Vendor: USMLE
Certifications: USMLE Certifications
Exam Code: USMLE-STEP-2
Exam Name: United States Medical Licensing Step 2
Updated: May 28, 2026
Q&As: 738 ( View Details)
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VCE
For each clinical setting described below, select the set of ABG determinations with which it is most likely to be associated. A 60-year-old man with morbid obesity
pH PaO2 PaCO2
A. 7.23 64 80
B. 7.39 88 40
C. 7.22 74 33
D. 7.54 75 24
E. 7.37 67 52
Correct Answer: E
ABG determinations are essential in the diagnosis of respiratory and acid-based disturbances. Extremely obese patients suffer from increased work of breathing, as well as elevation of the diaphragm with decrease in lung volume. The resultant hypoventilation is characterized by carbon dioxide retention leading to chronic respiratory acidosis with metabolic compensation (ABG set E in the question). When associated with somnolence, excessive appetite, and polycythemia, this is known as the pickwickian syndrome. Modest weight loss can lead to dramatic improvement in respiratory functioning. The earliest derangement in salicylate poisoning is hyperventilation, resulting in decreased PaCO2 and increased arterial pH (ABG set D). Eventually, there is CNS depression with somnolence and hypoventilation resulting in respiratory acidosis. Diabetic ketoacidosis may cause acute metabolic acidosis. In a healthy young adult with no lung disease, appropriate respiratory compensation occurs (ABG set C). Without insulin to reverse this process, the patient may go on to develop worsening acidosis and an inability to compensate adequately. ABG set A reflects acute respiratory acidosis (hypoventilation) without metabolic compensation. ABG set B is normal.
Several groups of organic compounds are associated with serious toxic effects when used in transformers because they withstand high temperatures
A. nitrosamines
B. epoxy compounds
C. PCBs
D. formaldehydes
E. organophosphorus compounds
Correct Answer: C
PCBs were extensively used in the manufacture of electrical transformers until production was halted in the mid-1970s. The first sign of chronic exposure to these substances is the appearance of an acne- like eruption with inflammatory pustules. Other effects are eye irritation and GI disturbance. The substances are persistent, and more than 25% of the population in the United States was discovered to have residues of greater than one part per million (ppm) in adipose tissue. Dietary exposure of the general population has been alleged to occur through milk, eggs, cheese, meat, and fish
A study finds that the relative risk of stomach cancer after the consumption of a new sugar substitute is 3.5 with a 95% confidence interval of 1.15.3. Which of the following best describes the true relative risk?
A. If repeated samples are taken from the population, 95% of the time the relative risk will fall between 1.1 and 5.3.
B. If repeated samples are taken from the population and confidence intervals are found for each sample, 95% of the confidence intervals will include the true population relative risk.
C. If repeated samples are taken from the population and confidence intervals are found for each sample, 95% of the confidence intervals will fall somewhere between 1.1 and 5.3.
D. If repeated samples are taken from the population, 95% of the time the true relative risk for the population will fall between 1.1 and 5.3.
E. Ninety-five percent of individuals from a particular sample will have a relative risk between 1.1 and 5.3.
Correct Answer: B
A confidence interval gives an estimated range of values which is likely to include an unknown population parameter, in this case the relative risk of stomach cancer with consumption of the sugar substitute. The estimated range is calculated from a given set of sample data. If independent samples are taken repeatedly from the same population, and a confidence interval calculated for each sample, then a certain percentage of the intervals will include the unknown population parameter.
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