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USMLE STEP2 Exam
Step2 (Page 15 )

Updated On: 30-Jan-2026
Page 15 of 149
PDF with 738 Questions

A 55-year-old-woman presents to the physician's office for evaluation of mammographic findings on a screening mammogram. She denies any breast masses, nipple discharge, pain, or skin changes. Past history is pertinent for insulin-dependent diabetes. Family history is positive for postmenopausal breast cancer in her mother. She has a normal breast examination and no axillary adenopathy. A mediolateral oblique (MLO) view of the right breast is shown in the figure below.



Which of the following is the most appropriate next step in management?

  1. observation, with repeat mammogram in 612 months
  2. ultrasound
  3. biopsy
  4. lumpectomy, radiation therapy, and sentinel lymph node (SLN) biopsy
  5. total mastectomy

Answer(s): A

Explanation:

The mammographic appearance of popcornlike, coarse calcifications in the breast is characteristic of an involuting, or degenerating fibroadenoma in a postmenopausal woman. Mammographic follow-up is appropriate. A repeat study at 6 months would be considered if no prior films are available in order to assess stability of a new mammographic finding. Though ultrasound is often performed for solid masses, the amount of calcification in the mass would lead to artifact, making interpretation difficult. Biopsy would not be suggested based on the characteristic mammographic findings. Other surgical procedures would not be indicated



Identify the following personality disorders with the symptoms listed below. Unwilling to take personal risks; perceives self as inept, unappealing, inferior

  1. antisocial
  2. avoidant
  3. borderline
  4. dependent
  5. histrionic
  6. narcissistic
  7. obsessive-compulsive
  8. paranoid
  9. schizoid
  10. schizotypal

Answer(s): B

Explanation:

Persons with personality disorders are rigidly bound to the use of patterns of defense and various traits that distinguish the disorders. All have problems with interpersonal relationships



Which of the following medications may be appropriate for treating children with attention deficit disorder?

  1. lithium
  2. bupropion
  3. alprazolam
  4. propranolol
  5. perphenazine

Answer(s): B

Explanation:

The antidepressant bupropion has been found effective for treating some cases of attention deficit disorder and offers help to those children not responsive to the usual treatment with stimulants (methylphenidate, pemoline). The remaining choices have not been found useful in treating this condition. They are lithium, a mood stabilizer; alprazolam, a benzodiazepine anxiolytic; propranolol, a betablocker; and perphenazine, an antipsychotic.



Identify the following personality disorders with the symptoms listed below. Chronic feelings of emptiness, fear of abandonment; unstable self-image

  1. antisocial
  2. avoidant
  3. borderline
  4. dependent
  5. histrionic
  6. narcissistic
  7. obsessive-compulsive
  8. paranoid
  9. schizoid
  10. schizotypal

Answer(s): C

Explanation:

Persons with personality disorders are rigidly bound to the use of patterns of defense and various traits that distinguish the disorders. All have problems with interpersonal relationships



Identify the following personality disorders with the symptoms listed below.
Seems to not care what others think or feel; is aloof

  1. antisocial
  2. avoidant
  3. borderline
  4. dependent
  5. histrionic
  6. narcissistic
  7. obsessive-compulsive
  8. paranoid
  9. schizoid
  10. schizotypal

Answer(s): I

Explanation:

Persons with personality disorders are rigidly bound to the use of patterns of defense and various traits that distinguish the disorders. All have problems with interpersonal relationships



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