USMLE STEP 2 LATEST 2026 TEST PAPER QUESTIONS
AND ANSWERS GRADED A+
✔✔Reaction to blood transfusion w/in minutes.
What type of blood transfusion rxn? - ✔✔IgA deficiency
✔✔Motor
Femoral:
Tibial:
Obturator:
Common peroneal / Fibular - ✔✔Femoral: Knee extension, hip flexion
Tibial: Flexion of knee and flexion of foot
Obturator: Adduction of thigh
Common peroneal: Anterior and lateral leg
✔✔Sensory
Femoral:
Tibial:
Obturator:
Common peroneal / Fibular - ✔✔Femoral: anterior thigh, medial leg
Tibial: leg (except medial) and plantar foot
Obturator: medial thigh
Common peroneal: anterolateral leg and dorsum of foot
✔✔Antibiotics for pregnancy - ✔✔Amoxicillin, nitrofurantoin, oral cephalosporin
✔✔Viral meningitis
MCC?
Rx? - ✔✔Enteroviruses (echovirus and coxsackie)
✔✔PE: Ab pain, N/V, Diarrhea, red eyes, periorbital edema, muscle pain, tenderness,
splinter hemorrhages?
Dx?
Transmitted?
Elevated WBC? - ✔✔Trichenollosis
Undercooked pork
Eosinophilia
✔✔Mucormycosis
Ax w/ what disease?
MCC?
Rx? - ✔✔DM
The Fungus Rhizopus
Surgical debridement + IV amphotericin B
,✔✔Nosocomial pneumonia in an intubated patient
Common gram (-) rod?
Rx? - ✔✔Pseudomonas aeruginosa
Rx: 4th generation cephalosporin (cefepime) or piperacillin/tazobactam
✔✔Mycobacterium avium
1. Prophylatic Rx when CD4 <50?
2. Medical Rx when infected? - ✔✔1. Azithromycin
2. Clarithromycin + ethambutol
✔✔HIV pt CD4 <50
PE: unexplained fever + cough. Test (+) for a virus
What virus?
Rx? - ✔✔CMV
gancyclovir
✔✔Cat Scratch disease
PE:
Organism:
Rx: - ✔✔PE: young, immunocompetent pt. localized cutaneous and lymph node
involvement
Bartonella henselae
oral Azithromycin
✔✔Listeria monocytogenes
DOC?
Type of patient? - ✔✔ampicillin
Baby, old, immunocompromised
✔✔Human bite or dog bite or cate bite
DOC?
Bacteria? - ✔✔Amoxicillin-clavulanate
Pastuerella multocida
✔✔Legionairre disease
DOC? - ✔✔Erythromycin
✔✔A weakly acid-fast branching gram (+) filamentous rod. Commonly infects
immunocompromised lungs.
Organism?
Rx? - ✔✔Nocardia
TMP-SMX
,✔✔Frequent cause of osteomyelitis in adults w/ nail wound? - ✔✔P. aeruginosa
✔✔Treatment of Histoplasmosis in HIV? - ✔✔IV amphotericin B + lifelong itraconazole
✔✔HIV pt w/ esophagitis
BIT?
If that fails? - ✔✔Assume candidiasis and treat w/ oral fluconazole.
If that fails then do endoscopy w/ cytology. Other possible causes: HSV (acyclovir) or
CMV (gancyclovir)
✔✔HIV Drugs and Side effects
Anemia
Pancreas / Neuropathy
Stones - ✔✔Anemia - Zidovudine (NRTI)
Pancreas - Didanosine (RTI)
Neuropathy - Stavudine (NRTI)
Stone - Indinavir (Protease Inhibitor)
✔✔Hospitalized diabetic alcoholic w/ pneumoniae
MCC?
Gram stain?
What type of cavitation - ✔✔Klebsiella pneumoniae
gram (-) encapsulated
"currant jelly"
✔✔Hospitalized pt w/ pneumoniae + cystic fibrosis + bronchiectasis
MCC? - ✔✔Pseudomonas aeruginosa
✔✔- Non-productive cough, H/A, rash
- No organism on gram stain
- cold agglutinins in blood
MCC? - ✔✔mycoplasma pneumoniae
✔✔HIV pt w/ diarrhea:
1. Profuse and watery. MCC?
2. Blood. MCC? - ✔✔Cryptosporidium parvum
CMV
✔✔1. Uncomplicated cystitis Rx?
2. Pyelonephritis Rx?
3 UTI in pregnancy? - ✔✔1. TMP-SMX 3 days
2. Ampicillin + gentamycin
3. Nitrofurantoin
, ✔✔Rx for impetigo? - ✔✔topical bacitracin or mupirocin
✔✔Rx for scabies? - ✔✔permethrin
✔✔Rx for a fungal infection w/ hair or nail involvement? - ✔✔Can't use topical
Terbinafine or Itraconazole
Se of terbinafine: liver
✔✔Rx for necrotizing fascitis - ✔✔Surgical debridement + antibiotics
- Staph or Clostridium perfringens
✔✔What is fluconazole used for? - ✔✔Superficial fungal infections
+ neutropenic fever
✔✔SE of amphotericin? - ✔✔hypokalemia
renal tubule acidosis
✔✔Pneumonia
1. Gram (+) diplococci
2. Gram (+) cocci in clusters
3. Gram (-) cocci
4. Gram (+) rods
5. Gram (-) rods - ✔✔1. +DC Streptococcus pneumoniae
2. +Cocci Clusters Staphylococcus
3. -C Neisseria
4. +R Listeria and Bacillus
5. -R Pseudomonas, Hemophilus, Klebsiella, Legionella
✔✔neonate PE: big head, big tongue, big organs, hypoglycemia, hyperinsulinemia,
Wilms tumor
Dx? - ✔✔Beckwith-Widman syndrome
✔✔WAGR syndrome
Chromosomal abnormality? - ✔✔Wilms tumor
Aniridia
Genitourinary syndrome
Retarded
Chr 11
✔✔PE: <1 yo, abdominal mass, crosses midline
Dx?
Confirm Dx? - ✔✔Neuroblastoma
catecholamines in urine
AND ANSWERS GRADED A+
✔✔Reaction to blood transfusion w/in minutes.
What type of blood transfusion rxn? - ✔✔IgA deficiency
✔✔Motor
Femoral:
Tibial:
Obturator:
Common peroneal / Fibular - ✔✔Femoral: Knee extension, hip flexion
Tibial: Flexion of knee and flexion of foot
Obturator: Adduction of thigh
Common peroneal: Anterior and lateral leg
✔✔Sensory
Femoral:
Tibial:
Obturator:
Common peroneal / Fibular - ✔✔Femoral: anterior thigh, medial leg
Tibial: leg (except medial) and plantar foot
Obturator: medial thigh
Common peroneal: anterolateral leg and dorsum of foot
✔✔Antibiotics for pregnancy - ✔✔Amoxicillin, nitrofurantoin, oral cephalosporin
✔✔Viral meningitis
MCC?
Rx? - ✔✔Enteroviruses (echovirus and coxsackie)
✔✔PE: Ab pain, N/V, Diarrhea, red eyes, periorbital edema, muscle pain, tenderness,
splinter hemorrhages?
Dx?
Transmitted?
Elevated WBC? - ✔✔Trichenollosis
Undercooked pork
Eosinophilia
✔✔Mucormycosis
Ax w/ what disease?
MCC?
Rx? - ✔✔DM
The Fungus Rhizopus
Surgical debridement + IV amphotericin B
,✔✔Nosocomial pneumonia in an intubated patient
Common gram (-) rod?
Rx? - ✔✔Pseudomonas aeruginosa
Rx: 4th generation cephalosporin (cefepime) or piperacillin/tazobactam
✔✔Mycobacterium avium
1. Prophylatic Rx when CD4 <50?
2. Medical Rx when infected? - ✔✔1. Azithromycin
2. Clarithromycin + ethambutol
✔✔HIV pt CD4 <50
PE: unexplained fever + cough. Test (+) for a virus
What virus?
Rx? - ✔✔CMV
gancyclovir
✔✔Cat Scratch disease
PE:
Organism:
Rx: - ✔✔PE: young, immunocompetent pt. localized cutaneous and lymph node
involvement
Bartonella henselae
oral Azithromycin
✔✔Listeria monocytogenes
DOC?
Type of patient? - ✔✔ampicillin
Baby, old, immunocompromised
✔✔Human bite or dog bite or cate bite
DOC?
Bacteria? - ✔✔Amoxicillin-clavulanate
Pastuerella multocida
✔✔Legionairre disease
DOC? - ✔✔Erythromycin
✔✔A weakly acid-fast branching gram (+) filamentous rod. Commonly infects
immunocompromised lungs.
Organism?
Rx? - ✔✔Nocardia
TMP-SMX
,✔✔Frequent cause of osteomyelitis in adults w/ nail wound? - ✔✔P. aeruginosa
✔✔Treatment of Histoplasmosis in HIV? - ✔✔IV amphotericin B + lifelong itraconazole
✔✔HIV pt w/ esophagitis
BIT?
If that fails? - ✔✔Assume candidiasis and treat w/ oral fluconazole.
If that fails then do endoscopy w/ cytology. Other possible causes: HSV (acyclovir) or
CMV (gancyclovir)
✔✔HIV Drugs and Side effects
Anemia
Pancreas / Neuropathy
Stones - ✔✔Anemia - Zidovudine (NRTI)
Pancreas - Didanosine (RTI)
Neuropathy - Stavudine (NRTI)
Stone - Indinavir (Protease Inhibitor)
✔✔Hospitalized diabetic alcoholic w/ pneumoniae
MCC?
Gram stain?
What type of cavitation - ✔✔Klebsiella pneumoniae
gram (-) encapsulated
"currant jelly"
✔✔Hospitalized pt w/ pneumoniae + cystic fibrosis + bronchiectasis
MCC? - ✔✔Pseudomonas aeruginosa
✔✔- Non-productive cough, H/A, rash
- No organism on gram stain
- cold agglutinins in blood
MCC? - ✔✔mycoplasma pneumoniae
✔✔HIV pt w/ diarrhea:
1. Profuse and watery. MCC?
2. Blood. MCC? - ✔✔Cryptosporidium parvum
CMV
✔✔1. Uncomplicated cystitis Rx?
2. Pyelonephritis Rx?
3 UTI in pregnancy? - ✔✔1. TMP-SMX 3 days
2. Ampicillin + gentamycin
3. Nitrofurantoin
, ✔✔Rx for impetigo? - ✔✔topical bacitracin or mupirocin
✔✔Rx for scabies? - ✔✔permethrin
✔✔Rx for a fungal infection w/ hair or nail involvement? - ✔✔Can't use topical
Terbinafine or Itraconazole
Se of terbinafine: liver
✔✔Rx for necrotizing fascitis - ✔✔Surgical debridement + antibiotics
- Staph or Clostridium perfringens
✔✔What is fluconazole used for? - ✔✔Superficial fungal infections
+ neutropenic fever
✔✔SE of amphotericin? - ✔✔hypokalemia
renal tubule acidosis
✔✔Pneumonia
1. Gram (+) diplococci
2. Gram (+) cocci in clusters
3. Gram (-) cocci
4. Gram (+) rods
5. Gram (-) rods - ✔✔1. +DC Streptococcus pneumoniae
2. +Cocci Clusters Staphylococcus
3. -C Neisseria
4. +R Listeria and Bacillus
5. -R Pseudomonas, Hemophilus, Klebsiella, Legionella
✔✔neonate PE: big head, big tongue, big organs, hypoglycemia, hyperinsulinemia,
Wilms tumor
Dx? - ✔✔Beckwith-Widman syndrome
✔✔WAGR syndrome
Chromosomal abnormality? - ✔✔Wilms tumor
Aniridia
Genitourinary syndrome
Retarded
Chr 11
✔✔PE: <1 yo, abdominal mass, crosses midline
Dx?
Confirm Dx? - ✔✔Neuroblastoma
catecholamines in urine
