pain. He also feels diaphoretic and nauseous. The patient states he is usually compliant with his medications but sometimes forgets to take them. He denies any alcohol use or illicit drug use. His temperature is 37.1°C (98.7°F), blood pressure is 165/104 mm Hg, pulse is 112/min, respiratory rate is 18/min, and oxygen saturation is 94%. On physical examination there is no jugular venous distension, and there are diminished but equal pulses bilaterally in the lower extremities. Cardiovascular examination reveals regular rate and rhythm without murmurs, rubs, or gallops. Because the patient has an allergy to CT contrast dye, an MRI of the chest is performed and is shown in the image below.

Which of the following is the most likely diagnosis?

A. Aortic dissection
B. Lumbar disc herniation
C. Pancreatic cancer
D. Perforated peptic ulcer
E. Ruptured aortic aneurysm

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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 #21237

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USMLE-Rx Step 2 Qmax Challenge #21237A 10-year-old boy with newly diagnosed acute lymphoid leukemia requires placement of a permanent intravenous access device.

Which of the following sets of laboratory values will allow the boy to undergo the procedure safely?

A. A
B. B
C. C
D. D
E. E

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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 #21202

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USMLE-Rx Step 2 Qmax Challenge #21202A 32-year-old man with trisomy 21 presents with fatigue and swollen, bleeding gums for the past 5 days. He lives in a group home, and was formerly employed in a factory manufacturing hair products. He has smoked 1 pack of cigarettes per day for the past 15 years. He denies use of alcohol or illicit drugs. Physical examination reveals pallor, diffuse petechiae, oozing oral mucosa, and splenomegaly. Bone marrow aspirate reveals the type of cell shown in the image.

Which of the following risk factors contributed most to the development of the patient’s condition?

A. Age <40 years
B. Down’s syndrome (trisomy 21)
C. Exposure to Epstein-Barr virus in his home
D. History of smoking
E. Prior lead exposure

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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 #21169

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USMLE-Rx Step 2 Qmax Challenge #21169Five full-term infants are enrolled in a study in which their total bilirubin level is measured daily for the first week of life and then weekly for the next 21 days. The chart lists total serum bilirubin (in milligrams per deciliter) for each infant for the duration of the study.

Which of the following infants has physiologic jaundice?

A. Infant A
B. Infant B
C. Infant C
D. Infant D
E. Infant E

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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 #21159

8

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USMLE-Rx Step 2 Qmax Challenge #21159A 2100-g (4.6-lb) boy was born at 32 weeks’ gestation by spontaneous vaginal delivery after an uncomplicated pregnancy to a Group B Streptococcus-negative, 22-year-old G2P1 woman. The amniotic fluid was clear. He began crying immediately after he was born. His Apgar scores were 9 and 10 at 1 and 5 minutes, respectively. Within 30 minutes of birth he was in respiratory distress, with tachypnea, nasal flaring, and subcostal retractions, and rhonchi throughout both lung fields. He was given supplemental oxygen but his condition deteriorated. He was intubated and given 100% oxygen. He did not receive surfactant. Despite this therapy he became increasingly cyanotic and died 2 days later. Below is a microscopic image of his lung tissue at autopsy.

Which of the following conditions most likely caused his death?

A. Bronchopulmonary dysplasia
B. Neonatal respiratory distress syndrome
C. Pneumonia
D. Pulmonary hemorrhage
E. Transient tachypnea of the newborn

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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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