USMLE Step 2 – High-Yield
Practice Questions (200 Verified
Q&A) | 2025
A 45-year-old man comes to clinic due to frequent fibrillation associated with a
rapid ventricular response rate. A radio-frequency ablation procedure is planned.
The access site is the right femoral vein. The ablation catheter is advanced to the
left atrium where radiofrequency energy is used to eliminate an ectopic focus of
abnormal electrical activity. During the procedure, the catheter most likely passes
through which of the following structures?
A. Aortic valve
B. Interatrial septum
C. Interventricular septum
D. Pulmonic valve
E. Tricuspid valve - CORRECT ANSWER>>>>A
A 68-year-old man with a history of permanent atrial fibrillation comes to the
office for follow-up. He has been having symptoms due to ineffective ventricular
rate control despite aggressive medical therapy. On examination, the patient's
heart rate is 125/min and irregular. ECG shows atrial fibrillation with rapid
,ventricular response. A catheter-based radiofrequency ablation of atrioventricular
node with placement of a permanent ventricular pacemaker is planned. The
ablation tip should be positioned at which of the following locations?
A. Between the tricuspid valve and the inferior vena cava opening
B. Interatrial septum near the opening of the coronary sinus
C. Left atrium near the opening of the pulmonary veins
D. The posterior border of the fossa ovalis
E. Upper part of crista terminalis near the superior vena cava
opening - CORRECT ANSWER>>>>B
A 23-year-old woman is brought to the emergency department with a chest
wound She was in her house during a severe thunderstorm when a large tree
branch fell through a window The window was shattered and large fragments of
wood and glass struck the patient She did not lose consciousness but her family
found her bleeding profusely and rushed her to the hospital Blood pressure is
80/50 mm Hg and pulse is 130/min The patient appears to be in severe distress
Physical examination shows a deep penetrating wound in the fourth intercostal
space along the left sternal border Smaller lacerations are noted across the face
,and forearms Which of the following structures is most likely injured in this
patient? A Inferior vena cava
B Left atrium
C Left ventricle
D Pulmonary trunk
E Right ventricle - CORRECT ANSWER>>>>E
A 35-year-old woman comes to the office due to solid food dysphagia for the
past several months. The patient has a sensation of food getting stuck in the mid-
thorax, but has no pain or
reflux She also has palpitations and dyspnea on exertion. The patient immigrated
to the United States from India 1 year ago. and was treated in her home country
for rheumatic heart disease. Barium esophagram demonstrates extrinsic
compression on the mid-esophagus Enlargement of which of the following is
most Iikely causing this patient's dysphagia? A. Left atrium
B Left ventricle
C. Pulmonary artery
D. Right atrium
E Right ventricle - CORRECT ANSWER>>>>A
, A 3 5-year-old previously healthy man is evaluated for several episodes of
syncope in the past 6 weeks. Physical examination is unremarkable
Echocardiogram shows no structural heart defect. An electrophysiologic study is
performed during which catheters are passed into the patient's right and left
atrium to record atrial electric potentials. Cardiac monitor currently shows
normal sinus rhythm Which of the following is the most likely earliest site of
electric activation? A Junction of left atrium and atrial appendage
B Left atrium near the opening of pulmonary veins
C Right atrium near the opening of inferior vena cava
D Right atrium near the opening of superior vena
cava
E Rig ht atnu m near the se pt al cu sp of tri cuspid valve - CORRECT
ANSWER>>>>B
A 33-year-old man comes to the emergency department due to fever chills cough
and shortness
of breath over the last week He smokes a pack of cigarettes a day consumes 2 or 3
alcoholic
Practice Questions (200 Verified
Q&A) | 2025
A 45-year-old man comes to clinic due to frequent fibrillation associated with a
rapid ventricular response rate. A radio-frequency ablation procedure is planned.
The access site is the right femoral vein. The ablation catheter is advanced to the
left atrium where radiofrequency energy is used to eliminate an ectopic focus of
abnormal electrical activity. During the procedure, the catheter most likely passes
through which of the following structures?
A. Aortic valve
B. Interatrial septum
C. Interventricular septum
D. Pulmonic valve
E. Tricuspid valve - CORRECT ANSWER>>>>A
A 68-year-old man with a history of permanent atrial fibrillation comes to the
office for follow-up. He has been having symptoms due to ineffective ventricular
rate control despite aggressive medical therapy. On examination, the patient's
heart rate is 125/min and irregular. ECG shows atrial fibrillation with rapid
,ventricular response. A catheter-based radiofrequency ablation of atrioventricular
node with placement of a permanent ventricular pacemaker is planned. The
ablation tip should be positioned at which of the following locations?
A. Between the tricuspid valve and the inferior vena cava opening
B. Interatrial septum near the opening of the coronary sinus
C. Left atrium near the opening of the pulmonary veins
D. The posterior border of the fossa ovalis
E. Upper part of crista terminalis near the superior vena cava
opening - CORRECT ANSWER>>>>B
A 23-year-old woman is brought to the emergency department with a chest
wound She was in her house during a severe thunderstorm when a large tree
branch fell through a window The window was shattered and large fragments of
wood and glass struck the patient She did not lose consciousness but her family
found her bleeding profusely and rushed her to the hospital Blood pressure is
80/50 mm Hg and pulse is 130/min The patient appears to be in severe distress
Physical examination shows a deep penetrating wound in the fourth intercostal
space along the left sternal border Smaller lacerations are noted across the face
,and forearms Which of the following structures is most likely injured in this
patient? A Inferior vena cava
B Left atrium
C Left ventricle
D Pulmonary trunk
E Right ventricle - CORRECT ANSWER>>>>E
A 35-year-old woman comes to the office due to solid food dysphagia for the
past several months. The patient has a sensation of food getting stuck in the mid-
thorax, but has no pain or
reflux She also has palpitations and dyspnea on exertion. The patient immigrated
to the United States from India 1 year ago. and was treated in her home country
for rheumatic heart disease. Barium esophagram demonstrates extrinsic
compression on the mid-esophagus Enlargement of which of the following is
most Iikely causing this patient's dysphagia? A. Left atrium
B Left ventricle
C. Pulmonary artery
D. Right atrium
E Right ventricle - CORRECT ANSWER>>>>A
, A 3 5-year-old previously healthy man is evaluated for several episodes of
syncope in the past 6 weeks. Physical examination is unremarkable
Echocardiogram shows no structural heart defect. An electrophysiologic study is
performed during which catheters are passed into the patient's right and left
atrium to record atrial electric potentials. Cardiac monitor currently shows
normal sinus rhythm Which of the following is the most likely earliest site of
electric activation? A Junction of left atrium and atrial appendage
B Left atrium near the opening of pulmonary veins
C Right atrium near the opening of inferior vena cava
D Right atrium near the opening of superior vena
cava
E Rig ht atnu m near the se pt al cu sp of tri cuspid valve - CORRECT
ANSWER>>>>B
A 33-year-old man comes to the emergency department due to fever chills cough
and shortness
of breath over the last week He smokes a pack of cigarettes a day consumes 2 or 3
alcoholic
