USMLE EXAM zm
Exam Solution
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USMLE Step 2 CK Internal Medicine 2026 A+ GRADE AS
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SURED COMPLETE SOLUTIONS AND VERIFIED ANSWER
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S (9FD8F)
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QUESTION 1 zm
Leukemoid reaction zm
ANSWER
Patient has leukocyte count >50k, high LAP score, more metamyelocytes than myelocytes
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QUESTION 2 zm
Chronic myeloid leukemia
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ANSWER
Patient has leukocyte count often >100k, low LAP score, fewer metamyelocytes than myelocytes, abs
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olute basophilia
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QUESTION 3 zm
Cyclosporine
ANSWER
Drug that inhibits transcription of IL-
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2, causes nephrotoxicity, htn, neurotoxicity, glucose intolerance, infection, malignancy, gingival hypert
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rophy and hirsutism
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QUESTION 4 zm
Tacrolimus
ANSWER
Drug that inhibits transcription of IL-2 but does not cause hirsutism or gum hypertrophy
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,QUESTION 5 zm
Mycophenolate
ANSWER
Drug that is a reversible inhibitor of inosine monophosphate dehydrogenase (rate-
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limiting enzyme in de novo purine synthesis), causes bone marrow suppression
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QUESTION 6 zm
Acute pericarditis
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ANSWER
Patient presents with sharp, pleuritic chest pain that is relieved by leaning forward
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QUESTION 7 zm
Diabetic ketoacidosis zm
ANSWER
Patient with DM presents with hyperventilation, glucose 250-
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500, bicarb <18, elevated anion gap, serum osmolality <320
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QUESTION 8 zm
Hyperosmolar hyperglycemic state zm zm
ANSWER
Patient with DM presents with altered mentation, glucose >600, bicarb >18, normal anion gap, seru
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QUESTION 9 zm
Hyperglycemia, ketonemia and anion gap metabolic acidosis
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ANSWER
DKA Triad
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QUESTION 10 zm
Autoantibodies to platelet factor 4 zm zm zm zm
, ANSWER
Genetic susceptibility to heparin-induced thrombocytopenia
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QUESTION 11 zm
Cholesterol embolism zm
ANSWER
Patient with history of comorbid conditions presents with livedo reticularis, Hollenhorst plaques (ey
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es), eosinophilia, renal injury after cardiac catheterization
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QUESTION 12 zm
Statin
ANSWER
Drug used in therapy for patient with estimated 10-year ASCVD risk >=7.5%
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QUESTION 13 zm
Triglycerides
ANSWER
Lipid level reduced by use of fish oil
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QUESTION 14 zm
Niacin
ANSWER
Drug that is effective in raising HDL and has a modest effect of lowering VLDL and LDL
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QUESTION 15 zm
Aortic stenosis
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ANSWER
Murmur in which patient has pulsus parvus et tardus (small amplitude and delayed upstroke)
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QUESTION 16 zm
Pyramidal tract disease zm zm
Exam Solution
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USMLE Step 2 CK Internal Medicine 2026 A+ GRADE AS
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SURED COMPLETE SOLUTIONS AND VERIFIED ANSWER
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S (9FD8F)
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QUESTION 1 zm
Leukemoid reaction zm
ANSWER
Patient has leukocyte count >50k, high LAP score, more metamyelocytes than myelocytes
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QUESTION 2 zm
Chronic myeloid leukemia
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ANSWER
Patient has leukocyte count often >100k, low LAP score, fewer metamyelocytes than myelocytes, abs
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olute basophilia
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QUESTION 3 zm
Cyclosporine
ANSWER
Drug that inhibits transcription of IL-
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2, causes nephrotoxicity, htn, neurotoxicity, glucose intolerance, infection, malignancy, gingival hypert
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rophy and hirsutism
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QUESTION 4 zm
Tacrolimus
ANSWER
Drug that inhibits transcription of IL-2 but does not cause hirsutism or gum hypertrophy
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,QUESTION 5 zm
Mycophenolate
ANSWER
Drug that is a reversible inhibitor of inosine monophosphate dehydrogenase (rate-
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limiting enzyme in de novo purine synthesis), causes bone marrow suppression
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QUESTION 6 zm
Acute pericarditis
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ANSWER
Patient presents with sharp, pleuritic chest pain that is relieved by leaning forward
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QUESTION 7 zm
Diabetic ketoacidosis zm
ANSWER
Patient with DM presents with hyperventilation, glucose 250-
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500, bicarb <18, elevated anion gap, serum osmolality <320
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QUESTION 8 zm
Hyperosmolar hyperglycemic state zm zm
ANSWER
Patient with DM presents with altered mentation, glucose >600, bicarb >18, normal anion gap, seru
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QUESTION 9 zm
Hyperglycemia, ketonemia and anion gap metabolic acidosis
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ANSWER
DKA Triad
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QUESTION 10 zm
Autoantibodies to platelet factor 4 zm zm zm zm
, ANSWER
Genetic susceptibility to heparin-induced thrombocytopenia
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QUESTION 11 zm
Cholesterol embolism zm
ANSWER
Patient with history of comorbid conditions presents with livedo reticularis, Hollenhorst plaques (ey
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es), eosinophilia, renal injury after cardiac catheterization
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QUESTION 12 zm
Statin
ANSWER
Drug used in therapy for patient with estimated 10-year ASCVD risk >=7.5%
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QUESTION 13 zm
Triglycerides
ANSWER
Lipid level reduced by use of fish oil
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QUESTION 14 zm
Niacin
ANSWER
Drug that is effective in raising HDL and has a modest effect of lowering VLDL and LDL
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QUESTION 15 zm
Aortic stenosis
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ANSWER
Murmur in which patient has pulsus parvus et tardus (small amplitude and delayed upstroke)
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QUESTION 16 zm
Pyramidal tract disease zm zm