Struggling with NBME shelf exam questions being very vague compared to UWorld

I am finding that the NBME shelf exam self assessment questions are very vague compared to UWorld questions. Someone on SDN actually described my feelings very aptly:

I marked 31/50 questions on form 6, and my threshold for marking was truly having no clue what the diagnosis was. It's just SO VAGUE. The information you get has little rhyme or reason. Tons of details you'd get in any reasonable clinical scenario are left out, so studying sensibly (e.g., knowing that you can always differentiate X from Y with Z clinical presentation) is out the window, because they simply won't give you the Z presentation (even if Z would always be present in real life). There are no pictures, only obscure descriptions of rashes or murmurs with none of the usual vocabulary. Half the exam is just IM in teenagers. The stuff you would know from the usual study materials is described extremely vaguely and often the right answer is based solely on the "most likely" or "most appropriate" aspect of the question.

I just absolutely hate this. UWorld is genetic diseases, TORCH infections, milestones, etc... Clinic/wards is infectious diseases and falls in children aged 0-5 for >80% of all patients. NBME exams are vague nonsense and adult diseases presenting oddly in teenagers and examiners going way out of their way to describe common diseases with esoteric nomenclature.

I've taken a few shelf exams already, but I can't remember if I felt the same way during those.

My question: is the actual Step 2 exam like this? I still have several months till I take it and a few more shelf exams before then, but this is making me worry. UWorld questions don't prepare me well enough to get beyond a ceiling score on the practice shelves due to how different the questions are, so I'm still developing my study approach and am at a bit of a loss.