Step 2 UWorld Self-Assessment (UWSA) 2 Practice Exam

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• Cavitation is most commonly seen with which histologic type of lung cancer?
• Which symptom is most characteristic of early dementia with Lewy bodies?
• For GBS prophylaxis during labor in a penicillin-allergic patient, which is an appropriate alternative?
• A patient with cirrhosis on spironolactone, furosemide, and lactulose has hepatic encephalopathy signs; what is the next step?
• Initial management of acute agitation in schizophrenia involves
• A short mother with an apparently constitutionally small infant has what long-term risk profile?
• Which drugs comprise RIPE therapy for active tuberculosis?
• What is the characteristic EEG finding in absence seizures?
• A patient under 30 presents with a palpable breast mass. What is the appropriate initial imaging?
• In a patient with massive pulmonary embolism presenting with syncope, what is the most likely mechanism?
• Sarcoma botryoides is a variant of which type of cancer?
• Which echo finding supports Group 3 pulmonary hypertension (lung disease) over Group 2 (left-sided heart disease)?
• Confidentiality should be broken in adolescent care under which circumstances?
• In a patient with right-sided heart failure treated with loop diuretics, which finding indicates preload reduction after treatment?
• For preterm labor, what step is typically taken to promote fetal lung maturity?
• If fetal fibronectin testing is negative, what is the implication?
• Which condition fits chronic watery diarrhea with normal colonoscopy and risk factors including age over 50, female, and smoking?
• Which corticosteroid is recommended as adjunctive therapy in empiric meningitis regimens for adults aged 18-50?
• For preeclampsia at term, what is the preferred management if both mother and fetus are stable?
• Uncal herniation from a basal ganglia hemorrhage typically presents with compression of which cranial nerve, resulting in a dilated pupil?
• Ogilvie's syndrome is best described as which condition?
• Outpatient treatment for community-acquired pneumonia in a previously healthy adult?
• In empiric meningitis therapy, which patient population warrants addition of ampicillin to cover Listeria?
• Magnesium sulfate in acute severe asthma is considered in which scenario?
• Which diuretic is typically started first for ascites in cirrhosis?
• If a direct oral anticoagulant is contraindicated, which option serves as an alternative anticoagulation strategy for AF with high stroke risk?
• Direct inguinal hernia is due to weakness of which structure?
• To obtain informed consent from a non-English-speaking patient, the recommended approach is
• What are the two most common etiologies of acute pancreatitis that should be identified early?
• In dementia with Lewy bodies, memory impairment is typically affected in which pattern?
• After the first trimester, which antithyroid drug is preferred for managing maternal hyperthyroidism?(
• Cupping of the optic disc is most characteristic of which condition?
• Choriocarcinoma can develop after which obstetric events?
• A patient aged 30 or older presents with a palpable breast mass. What is the recommended initial imaging?
• Safe correction rate for hyponatremia in a symptomatic patient is to...
• In Kawasaki disease, early IVIG and high-dose aspirin therapy reduces the risk of which complication?
• Adrenal production of DHEAS is dependent on which hormone?
• Initial management of ascites in cirrhosis typically includes which of the following?
• Which congenital infection is classically associated with fetal hydrops and severe neonatal anemia?
• For exclusive breastfeeding, postpartum menstruation resumes after more than how many months?
• After femoral artery catheterization, which finding favors a femoral artery pseudoaneurysm over an arteriovenous fistula?
• In a patient with acute gout who recently had a drug-eluting stent placed and is hospitalized for congestive heart failure, which anti-gout medication is preferred?
• What is the first-line treatment for Kawasaki disease?
• What testing strategy is emphasized when evaluating myocardial infarction in diabetics with silent symptoms?
• Which is recommended for hyperthyroidism management in pregnancy during the first trimester?
• Abdominal radiographs classically show which findings in gallstone ileus?
• Bronchiectasis is best defined as which of the following?
• Which radiographic sign supports the diagnosis of gallstone ileus?
• The cupping seen in glaucoma is due to loss of which retinal structure?
• Which principle best describes antibiotic stewardship?
• Empiric therapy for hospital-acquired pneumonia in a ventilated patient should include
• What is an effective treatment option for Mycoplasma pneumoniae infection?
• Sudden monocular vision loss with retinal pallor and a cherry red fovea is most consistent with which diagnosis?
• Chronic hypoparathyroidism can lead to calcifications in which brain region, potentially producing movement disorders?
• In suspected adrenal crisis, which is essential in addition to hydrocortisone?
• Which long-term risk is associated with fetal growth restriction (FGR) but not with constitutionally small infants?
• Which sequence describes initial management of gestational diabetes?
• Which statement about fetal fibronectin is true?
• Which autoimmune epidermal hyperproliferative disorder is classically described as autoimmune?
• Hyper IgE syndrome is characterized by recurrent skin and lung infections and an eczematous pruritic rash. Which finding is NOT typically seen?
• Initial management for diabetic ketoacidosis?
• Failure of closure of which structure is associated with hydrocele formation?
• Management of acute appendicitis typically includes
• A patient with severe acne on oral tretinoin who is already on birth control; which additional precaution is appropriate?
• Tocolysis in preterm labor should be used under what condition?
• What is essential in evaluating a diabetic patient with suspected myocardial infarction who has silent symptoms?
• What constitutes long-term management for NSAID-associated peptic ulcer disease?
• An adolescent with non-suicidal cutting asks you not to tell a parent. What is the appropriate next step in managing confidentiality?
• Pneumococcal vaccination in adults is indicated for individuals with which condition?
• A patient with nonvalvular atrial fibrillation and a CHA2DS2-VASc score of 4. What is the recommended anticoagulation strategy?
• Osteomalacia is characterized by which of the following defects?
• In prosthetic valve thrombosis, what is the strongest risk factor?
• Which fever presentation in a child is most likely to require imaging and laboratory evaluation according to pediatric guidelines?
• Bipolar I vs Bipolar II: which statement differentiates them most clearly?
• Massive pulmonary embolism is defined as occlusion of more than what percent of the pulmonary arterial circulation?
• First-line pharmacotherapy for major depressive disorder is best described as
• Leiomyomas are composed of which tissue?
• An elderly patient with poor diet, found on the floor, thin and weak, with small rough papules and surrounding hemorrhage on the skin most likely has deficiency of which vitamin?
• DIC management in a septic patient focuses on
• Direct inguinal hernia is due to which anatomical weakness?
• Which statement best describes Thromboangiitis obliterans (Buerger disease)?
• Transjugular intrahepatic portosystemic shunt (TIPS) is performed in which situation?
• Which facial features are most characteristic of fetal alcohol syndrome?
• Which antibiotic class is avoided in pregnancy due to safety concerns?
• A 45-pack-year smoker with weight loss, chest pain, and hemoptysis has a cavitary lesion in the upper lobe. Which histologic type is most likely?
• In a premenopausal woman with iron-deficiency anemia, the initial management includes
• Indirect inguinal hernia is associated with which mechanism?
• In labor, a patient who is GBS-positive with a high-risk penicillin allergy should receive which intrapartum prophylaxis?
• What is the primary mechanism by which systemic corticosteroids aid in acute asthma management?
• Basophilic stippling with fatigue, abdominal discomfort, constipation, and weakness suggests poisoning with which substance?
• Which antibiotics are considered appropriate for treating a urinary tract infection in pregnancy?
• Which of the following is a potential adverse effect of transjugular intrahepatic portosystemic shunt (TIPS)?
• Which of the following are examples of tocolytic medications?
• In CKD stage 3 with hypertension, which antihypertensive class is preferred for renal protection?
• Fetal fibronectin testing is used in which scenario?
• In narcolepsy, what is the characteristic finding on polysomnography?
• Chediak-Higashi syndrome is due to what defect?
• During emergent reperfusion therapy for STEMI with PCI within 90 minutes, which antiplatelet strategy is recommended?
• Iron-deficiency anemia in a premenopausal woman—initial management includes
• Which anti-gout medication should be avoided in elderly patients with severe renal dysfunction?
• Bronchioloalveolar carcinoma typically presents as which radiographic pattern?
• A 75-year-old patient with progressive cognitive decline, fluctuating cognition, visual hallucinations, parkinsonian features, and frequent falls is most consistent with which diagnosis?
• An obese patient with a yeast-looking rash under the breasts is evaluated. Microscopy of skin scrapings would most likely show which finding?
• Initial management of acute pancreatitis should include which of the following?
• Gallstone ileus occurs due to mechanical small bowel obstruction from a gallstone that passes through a biliary-enteric fistula.
• Which imaging/labs approach is recommended when evaluating pediatric fever with signs suggesting meningitis?
• Which description is characteristic of fascial dehiscence after abdominal surgery?
• If postpartum hemorrhage persists after uterotonics and tranexamic acid, what intervention may be considered?
• In a term infant with poor breathing at birth, which sequence of steps is recommended?
• First-line therapy for a COPD exacerbation with dyspnea includes which of the following?
• Severe aortic stenosis valve area is less than how many square centimeters?
• In symptomatic hyponatremia with severe symptoms, which intervention is recommended?
• Which imaging modality can be used to diagnose acute appendicitis when CT is contraindicated or unavailable?
• A patient with COPD and signs of pulmonary hypertension develops worsening renal failure after receiving furosemide. What is the most likely cause?
• Which component is part of the initial emergency department management for acute severe asthma?
• Sarcoma botryoides presents as which description in young girls?
• An elderly man with signs of nephrotic syndrome, diabetes, and hypertension has elevated 24-hour urine protein but normal ultrasound kidneys. What is the next best step?
• In prosthetic valve patients, intake of vitamin K–rich supplements can affect INR in which way?
• First-line management of prerenal AKI due to volume depletion is which of the following?
• What is the time window for administering IV alteplase in eligible patients with acute ischemic stroke?
• Classic presentation and management of acute appendicitis includes
• Which management is appropriate for a hemodynamically stable ectopic pregnancy?
• Which periosteal reaction is seen in both osteosarcoma and Ewing sarcoma?
• Which statement best distinguishes Candida intertrigo from dermatophyte infections in intertriginous areas?
• In hepatic encephalopathy, what is a primary treatment to reduce ammonia levels?
• Which diagnosis is associated with oval macrocytosis and neutrophil hyposegmentation/hypogranulation?
• First-line management for postpartum hemorrhage due to uterine atony includes
• A calcium-phosphorus product greater than 55 increases the risk of soft tissue calcification. This finding can be seen in which condition due to chronic electrolyte disturbance?
• Which retinal sign is classically associated with central retinal artery occlusion?
• Which statement best describes pneumococcal vaccination indications in adults?
• The treatment for choriocarcinoma is primarily which modality?
• Infants born macrosomic after poorly controlled second-trimester gestational diabetes are at risk for developing which neonatal complication?
• Which of the following is a good prognostic factor for schizophrenia?
• A 58-year-old man presents with chest pain and ST elevations in inferior leads. What is the most appropriate immediate management?
• Hydrocele can result from failure of closure of which embryologic structure?
• Prophylaxis for DVT after orthopedic surgery typically involves
• Which finding is characteristic of CREST syndrome and helps distinguish it from Thromboangiitis obliterans?
• Why should tetracyclines not be given with isotretinoin?
• Which agents are used for rapid blood pressure reduction in hypertensive emergency during pregnancy?
• What is the initial therapeutic approach for suspected active tuberculosis?
• Management of suspected bacterial meningitis in the elderly includes
• Which form of emphysema is most strongly associated with alpha-1 antitrypsin deficiency?
• Initial management of an acute upper GI bleed with hemodynamic instability includes which of the following?
• A 62-year-old woman with 6 months of watery, non-bloody diarrhea. Colonoscopy shows normal mucosa; biopsy would most likely show which finding?
• Postpartum resumption of menses for formula feeding infants occurs around which weeks?
• To prevent postoperative pneumonia in a patient with COPD, which intervention is most beneficial?
• In a COPD exacerbation, antibiotics are indicated when?
• Which principle is fundamental in managing antibiotic adverse effects?
• In a 39-year-old woman with a history of spontaneous abortion, symmetric uterine enlargement and a red vascular nodule in the posterior fornix that bleeds easily, the most likely diagnosis is which?
• In an elderly immunocompromised patient, which preventive measure would most likely have prevented Listeria meningitis?
• Which statement best differentiates Ewing sarcoma from osteosarcoma?
• In severe hyperkalemia with ECG changes, what is the initial step?
• Which combination of interventions is most appropriate for managing severe features of preeclampsia?
• In uncal herniation, which cranial nerve is compressed first, producing a blown pupil?
• What precaution should adolescents with infectious mononucleosis observe?
• Which finding best differentiates neuroleptic malignant syndrome from serotonin syndrome?
• Which maternal exposure is associated with the newborn features described (low birth weight, small eye openings, low set ears, sunken nasal bridge, thin upper lip)?
• Which statement best differentiates trisomy 18 from fetal alcohol syndrome based on extra features?
• In gallstone ileus, the obstructing stone often causes intermittent obstruction as it traverses the bowel until it becomes impacted again. Which option describes this pattern?
• Initial management for hyperosmolar hyperglycemic state (HHS)?
• Tx for PTSD nightmares?
• After thyroidectomy, a patient presents with hyperphosphatemia and hypocalcemia. What is the most likely diagnosis?
• Which of the following is NOT a poor prognostic factor for schizophrenia?
• What is the best diagnostic study to confirm leiomyoma uteri?
• Delayed wound healing is most closely associated with deficiency of which vitamin?
• Empiric therapy for suspected bacterial meningitis in adults aged 18-50?
• Brightly reflective retinal plaques due to cholesterol embolization from the carotid arteries cause which transient visual event?
• Indirect inguinal hernias are often associated with what embryologic event?
• In suspected thyroid storm, which medication should be started first to control adrenergic symptoms?
• Emphysema is defined as which of the following?
• Antiphospholipid syndrome prolongs which coagulation test?
• In sepsis, what is the most time-critical step after recognition?
• Empiric antibiotic regimen for suspected meningitis in adults over 50 should include
• Which statement about tocolysis in preterm labor is correct?
• Which congenital infection is most common and is associated with periventricular calcifications and microcephaly?
• In diabetic ketoacidosis management, which electrolyte requires close monitoring and potential rapid replacement as insulin and fluids are given?
• Which drug is used to treat the dormant hepatic phase of malaria?
• Which of the following is a risk factor for retained placenta?