First Aid USMLE Step 2 CS Mini
Cases: Comprehensive Clinical
Skills Practice for Medical
Students, Residents, and Exam
Success
Presentation:
26 yo M presents after falling and losing consciousness at work. He had rhythmic
movements of the limbs, bit his tongue, and lost control of his bladder. He was
subsequently confused after regaining consciousness (as witnessed by his
colleagues) - ANSWER-Differential:
Generalized tonic-clonic seizure
Convulsive syncope
Substance abuse/overdose
Malingering
Hypoglycemia
Workup:
CBC
Electrolytes, glucose
,Urine toxicology
EEG
MRI—brain
CT—head
LP—CSF analysis
ECG
Presentation:
34 yo F nurse presents with worsening cough of 6 weeks' duration accompanied
by weight loss, fatigue, night sweats, and fever. She has a history of contact with
tuberculosis patients at work. - ANSWER-Differential:
Tuberculosis
Pneumonia
Lung abscess
Vasculitis
Lymphoma
Metastatic cancer
HIV/AIDS
Sarcoidosis
Workup:
CBC
PPD/QuantiFERON Gold
,Presentation:
55 yo F c/o dizziness for the past day. She feels faint and has severe diarrhea that
started 2 days ago. She takes furosemide for hypertension. - ANSWER-Differential:
Orthostatic hypotension due to dehydration (diarrhea, diuretic use)
Vestibular neuronitis
Labyrinthitis
Benign positional vertigo
Vertebrobasilar insufficiency
Workup:
Orthostatic vital signs
CBC
Electrolytes
Rectal exam, stool for occult blood
Stool leukocytes
Presentation:
65 yo M presents after falling and losing consciousness for a few seconds. He had
no warning before passing out but recently had palpitations. His history includes a
coronary artery bypass graft. - ANSWER-Differential:
Cardiac arrhythmia (causing syncope)
Severe aortic stenosis
Syncope (other causes)
Seizure
, Pulmonary embolism
Workup:
ECG
Holter monitoring
CBC
Electrolytes, glucose
Echocardiography
CT—head
Presentation:
1-month-old F is brought in because she has been spitting up her milk for the last
10 days. The vomiting episodes have increased in frequency and forcefulness.
Emesis is nonbloody and nonbilious. The episodes usually occur immediately after
breastfeeding. She has stopped gaining weight. - ANSWER-Differential:
Pyloric stenosis
Partial duodenal atresia
GERD
Gastroenteritis
Hepatitis
UTI
Otitis media
Workup:
Cases: Comprehensive Clinical
Skills Practice for Medical
Students, Residents, and Exam
Success
Presentation:
26 yo M presents after falling and losing consciousness at work. He had rhythmic
movements of the limbs, bit his tongue, and lost control of his bladder. He was
subsequently confused after regaining consciousness (as witnessed by his
colleagues) - ANSWER-Differential:
Generalized tonic-clonic seizure
Convulsive syncope
Substance abuse/overdose
Malingering
Hypoglycemia
Workup:
CBC
Electrolytes, glucose
,Urine toxicology
EEG
MRI—brain
CT—head
LP—CSF analysis
ECG
Presentation:
34 yo F nurse presents with worsening cough of 6 weeks' duration accompanied
by weight loss, fatigue, night sweats, and fever. She has a history of contact with
tuberculosis patients at work. - ANSWER-Differential:
Tuberculosis
Pneumonia
Lung abscess
Vasculitis
Lymphoma
Metastatic cancer
HIV/AIDS
Sarcoidosis
Workup:
CBC
PPD/QuantiFERON Gold
,Presentation:
55 yo F c/o dizziness for the past day. She feels faint and has severe diarrhea that
started 2 days ago. She takes furosemide for hypertension. - ANSWER-Differential:
Orthostatic hypotension due to dehydration (diarrhea, diuretic use)
Vestibular neuronitis
Labyrinthitis
Benign positional vertigo
Vertebrobasilar insufficiency
Workup:
Orthostatic vital signs
CBC
Electrolytes
Rectal exam, stool for occult blood
Stool leukocytes
Presentation:
65 yo M presents after falling and losing consciousness for a few seconds. He had
no warning before passing out but recently had palpitations. His history includes a
coronary artery bypass graft. - ANSWER-Differential:
Cardiac arrhythmia (causing syncope)
Severe aortic stenosis
Syncope (other causes)
Seizure
, Pulmonary embolism
Workup:
ECG
Holter monitoring
CBC
Electrolytes, glucose
Echocardiography
CT—head
Presentation:
1-month-old F is brought in because she has been spitting up her milk for the last
10 days. The vomiting episodes have increased in frequency and forcefulness.
Emesis is nonbloody and nonbilious. The episodes usually occur immediately after
breastfeeding. She has stopped gaining weight. - ANSWER-Differential:
Pyloric stenosis
Partial duodenal atresia
GERD
Gastroenteritis
Hepatitis
UTI
Otitis media
Workup:
