USMLE-Rx Step 2 Practice Q's

USMLE-Rx Step 2 Qmax Challenge #21642

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

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A 28-year-old man presents to the clinic complaining of heaviness in his testicle for 2 weeks. He says he feels as though his testicle is enlarged. The man has a temperature of 37.2°C (98.9°F), heart rate of 60/min, and blood pressure of 115/70 mm Hg. He has a normal abdominal examination with no palpable masses. The right testicle is noticeably larger than the left testicle. There are no discrete nodules. Testicular ultrasound is performed, followed by an orchiectomy. He is found to have a seminoma and a retroperitoneal lymph node that is enlarged at 1.8 cm. He is given a diagnosis of stage IIA testicular seminoma (T2N1M0).

What additional treatment is needed?

A. Contralateral orchiectomy
B. Platinum-based chemotherapy and bilateral orchiectomy
C. Prophylactic mediastinal radiation
D. Retroperitoneal lymph node dissection
E. Retroperitoneal radiation

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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 #21636

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 56-year-old man with erectile dysfunction and hypertension presents to his doctor with aching low back pain. He says that the back pain has grown in intensity over the past 2 months and is now a 7 of 10 in intensity. The patient denies any back trauma or recent heavy lifting. He says the back pain does not radiate and is relatively constant in nature. His temperature is 37.2°C (98.9°F), heart rate is 100/min, respiratory rate is 14/min, and blood pressure is 140/80 mm Hg. On physical examination his back is atraumatic, and the pain does not increase in intensity with percussion or palpation of the lower back. There is no costovertebral angle tenderness. The patient’s laboratory values are significant for alkaline phosphatase of 800 U/L and prostate-specific antigen of 12 ng/mL (normal: 0-4 ng/mL).

Which of the following is the most likely location of the primary lesion?

A. Immature prostatic muscle cells
B. Lumbar vertebral body
C. Peripheral zone of the prostate
D. Seminal vesicle
E. Transition (periurethral) zone of the prostate

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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 #21623

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

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A 62-year-old woman with hypertension, diabetes, and rheumatoid arthritis presents to an outpatient clinic for follow-up. A recent abdominal CT obtained during a work-up for abdominal pain and bloody diarrhea revealed diverticulitis and a cystic renal lesion. The cyst was described as contrast-enhancing and 4 cm in diameter, with a 1-cm solid component visible in the center of the lesion. The cyst wall was 3-4 mm thick.
What is the proper management of this renal cyst?

A. Cisplatin-based chemotherapy
B. Follow-up CT scan in 6 months
C. Renal biopsy
D. Renal MRI
E. Surgical excision

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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 #21615

5

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

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A 67-year-old man presents to a primary care physician as a new patient. He says he has always been healthy, except for three episodes of gout over the past 4 years. He is not currently using any chronic medications, and his only complaint is recurrent episodes of gout, confirmed each time by joint aspiration and microscopic analysis of synovial fluid. His physician advises him that certain lifestyle choices can affect his risk for recurrent episodes of gout.

Which of the following is a risk factor for the development of gout?

A. Alcohol intake
B. High fluid intake
C. High vitamin C intake
D. Low-normal body mass index
E. Low-purine diet

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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 #21610

7

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

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USMLE-Rx Step 2 Qmax Challenge #21610A 75-year-old man presents to his family physician with a 3-day history of joint pain. The patient has had various “aches and pains” in his joints over the years, but in the past 3 days he has noticed that his first metatarsophalangeal (MTP) joint in his left foot has become very painful. He describes the pain as a dull, constant ache, 7 of 10 in severity. He denies any recent trauma or exposure to infectious agents. The remainder of his musculoskeletal examination is normal, with full range of motion and no focal tenderness in any of his other joints. The first MTP in the left foot is warm, erythematous, and extremely tender to touch. Synovial fluid presents with elevated WBCs and no RBCs, and a Gram stain is negative. Polarized light microscopy is shown in the image below.

Which of the following is the most likely diagnosis?

A. Acute gout
B. Osteoarthritis
C. Rheumatoid arthritis
D. Septic arthritis
E. Systemic lupus erythematosus

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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 #21592

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).

USMLE-Rx Step 2 Qmax Challenge #21592A 62-year-old attorney presents to a primary care clinic complaining of chronic lower back pain and stiffness. He denies any history of trauma or strain to his back. He states that the stiffness is most severe in the morning and improves over the course of the day, especially after he exercises. Physical examination reveals decreased range of motion in the lumbar spine, as well as loss of natural lordosis. X-ray of the spine is shown in the image.

His condition is most likely associated with which of the following?

A. Anti-DNA antibodies
B. History of gonococcal infection
C. HLA-B27
D. Rheumatoid factor
E. Severe loss of bone density

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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 #21599

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).

USMLE-Rx Step 2 Qmax Challenge #21599A 55-year-old white man presents to the emergency department complaining of diffuse, constant bone pain for the past 3 months. He is a schoolteacher. He denies any recent history of trauma or infection. He does note that his favorite fitted baseball hat no longer fits. His temperature is 37.6°C (99.7°F), blood pressure is 120/75 mm Hg, pulse is 85/min, and respiratory rate is 22/min. Physical examination reveals no focal points of tenderness. Mild frontal bossing and bilateral tibial bowing are noted. X-ray of the pelvis is shown in the image.

Which of the following is the most likely diagnosis?

A. Ankylosing spondylitis
B. Paget’s disease
C. Pituitary adenoma
D. Rickets
E. Scurvy

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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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