USMLE STEP 2 LATEST 2026 EXAM QUESTIONS AND
ANSWERS GRADED A+
✔✔Treatment of choice for adjustment disorder? - ✔✔Psychodynamic psychotherapy
✔✔Absence of lower esophagus peristaltic waves and increased LES tone?
Rx?
Cx? - ✔✔Achalasia
Rx: Esophageal balloon dilation
Cx: Heartburn
✔✔PE of congenital rubella? - ✔✔Deafness, cataract, cardiac
✔✔PE of congenital toxoplasmosis? - ✔✔Chorioretinitis, hydrocephalus, intracranial
calcification
✔✔1. Causes of protracted labor?
2. Treatment for a women in protracted labor? - ✔✔1. Power, Passenger, Pelvis
2. Oxytocin or amniotomy
If protracted labor becomes arrested labor, CS is next option
✔✔Cardiac tamponade
EKG?
Pulmonary findings?
What other sign? - ✔✔1. Electrical alternans (varying QRS lengths)
2. Lungs are clear!
3. Pulsus paradoxus
✔✔Constrictive pericarditis
Auscultation?
Sign? - ✔✔1. Pericardial knock (diastolic, S3)
2. Kussmaul's sign
✔✔CSF lab findings in HSV encephalitis
1. Lympocytes?
2. RBC? - ✔✔1. increased lymphocytes
2. increased RBC (hemorrhagic fronto-temporal lobe)
✔✔Which 1 has oral lesions:
pemphigus vulgaris or bullous pemphigoid? - ✔✔pemphigus vulgaris
✔✔TB pleural exudate
1. Protein?
2. Glucose?
,3. WBCs? - ✔✔1. Increased protein
2. Normal glucose
3. Lots of lymphocytes
✔✔Empyema pleural exudate
1. Glucose?
2. WBCs? - ✔✔1. Low glucose
2. Neutrophils
thick pus
✔✔1. BDT for spontaneous bacterial peritonitis?
2. Abdomen on palpation?
3. Rx? - ✔✔1. Paracentesis: >250 neutrophils
2. No guarding or palpation
3. IV antibiotics
✔✔anti-centromere? - ✔✔Scleroderma --> CREST
✔✔SIADH
Define:
Plasma Os?
Plasma Na?
Urine Os?
Urine Na? - ✔✔Free water retention
Plasma Os: decreased
Plasma Na: decreased
Urine Os: Increased
Urine Na: Increased
✔✔TB CXR? - ✔✔Unilateral upper lobe infiltrate w/ cavitation
Hilar lymphadenopathy
✔✔Etiology of SIADH?
Rx? - ✔✔Any lung malignancy (SCC, sarcoid, TB)
Drugs eg SSRI
Rx: fluid restriction
✔✔DI
Define:
PE:
Serum Os
Serum Na
Urine Os
,Urine Na - ✔✔Define: Inability to concentrate urine
PE: polyuria, polydipsia
Serum Os increased
Serum Na increased (hypernatremia)
Urine Os decreased
Urine Na decreased
✔✔Rx of Peripheral DI - ✔✔Diuretics: HCTZ (increase Na excretion)
NSAIDS
✔✔Takayasu's vasculitis
1. What type of vasculitis?
2. PE - ✔✔1. Granulomatous vasculitis
2. Absent upper extremity pulse (pulseless disease), vision problems, stroke)
✔✔Wegener's
1. What type of vasculitis?
2. PE? - ✔✔1. Granulomatous
2. Upper and lower respiratory tract! (+kidney!)
✔✔Churg-Strauss
1. Vasculitis?
2. PE? - ✔✔Granulomatous
Allergic rhinitis, eosinophils
✔✔Kawasaki Disease
1. Vasculitis?
2. PE
3. Rx?
4. Cx of Kawasaki? - ✔✔1. Necrotizing
2. Fever, red conjunctiva, oral mucous membrane involvement, erythema of palms and
soles, cervical lymphadenopathy
3. IVIG + aspirin
4. Heart failure, Coronary occlusion
✔✔Pupil size
1. Opiod OD
2. Benzo OD - ✔✔1. Miosis
2. Normal size
✔✔Rx of Opiod OD? - ✔✔Naloxene
✔✔Beta-blocker OD
1. PE?
, 2. Rx? - ✔✔1. Bradycardia and hypotension
2. Glucagon
✔✔Rx of Benzo intox - ✔✔Flumazenil
✔✔Farmer who OD's on organophosphates.
Best 1st 2 things to do? - ✔✔Remove all clothing and wash body.
Give atropine
✔✔TCA overdose
1. What will be on EKG?
2. Rx?
3. If pt died, MCC? - ✔✔1. Prolonged QRS (decreases myocardial conduction velocity
by inhibiting fast Na channels)
2. Sodium bicarbonate (shortens QRS)
3. Ventricular arrythmia
✔✔Distinguish ethylene glycol and methanol OD - ✔✔Ethylene glycol: kidneys
Methanol: eyes
✔✔Aspirin OD
PE? - ✔✔Tinnitus, fever, hyperventilation
✔✔Cohort study with ~40% of participants lost to follow-up creates what type of bias? -
✔✔Selection bias
✔✔Observer bias or ascertainment bias come about how? - ✔✔Flaws in study design
✔✔Recall bias is a potential problem in what type of study? - ✔✔case-control
✔✔z-test or t-test do what? - ✔✔Compare 2 means (not proportions)
✔✔ANOVA test is used for what? - ✔✔Compare means of 3 or more variables
✔✔Chi-square is used for what? - ✔✔Compare proportions
✔✔Is a case control study a prospective or retrospective study? - ✔✔retrospective.
The movement if from the EFFECT to the CAUSE
✔✔Best study to calculate incidence?
Best study to calculate prevalence? - ✔✔Incidence = Cohort
Prevalence = Cross-sectional
ANSWERS GRADED A+
✔✔Treatment of choice for adjustment disorder? - ✔✔Psychodynamic psychotherapy
✔✔Absence of lower esophagus peristaltic waves and increased LES tone?
Rx?
Cx? - ✔✔Achalasia
Rx: Esophageal balloon dilation
Cx: Heartburn
✔✔PE of congenital rubella? - ✔✔Deafness, cataract, cardiac
✔✔PE of congenital toxoplasmosis? - ✔✔Chorioretinitis, hydrocephalus, intracranial
calcification
✔✔1. Causes of protracted labor?
2. Treatment for a women in protracted labor? - ✔✔1. Power, Passenger, Pelvis
2. Oxytocin or amniotomy
If protracted labor becomes arrested labor, CS is next option
✔✔Cardiac tamponade
EKG?
Pulmonary findings?
What other sign? - ✔✔1. Electrical alternans (varying QRS lengths)
2. Lungs are clear!
3. Pulsus paradoxus
✔✔Constrictive pericarditis
Auscultation?
Sign? - ✔✔1. Pericardial knock (diastolic, S3)
2. Kussmaul's sign
✔✔CSF lab findings in HSV encephalitis
1. Lympocytes?
2. RBC? - ✔✔1. increased lymphocytes
2. increased RBC (hemorrhagic fronto-temporal lobe)
✔✔Which 1 has oral lesions:
pemphigus vulgaris or bullous pemphigoid? - ✔✔pemphigus vulgaris
✔✔TB pleural exudate
1. Protein?
2. Glucose?
,3. WBCs? - ✔✔1. Increased protein
2. Normal glucose
3. Lots of lymphocytes
✔✔Empyema pleural exudate
1. Glucose?
2. WBCs? - ✔✔1. Low glucose
2. Neutrophils
thick pus
✔✔1. BDT for spontaneous bacterial peritonitis?
2. Abdomen on palpation?
3. Rx? - ✔✔1. Paracentesis: >250 neutrophils
2. No guarding or palpation
3. IV antibiotics
✔✔anti-centromere? - ✔✔Scleroderma --> CREST
✔✔SIADH
Define:
Plasma Os?
Plasma Na?
Urine Os?
Urine Na? - ✔✔Free water retention
Plasma Os: decreased
Plasma Na: decreased
Urine Os: Increased
Urine Na: Increased
✔✔TB CXR? - ✔✔Unilateral upper lobe infiltrate w/ cavitation
Hilar lymphadenopathy
✔✔Etiology of SIADH?
Rx? - ✔✔Any lung malignancy (SCC, sarcoid, TB)
Drugs eg SSRI
Rx: fluid restriction
✔✔DI
Define:
PE:
Serum Os
Serum Na
Urine Os
,Urine Na - ✔✔Define: Inability to concentrate urine
PE: polyuria, polydipsia
Serum Os increased
Serum Na increased (hypernatremia)
Urine Os decreased
Urine Na decreased
✔✔Rx of Peripheral DI - ✔✔Diuretics: HCTZ (increase Na excretion)
NSAIDS
✔✔Takayasu's vasculitis
1. What type of vasculitis?
2. PE - ✔✔1. Granulomatous vasculitis
2. Absent upper extremity pulse (pulseless disease), vision problems, stroke)
✔✔Wegener's
1. What type of vasculitis?
2. PE? - ✔✔1. Granulomatous
2. Upper and lower respiratory tract! (+kidney!)
✔✔Churg-Strauss
1. Vasculitis?
2. PE? - ✔✔Granulomatous
Allergic rhinitis, eosinophils
✔✔Kawasaki Disease
1. Vasculitis?
2. PE
3. Rx?
4. Cx of Kawasaki? - ✔✔1. Necrotizing
2. Fever, red conjunctiva, oral mucous membrane involvement, erythema of palms and
soles, cervical lymphadenopathy
3. IVIG + aspirin
4. Heart failure, Coronary occlusion
✔✔Pupil size
1. Opiod OD
2. Benzo OD - ✔✔1. Miosis
2. Normal size
✔✔Rx of Opiod OD? - ✔✔Naloxene
✔✔Beta-blocker OD
1. PE?
, 2. Rx? - ✔✔1. Bradycardia and hypotension
2. Glucagon
✔✔Rx of Benzo intox - ✔✔Flumazenil
✔✔Farmer who OD's on organophosphates.
Best 1st 2 things to do? - ✔✔Remove all clothing and wash body.
Give atropine
✔✔TCA overdose
1. What will be on EKG?
2. Rx?
3. If pt died, MCC? - ✔✔1. Prolonged QRS (decreases myocardial conduction velocity
by inhibiting fast Na channels)
2. Sodium bicarbonate (shortens QRS)
3. Ventricular arrythmia
✔✔Distinguish ethylene glycol and methanol OD - ✔✔Ethylene glycol: kidneys
Methanol: eyes
✔✔Aspirin OD
PE? - ✔✔Tinnitus, fever, hyperventilation
✔✔Cohort study with ~40% of participants lost to follow-up creates what type of bias? -
✔✔Selection bias
✔✔Observer bias or ascertainment bias come about how? - ✔✔Flaws in study design
✔✔Recall bias is a potential problem in what type of study? - ✔✔case-control
✔✔z-test or t-test do what? - ✔✔Compare 2 means (not proportions)
✔✔ANOVA test is used for what? - ✔✔Compare means of 3 or more variables
✔✔Chi-square is used for what? - ✔✔Compare proportions
✔✔Is a case control study a prospective or retrospective study? - ✔✔retrospective.
The movement if from the EFFECT to the CAUSE
✔✔Best study to calculate incidence?
Best study to calculate prevalence? - ✔✔Incidence = Cohort
Prevalence = Cross-sectional
