USMLE STEP 2 UWORLD MISSED
QUESTIONS WITH CORRECT ANSWERS,
EXAMS OF NURSING
What are the 5 main complications of pancreatitis? Correct
Answer 1. pancreatic pseudocyst
2. ileus
3. pleural effusion
4. ARDS
5. Renal Failure
How do you treat an esophageal stricture? Correct Answer
Biopsy the lesion then dilate the esophagus
Pts with Pickwickian Syndrome and OSA have this pH
abnormality Correct Answer Metabolic alkalosis to compensate
for respiratory acidosis - increase bicarbonate retention and
secretion of chloride
What two tests need to be ordered to evaluate gross hematuria in
an asymptomatic patient? Correct Answer Ct with contrast and
cystoscopy
What is associated with maternal cocaine abuse, triple bubble
sign on x-ray, gas less rectum, bilious vomiting in preterm infant?
Correct Answer jejunal atresia
What is the next best test to order in a 3yo with acquired
torticollis? Correct Answer AP/Lateral Cervical Spine X-ray to
rule out AA subluxation/retropharyngeal abscess
,A 14yo boy presents with nasal obstruction, a visible nasal mass,
frequent epistaxsis. What is the diagnosis? Correct Answer
Juvenile Angiofibroma
What is the prophylaxis treatment for pt with a PMHx of
Rheumatic Fever? Correct Answer Penicillin G every 4 weeks
5 years or until 21 without carditis (whichever is longer)
10 years or until 21 with carditis but without heart or valvular
disease
10 years or until 40 with carditis and valve disease
Rhinne Test Correct Answer AC > BC b/l = nl test
BC>AC in the affected ear = conductive hearing loss
Sensorineural = nL in both
Weber Test Correct Answer Place tuning fork on the middle
head
NL = equal B/L hearing
abnormal conductive - Lateralizes to the affected side bc
conductive hearing loss allows to block out ambient noise and
focus on the vibrating sound better than a normal ear
abnormal sensoneural - lateralizes away from the affected ear
Otospongiosis Otosclerosis Correct Answer F 20s-30s with
conductive hearing loss
CT scan lucent focus in the temporal bone near the oval window
tx surgical stadepectomy
Young child with CF, 2 week hx of URI, presents with pneumonia.
What is the treatment? Correct Answer Vancomycin
-staph aureus is the most common cause of pneumonia after URI
in YOUNG CF patient. MRSA should be assumed.
Pinealoma Correct Answer Develops in the dorsal aspect of the
midbrain
, -Intracranial HTN Obstructive Hydropcephalus
-Parinaud's sign - (paralysis of vertical gaze) - dorsal midbrain
syndrome
-Collier's sign - retraction of the eyelid
Vasovagal Syncope Correct Answer Prodrome of diaphoresis,
dizziness, nausea
Diagnose with a table tilt test
Small intestinal bacterial overgrowth Correct Answer Caused by
Anatomic abnormalities, Motility disoders(DM, TQ###
scleroderma)
-Malsbsorption symptoms
-Diagnose with jejunal aspirate showing >10organisms/mL
Glucose breath testing
Tx: Antibiotics (rifaximin, augmentin), high fat low sugar diet,
avoid anti-moility agents, trial of pro motility agents
(metoclopromide)
Gun shot wounds in the thorax Correct Answer Any penetrating
injury in the thorax below the level of the nipples has potential to
also involve the abdomen through the diaphragm and is assumed
to involve both compartments until proven otherwise.
Disseminated Histoplasmosis Correct Answer Ohio river valley
in immunocompromised patients
Look for
-B/L pulmonary infiltrates
-mucus ulcers
-cytopenias, hepatosplenomegaly
DDx: urine antigen test
Tx: Amphotericin B then itraconazole oral
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