SHELF / USMLE Step 2 Practice Questions > Internal Medicine > Oncology
82 Case based vignette style practice questions from the American College of Physicians (ACP) with answers & thorough explanations - DOWNLOAD the .pdf
Want more great practice questions for the Medicine Shelf Exam? Go with MKSAP for Students 3
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SHELF / USMLE Step 2 Practice Questions > Internal Medicine > Neurology
92 Case based vignette style practice questions from the American College of Physicians (ACP) with answers & thorough explanations - DOWNLOAD the .pdf
Want more great practice questions for the Medicine Shelf Exam? Go with MKSAP for Students 3
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SHELF / USMLE Step 2 Practice Questions > Internal Medicine > Nephrology
58 Case based vignette style practice questions from the American College of Physicians (ACP) with answers & thorough explanations - DOWNLOAD the .pdf
Want more great practice questions for the Medicine Shelf Exam? Go with USMLE Step 2 CK Qbook (Kaplan USMLE Qbook)
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SHELF / USMLE Step 2 Practice Questions > Internal Medicine > Infectious Disease
183 Case based vignette style practice questions from the American College of Physicians (ACP) with answers & thorough explanations - DOWNLOAD the .pdf
Want more great practice questions for the Medicine Shelf Exam? Go with USMLE Step 2 CK Qbook (Kaplan USMLE Qbook)
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SHELF / USMLE Step 2 Practice Questions > Internal Medicine > Hematology
66 Case based vignette style practice questions from the American College of Physicians (ACP) with answers & thorough explanations - DOWNLOAD the .pdf
Want more great practice questions for the Medicine Shelf Exam? Go with USMLE Step 2 CK Qbook (Kaplan USMLE Qbook)
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SHELF / USMLE Step 2 Practice Questions > Internal Medicine > Endocrinology
26 Case based vignette style practice questions from the American College of Physicians (ACP) with answers & thorough explanations - DOWNLOAD the .pdf
Want more great practice questions for the Medicine Shelf Exam? Go with MKSAP for Students 3
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SHELF / USMLE Step 2 Practice Questions > Internal Medicine > Dermatology
67 Case based vignette style practice questions from the American College of Physicians (ACP) with answers & thorough explanations - DOWNLOAD the .pdf
Want more great practice questions for the Medicine Shelf Exam? Go with MKSAP for Students 3
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SHELF / USMLE Step 2 Practice Questions > Internal Medicine > Cardiology
85 Case based vignette style practice questions from the American College of Physicians (ACP) with answers & thorough explanations - DOWNLOAD the .pdf
Want more great practice questions for the Medicine Shelf Exam? Go with MKSAP for Students 3
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SHELF / USMLE Step 2 Practice Questions > Family Medicine
Case Based Vignette Style Questions from Medscape & the ACP with Answers & Explanations (.pdf)
Recommended family medicine text: Essentials of Family Medicine (Sloane)
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Below are the must have books / sites / programs that WILL make your life easier in med school (for specific subjects & clerkships see the appropriate post, below are overarching resources in alphabetical order).
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Shelf Exam Information from the NBME
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SHELF / USMLE Step 2 Practice Questions > Surgery
Q1) You have been asked to perform a preoperative consultation on a 65-year-old male who will be undergoing a testicular hernia repair. Of the following findings, which is of most concern in predicting a cardiac complication in this patient undergoing noncardiac surgery?
a) Age over 60Q2) A right hemicolectomy is performed on a 57-year-old woman with adenocarcinoma who had a preoperative elevation of carcinoembryonic antigen (CEA) to 144. After falling to normal levels postoperatively, her most recent (24-month) follow-up level was 86. Correct statements regarding CEA and colorectal tumors include which of the following?
b) History of myocardial infarction 3.5 years ago
c) Harsh systolic crescendo-decrescendo murmur radiating to the carotids
d) ECG and subsequent telemetry showing up to five PVCs per minute
e) Serum creatinine 2.0 mg/dL
a) elevated CEA is indicative of a tumor of gastrointestinal origin
b) a low CEA level after resection of a colon tumor is a poor marker of disease control
c) 90% of colorectal tumors produce CEA
d) there is a high likelihood of liver involvement if the CEA level is high (greater than 100 ng/mL)
e) CEA levels are unusually low in cigarette smokers
a) Increase in sodium and water excretion
b) Increase in renal perfusion
c) Decrease in cortisol levels
d) Hyperkalemia
e) Hypoglycemia
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SHELF / USMLE Step 2 Practice Questions > Surgery
Q1) A workup for a patient with frequent and multiple areas of cutaneous ecchymosis discloses a large spleen and evidence of immune (idiopathic) thrombocytopenic purpura (ITP). ITP includes which of the following?
a) A significant enlargement of the spleenQ2) 4. A 27-year-old man undergoes general anesthesia for a hernia repair. As the anesthesia begins, his jaw muscles tense and he becomes generally rigid. He becomes febrile, tachycardic, and tachypnic. Intravenous administration of which of the following agents may be lifesaving?
b) A high reticulocyte count
c) Megakaryocytic elements in the bone marrow
d) An increase in platelet count on cortisone therapy
e) Patient age of less than 5 years
a) Suxamethonium
b) Nitrous oxide
c) Succinylcholine
d) Dantrolene
e) Phenobarbital
a) Colonoscopic decompression and rectal tube placement
b) Saline enemas and digital disimpaction of fecal matter from the rectum
c)Colon resection and proximal colostomy
d)Oral administration of metronidazole and checking a Clostridium difficile titer
e)Evaluation of an electrocardiogram and obtaining an angiogram to evaluate for colonic mesenteric ischemia
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SHELF / USMLE Step 2 Practice Questions > Surgery
Q1) A 75-year-old male undergoes an abdominal CT looking for liver metastases from a known colonic adenoma. On the CT a 4.9 cm abdominal aortic aneurysm(AAA). Which of the following risk factors is NOT a contributor to this pt's AAA?
a) His age.Q2) A 64 year old diabetic male with a history of PVD presents to vascular clinic with pain and paresthesias of the L foot. The pain improves with rest but always returns after walking approximately 6 city blocks. Which of the following likely represent this patients test results after and ABI?
b) Hypercholesterolemia.
c) Diabetes.
d) Smoking.
e) Hypertension.
a) ABI = 1.1 - 1.4
b) ABI = 0.9 - 1.0
c) ABI = 0.6 - 0.8
d) ABI = 0.4 - 0.5
e) ABI < 0.3
a) Permanent suture material is preferred
c) Sutures should be removed in 2 weeks to minimize infection
d) Sutures should be placed 3 to 4 mm apart and 4 mm from the wound edge
e) Knots should be centered on the wound
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SHELF / USMLE Step 2 Practice Questions > Surgery
Q1) A 15-year-old male cut his arm while climbing a chain link fence. No foreign bodies are found in the cut anf the wound is thoroughly cleaned. The patient was never immunized against tetanus toxoid. Which of the following represents appropriate management?
a) The patient may be given a toxoid booster.Q2) A 64 year patient who has been on IV heparin for 3 days for a DVT begins to have hematemesis from a bleeding GI ulcer. What is the appropriate management?
b) The patient may be immunized in three separate doses.
c) The patient may be treated with penicillin as prophylaxis against Clostridia tetani.
d) Passive immunization with tetanus immunoglobulin is recommended.
e) The wound should not be sutured.
a) Decrease the heparin dose & administer blood products as needed.
b) Switch to Coumadin.
c) Stop heparin and observe for 3 day to see if the DVT resolves.
d) Stop the systemic heparin and administer thrombolytics directly to the femoral vein.
e) Stop the systemic heparin and place an IVC filter.
a) a CBC with diff.
b) an abdominal flat plate
c) ESR
d) an obstruction series
e) an upper GI
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Here are templates for pre-op, post-op, and progress notes that will ensure you don't forget anything important when rounding on your surgical patients
Surgery Pre-Op Note
Surgery Post-Op Note
Surgery Progress Note
I am currently studying for my surgery Shelf Exam and have come across 2 great books, both are cased based and work through clinical scenarios much like the actual exam:
Surgical Attending Rounds
NMS Surgery Casebook: surgical cases that begin with a clinical scenario and go through the decision-making process of patient management step-by-step.
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| PT | PTT | Inherited Coagulopathies | Acquired Coagulopathies |
| ↑ | nl. | factor VII deficiency | warfarin |
| nl | ↑ | hemophilias | heparin |
| ↑ | ↑ | prothrombin deficiency | heparin + warfarin |
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SHELF / USMLE Step 2 Practice Questions > Internal Medicine > Hematology / Oncology
Q1) A 72-year-old for a routine exam. She has hypertension for which she takes a daily aspirin and ramipril. Her medical history is otherwise noncontributory.
On physical examination, pulse rate is 80/min, and blood pressure is 140/80 mm Hg. There is no bony tenderness, splenomegaly, or lymphadenopathy. Laboratory studies indicate a hemoglobin of 13.6 g/dL , leukocyte count of 7200/μL, and a platelet count of 247,000/μL. Total serum protein level is elevated to 8.0 g/dL, and serum creatinine and calcium concentrations are normal. Serum protein electrophoresis reveals a 1.2-g/dL monoclonal protein spike, further identified as IgG-κ by immunofixation. Bone marrow aspirate smear shows 7% plasmacytosis. No lytic lesions are detected on bone survey. hich of the following is the most appropriate next step in the management of this patient?
a) Thalidomide and dexamethasoneQ2) A previously healthy 45-year-old man presents for the 4th time in 6 months with URI symptoms complaining of a sore-throat and waxing and waining cervical lymhadenopathy? He has undergone several courses of antibiotics, but his symptoms never fully disappear. On exam he has a low grade fever and a bp of 105/70. A left cervical non-tender, non-mobile lymph node measuring 3x3cm is appreciated. No other lymphadenopathy is palpable. A lymph node biopsy is performed. Which of the following is the most likely diagnosis?
b) positron emission tomography
b) bisphosphonates
d) repeated serum protein electrophoresis in 3 to 6 months
a) Burkitt lymphoma
b) diffuse large cell lymphoma
c) follicular mixed lymphoma
d) follicular small cleaved cell lymphoma
e) immunoblastic lymphoma
a) Phlebotomy and anagrelide
b) oral iron supplementation and low-dose aspirin
c) hydroxyurea and aspirin, 325 mg/d
d) phlebotomy and low-dose aspirin
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SHELF / USMLE Step 2 Practice Questions > Internal Medicine > Rheumatology
Q1) A 36-year-old man is evaluated for worsening left knee pain and swelling of 2 days' duration. He does not have dysuria or any systemic symptoms. He has not seen a physician since his last routine physical examination, which was normal and occurred 2 years ago. His father has gout and coronary artery disease. On physical examination, he is afebrile. He walks with a limp because of his pain. The left knee is warm, tender, and distended. The remainder of the examination is unremarkable.
Laboratory Studies
Hemoglobin - 13.3 g/dL
Leukocyte count - 8600/µL normal differential)
Platelet count - 320,000/µL
Urinalysis - Normal
Aspiration of the knee joint yields 20 mL of fluid (leukocyte count, 30,000/µL; 94% neutrophils). No crystals are seen on polarized light microscopy of the fluid, and Gram stain is negative. Results of mucosal, blood, and synovial fluid cultures are pending. Which of the following is the most appropriate next step in this patient's management?
a) IV antibiotics; repeat aspiration of the knee jointQ2) A 45-year-old woman is evaluated for a facial rash of 6 months' duration that involves the cheeks and nose. She is unsure whether sun exposure worsens the rash. She does not have rash elsewhere, fatigue, ulcers, or joint pain. She has a history of autoimmune hypothyroidism with positive antimicrosomal antibodies and is antinuclear antibody positive. Physical examination reveals an erythematous rash with discrete papules and pustules limited to the cheeks, nasolabial folds, and nose. The remainder of the examination is unremarkable. Current laboratory studies, including complete blood count, serum chemistry studies, and thyroid-stimulating hormone, are normal. Which of the following is the most likely diagnosis?
b) NSAIDS
c) NSAIDS and oral antibiotics
d) Knee radiograph; erythrocyte sedimentation rate
a) dermatomyositis
b) systemic lupus erythematosus
c) roseacea
d) seborrheic dermatitis
e) psoriasis
a) discontinue alendronate
b) discontinue etanercept
c) discontinue hydroxychloroquine
d) administer stress-dose hydrocortisone therapy
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